Ontario forced to slow new medical school plans after ignoring warnings: AG

A lack of planning in the Ford government’s expansion of Ontario’s medical schools meant the province has created family medicine spaces more slowly than it had planned, the auditor general has found.

As part of its plans to improve access to primary care, the government announced the number of places available at Ontario’s medical schools would be substantially increased.

Part of the plan included the creation of two new medical schools at Toronto Metropolitan University and York University, along with an expansion to six of its existing schools.

The rush to fulfil the promise of new medical schools, however, appears to have left the government ignoring warnings from the sector that there were not enough training opportunities to accommodate new students.

Auditor General Shelley Spence found the government did not “document an analysis of key considerations to support their expansion decision.”

In particular, the government failed to listen to warnings from leaders at its medical schools that there is “currently a limit on the amount of family medicine training that can occur, with current sites and preceptors already at full capacity.”

That warning came in November 2023, the auditor general found, but the government pressed ahead with its plan.

By the end of this academic year, the auditor general suggested that the cap on graduate training opportunities will have an impact.

At the conclusion of the 2025/26 year, medical schools will have rolled out 44 per cent fewer postgraduate family medicine seats than they had originally planned as a direct result of the blockade, the report found.

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“The majority of the family medicine seat expansion is expected to be rolled out starting in the 2026/27 academic year,” the auditor general concluded.

A spokesperson for the premier’s office pushed back on the suggestion the plan had been slow, saying TMU’s medical school opened “at full capacity,” with 94 undergraduate seats this past September.

“The plan for post graduate seats (residency positions) was always meant to be scaled up year after year as the school grew, reaching full capacity over 5 years,” they said.

Parliamentary Assistant to the Minister of Health Anthony Leardi couldn’t say on Tuesday why the ministry had not taken into account the need to have training options for medical graduates, forcing it to slow down its expansion plans.

“We set ourselves a goal, it’s a very high goal, we’re going to try to meet that goal,” he told reporters. “We’re heading towards that goal, we’ve already increased the number of doctors being trained and graduated in the province of Ontario.”

The auditor general found a lack of analysis from the government for its medical school expansion plan meant the level of funding required to create more training sites was not properly assessed.

That’s important because postgraduate family medicine students generally require two years of training at a site which supports residencies for students.

As a result, by the end of the current year, medical schools will have rolled out 115 new family medicine seats, 89 (or 44 per cent) fewer than the number they had planned.

“Medical schools identified the lack of sufficient family physician training sites, such as PCTCs, as the primary reason for rolling out fewer seats than planned,” the auditor general wrote.

Despite the report’s findings, Leardi suggested more seats could have been added.

“Could we graduate more? Yes, we’d be happy to,” he said.

“I think that when you’re actually increasing the number of doctors being trained and educated in Ontario, that indicates a very successful plan.”

The report also found Ontario had not specifically set up any performance indicators to show whether its increase in medical seats was actually helping connect more people to the health-care system.