Ontario needs new family physicians so urgently that at least one Ontario university has set up a medical school that is dedicated to accepting new medical students that commit to studying family medicine.
It was one of the topics discussed Tuesday when the Ontario Medical Association held an online news conference to discuss the decline in the number of medical students choosing family medicine. Sudbury and Thunder Bay are home to NOSM University, a medical school that also promotes the importance of family medicine, especially for Northern Ontario.
Dr. Gena Piliotis, the associate dean of undergraduate medical education at Queen's University in Kingston, said the concern is that not enough Ontario medical students are focussed on family medicine early on in their medical education. She said most medical schools are very much specialty-based in clinical training and pre-clinical teaching.
"And so that's definitely part of what we're trying to address," said Piliotis.
"At Queen's, we have developed a new campus in Oshawa, in partnership with Lakeridge Health. And this is a program that is dedicated to students who have chosen a career in family medicine at the get go," she told the news conference.
She said students take part in a full medical program designed to deliver all of the medical school training through the lens of a family physician.
Piliotis said this also has family physicians doing the training and being part of the medical education from day one.
Dr. Cathy Risdon, chair of the Department of Family Medicine at McMaster University in Hamilton, acknowledged that Queen's is pioneering in its approach but said it is not easy. She said it is difficult to separate the education process from the actual practice environment.
"The other challenge is that we actually know there has been some recent studies that demonstrate that the most complex medical specialty is family medicine, because of the vast number of patients we see, and our uncanny ability to manage a lot of problems simultaneously as expert generalists," said Risdon.
Sudbury.com asked whether the medical education process could be fast-tracked or somehow modified to let family physicians get their education more quickly.
Risdon said it might be possible but not necessarily practical.
"McMaster can train a medical student in three years with a two-year family medicine residency. And that is sort of the shortest time to get someone out," she said.
"And our graduates are still telling us that they would love to be part of a team, they would love to be part of a supportive environment so that their clinical competence and expertise grows in the first few years of practice. So with really supportive practice environments, we could probably grow really strong and confident family docs who stay for the long haul. But again, we have to address the practice environment," said Risdon.
Modifying the program is something that could be done, but the university would face a lot of regulatory hurdles first, said Dr. Piliotis of Queen's University.
"There would be so many different places that we'd have to have a truly integrated program, which I do think we could very easily shave off time, not because there's less to do in family medicine, but because there's wasted time in our MD programs that we could recapture," said Piliotis.
"So I think that is something that we're thinking about. It's just in its early phases, and we're focusing on getting our program up and running. And then that's the next part that we're hoping to tackle," she added.
OMA president Dr. Andrew Park also commented on the shortage of family doctors in Ontario saying some 2.3 million Ontario residents do not have a family doctor. He said that number is expected to double in the next two years.
Park said many medical students are aware that by going into medicine they are not only setting up a practice, they are also setting up a business.
Park said one of the problems is that OHIP billings for family medicine are too low; barely enough to sustain many family practices. Another issue he said is "the crushing burden" of administrative paperwork that physicians are required to look after.
"This has to change. What does this all mean for patients? It means that there will be less family doctors practicing Family Medicine, which means less access to care," said Park.
He said one of the goals of the OMA is to work with the Ontario government to negotiate ways to make the practice of family medicine more attractive to future medical students.
Len Gillis covers health care along with mining news for Sudbury.com.
