Regulatory colleges across Canada are actively focusing on improving labour mobility for doctors, a move that could significantly impact the healthcare system across the nation. Currently, no regulatory college has the authority to issue or accept a pan-Canadian medical license, which poses significant challenges. The process to obtain an additional license in another province is often lengthy and costly, taking months and costing thousands in fees. This creates artificial barriers that prevent doctors from practicing across provincial borders, a situation exemplified by the need for a rural emergency room to potentially close for a weekend due to licensing restrictions. A more flexible licensing system could prevent such scenarios and enhance healthcare delivery across the country.
The Atlantic provinces have taken a notable step forward by launching a multi-jurisdictional licensing system in May 2023. Under this system, doctors who opt in are immediately licensed in all four Atlantic provinces for an annual fee of $500. This initiative represents a promising model for other regions to consider. In October 2023, federal, provincial, and territorial health ministers committed to advancing labour mobility for health professionals, including doctors and nurses, to facilitate their practice across jurisdictions without significant delays or additional requirements.
The current system's complexity is one of the biggest obstacles, as highlighted by a survey conducted by the Canadian Medical Association (CMA). The survey found that 95% of doctors support the idea of a national licensure system. Such a system would likely encourage doctors to remain in Canada, continue practicing part-time during retirement, and assist their colleagues more effectively.
"The overall complexity of the process," the time (often months long) and costs (thousands of dollars in fees) were cited as the biggest obstacles in applying for an additional licence." – (CMA survey respondents)
The Federation of Medical Regulatory Authorities of Canada is actively working to simplify the process for physicians seeking to move between provinces. The establishment of a National Registry of Physicians aims to reduce red tape and paperwork involved in applying for another license. Stephanie Price, speaking on behalf of this initiative, emphasized that all provincial legislation mandates that doctors must hold a local license to practice.
"All of them have provincial legislation that contains some version of the phrase that says, 'To call yourself a doctor or practise medicine in this province, you must have a licence from this college.'" – Stephanie Price
Price further noted that none of the regulatory colleges currently can pursue pan-Canadian licensure unless instructed by their respective ministers of health.
"They don't have the ability to pursue pan-Canadian licensure and none of their ministers of health have asked them to." – Stephanie Price
The potential benefits of such a system are evident. A national licensure could alleviate staffing shortages during emergencies, allowing doctors from different provinces to assist without undergoing lengthy processes.
"Let's say there's a rural emergency room that needs to close for a weekend. Some doctors in Toronto might be able to help out for a weekend. They're not going to pay thousands of dollars and go through that application process to help for a weekend," – Dr. Joss Reimer
Dr. Joss Reimer advocates for the flexibility that a national system could provide, allowing doctors to work seamlessly across Canada.
"What we want to see is an ability for doctors to work anywhere in the country." – Dr. Joss Reimer
The Atlantic provinces' model shows how quickly licensing can occur during emergencies, which is crucial when facilities face closures due to staffing shortages.
"Anyone who has a full licence and a clean record is immediately licensed in a new province, and that can be done in a matter of days, sometimes in matter of hours when there are emergency situations, like a hospital emergency room is about to close." – Stephanie Price
Recognizing the high standard of training received by Canadian doctors, many argue that it should be acknowledged nationwide without unnecessary hurdles.
"To set up these artificial barriers where a physician who is trained in Toronto can't work in Halifax really doesn't make sense when we do know that the training they received in Toronto is going to be top tier." – Stephanie Price
The Canadian Medical Association views these developments as paving the way toward a more unified and efficient healthcare system.
"represents a path to a more unified and efficient health-care system" – Canadian Medical Association
