Physicians in Canada
s and surgeons play an important role in the provision of health care in Canada. They are responsible for the promotion, maintenance, and restoration of health through the study, diagnosis, prognosis, and treatment of disease, injury, and other physical and mental impairments. As Canadian medical schools solely offer the Doctor of Medicine or Doctor of Medicine and Master of Surgery degrees, these represent the degrees held by the vast majority of physicians and surgeons in Canada, though some have a Doctor of Osteopathic Medicine from the United States or Bachelor of Medicine, Bachelor of Surgery from the commonwealth countries and Europe.
In order to practice in a Canadian province or territory, physicians and surgeons must obtain certification from either the College of Family Physicians of Canada or the Royal College of Physicians and Surgeons of Canada, as well as become members of the provincial or territorial medical professional regulatory authority.
History
were initially places which cared for the poor as those with higher socioeconomic status were cared for at home. In Quebec during the 18th century, a series of charitable institutions, many set up by Catholic religious orders, provided such care.The first medical schools were established in Lower Canada in the 1820s. These included the Montreal Medical Institution, which is the McGill University Faculty of Medicine today. In the mid-1870s, Sir William Osler changed the face of medical school instruction with the introduction of the hands-on approach. The College of Physicians and Surgeons of Upper Canada was established in 1839, and in 1869, it was permanently incorporated. In 1834, William Kelly, a surgeon with the Royal Navy, introduced the idea of preventing the spread of disease via sanitation measures following epidemics of cholera. In 1892, Dr. William Osler wrote the landmark text The Principles and Practice of Medicine, which dominated medical instruction in the West for the following half century. Around this time, a movement began that called for the improved healthcare for the poor, focusing mainly on sanitation and hygiene. This period saw important advances including the provision of safe drinking water to most of the population, public baths and beaches, and municipal garbage services to remove waste from the city. During this period, medical care was severely lacking for the poor and minorities such as First Nations.
Women in medicine in Canada
In the late nineteenth and early twentieth centuries, women made inroads into various professions including teaching, journalism, social work, and public health. In 1871, female physicians Emily Howard Stowe and Jennie Kidd Trout won the right for women to be admitted to medical schools and were granted licences from the College of Physicians and Surgeons of Ontario. In 1883, Emily Stowe led the creation of the Ontario Medical College for Women, affiliated with the University of Toronto. These advances included the establishment of a Women's Medical College in Toronto, as well as in Kingston, Ontario. Stowe's daughter, Augusta Stowe-Gullen, became the first woman to graduate from a Canadian medical school.Canadian healthcare system
Healthcare in Canada is delivered through thirteen provincial and territorial systems of publicly funded health care, informally called Medicare. It is guided by the provisions of the Canada Health Act of 1984. The government ensures the quality of care through federal standards. The government does not participate in day-to-day care or collect any information about an individual's health, which remains confidential as per the doctor-patient relationship. Canada's provincially based Medicare systems are cost-effective because of their administrative simplicity. In each province, each doctor handles the insurance claim against the provincial insurer. There is no need for the person who accesses healthcare to be involved in billing and reclaim. Private health expenditure accounts for about 30% of health care financing. The Canada Health Act does not cover prescription drugs, home care or long-term care, or dental care, which implies that most Canadians rely on private insurance from their employers or the government to pay for the costs associated with these services. Provinces provide partial coverage for children, those living in poverty, and seniors. Programs vary by province.Canada has a ratio of practising physicians to population that is below the OECD average.
In 2018-2019, the average gross payment per physician reached $347,000 a year. Alberta had the highest average salary of around $230,000, while Quebec had the lowest average annual salary at $165,000, arguably creating inter-provincial competition for doctors and contributing to local shortages at the time. In 2018, to draw attention to the work of nurses and the declining level of service provided to patients, more than 700 physicians, residents, and medical students in Quebec signed an online petition asking for their pay raises to be canceled.
