Employment Patterns of Canada’s Newly Certified Medical Specialists: a study

Our 2019 report features updated data on the job status of newly certified specialist physicians and highlights some of the key enablers and complex barriers to finding employment.


Despite troubling patient wait lists, a number of newly minted medical specialists in Canada face employment challenges at the time of certification.

Since 2011, the Royal College of Physicians and Surgeons of Canada has been collecting data on specialists and subspecialists through:


An initial survey sent to all newly certified specialists between four to 12 weeks following their final Royal College certification examinations.

Initial


A follow-up survey sent to those who reported employment challenges in the initial survey. This survey is sent between 12 to 17 months following their Royal College certification.

Follow-Up

This 2019 report examines:

  • employment patterns of 6,236 newly certified specialists between 2011-17;
  • physician employment trends by province;
  • how long it took new specialists to secure a post; and
  • key enablers and barriers for specialists to finding employment.

Note:  this report delves into the employment challenges experienced by specialists and does not look into employment issues that may affect family physicians.

Key findings


As high as 19% of newly certified specialists cannot find work at the time of their certification.
Employment challenges are greater in more resource-intensive specialties.
Employment challenges vary greatly from province to province.
It can take more than one year for some medical specialists to find a clinical post.
75% of those who are continuing training do so because they think this will make them more employable.
Physician employment challenges do not necessarily mean there’s an oversupply of specialists.


Biggest barriers to finding employment

There are a number of complex factors affecting employment, including:


Too few available positions in some specialties

Family matters: desire or need to stay near family

Fewer hires and access to operating room time and resources

Poor access to job listings

The need for spousal employment

The delayed retirement of established specialists



[I] cannot move due to husband's employment: already sacrificed 5 years of training living in different cities

Newly certified anesthesiologist
Spouse is also a surgeon and we are limited by needing 2 surgical positions in the same city!

Newly certified general surgeon


Orthopedic Surgery: A concerning example

  • An average of 36% of orthopedic surgeons surveyed by the Royal College reported not having a job at the time of their certification.
  • Hip and knee replacements have gone up in Canada by 19% and 14%, respectively. These percentages are likely to continue rising with an aging population (based on fee-for service billing data between 2011 and 2015).
  • But limited access to resources (e.g., operating room time, staff, beds) impacts how many orthopedic surgeons can practice and how much work they can do.
  • The orthopedic surgeon workforce is aging and there are fewer trainees entering the field.

Will there be enough orthopedic surgeons to meet future patients’ health needs?

I am currently doing a locum where I am just doing trauma/on-call work. I get no elective OR time and have no elective clinic access currently.
Resources continue to shrink, demand continues to increase, and number of jobs continues to decrease. There is now a well-established group of individuals performing serial locums (temporary positions) locally that continue to increase...




Future reports will look deeper

Working with our national and provincial stakeholders, we aim to be a catalyst for solutions on physician employment challenges, and to inform health workforce and career planning. Future reports will explore medical workforce issues such as: do employment patterns affect men and women equally? Is working a locum (i.e., temporary replacement) a deliberate career choice or a stopgap until a permanent post is secured?