By Dr. Andrew Padmos

A new blog post by AMFC President and CEO Geneviève Moineau proposes that the Canadian medical education system should reduce the number of entry routes in answer to medical students’ career choice challenges (i.e. inadequate time to experience a sufficient number of entry disciplines).

I agree that we have to support Canada’s future doctors to make the best choice. However, I would propose that complex issues are not well served by simple solutions.

The proposal to reduce the current number of entry routes serves only to delay the student’s choice and doesn’t necessarily address the challenges outlined above. The 29 specialties Dr. Moineau refers to have been thoughtfully considered by volunteer specialists and residency program directors from Canada’s medical schools. Entry disciplines are indicative of the diversity of society’s health needs.

Dr. Moineau states that 70% of students feel they don’t have enough exposure to the breadth of disciplines before making their choices. This is in sharp contrast to the 67.8% of graduating medical students who said they were satisfied or very satisfied with the information they received about specialties. (Source: 2017 AFMC Graduation Questionnaire). In addition, the 2012 National Physician Survey of Medical Students cites 80.8% of fourth year medical students as stating their medical education did (or will) prepare them to select a residency training program. While different studies provide differing results, we can’t lose sight of the need to support medical students to make the most informed choices for their personal wellbeing and, most importantly, choices that are in the interest of Canadians.

Solutions may lie in the undergraduate domain, not in restricting choices of entry routes. Instead, let’s rethink undergrad medical education:

  • How can we provide medical students with the exposure they need outside of the ‘rotation box’?
  • Can we work together to identify creative options such as bringing physicians from different specialties into the classroom or improved career counseling to demystify certain less-known specialties?
  • Can we explore ways to improve the current electives process to create better outcomes?

The crux of the matter is the number of residency positions is already shrinking in Canada; choices will be further reduced as the ratio of undergraduate/postgraduate tightens. New technologies, market forces, and changing demographics will continue to create significant challenges to balancing the needs of physicians’ careers against society’s health care needs.

As I mentioned earlier, this is a complex system issue. It’s going to require collaboration and partnership across the system to solve this challenge – only by rallying together we can make the impossible possible. We thank Dr Moineau for raising the issue of the challenges our medical students face. The Royal College looks forward to collaborating with our undergraduate medical school curriculum partners to work on solutions.

Andrew Padmos, BA, MD, FRCPC, FACP
Chief Executive Officer