In 1991, the Ontario Medical Association agreed to become a province-wide closed shop, making the OMA union a monopoly. Critics argue that this measure has restricted the supply of doctors to guarantee its members' incomes. In 2008, the Ontario Medical Association and the Ontario government agreed to a four-year contract with a 12.25% doctors' pay raise, which was expected to cost Ontarians an extra $1 billion. Ontario's then-premier Dalton McGuinty said, "One of the things that we've got to do, of course, is ensure that we're competitive... to attract and keep doctors here in Ontario...".
In December 2008, the Society of Obstetricians and Gynaecologists of Canada reported a critical shortage of obstetricians and gynecologists. The report stated that 1,370 obstetricians were practising in Canada and that number is expected to fall by at least one-third within five years. The society is asking the government to increase the number of residency positions obstetrics and gynecology by 30 percent a year for three years and also recommended rotating placements of doctors into smaller communities to encourage them to take up residence there.
Each province regulates its medical profession through a self-governing regulatory body, which is responsible for licensing physicians, setting practice standards, and investigating and disciplining its members.
The national doctors association is called the Canadian Medical Association; it describes its mission as "To serve and unite the physicians of Canada and be the national advocate, in partnership with the people of Canada, for the highest standards of health and health care." Because healthcare is deemed to be under provincial/territorial jurisdiction, negotiations on behalf of physicians are conducted by provincial associations such as the Ontario Medical Association. The views of Canadian doctors have been mixed, particularly in their support for allowing parallel private financing. The history of Canadian physicians in the development of Medicare has been described by David Naylor. Since the passage of the 1984 Canada Health Act, the CMA itself has been a strong advocate of maintaining a strong publicly funded system, including lobbying the federal government to increase funding, and being a founding member of the Health Action Lobby.
However, internal disputes may occur. In particular, some provincial medical associations have argued for permitting a larger private role. To some extent, this has been a reaction to strong cost control; CIHI estimates that 99% of physician expenditures in Canada come from public sector sources, and physicians—particularly those providing elective procedures who have been squeezed for operating room time—have accordingly looked for alternative revenue sources. One indication came in August 2007 when the CMA elected as president Dr. Brian Day of British Columbia, who owns the largest private hospital in Canada and vocally supports increasing private healthcare in Canada. The CMA presidency rotates among the provinces, with the provincial association electing a candidate who is customarily ratified by the CMA general meeting. Day's selection was sufficiently controversial that he was challenged—albeit unsuccessfully—by another physician member.
Demographics
According to the Canadian Institute for Health Information, in 2023, Canada had a total of 97,384 physicians, translating to approximately 243 physicians per 100,000 population. The physician workforce consisted of 54% male and 46% female practitioners. The average age of physicians in 2023 was 49.3 years — 51.7 for males versus 46.4 for females. Among family physicians, 50.4% were female, reflecting a near gender balance, while among specialists, 40.7% were female, indicating a lower proportion of women in specialized medical fields. Almost half of the physicians in the country were general practitioners or family physicians, and 29% of them were foreign trained.Regional variations show significant variation across provinces and territories. The highest physician densities were observed in British Columbia and Nova Scotia, followed closely by Ontario and Quebec. In contrast, lower physician densities were reported in Prince Edward Island and Saskatchewan, with other provinces such as Alberta, Manitoba and Atlantic Canada regions falling in between.
According to the Government of Canada and CIHI, in 2022, 37% of physicians in the country were immigrants, and 27% of physicians were International medical graduates. Census 2021, reported that there were 39,474 immigrant physicians in Canada. In contrast, the Canadian Medical Association reported that only 41% of the IMGs living in Canada were practising medicine. Furthermore, 31% of family physicians, 25% of medical specialists and 16% of surgical specialists were foreign trained. According to Statista in 2023, the leading countries of origin for IMGs were South Africa, followed by India and the United Kingdom.