Medical students’ perspectives on long-term care

As second-year medical students, we visited a local long-term care home and witnessed the challenges faced by both residents and staff. Conversations with residents deepened our understanding of their daily lives and the essential role these facilities play, while discussions with staff highlighted the strain placed on the system by limited resources and a lack of physician availability. One resident shared that they had waited nearly 2 years for placement. While Canada’s physician shortage is well documented, experiences like this reflect a broader issue: growing demand for long-term care is outpacing the system’s capacity to provide it.

By 2028, more than one-fifth of Canada’s population will be over 65 years of age, intensifying demand for long-term care services.[1] In British Columbia, the number of publicly subsidized long-term care beds per 1000 adults 75 years of age and older has fallen from 77 beds in 2015–2016 to 58 beds in 2024–2025, indicating a widening gap between demand and available care.[2] At the same time, the number of people waiting for long-term care has more than tripled, rising from 2381 individuals in 2016 to 7212 in 2025.[2]

These delays have consequences beyond the long-term care sector. Many seniors who require long-term care remain in hospital beds while awaiting placement, classified as alternate-level-of-care patients. In BC, seniors account for 80% of alternate-level-of-care cases, underscoring the close link between alternate-level-of-care shortages and hospital overcrowding.[2] Prolonged hospital stays can contribute to poorer health outcomes for older adults, including functional decline, increased infection risk, and worsening mental health, while simultaneously limiting access to acute care beds for others.

Workforce shortages further compound these system pressures. Long-term care residents often have complex medical needs that require consistent physician oversight. However, many facilities struggle to recruit and retain physicians willing to practise in long-term care settings. Administrative demands, travel between facilities, and on-call responsibilities can make long-term care practice difficult to sustain, particularly in the broader context of family physician shortages.[3]

Encouragingly, BC has introduced initiatives through the Family Practice Services Committee to support the long-term care physician workforce. The Long-Term Care Initiative provides funding for after-hours availability, quality improvement, and compensation for physicians serving as most-responsible providers.[4] Together, these measures aim to strengthen continuity of care, support clinicians, and reduce unnecessary hospital transfers.

As medical learners, we believe that increasing exposure to long-term care during training may help address this challenge. Early and meaningful engagement in long-term care settings can foster clinical competence, empathy, and a deeper understanding of the needs of older adults. Expanding clinical placements and elective opportunities within long-term care could encourage more trainees to consider careers caring for this vulnerable population.

Ensuring timely access to long-term care is essential, not only for the well-being and dignity of older adults, but also for the resilience of the health care system. Addressing long-term care capacity, workforce support, and training opportunities will be critical as Canada prepares for the growing demands of an aging population.
—Ava Hughes, BSc
—Raha Masoudi, BSc
—Ava Cornell, BSc
—Savannah Swann, MSc
Medical Students, University of British Columbia Faculty of Medicine

References

1.    Gibbard R. Meeting the care needs of Canada’s aging population. Ottawa: Conference Board of Canada, 2018. Accessed 16 March 2026. www.cma.ca/sites/default/files/2018-11/Conference%20Board%20of%20Canada%20-%20Meeting%20the%20Care%20Needs%20of%20Canada%27s%20Aging%20Population%20%281%29.PDF.

2.    Office of the Seniors Advocate BC. From shortfall to crisis: Growing demand for long-term care beds in B.C. Victoria, BC: Office of the Seniors Advocate BC, 2025. Accessed 16 March 2026. www.seniorsadvocatebc.ca/app/uploads/sites/4/2025/07/From-Shortfall-to-Crisis-Report.pdf.

3.    College of Family Physicians of Canada, Canadian Society for Long-Term Care Medicine. Joint position statement on the role of family physicians in long-term care homes. Mississauga, ON: College of Family Physicians of Canada, 2021. Accessed 16 March 2026. www.cfpc.ca/CFPC/media/PDF/Role-Family-Physicians-Long-Term-Care-March-2021.pdf.

4.    Family Practice Services Committee. Long-term care. Updated 16 December 2024. Accessed 16 March 2026. https://fpscbc.ca/what-we-do/clinical-supports/long-term-care.