Resolving Canada’s doctor shortage crisis: Senators Kutcher and Ravalia
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Canada is in a primary health care crisis. We have written about this before, and it is known that some 6.5 million Canadians do not have a family doctor. We require thousands of practice-ready physicians to meet the primary health care needs of Canadians.
Even during the election, no political party ever mentioned the implementation of an existing solution that can be scaled up rapidly. With several senators, we presented a report on this solution back in February. The Government of Canada can quickly and cost-effectively help mitigate this crisis by directly funding Practice Ready Assessment (PRA) programs across Canada.
PRA programs provide an accelerated pathway to licensure for internationally trained physicians (ITPs), thousands of whom are currently living in Canada as permanent residents and citizens. ITPs have completed their medical school and residency training in a country outside Canada and have practised medicine abroad. They are not recent medical school graduates — they are experienced mid-career physicians.
They have also completed all Canadian medical licensing requirements, except for one: a competency assessment. This can be provided through a PRA and can be completed in 12 weeks or less. Successful completion of a PRA indicates that the ITP has demonstrated the ability to provide medical care at Canadian standards and makes them eligible for licensure by provincial and territorial medical licensing authorities.
We have put forward to each political party that the federal government should fund at least 4,500 PRA slots across the country over a four-year period. Given that the average family physician has a patient carrying capacity of about 1,500 patients per year, this would give most Canadians access to a family doctor by the end of the defined time period.
Our proposal is expedient, since being licensed through a PRA is much quicker than a two-year residency route. It is also much more cost-efficient. The average 12-week PRA may cost around $35,000 per position, compared to $340,000 per completed resident position.
We are encouraged by the recent initiatives between the Medical Council of Canada and provincial and territorial groups to enhance the PRA program nationally. Existing programs have made important strides, and additional funding and resources would ensure expediency. Model PRA programs, such as those in Nova Scotia and Newfoundland and Labrador, are already active. These need to be scaled up nationally.
We also propose that the federal government directly fund the Medical Council of Canada to continue to provide a national standardized assessor/assessment training and evaluation program as well as a single point of entry for ITPs applying for a PRA.
The total cost of the initiative would be less than $200 million. This would represent around 0.3% of what the federal government spends in one year on the Canada Health Transfer.
The return on investment would be significant. ITPs would now be practising medicine, paying taxes and hiring staff. Canadians would have much better access to a family physician, and emergency room visits and unneeded time away from work would decrease. Better access to preventive care would reduce crisis care costs.
This is a win-win situation. Will all political parties commit to making this happen?
Senator Stan Kutcher is a Canadian psychiatrist. He represents Nova Scotia in the Senate.
Senator Mohamed-Iqbal Ravalia is a former family physician. He represents Newfoundland and Labrador in the Senate.
This article appeared in the April 28, 2025 edition of The Hill Times.
Canada is in a primary health care crisis. We have written about this before, and it is known that some 6.5 million Canadians do not have a family doctor. We require thousands of practice-ready physicians to meet the primary health care needs of Canadians.
Even during the election, no political party ever mentioned the implementation of an existing solution that can be scaled up rapidly. With several senators, we presented a report on this solution back in February. The Government of Canada can quickly and cost-effectively help mitigate this crisis by directly funding Practice Ready Assessment (PRA) programs across Canada.
PRA programs provide an accelerated pathway to licensure for internationally trained physicians (ITPs), thousands of whom are currently living in Canada as permanent residents and citizens. ITPs have completed their medical school and residency training in a country outside Canada and have practised medicine abroad. They are not recent medical school graduates — they are experienced mid-career physicians.
They have also completed all Canadian medical licensing requirements, except for one: a competency assessment. This can be provided through a PRA and can be completed in 12 weeks or less. Successful completion of a PRA indicates that the ITP has demonstrated the ability to provide medical care at Canadian standards and makes them eligible for licensure by provincial and territorial medical licensing authorities.
We have put forward to each political party that the federal government should fund at least 4,500 PRA slots across the country over a four-year period. Given that the average family physician has a patient carrying capacity of about 1,500 patients per year, this would give most Canadians access to a family doctor by the end of the defined time period.
Our proposal is expedient, since being licensed through a PRA is much quicker than a two-year residency route. It is also much more cost-efficient. The average 12-week PRA may cost around $35,000 per position, compared to $340,000 per completed resident position.
We are encouraged by the recent initiatives between the Medical Council of Canada and provincial and territorial groups to enhance the PRA program nationally. Existing programs have made important strides, and additional funding and resources would ensure expediency. Model PRA programs, such as those in Nova Scotia and Newfoundland and Labrador, are already active. These need to be scaled up nationally.
We also propose that the federal government directly fund the Medical Council of Canada to continue to provide a national standardized assessor/assessment training and evaluation program as well as a single point of entry for ITPs applying for a PRA.
The total cost of the initiative would be less than $200 million. This would represent around 0.3% of what the federal government spends in one year on the Canada Health Transfer.
The return on investment would be significant. ITPs would now be practising medicine, paying taxes and hiring staff. Canadians would have much better access to a family physician, and emergency room visits and unneeded time away from work would decrease. Better access to preventive care would reduce crisis care costs.
This is a win-win situation. Will all political parties commit to making this happen?
Senator Stan Kutcher is a Canadian psychiatrist. He represents Nova Scotia in the Senate.
Senator Mohamed-Iqbal Ravalia is a former family physician. He represents Newfoundland and Labrador in the Senate.
This article appeared in the April 28, 2025 edition of The Hill Times.