Social Accountability and Medical Education in Canada:
A Canadian Physician’s Duty to Society
There are few privileges as great as that of being a physician. In taking the Hippocratic Oath, you are committing to a lifetime of service to your patients and accepting responsibility for the confidence that will be placed in your ability to make life-affecting decisions. Other important aspects of your duty to society will be to undertake lifelong learning to keep your skills and knowledge up to date and provide continuity of care to your patients.
The World Health Organization has identified the social accountability mandate of medical schools as the obligation to direct their students’ education, research, and service activities towards addressing the priority health concerns of the community, region, and/or nation they have a mandate to serve—as identified jointly by governments, health care organizations, health professionals, and the public.
In countries where medical education is government-funded, it is reasonable to expect those who receive their Doctor of Medicine (MD) degree to respond to the needs of the population. Canadian medical schools consider this social accountability as integral to their collective mandate. As Canada finds ways to better align the physician workforce with population health needs—and to create greater flexibility within that workforce—changes will occur in Canadian medical education and training opportunities.
Some large Canadian cities are oversaturated with certain specialties, while some smaller communities simply cannot offer certain practice opportunities. At the same time, advances in healthcare have reduced the number of practitioners needed for some specialties. As many Canadians still do not have a family physician, governments are requiring increases in the number of training positions for general practitioners.
Those wishing to pursue a career as a physician in Canada will have to take these realities into account in considering their specialty and the type and location of their future practice. In the current environment, trainees in Canada may have to be flexible with regard to their choice of specialty and ultimate practice location. It is important to note that those who complete MD training outside of this country have no guarantee of securing a training position in Canada, let alone in their desired specialty or practice location.
The mix, distribution, and number of physicians is a central issue in the current Canadian healthcare landscape. A Health Canada-funded initiative called the Future of Medical Education in Canada identified, as the first recommendation in its 2012 postgraduate report, the need “to produce the right mix, distribution, and number of physicians to meet societal needs.” In June 2012, the Conference of Deputy Ministers of Health directed the Committee on Health Workforce to work with the Association of Faculties of Medicine of Canada (AFMC) to examine ways to advance this recommendation.
The resulting Physician Resource Planning Task Force, co-chaired by the province of Ontario and the AFMC, is composed of representatives from the federal, provincial, and territorial governments, national stakeholders, medical educators, and learner organizations. As outlined in its terms of reference, its members have agreed to focus on three key activities:
developing a process for addressing physician imbalances across identified specialties,
creating a pan-Canadian physician planning tool to better understand the complexities of physician supply, and
providing accurate information to support decision making by those considering and currently pursuing medical education, both in Canada and abroad.
The fulfillment of this last objective has led to the creation of Future MD Canada, a career-counselling data set for use both by potential and current medical learners and by those who provide them with advice and guidance in choosing their career path.
What Is Future MD Canada?
Future MD Canada is an online tool developed collaboratively by Canada’s medical education partners to assist with career planning. It contains timely, accurate, and descriptive data about many aspects of physician education, training, and entry into practice, including answers to some of the most frequently asked questions raised by people considering a career as a physician in Canada. The information in Future MD Canada has been reviewed by medical students, residents, and practising physicians to ensure accuracy.
A Final Word
Your interest in and commitment to practising medicine in Canada should be founded on a personal sense of accountability to society and the community you hope to serve. Whether you pursue a career in family medicine or another specialty, being aware of the health needs of Canadians and reflecting on your role in meeting those needs is a great way to contemplate your career.