Easing hurdles placed in front of foreign-trained doctors could help solve the physician shortage in the north, according to British Columbia Medical Association president Dr. Shelley Ross.
"We put up so many blocks to keep out the not-so-bright that we're losing the bright ones," Ross said Wednesday as her province-wide president's trip stopped in Prince George. "They don't apply because they have to waste a year to even try for a residency spot."
Ross pointed to jurisdictions like Alberta and Saskatchewan, which have already made it easier for doctors trained in places like Ireland or Australia to work domestically as examples for B.C. to follow.
Although she acknowledges doctors trained outside Canada can't jump right into the system, Ross said having them work with local physicians during an observation period could help determine who is ready for a residency program.
"Let them do some elective time with physicians back here in B.C., evaluate them, and then let them apply for those [international medical graduate residency] spots," Ross said. "They know the culture, they speak the language and they have roots, often, in rural areas."
The medical association has already been in talks with the government and medical schools about the plan and she expects those discussions will continue. With a long-standing reciprocity agreement with South Africa recently severed, it's more critical now to find other countries to attract doctors from.
In addition to having medical training in the northern and rural areas, Ross said it's also important to have residencies available in those parts of the province.
"It's often where you'll make your contacts, you'll get offered to join a practice, so you put down roots and that's where you'll stay," he said.
According to figures provided by Northern Health, 26 of the 37 participants in the UBC/UNBC rural family practice residence program were recruited to stay in the region over the past three years. Nine of the current residents have also expressed interest in setting up practices locally.
Ross said the medical association must also work with the province and universities to make sure the right doctors are being trained to fill current needs.
"Do we need general practitioners? Do we need super-specialists? Do we need general internists? General surgeons?" she asked. "So we want to go back along the path and say, who should we be training?"
Ross would also like to see better collaboration between medical professionals, particularly between doctors and nurse practitioners.
"We've got to look for efficiencies and we've got to look for a team approach," she said. "Not these silos where everyone thinks they're an independent profession and I'm going to do it my way and I don't want to hear anything from you."
For example,she said nurse practitioners could be used to hold group meetings for patients with the same condition, which would save physicians from having to repeat the same information over and over again.
"All these diabetics need to learn how to eat properly, exercise and check their blood pressure," Ross said. "[The nurse practitioner can] take care of that and if there's something that way out of the usual, then send them back to the family doctor."
Nurse practitioners see themselves as independent from physicians, which Ross believes can sometimes cause problems in family practice. She would like to see B.C. adopt physicians assistants, which are currently used in Manitoba, Ontario and the Canadian military.
"We'd like to see the physician as the overseer and the best-trained generalist who can see the big picture," Ross said. "But we're very interested in physician's assistants. They're a bit different from nurse practitioners in that they work under the supervision of a doctor."
Ross has already visited Vancouver Island, the Interior, the Kootenays and the Peace regions as part of her tour and said the aim of the tour is to engage with its membership from across the province. Among her stops in Prince George on Wednesday were tours of both UHNBC and the Northern Medical Program. She also met with doctors and medical students to find out what their concerns are.
"One thing we always hear the further north and more rural we get is physician manpower," Ross said.
