Opinion: Reflections on Quebec's doctor shortage by one who left

Article content Last week, McGill University hosted its annual homecoming celebration. I attended the reunion of my medical school class of 1974, which included 132 individuals at the time of graduation. During my weeklong visit, I chatted with old friends as well as my classmates and was struck by some of the stories I heard about how difficult it was for many Quebec residents to access a primary care physician.

I had heard these stories before, but the situation seemed more dire. Moreover, some stated that it was difficult for those who received their medical and postgraduate education outside the province to get a licence in Quebec, despite the shortage of physicians. I was born and grew up in Montreal and had all my formal education there, including eight years at McGill.



My education there was first class, but I left Canada for the U.S. for postgraduate training and eventually immigrated to the U.

S. for personal and professional reasons. Upon return from my reunion, I read an article in The Gazette in which Parti Québécois Leader Paul St-Pierre Plamondon has proposed significantly limiting the number of international university students who have not mastered French, should the PQ gain power in the next provincial election in 2026.

Presumably this policy would apply to foreign medical students as well. This has understandably raised alarm among McGill leadership and alumni. Based on the data from my graduating class, albeit limited, it may be appropriate to consider this policy in the context of the physician shortage and brain drain of qualified doctors over the years.

Of my graduating class, 89 (67 per cent) were from Quebec (mostly Montreal); 19 (14 per cent) were from the U.S.; 16 (12 per cent) were from other provinces; and the rest were from other countries.

Unfortunately, at least 15 (11 per cent) of our class have died. Where I have information on about 70 members of my class (admittedly not a statistical sample), 22 (31 per cent) practised in Quebec and 48 (69 per cent) practised outside Quebec. Breaking this down, 25 (36 per cent) practised in the U.

S., 16 (23 per cent) practised in Ontario, five (7 per cent) moved to other provinces and two (3 per cent) live in other countries. For context, 55 of the 70 (79 per cent) were permanent residents of Quebec at the time of graduation.

Clearly, many of these chose to leave the province. There are likely multiple reasons for this migration, but probably the most common were the political environment in Quebec beginning in the 1970s, the restrictions by the Quebec government on medical practice income, and significantly more professional opportunities in the U.S.

This was certainly true in my case. These reasons may be no less true today. Having worked in New Jersey state government as deputy commissioner of health during my career, I have an appreciation for how and why government may promulgate policies that make professionals unhappy.

The most basic reason is that it’s for the common good of society. And from that perspective, given the flight of medical professionals, the proposed PQ policy could be a partial answer (and I emphasize partial) to mitigating the dearth of practitioners in la belle province. There are some drawbacks to this policy, though, such as the benefits of diverse perspectives in a class.

During my visit, I was able to observe the diversity of students on the McGill campus. Drawing prospective medical students (all of whom presumably are bilingual) from McGill and other Quebec universities, with some from outside the province, including the U.S.

, should provide for the requisite multicultural environment conducive to a comprehensive medical education. And at the same time, minimize the likelihood of these professionals leaving permanently for greener pastures when they graduate. Making it easier for doctors educated elsewhere to be licensed, together with appropriate educational policies, can go a long way to addressing the physician shortage in Quebec.

Eddy A. Bresnitz is a retired internist and public health physician living in Bala Cynwyd, Pa. His career has spanned leadership positions in academia, government and the private sector.

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