British Columbia needs another medical school training a new type of physician! British Columbia has the third largest population in Canada. Alberta, which has the fourth largest population, has two medical schools, and Quebec, which has the second largest, has four. This disparity is reflected in the number of medical school graduates per 100 000 population by province [see Table].
Historically, British Columbia has relied on other jurisdictions to train physicians who would then relocate to BC. In today’s global shortage this is no longer a reliable solution. British Columbia already has a significant deficit in the number of physicians and, currently, Fraser Health needs an additional 150 physicians. It is time to both dramatically increase the number of physicians being trained in British Columbia and, of the increased number, train a significant portion with different skills. We applaud the continued expansion of the UBC distributed model of medical education. While this will make inroads into the gap, it will not be sufficient to alleviate the current deficit and meet the projected need for physicians in BC. Fraser Health alone will require an additional 600 physicians by 2013.
The World Health Organization identified the new competencies required by the health care workforce of the future. Pruitt and Epping-Jordan noted that caring for patients with chronic conditions is different than caring for or managing an episodic illness, and we need to consider a different approach to educating much of our physician workforce. With a stronger focus on population health, these physicians will have enhanced skills to manage and use resources to improve and maintain the health of individuals and communities. We agree that there needs to be a focus on the community, including residential facilities. The issues highlighted by these authors are those of Fraser Health—a rapidly growing population including many diverse ethnic and cultural groups and a need to manage illness outside of our emergency departments.
We must take ownership of our workforce challenges. We need to work with all stakeholders to look at new models of medical education and create a new curriculum that responds to our community needs. We need to think innovatively on how we might fund such new approaches. For this non-conventional approach to succeed, we will require new, creative partnerships from diverse jurisdictions.
Great change is usually based on three key factors: evidence, opportunity, and courage. There is evidence and opportunity and, for its part, Fraser Health has the courage to move ahead collaboratively in developing a second innovative program of medical education in British Columbia.
—Nigel J. Murray, MD
President and CEO, Fraser Health
—Thomas F. Ward, MD
Executive Medical Director, Fraser Health
1. Fraser Health Authority, ELM Group. Physician Recruitment and Retention Plan. August 2008.
2. Pruitt S, Epping-Jordan J. Preparing the 21st century global healthcare workforce. BMJ 2005;330:637-639. Full Text
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