Cost cuts haunt medical body

The Canadian government's decision to drastically reduce student enrolment in medical schools ten years ago is being reversed as the country faces a shortage of doctors.

Critics say the shortages can be traced to a report by two health economists that suggested fewer medical students in 1991 as a way to lower general health spending. The medical faculties complained at the time that cuts would harm Canada's ability to sustain its workforce of physicians.

The numbers at medical schools are returning gradually to pre-cut levels. At one point, the University of Toronto took a 30 per cent cut in first-year enrolments in one year.

An extra 107 spaces for first-year medical students have been allocated across the country. This raises the first-year total to 1,741, which is still far below the 2,500 a year recommended by the Association of Canadian Medical Colleges.

John Cairns, association president, said: "It is an untenable situation that no self-respecting country ought to tolerate."

He said that bar Britain, Canada trails every country in the industrialised world in the ratio of medical students to population. But Britain, he pointed out, is reversing its situation faster than Canada, with a higher ratio of medical students to population.

Dr Cairns, dean of medicine at the University of British Columbia, said the low ratio had led to more than 200 students a year enrolling in foreign medical schools and then seeking residency training in Canada.

Noni MacDonald, dean of Dalhousie Medical School, said that increasing the numbers of enrolments will not be easy.

Nova Scotia has asked Dalhousie to take 24 more recruits a year, a prospect that the overcrowded school feels is too daunting. Dr MacDonald said: "We cannot put them in the hallways."

Instead, Dalhousie has recommended admitting eight more students a year for three years. It is negotiating with the province to seek the necessary funding.