1. History
    Women in medicine in Canada 

2. Canadian healthcare system

3. Education and training
    Medical school  Residency  Fellowship 

4. Licensure
    Medical Council of Canada  College of Family Physicians of Canada  Royal College of Physicians and Surgeons of Canada  Provincial or territorial regulatory authority 

5. Canadian Medical Protective Association

6. Continuing professional development

7. Selected Canadian medically relevant publications

8. Notable Canadian physicians

9. See also

10. References

Physicians 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 (M.D.) or Doctor of Medicine and Master of Surgery (M.D., C.M.) degrees, the vast majority of physicians in Canada have a Doctor of Medicine degree, though some have a Doctor of Osteopathic Medicine (D.O.) or Bachelor of Medicine, Bachelor of Surgery (M.B., B.S.).

In order to practice in a Canadian province or territory, physicians must obtain certification from either the College of Family Physicians of Canada (CFPC) or the Royal College of Physicians and Surgeons of Canada (RCPSC), as well as become members of the provincial or territorial medical professional regulatory authority.

History

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. These advances included the establishment of a Women’s Medical College in Toronto (and in Kingston, Ontario) in 1883, attributed in part to the persistence of Emily Stowe, the first female physician to practise in Canada. Stowe’s daughter, Augusta Stowe-Gullen, became the first woman to graduate from a Canadian medical school.^[1]

Canadian healthcare system

Healthcare in Canada is delivered through thirteen provincial and territorial systems of publicly funded health care, informally called Medicare.^[2] It is guided by the provisions of the Canada Health Act of 1984.^[3] 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.^[4] 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.^[5] 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.^[4] Provinces provide partial coverage for children, those living in poverty, and seniors.^[4] Programs vary by province.

Canada has a ratio of practising physicians to population that is below the OECD average.^[6]

In 2006, it was reported that family physicians in Canada earned an average of $202,000 a year.^[7] 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.^[7] 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.^[8]

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.^[9] 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...".^[10]

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.^[11]

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;^[12] 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."^[13] 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.^[14] 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 (and active participant in) the Health Action Lobby (HEAL).^[15]

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.^[16]

Education and training

There are multiple components to the education of a physician in Canada, and the process varies slightly between provinces.

Medical school

Generally, in order to be admitted into a Canadian medical school, one must have completed at least an undergraduate degree.

There are currently seventeen medical schools in Canada. They offer a three- to five-year Doctor of Medicine (M.D.) or Doctor of Medicine and Master of Surgery (M.D., C.M.) degree.

Although presently most students enter medicine having previously earned another degree, the M.D. is technically considered an undergraduate degree in Canada.

Residency

Residency training is also known as postgraduate medical education.

Graduating medical students in Canada must apply to a residency position via the Canadian Residency Matching Service (CaRMS). Some of the available programs include family medicine, internal medicine, emergency medicine, anesthesia, pediatrics, psychiatry, obstetrics and gynecology, radiology, general surgery, orthopedic surgery, neurosurgery, and urology.

Fellowship

Fellowship is an optional phase of training available to physicians having completed at least part of their residency training.

Although fellowships are much more common among specialist physicians and surgeons, some are available for physicians having completed training in family medicine.

Licensure

Canadian physicians must undergo an extensive process of licensing in order to practice independently. Upon graduating from medical school, they must pass the Medical Council of Canada Qualifying Examination, Part 1. Following residency training, they pass Part 2 of the Medical Council of Canada Qualifying Examination, in addition to their specialty written examinations and objective structured clinical examinations with the CFPC or RCPSC and any supplementary examinations required by provincial or territorial regulatory authorities.

Graduating family physicians will need to pass their CPFC examinations, while specialist physicians or surgeons will need to pass their RCPSC examinations.

Medical Council of Canada

College of Family Physicians of Canada

Royal College of Physicians and Surgeons of Canada

Provincial or territorial regulatory authority

Once the MCC Qualifying Examination Part 2 and the CFPC or RCPSC examinations are completed, the physician must contact their provincial or territorial regulatory authority in order to obtain their license to practice independently.

For example, in the province of Quebec, the Collège des médecins du Québec is the regulatory authority which emits licenses to physicians and surgeons working within the province. In Ontario, the regulatory college is the College of Physicians and Surgeons of Ontario.

