College of Medicine giving consideration to international medical graduates

The University of Saskatchewan’s College of Medicine is working to address the doctor shortage through increasing residency seats and opportunities in the province, according to its dean.

Preston Smith, a family doctor and the dean of the college, was “very happy” with the additional funding provided to the college in the 2023-24 Saskatchewan budget.

He said the $5.8-million boost will serve two main purposes, both contributing to recruiting and retaining physicians in the province.

About half of the funding will allow the college to recruit more physicians to complete academic work for the College of Medicine over the next few years, Smith said, allowing protected time in a physician’s work week to do so.

Other funding will go towards completing work the college has had in progress and was announced last year, including new residency positions in Yorkton and the development of a new residency program in oncology.

However, as current shortages of physicians and specialists still impact the province, questions about the training of internationally educated medical graduates and retention of Saskatchewan doctors have been raised.

Residency efforts

Presently, there are 128 residency seats in Saskatchewan, including those newer positions. Fifty-two of those seats are in family medicine.

The first round of residency matches through the national Canadian Resident Matching Service (CaRMS) wrapped up just last week, Smith shared. Of the 128 spots in the province, 117 were filled in the first round.

Thirty-six of those positions went to international medical graduates (IMGs) or Canadians who studied abroad. A remaining 11 positions will be decided during the second round next month and could include more of these graduates.

Dr. Anurag Saxena, a professor and associate dean at the College of Medicine, said over the past five years, an average of 71 per cent of residents who trained in family medicine in Saskatchewan have remained in the province.

“Those are very, very good numbers for us,” he said.

Saxena also said about 40 to 45 per cent of U of S medical school graduates are retained in the province to train during their residency. Those who leave may do so out of personal preference or to train under a program that is not offered in Saskatchewan.

That retention rate, Saxena explained, is comparable to rates seen at other medical schools across Canada. Smith said no medical school is able to retain all of its students.

“Our students make their own choices about where they want to do residency,” Smith said.

The national market also contributes to students coming to Saskatchewan to train from elsewhere in Canada. Smith put that number at around 30 in Saskatchewan this year.

“It would always be that we try and pick the students that we think are most likely going to stay in Saskatchewan,” Smith said of the process.

Smith said one of the most important things the College of Medicine does is selecting the right students.

“Obviously we want talented, bright, compassionate people to become medical students but we want those to be students who are likely going to try to stay in Saskatchewan,” Smith said.

The college uses academic performance as well as references, interviews and other tools to assess students’ interest in specialties and their interest in remaining in Saskatchewan. Smith said indicators like where someone went to high school can be a better indicator than where someone was born when predicting whether they might stay in the province long term.

The college, he said, is also working to provide a learning experience close to home in Saskatchewan for students.

Smith maintained Saskatchewan students are prioritized to receive medical school seats, with only five of the 100 available spots in the province open to any Canadian. A different process applies to residency spots.

When asked about IMGs, Smith noted more residency spots would provide more opportunities for training. However, he said Saskatchewan currently has one of the highest ratios of residency positions to undergraduate positions compared to other provinces.

He also referred to the Saskatchewan International Physician Practice Assessment (SIPPA) program, which he claimed to be comparable to Alberta’s International Medical Graduate (AIMG) program — one that prioritizes medical graduates with strong ties to Alberta.

Through the SIPPA program, candidates who are licensed doctors in other countries that have standards not recognized by Canada can apply to become licensed. This does not apply to graduates who haven’t completed a residency.

Saskatchewan’s efforts have been more effective at providing international medical graduates and Canadians who studied abroad with residency spots than the program in Alberta, according to Saxena.

The associate dean has been heading up a report to be published on Friday for the Ministry of Immigration regarding IMGs and recommendations to improve the system to see more people with medical degrees given opportunities to train and practise in Saskatchewan.

“We are open to doing anything we can do much better,” Saxena said.

He also prepared a report on the AIMG program years ago.

Saxena explained there are seats for residency in Saskatchewan set aside for competitive selection, meaning Canadian medical school graduates and international medical school graduates can apply.

An IMG could be someone who has immigrated to Canada or a Canadian who studied outside of the country.

Saxena said there are 15 seats for international medical graduates, as well as access to competitive seats and second-round selections that increase how many residency spots are filled by IMGs each year.

Saskatchewan’s program sees about 25 to 30 per cent of its residency seats filled by international medical graduates, Saxena said, compared to about 21 per cent of seats in Alberta between its two universities.

About 90 per cent of IMGs in Saskatchewan are Canadians who have studied abroad or who have strong connections to Saskatchewan.

“That’s a very good number for us,” Saxena said. “Although we use a different approach, our results, I would have to say, are slightly better than what’s happening next door.”

There is also a very small program that helps a handful of international graduates who have immigrated to Canada and are living in Saskatchewan by preparing them ahead of their residency training.

An international medical graduate himself, Saxena said there are fewer barriers today for individuals trying to secure a residency position in Saskatchewan than there were 30 years ago, including more spots available to IMGs.