The Defectors

The Canadian health care system is hemorrhaging. We're losing doctors faster than we're gaining them. In fact, an estimated 30% of Ontario doctors are leaving within 2 years of completing their training. It is fairly safe to assume that the majority of these doctors end up in the U.S.

Why? No big mystery. Much of it comes down to money. There is more of it in the States. Docs south of the border are paid considerably more (in the private system, at least) than here in Canada. Higher income brackets also pay less in taxes in the U.S. In many specialties, the resources are easier to come by-- anecdotally, I've heard of docs being lured with the promise of less call, shorter wait times for investigations and specialist consults, labs filled with willing grad students to complete your every academic bidding, shiny new clinics with nurses (also making more than their Canadian counterparts) and physician's assistants happy to take the scut and paperwork off your hands... a virtual utopia for a new physician.

Do I begrudge them leaving? Not at all. I'm sure some of them have reasons that stretch beyond the almighty dollar. Family, geography, politics, weather... who am I to judge their choices? Good luck in your future endeavors and pay your bill at the border.

Um... bill, you say? What bill would that be?

Well, let's see. Medical school, in spite of tuition deregulation, is subsidized by the Canadian taxpayer. Your spot in medical school was intended to fill a need in Canadian society. Although clearly an imperfect science, the number of spots available to train Canadian physicians is supposed to be a prediction of the number of doctors that will be needed to serve Canadians down the road. When a young physician reaps the benefits of training in the Canadian system, it doesn't seem fair to then head to greener pastures for personal benefit. Compare the cost of medical school tuition in Canada (from $3500 yearly to $16000 CAN yearly, depending on the school) to the cost of medical school tuition in the U.S. (over $30K USD at non-state-funded universities, the only ones that will accept Canadian students)... it would be crazy to go to the U.S. for medical school when you could score the same degree for a fraction of the price here at home. But to then head down to the States to earn significantly more after benefiting from a taxpayer-subsidized education? Not cool.

I'm not saying that doctors in Canada should be shackled to the CN Tower. Hey... if you want to go, go. If you're moving solely for the financial gain you're probably not the kind of physician I'd want treating my family members anyway. But on your way through immigration, please write a cheque to the Canadian taxpayers for the balance of your education. That way it can be reinvested in the system and used to train future physicians who will stay-- or at least be put towards strengthening the system in general. Really. The way I see it, it's the least you can do.