Dozens of training slots for family doctors will go unfilled across the country this year, with the number of vacancies doubling in Alberta – a development that suggests Canadians without family doctors could continue to struggle to find them.
The Canadian Resident Matching Service (CaRMS), the organization that connects medical school graduates with residency positions, released data on Thursday that show 100 positions in family medicine went unfilled in 2023, up slightly from 99 last year. That is the largest number of family medicine vacancies recorded in at least a decade.
But the number of available family medicine training positions increased by 60 spots nationwide, according to John Gallinger, the chief executive officer of CaRMS, which means more medical school graduates will be training to work as family physicians this year than last. There were a total of 1,470 family medicine residency spots filled in 2022, and there are 1,529 filled this year.
Provincial governments increased the number of residency positions in family medicine in a bid to combat a growing crisis in primary care. An estimated 15 per cent of Canadians – about six million people – don’t have regular health care providers, according to Statistics Canada surveys. Other studies, which rely on health care administrative data, show the true number is likely higher. Even patients who have family doctors report difficulty seeing them on short notice.
“We have a shortage of family doctors in the country and, with not enough people having a family doctor right now, we desperately need them to enter the work force,” said Tara Kiran, a family doctor and primary-care researcher at the University of Toronto. “Although it’s great to see many of the spots being filled, it is disappointing to not be able to fill all of them.”
Residency is the last leg of the long journey to becoming a fully licensed doctor. Medical school graduates must complete between two and seven years of hands-on training as residents.
Breakdown of medical residency
vacancies in Canada by discipline
and region
2014 to 2023
Family
medicine
All other
disciplines
Regional
total
2014 (64 vacancies)
Western
16
2
14
Ontario
5
5
Quebec
40
22
18
Atlantic
3
3
2015 (73 vacancies)
Western
9
1
8
Ontario
1
1
Quebec
63
43
20
Atlantic
0
2016 (51 vacancies)
Western
5
5
Ontario
2
2
Quebec
44
41
3
Atlantic
0
2017 (64 vacancies)
Western
4
4
Ontario
2
2
Quebec
58
56
2
Atlantic
0
2018 (78 vacancies)
Western
7
7
Ontario
2
2
65
4
Quebec
69
Atlantic
0
2019 (52 vacancies)
2
10
Western
12
Ontario
10
7
3
Quebec
29
23
6
Atlantic
1
1
2020 (56 vacancies)
4
2
Western
6
Ontario
13
11
2
Quebec
36
34
2
Atlantic
1
1
2021 (94 vacancies)
5
3
Western
8
9
1
Ontario
10
75
1
Quebec
76
Atlantic
0
2022 (115 vacancies)
Western
20
11
9
Ontario
19
15
4
73
3
Quebec
76
Atlantic
0
2023 (110 vacancies)
All 22 family medicine vacancies in Western Canada are in Alberta
Western
32
22
10
Ontario
3
3
Quebec
73
73
2
Atlantic
2
MURAT YÜKSELIR / THE GLOBE AND MAIL, SOURCE:
CANADIAN RESIDENT MATCHING SERVICE
Breakdown of medical residency vacancies
in Canada by discipline and region
2014 to 2023
Family
medicine
All other
disciplines
Regional
total
2014 (64 vacancies)
Western
16
2
14
Ontario
5
5
Quebec
40
22
18
Atlantic
3
3
2015 (73 vacancies)
Western
9
1
8
Ontario
1
1
Quebec
63
43
20
Atlantic
0
2016 (51 vacancies)
Western
5
5
Ontario
2
2
Quebec
44
41
3
Atlantic
0
2017 (64 vacancies)
Western
4
4
Ontario
2
2
Quebec
58
56
2
Atlantic
0
2018 (78 vacancies)
Western
7
7
Ontario
2
2
65
4
Quebec
69
Atlantic
0
2019 (52 vacancies)
Western
12
2
10
Ontario
10
7
3
Quebec
29
23
6
Atlantic
1
1
2020 (56 vacancies)
Western
6
4
2
Ontario
13
11
2
Quebec
36
34
2
Atlantic
1
1
2021 (94 vacancies)
Western
8
5
3
Ontario
10
9
1
Quebec
76
75
1
Atlantic
0
2022 (115 vacancies)
Western
20
11
9
Ontario
19
15
4
Quebec
76
73
3
Atlantic
0
2023 (110 vacancies)
All 22 family medicine vacancies in Western Canada are in Alberta
Western
32
22
10
Ontario
3
3
Quebec
73
73
2
Atlantic
2
MURAT YÜKSELIR / THE GLOBE AND MAIL, SOURCE:
CANADIAN RESIDENT MATCHING SERVICE
Breakdown of medical residency vacancies in Canada by discipline and region
2014 to 2023
Regional total
Family medicine
All other disciplines
2014 (64 vacancies)
2019 (52 vacancies)
2
10
Western
12
Western
16
2
14
Ontario
10
7
3
Ontario
5
5
Quebec
29
23
6
Quebec
40
22
18
Atlantic
1
1
Atlantic
3
3
2020 (56 vacancies)
2015 (73 vacancies)
Western
6
4
2
Western
9
1
8
Ontario
13
11
2
