Schema Magazine

Work For All launched the third film of their 10-week Campaign last Wednesday with Médecins sans Résidence or, Doctors Without Residency. In contrast to the cheekiness of Cal Garingan's mockumentary Jaded and the intimate insights of Shane Belcourt's short, but poignant, film Boxed In, Doctors Without Residency takes more of a serious tone, but nevertheless makes a strong statement about how the effects of racism in the workplace inevitably develop into a concern for the community at large.

Watch this film and spread the word.

Doctors Without Residency is less than 10 minutes long and it's something that all Canadians should watch, because many of us know about the health care problem in the U.S., but are unaware of the crisis here in our own country. And the solution isn't only to pump more money into health care (much to my surprise); it starts at the very fundamental level of human rights and equality—an idea I thought our country and government had learned to respect and follow.

Note: After watching the film, it was hard to stay quiet and indifferent to the situation. For this reason, this film review serves also as an opinionated piece. Please also note that the shortage of doctors is a fairly sticky issue and the points made below only scratch the surface of this rather complex and deep topic. I encourage anyone who is interested to dig further for details and comment if inclined to do so!

Description of the Film

The film opens to a busy scene in a medical clinic. Families with young children stand in line to put their names on the queue, anticipating a lengthy wait time before they can see the doctor. The appointment may only last for a few minutes tops, but with a hundred or so patients coming in each day and a handful of physicians present, one would be lucky to get any time at all. The health care crisis in Canada doesn't get any more real than this.

Meanwhile, you hear the voices of foreign trained doctors and International Medical Graduates (IMGs) who are ready, qualified and more than willing to serve the public. However, the red tape that stands between the Canadian Medical Association (CMA), the Canadian government and the applicants creates more headache than relief.

A (Steep) Uphill Climb

Some medical schools do not meet Canadian standards and IMGs who come from these schools are seen as greater liabilities than those who are trained on Canadian soil, in approved Canadian institutions. Individuals from unrecognized schools have little to no chance at obtaining a residency. For the rest, in order to even be considered a viable candidate, all applicants must pass the MCCEE (Medical Counsel of Canada Evaluating Examination), which is a four-hour computer-based exam offered in both English and French. Theoretically, passing the MCCEE indicates that one is ready and qualified to practice, but obtaining a residency ultimately boils down to the interview. Sadly, few make it past this round.

The Bias

In the film, health care employers explain that when interviewing applicants, those who a) come from a different country whose first language is not French or English and b) are trained in an international university or college (that is not recognized by the CMA) are at a considerable disadvantage. The only exceptions to the latter restriction are candidates from the U.S. who, perhaps for political reasons, are examined with less scrutiny. After years of rejecting so many foreign doctors and IMGs, however, a general bias against international candidates has developed and it is now imperative for the CMA and the Canadian government to review interview and application processes.

Numbers - Unequal Opportunity

Every year, one hundred residency positions remain unfilled in Quebec. In British Columbia, only 18 spots are open for IMGs applying from all over the world. Last year in BC, 94 positions were unfilled and 60% of the declined applicants were foreign trained doctors. What's worse is that the system by which the CMA hires is not transparent and as a result, most international applicants have no idea why they were declined or rejected. The numbers do not lie. If the majority of declined candidates are from abroad, it doesn't take a statistician to see the correlation.

Solutions to Explore

O Canada, open your doors! In truth, opening doors for IMGs and foreign doctors can help solve the shortage of doctors and is a cost effective choice, given that the candidates meet all the requirements and are fully qualified. Moreover, their education was free, in comparison to doctors trained in Canada whose tuition was heavily subsidized by the government. Thus, we could be getting more doctors in the hospitals and clinics at no extra cost to the country or its tax payers.

I see you! Declined candidates should be given full disclosure as to the details of their rejection or, at the very least, be given some indicator by which to measure future attempts at obtaining a residency. If not, then it should be clear to all potential applicants why one might not be chosen for the position.

Mo' Money, No Problems The Canadian government needs to recognize that the shortage of health care professionals is a serious problem and therefore, must allocate funds appropriately. Proper health care is a right that all Canadians should have (since we pay for it) and should not be seen as a luxury.