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扩大加拿大的医疗保健能力:国际培训医生的潜力。

Expanding healthcare capacity in Canada: the potential of internationally trained physicians.

作者信息

Leiva Tobelem Luis Francisco, Ynoe de Moraes Fabio, Santos Filipe Nadir Caparica

机构信息

Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, ON, Canada.

Department of Anesthesia, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada.

出版信息

Lancet Reg Health Am. 2025 Apr 16;46:101095. doi: 10.1016/j.lana.2025.101095. eCollection 2025 Jun.

Abstract

Canada's healthcare system is facing a severe shortage of doctors, leaving millions of Canadians struggling to access essential primary and specialist care. Despite substantial investment in healthcare, Canada still falls behind other OECD countries in having enough physicians to meet patient needs. This crisis, fueled by inadequate workforce planning, an aging population, and increasing physician burnout, has forced more patients to rely on emergency departments for basic care, driving up costs and reducing quality of service. Internationally trained physicians (ITPs) represent a significant yet underutilized resource. However, they encounter numerous barriers, including restrictive licensing practices, insufficient residency spots, and accreditation systems that occasionally value training length more than clinical performance or demonstrated competency. To address these urgent challenges, Canada should expand on competency-based accreditation methods, build on existing Practice Ready Assessment programs, create more residency placements for ITPs, and reduce bureaucratic hurdles. Taking immediate steps toward these reforms will improve healthcare access, patient outcomes, and ensure long-term sustainability of healthcare across Canada.

摘要

加拿大的医疗保健系统正面临严重的医生短缺问题,数百万加拿大人难以获得基本的初级和专科护理。尽管在医疗保健方面投入了大量资金,但在拥有足够数量的医生以满足患者需求方面,加拿大仍落后于其他经合组织国家。这场危机因劳动力规划不足、人口老龄化以及医生职业倦怠加剧而加剧,迫使更多患者依赖急诊科获得基本护理,从而推高了成本并降低了服务质量。国际培训医生(ITPs)是一项重要但未得到充分利用的资源。然而,他们面临诸多障碍,包括严格的许可制度、住院医师培训名额不足以及认证体系,这些体系有时更看重培训时长而非临床绩效或已证明的能力。为应对这些紧迫挑战,加拿大应扩展基于能力的认证方法,在现有“实践就绪评估”项目的基础上加以完善,为国际培训医生创造更多住院医师培训岗位,并减少官僚障碍。立即朝着这些改革方向采取措施将改善医疗保健的可及性、患者治疗效果,并确保加拿大医疗保健系统的长期可持续性。

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