Family medicine is challenging, vast and endlessly rewarding, and I am here for all of it. But reform is urgently needed to encourage medical students to choose family medicine again.
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March 19 was Match Day, when graduating medical students across Canada found out which speciality they had been accepted into for residency training. Which specialty and where they go for training is based on how highly a medical student ranks each program. Residency is the portion of their medical education that prepares them for their future careers as physicians — whether it be in surgery, radiology, pediatrics or emergency medicine, to name a few. Or family medicine, which makes up half of physicians in Ontario.
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This year, across the country there are 272 residency positions left unfilled in family medicine. If there ever was an indicator that family medicine is in crisis, this is it.
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The past few months, media attention has amply detailed the catastrophic collapse of family medicine, but devastatingly, the match results confirm that fewer medical students are choosing to be family doctors. They particularly don’t want to be family physicians in Ontario: there were only six un-matched family medicine residency slots in British Columbia compared to 116 in Ontario. Why is there a 20-fold worse vacancy rate in Ontario compared to B.C.?
This breaks my heart.
I love family medicine. I have been a family doctor for 26 years and truly have the best job in the world. Each day is rich and varied: parents with newborns; managing complex diseases; caregivers adjusting to worsening dementia; house calls to vulnerable populations; patients in long-term care; addictions; palliative care; schizophrenia; putting in IUDs; excising skin cancers; pronouncing deaths in the home; breaking bad news; and celebrating triumphs. The scope of family medicine is challenging, vast and endlessly rewarding, and I am here for all of it.
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Since 2007, I’ve had the privilege of working in an academic family medicine clinic teaching family medicine to residents. I love the residents, learning from these incredible clinicians and watching them become superb family doctors.
Hanging on the corkboard of our clinic teaching room is a stockpile of photos clipped together of past years’ family medicine residents. I love flipping through it and wondering where these colleagues are now. It gets heavier each July when a new group begins training in our clinic, and we add their faces to the board. The stack keeps falling off the wall, but more clips and tacks are added to keep it displayed. The collection of faces represents the calling of family medicine: all these extraordinary former medical students chose family medicine.
Calls and recommendations for funding changes for family physicians have been copiously and expertly articulated elsewhere. My shout from the rooftop of health care is that legislators and politicians understand the grave significance of these match results for family medicine. Health care does not exist without family physicians, full stop. Reform is urgently needed to encourage medical students to choose family medicine again. In Ontario.
Dr. Karen Hall Barber is an Associate Professor in the Department of Family Medicine at Queen’s University in Kingston, Ont.
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