In August of 2015, the Ontario Ministry of Health announced plans to cut 50
residency positions over two years, with 25 being cut in 2016, and 25 in 2017. While some of these cuts will be for medical school graduates from outside of Canada, Canadian resident positions will also be cut. These cuts come in light of the Liberal government’s attempt to balance the budget in Ontario, in an attempt to more efficiently allocate health care dollars.
The Ministry of Health regulates residency positions which are typically determined by the number of doctors that need to be trained and by the available funding for residency positions. It will take other things into consideration, such as the specialties and nature of residency positions. The number of
medical school graduates is determined by the enrollment at medical schools, and the schools make money per graduate. Especially given that medical school takes 3-5 years to complete, and that residencies in Ontario have been increasing since 2004, this makes it much more likely that there will be more applicants than available residencies in Ontario.
Applying graduates use a
matching service (CaRMS) which has applicants and programs of choice rank each other by desirability. An algorithm will then match applicants and programs. Many applicants go unmatched, including 114 Canadian applicants in 2015. The pool of applicants includes local graduates, applicants from previous years who did not receive a residency position, and applicants from other provinces and countries. Ontario already hires the most international graduates of any other province. Last year, 220 of 1274 first year residents were international graduates.
Since 2004, residence positions in Ontario have been increasing, peaking at approximately 1,200. Now that the peak has come,
unmatched graduates are more likely to increase and consequently apply in subsequent years. While it is expected that the graduating year in Ontario will be less than the number of available residencies, this does not mean that every Ontario graduate will be matched to a residency program. Competition might also increase given that graduates from other provinces may wish to study in Ontario.
So why is Ontario so competitive? Internationally speaking, Canada is a desirable place to practice, with over 2,000 out of country physicians applying for residencies. Beyond that, Ontario’s doctors are the
highest paid in the country. It appears likely that the struggle for Ontario medical graduates to find a residency will only increase in 2017 as another 25 positions disappear and the unmatched applicants pile up. It remains to be seen whether these positions will be restored in the future, and it is difficult to predict how this will affect medical school enrollment positions.
Some are concerned that this decrease in available residency positions will result in graduates heading out of province. The Ontario Medical Association has criticized the move to cut healthcare funding in this area.
