Students contemplating careers in medicine need a reality check about their prospects of moving back to B.C. if they go to medical school abroad, an associate dean of medicine at the University of B.C. said Monday.
â€œThey need to know how much more severe that competition is if they go abroad and want to apply for residency positions here upon graduation,â€� said Dr. Dave Snadden. As well, high school students should not be encouraged to apply to foreign schools unless theyâ€™re also given that â€œreality check,â€� he added.
Between 80 and 100 B.C. students graduate each year from medical schools in places such as the U.K. and Australia. But over the past five years, they have secured less than two per cent of UBCâ€™s residency positions, according to the Society for Canadians Studying Medicine Abroad (SOCSMA).
Meanwhile, the group has accused UBC of â€œsellingâ€� postgraduate residency spaces to doctors from countries around the Persian Gulf whose governments pay $75,000 per student, per year, to have them study abroad.
B.C. students choose to attend foreign medical schools for a variety of reasons.
Some medical schools, like those in the U.K. allow direct entry, without an undergraduate degree.
Others turn to foreign schools because they have been turned away by UBC or other Canadian schools.
Last year, the B.C. Ministry of Health funded 292 residency positions for freshly minted medical school graduates; 266 were graduates from Canadian medical schools and 26 were international medical graduates (IMG).
B.C. students who go to foreign schools are lumped into the IMG category, which is open to those from this province who are Canadian citizens, permanent residents, or hold refugee status. Foreign-born and trained doctors who are not sponsored by their home governments also compete for the same IMG spaces.
There is no preferential treatment offered to B.C. born and bred applicants, said Snadden. To do so would be discriminatory, he said.
The SOCSMA, which has about 350 members, including students and parents, maintains that UBC discriminates against students from this province who study abroad by forcing them to compete in the international pool for so few spots.
Snadden said UBC has just started to work with the Ministry of Advanced Education to alert high school guidance and university counsellors about the poor odds of getting postgraduate training spots for students who want to move back to B.C.
As well, UBC medical students who visit high schools to talk about medical careers are being urged to have the same conversation about the potential downside of studying at foreign schools.
Snaddenâ€™s comments were made on the same day the SOCSMA called on UBC to end the practice of â€œsellingâ€� positions to sponsored foreign students.
There are 43 doctors from countries such as Saudi Arabia, Libya, Bahrain, United Arab Emirates and Kuwait now training in medical or surgical specialties in postgraduate residency positions at teaching hospitals in B.C.
Another 39 â€” also mostly from countries around the Persian Gulf â€” are doing more advanced fellowships here, all paid for by their home countries, not subsidized by B.C. taxpayers.
The SOCSMA contends the visa trainees â€” so-named because they obtain temporary visas to work here for various terms before returning to their homelands â€” take precious jobs away from B.C. graduates of foreign medical schools who want to return home to practice.
Snadden disagrees the visa trainee program denies postgraduate training to B.C. medical graduates who have studied abroad. Residents or fellows from the Middle East are usually placed in specialties which are less attractive to other doctors because of the limited long-range job opportunities in certain areas, he said, citing pediatric gastroenterology as one example.
Snadden said the program complies with long-standing agreements signed by the Canadian government to share medical expertise with the international community. The $75,000 annual fee charged to those foreign-born graduates isnâ€™t profit for UBC; it offsets the cost and hospital department expenses associated with training, he said. Trainees who do not perform to certain high standards can be sent home. Foreign doctors are required to return to their home countries upon completion of their programs.
Snadden said the visa trainee program provides a cultural dimension to the health care system. â€œWeâ€™re a multicultural society and we benefit from this arrangement because of their additional language skills.â€�
Many of Canadaâ€™s 17 medical schools sell trainee spots to Saudi Arabia and other Gulf states and this is not the first time controversy has erupted.
Dr. Andrew Thompson, a Vancouver General Hospital heart surgeon who is president of the SOCSMA, said a large medical school like UBC doesnâ€™t need to sell spots to stay afloat. His own daughter graduated from the University of Auckland and is staying in New Zealand to do her residency training.
He added the reality that only two per cent of doctors in residency training in this province are foreign-trained and B.C.-bred attests to the fact it is near-impossible for those graduates to return home to practice.
â€œEvery year, there are up to 160 international medical graduates from B.C. who are trying to find training spots here, but UBC only makes a handful of residencies available to B.C. residents who graduate from foreign medical schools in countries like England, Ireland, Scotland and Australia.
â€œCanada takes doctors for postgraduate training from countries no Canadians would ever go [to study]. So is it appropriate for UBC to be selling educational bandwidth at the same time as it is denying these doctors a right to return to B.C.?â€� he said.
â€œI think UBC can measure the benefits of this practice in economic terms only,â€� he said, when asked about the cultural advantage of offering postgraduate training to doctors who are foreign-born and trained.
The SOCSMA, whose members include doctors working at UBC, maintains that selling residencies to non-British Columbians is wasting capacity and not addressing the urgent needs of B.C. patients who canâ€™t access family doctors and specialists in a timely fashion.
â€œUBC could be putting dozens of new doctors in B.C. communities each year,â€� said Thompson. â€œInstead, itâ€™s created a system that discourages brilliant students from even considering applying to UBC. Many of these students have graduated with top marks, in the 99th percentile from top-rated schools in Australia, Britain, New Zealand and Ireland.â€�
Sun Health Issues Reporter