In response to what the Alberta government acknowledges is an ongoing physician shortage in the province, Advanced Education Minister Demetrios Nicolaides and Health Minister Jason Copping announced plans Thursday to look at offering more training in different areas of the province.
Nicolaides and Copping spoke at a news conference at Calgary’s Foothills Medical Centre on Thursday morning.
The ministers said the province is investing $1 million to look at how to provide more training opportunities outside of Alberta’s two largest cities, specifically at the University of Lethbridge and Northwestern Polytechnic in Grande Prairie.
The government noted the funds for the exploratory work to determine the training centres’ feasibility will be used by the University of Alberta, University of Calgary, University of Lethbridge and Northwestern Polytechnic and that all four institutions will collaborate together on the project.
Copping said while he could not say how many are working in rural areas, Alberta gained 254 physicians in 2022 and said the province currently has a record number of doctors registered in Alberta.
“(But) we still have a lot of work to do,” he acknowledged. “We need them in smaller communities where it’s harder to recruit them and harder to keep them.”
READ MORE: Town northwest of Edmonton calls on province to help as doctor plans to leave
Ongoing impacts resulting from a shortage of physicians in rural Alberta continue to be reported. Just under three weeks ago, two emergency departments in smaller Alberta communities — Ponoka and Beaverlodge — were forced to temporarily close because of a shortage of physicians.
“Help is on the way,” Copping said. “This is just one piece of a much broader strategy.
“It’s going to take time to get the program (announced today) set up, to get the doctors trained…. We’re talking a six- to eight-year period to be able to do this, but if you don’t start, you’ll never get there.”
READ MORE: Rural Alberta ERs close temporarily amid physician shortages
Nicolaides said Thursday’s announcement is meant to ensure Alberta is “training more doctors where they are needed most: in our rural and remote communities.”
He added that data shows about 75 per cent of students in the health-care field will continue to work in rural areas if they are trained in rural areas.
Copping suggested that the problem has been magnified by burnout and early retirements brought on by the COVID-19 crisis that emerged in 2020.
“The pandemic has had a tremendous impact on the health workforce — across Canada,” he said. “And that very much includes physicians.”
Copping added that he appreciates “the challenge that our system has been under,” particularly in the fall when Alberta hospitals were strained by rising numbers of people with COVID-19, RSV and influenza.
Get weekly health news
The ministers did not provide specific details about what the feasibility study will need to determine to move forward with new training initiatives in Lethbridge and Grande Prairie. However, Nicolaides said “key benchmarks that we’re looking for is the ability to train and recruit.”
Copping said his government is employing a variety of strategies to ensure more doctors are working in rural Alberta, including “leveraging newcomers who want to come to the province,” something he said is exemplified by initiatives in Lethbridge as part of ongoing efforts to increase the number of physicians there.
At this time last year, Copping announced details of the government’s new RESIDE (Rural Education Supplement and Integrated Doctor Experience) program, which aimed to address shortages in rural Alberta by offering financial incentives for doctors who start practising in remote areas in exchange for them spending at least three years working in a designated rural community.
READ MORE: RESIDE program hopes to incentivize new family doctors to work in 15 rural Alberta areas
In October, the College of Physicians and Surgeons of Alberta (CPSA) announced that Alberta Health had approved a number of recommendations that were made to improve the program, including offering physicians more flexibility, such as agreements that involve just a two-year term.
Copping noted changes were made to that program because there was a recognition it was not initially being as effective for recruitment as hoped.
“We didn’t get the applications that we wanted,” he acknowledged Thursday. “You need to learn from it so we actually changed the criteria, made it much more wide open… and added additional money for it.
“We are going to keep working until we get it right. The worst thing to do is not do anything.”
The government also noted that its new agreement with the Alberta Medical Association includes a provision to invest $15 million annually to support physician recruitment and retention for physicians who practise full-time in “underserved areas,” as well as an additional $12 million annually for the Rural Remote Northern Program.
Following the news conference, Opposition health critic David Shepherd issued a news release in response to Copping and Nicolaidess’ plans.
“One-million dollars and a news release will not build two regional training hubs,” he said. “At best, graduates from these potential programs are many years away. We have a severe staffing crisis in Alberta right now.
“Health-care workers born and raised in Alberta are leaving to practise in other places to escape the hostility of this UCP government. (Former health minister) Tyler Shandro is currently sitting in a disciplinary hearing related to his unacceptable conduct toward doctors.”
Shepherd also said he believes health professionals will be more reluctant to work in Alberta while Danielle Smith remains premier because of her views on COVID-19. Smith has expressed support for people who opposed public health measures during the pandemic and those who choose not to be vaccinated.
CPSA pilot program
Last week, the CPSA announced it was launching a five-year pilot project aimed at streamlining the process for international medical graduates (IMGs) to work in Alberta. The pilot applies to those with training comparable to what physicians would receive at a university in Canada.
“The goal of the pilot is to evaluate whether eligible IMGs may begin independently practising in their identified communities faster, while still ensuring patient safety is the top priority,” the CPSA said on its website.
“The five-year pilot project waives certain requirements, such as clinical review exams and the first three-month assessment for IMGs that have comparable training to that obtained in Canadian universities, as identified by experts in postgraduate medical training.
“Those who qualify will now go directly to their identified communities and begin practising independently while completing their supervised practice assessment.”
Rising costs leading to doctor shortages
Despite the government’s promises to offer more training, doctors in rural areas say rising costs and declining quality of life are causing shortages across the province.
Dr. Brendan Flowers, a physician based in Canmore, said many practitioners have left the area because it has become too expensive to live and work there.
“A few doctors had to walk away (from my clinic) because they realized it wasn’t financially viable,” Flowers told Global News.
“The cost of daycare, the cost of groceries and the cost of bills have increased compared to Calgary.
“There’s a perception that physicians are high-income earners, but we don’t have health benefits we can opt into. We don’t have pensions and we spend a lot of time going through school.”
It has also become expensive to run a clinic, he said.
“Patients are just completely unaware that the health care might be free to those who receive it, but it’s by no means free to the physician to provide it,” Flowers said.
“Although a clinic is publicly funded through Alberta Health Service, it’s actually privately administered. I’m a clinic owner and I have to pay the staff, pay the rent, and pay for the supplies.
“For that to be a sustainable model, I need to pass those forward to our physicians which is reflected in our overhead, which is typically 30 per cent to 35 per cent here because of the increased cost of wages and cost of living.
“Some of these physicians are paying more than they would be in a city.”
Flowers also said many doctors have left the profession to pursue a better work-life balance. Many want a flexible schedule as opposed to working three to four days a week at a clinic.
“That’s unfortunately an old type of model for physicians because they want to be working two to three days a week while pursuing other professional endeavors,” he said.
“It’s trying to incorporate that work life and how to balance patient care versus personal care.”
Flowers said the Alberta government’s announcement may help with the doctor shortages but it’s more important to retain those already working.
He said the province should look into reducing barriers experienced by international physicians. According to the Government of Canada, immigrants make up 36 per cent of the health-care sector.
“Many people don’t realize that Alberta structures their sponsorship program a bit differently. Clinics are burdened with the cost of hiring international physicians,” Flowers said.
“We’re expected to pay for the sponsorship and the fees incurred… The province should try to figure out if there are creative ways to help clinics out and communities out.
“A combination of short-term options and long-term training should address the issue.”
Comments