Resident Doctors of Canada (RDoC) has reviewed Motion 4 that will be voted on at the upcoming College of Family Physicians of Canada (CFPC) Annual Meeting of Members on November 1st. We wish to publicly express our strong support for this motion. RDoC is a solutions focused organization and on behalf of resident doctors across Canada we call on the CFPC members to vote in favour of this motion calling for the review and suspension of 3rd Year Family Medicine Practice Implementation. It is essential to the future of Family Medicine training and the Canadian public that the CFPC halt its implementation of a third year of training to allow for a thorough, inclusive consultation process and a review and presentation of evidence which must unequivocally support the need for an additional year of training before any implementation begins.
As stated in our January 6, 2023 response to the CFPC’s request for feedback, it is the RDoC position that no changes should be made regarding residents’ education without residents being directly involved in that process. RDoC’s submission on January 6th has been RDoC’s only formal opportunity to date, to provide feedback on the CFPC’s plan to extend Family Medicine training, moreover, this request for feedback was made after the CFPC Board of Directors approved the recommendation in the Outcomes of Training Project (OTP) Report to proceed with an extension of training. As the leading organization representing the interests of all resident doctors outside of Quebec, it is RDoC’s position that this one-time request for feedback does not constitute sufficient consultation with Canada’s resident doctors.
It is also the position of RDoC that any proposed extension of training in any discipline must have a rigorous, evidence-based rationale including specific objectives that need to be achieved in the extended period. It must also prove a lack of specific ability in the current program to meet the training objectives or to be successful in the certification exams. To this point, RDoC has not seen evidence that clearly demonstrates how an extension of Family Medicine training is needed or justified.
Beyond the lack of evidence of the need for an extension of training the following are three major concerns that resident doctors across Canada raised during our consultation process, these concerns were included in our January 6th submission.
- Deter recruitment: There was strong concern that the additional year of training will deter medical students from choosing Family Medicine as their preferred specialty, thereby putting additional stress on those who choose to enter the specialty and causing greater competition in other specialties. In addition, if the additional year acts as a deterrent for recruitment, it will negatively impact the public health system and the health of Canadians by even further exacerbating the current family doctor shortage crisis.
- Since RDoC submitted its position in January 2023 these concerns are now being echoed by many groups, including the SRPC who fear the impact this will have on access to family doctors in rural areas. In a survey completed by the SRPC this year, 63% of Family Medicine residents surveyed felt that an extension of training would affect their choice in a family residency program. In addition, a survey was conducted by The Review Course in Family Medicine of second year Family Medicine residents and the initial findings from that survey showed that 42% of Family Medicine residents surveyed would have reconsidered pursuing Family Medicine as a speciality if it had been a three year program.
- Financial concerns: Residents have major concerns regarding the financial implications of an extension of training. Specifically, data needs to be provided to demonstrate that the financial implications this will have for residents and the medical system, in general, have been considered.
- Delay residents’ life planning: Another strong concern is that the extra year would negatively impact residents’ ability to settle themselves and their families long term; this may disproportionately impact older residents, who may already have families. This may also negatively impact their well-being and financial security.
RDoC understands and respects that the common objective is best quality education for the best quality medical care for all Canadians. There is a national crisis in family medicine. The problems are multiple and complex. It is imperative that a solution to one problem does not exacerbate another. Now, more than ever, medical students need to be incentivized to choose Family Medicine. This is the time for innovative thinking and collaboration to make that happen. RDoC looks forward to working with the CFPC to support this critical work.
Sincerely,
Resident Doctors of Canada
