Issue 3: October 2024

Health Canada estimates our country is presently short 13,000 family physicians and estimates the deficit will be 20,000 in five years. 

While the expansion of residency seats and the launch of new faculties will help in the long term, Canada presently graduates around 1400 family physicians each year. Domestic supply will not meet our needs. Of the 36 member countries in the Organization for Economic Co-operation and Development (OECD), Canada ranks 33rd in the rate of graduating physicians. On average, member countries graduate 14.2 physicians per year per 100,000 people. Canada produces 7.5 per 100,000. 

I approached the Premier with the proposal to open an assessment centre for physicians seeking to work in primary care from jurisdictions in which their training was not recognized in Canada.

We have long depended on internationally trained physicians. Most people are surprised to learn that, in our province, 34% of our physicians did some or all their training internationally. We need more.

In recent years, the College has moved away from reliance on Canadian examinations as the only measure of competence for internationally trained physicians. We increasingly rely on workplace-based assessment, but this is a time and resource-intensive approach. The volume of physicians trained outside of Canada wishing to practice in Nova Scotia exceeds the province’s capacity to assess them. We were turning away potentially licensable physicians.

I approached the Premier with the proposal to open an assessment centre for physicians seeking to work in primary care from jurisdictions in which their training was not recognized in Canada. I had met with the Medical Council of Canada, which was keen to partner and eager to develop training and accreditation for physicians. Through training, and through centralizing the assessment in a dedicated centre, we are confident that more physicians can be quickly and safely identified for licensure. The underlying philosophy is a commitment to open the door wider to internationally trained physicians without lowering the bar of competence for licensure.

On October 8 the Premier announced Nova Scotia is opening an international medical graduate assessment centre in Halifax. It will be the first of its kind. Physicians trained and certified in workplace-based assessment will lead this work. The assessments will be competency-based, not time-based, so outliers will be processed quickly.

The initiative will begin with four to six internationally trained physicians providing primary care for about 2,500 patients. Two Nova Scotia physicians will supervise the candidates and assess them for independent licensure. Over time, the centre will expand to include five physician-led teams of up to three international medical graduates each. This work will build on the momentum of the Welcome Collaborative, our onboarding and initiation program designed to set newly arrived physicians up for success in practice.

It is an exciting announcement. I am grateful to the provincial government for funding and believing in the idea. I am equally grateful for the enthusiasm coming from many corners of the profession. While there is much work left to do, our target to open the clinic is January 2025.