Ontario
1
1
Quebec
36
34
2
Quebec
63
43
20
Atlantic
1
1
Atlantic
0
2021 (94 vacancies)
2016 (51 vacancies)
Western
8
5
3
Western
5
5
Ontario
10
9
1
Ontario
2
2
Quebec
76
75
1
Quebec
44
41
3
Atlantic
0
Atlantic
0
2022 (115 vacancies)
2017 (64 vacancies)
Western
20
11
9
Western
4
4
Ontario
19
15
4
Ontario
2
2
Quebec
76
73
3
Quebec
58
56
2
Atlantic
0
Atlantic
0
2023 (110 vacancies)
2018 (78 vacancies)
All 22 family medicine vacancies in Western Canada are in Alberta
Western
32
22
10
Western
7
7
Ontario
3
3
Ontario
2
2
Quebec
73
73
65
4
Quebec
69
Atlantic
2
2
Atlantic
0
MURAT YÜKSELIR / THE GLOBE AND MAIL, SOURCE: CANADIAN RESIDENT MATCHING SERVICE
Every year, students in the final year of medical school apply to their disciplines and programs of choice for residency, while the programs rank their top choices of students. CaRMS then matches graduates and programs in two rounds. Results of the final round were released Thursday.
A total of 110 spots went unfilled in all disciplines, down from 115 last year. Of the 100 vacancies in family medicine this year, two were in Atlantic Canada, three in Ontario, 73 in Quebec and 22 in Alberta.
Alberta stands out as the province where family medicine vacancies increased the most, doubling to 22 from 11 vacancies last year.
Rosemary Pawliuk, the president of the Society for Canadians Studying Medicine Abroad, attributed the increase to Alberta’s decision not to follow every other province in allowing international medical graduates – a group that includes Canadians who study at overseas medical schools – to participate in the second round of matching this year.
If those provinces hadn’t allowed international graduates to participate in the second round, Ms. Pawliuk said, “we would have had a horrendous increase in unfilled positions.”
“If you really want to maximize you make the competition open,” she added.
International graduates were allowed to apply for positions that went unfilled in the first round until a few years ago, when provinces changed their policies in an effort to ensure that as many graduates of Canadian medical schools as possible secured crucial residency posts.
The policy change reduced the number of unmatched graduates of Canadian medical schools, but contributed to an increase in the number of vacancies, particularly in family medicine. This year, with international graduates allowed into the second round, 555 graduates trained abroad nabbed residency slots – the highest number in at least a decade.
But 847 international medical graduates still went unmatched, according to CaRMS data. The number of students who graduated from Canadian medical schools this year and went unmatched was 54, up from 35 last year.
Canada isn’t making the most of its family doctors’ time in the face of critical shortages
Scott Johnston, press secretary for Alberta Minister of Health Jason Copping, said in an e-mail that the province is considering allowing international medical graduates into the second round next year. In the meantime, the universities of Calgary and Edmonton will be filling as many of the unfilled seats as possible “through a post-matching process with Alberta-based international medical graduates,” Mr. Johnston said.
Filling family medicine residency posts has been a long-standing struggle for Quebec, where a requirement that candidates speak French limits the province’s ability to attract future doctors from across the country.
“It’s another unhappy day for family medicine,” Marc-André Amyot, president of Quebec’s federation of general practitioners, said after CaRMS released the match results.
Over the past decade a total of nearly 550 family medicine residency spots have not found takers in Quebec. “Imagine what we could have done with those positions, the better access we could have,” Dr. Amyot said.
Traditional office-based family medicine is struggling to attract doctors across Canada, said Christie Newton, president of the College of Family Physicians of Canada. She said young doctors are looking to share the primary-care workload by practising in teams, and are seeking remuneration that is closer to what their specialist colleagues earn.
“You can create as many spots as you want, and if we had all of the seats filled it still wouldn’t guarantee they would graduate and practice in the community, which is what Canadians need,” Dr. Newton said. “So there need to be other solutions, which are primarily practice reform.”