Canadian Medical Protective Association

The Canadian Medical Protective Association (CMPA) is a non-profit association committed to provide advice and assistance when medical-legal issues arise in a physician's practice. They provide legal defense, liability protection, and risk-management education for physicians in Canada They also provide monetary compensation to patients and their families proven to have been harmed by negligent clinical care.

Continuing professional development

Continuing professional development, previously known as continuing medical education, is an important ethical and regulatory requirement of every physician's and surgeon's duty to the care of their patients.

Selected Canadian medically relevant publications

• Applied Physiology, Nutrition, and Metabolism
• Biochemistry and Cell Biology
• Canadian Family Physician
• Canadian Journal of Physiology and Pharmacology
• Canadian Journal of Rural Medicine
• Canadian Medical Association Journal
• Canadian Medical Education Journal
• Médecin du Québec

Notable Canadian physicians

• Maude Abbott (1896–1940) – Canadian physician, among Canada's earliest female medical graduates, internationally renowned expert on congenital heart disease, and one of the first women to obtain a BA from McGill University
• Evan Adams – First Nations medical doctor, medical advisor, Deputy Provincial Health Advisor (BC), and actor
• Maria Louisa Angwin (1849–1898) – first woman licensed to practice medicine in Nova Scotia
• Elizabeth Bagshaw CM (1881–1982) – physician and birth control activist
• Frederick Banting KBE MC LLD (hc) ScD (hc) FRSC (1891–1941) – Nobel laureate, co-discoverer of insulin
• Norman Bethune (1890–1939) – surgeon, inventor, socialist, battlefield doctor in Spain and China
• Wilfred Gordon Bigelow OC LLD (hc) FRSC (1913–2005) – inventor of the first artificial pacemaker
• Daniel Borsuk – Montreal plastic surgeon, pioneer in facial reconstruction, and leader of first Canadian face transplant
• Basil Boulton (1938–2008) – pediatrician and child health advocate
• John Callaghan OC AOE (1923–2004) – pioneer of open-heart surgery
• Carl Goresky OC (1932–1996) – physician and scientist
• James Heilman (born 1979/1980) – head of the department of emergency medicine at East Kootenay Regional Hospital in Cranbrook, British Columbia, active contributor to WikiProject Medicine, and a volunteer Wikipedia administrator
• Ernest McCulloch CM OOnt FRSC FRS (1926–2011) – cellular biologist credited with the discovery of stem cell with James Till
• Frances Gertrude McGill (1882–1959) – pioneering forensic pathologist and criminologist
• Henry Morgentaler CM LLD (hc) (1923–2013) – abortionist who helped legalize abortion in Canada and strengthen the power of jury nullification
• William Osler Bt (1849–1919) – physician, called the "father of modern medicine"; wrote Principles and Practice of Medicine
• Wilder Penfield OM CC CMG FRS (1891–1976) – neurosurgeon, discovered electrical stimulation of the brain
• David Sackett CC FRSC (born 1934) – founded the first department of clinical epidemiology in Canada at McMaster University
• Sydney Segal {{Post-nominals|country=CAN|CM|OBC}} (1920–1997) – pediatrician and neonatologist particularly known for his work with sudden infant death syndrome
• Albert Ross Tilley (1904–1988) MD FRCS(C) OBE OC – plastic surgeon

See also

• College of Family Physicians of Canada
• Royal College of Physicians and Surgeons of Canada

References

• Air transport in Cambodia
• Air transport in Canada
• Air transport in India
• Air transport in Pakistan
• Air transport in the United States
• Air transport in Yugoslavia
• Air Transport Network
• Air Transport Services Group
• Air Transport Services Group, Inc
• Air Transport Wing 62
• Airtraq
• Air travel and climate change
• Air travel and global warming
• Air travel and the environment
• Air Travel Card
• Air travel disruption after the 2011 Grímsvötn eruption
• Air travel disruption after the 2011 Puyehue-Cordón Caulle eruption
• Airtricity League XI
• Airtrike Eagle 5
• Airtronics
• Air Turbo Ramjet Engine with eXpander cycle
• Air Turks and Caicos
• Air TV Series
• Air (Tyson Ritter song)
• Airumbria