A communication from the CMA
Matter of Fact
Number of doctors sued in United Kingdom in past 15 years over medical treatment provided at least 20 years earlier: 557 Longest term between provision of treatment and filing of suit: 53 years Proportion of successful claims: 8%, with awards totalling more than £3 million
Members Only
One copy of Determining Medical Fitness to Drive: a Guide for Physicians is available free of charge to all CMA members, who can also order additional copies for $27.95 instead of the list price of $34.95. The guide, updated in 2000, includes diagnostic assessment tools, regulations for reporting unfit drivers and comprehensive tables and recommendations concerning key medical conditions. Plans are currently being developed to update the guide, which is generally considered the country’s best source of fitness-todrive information. Call the CMA’s Member Service Centre, 888 855-2555, x2307, or email cmamsc@cma.ca.
Residency match 2004: The tightest ever?
With the tightest and most competitive residency match in the history of Canadian medical education looming, concern is growing inside and outside the country’s medical schools. A recent online poll conducted by the Canadian Federation of Medical Students (CFMS) revealed that 83% of members think that ensuring an adequate number of postgraduate positions should be the organization’s top priority, with high tuition fees a distant second at 17%. Data from the Canadian Resident Matching Service (CaRMS) indicate why. In 2004, 1426 people have applied for 1359 spots. Sandra Banner, executive director at CaRMS, says this is not the first time applications have outnumbered the available positions, “but the situation is more extreme this year — it is going to be very, very tight.” The reason is simple: increases in the number of ministry-funded PGY1 positions have not kept pace with increases in medical school enrolment, and the buffer of extra training positions has all but disappeared. The CMA and its divisions, which have already written to the country’s ministers of health about the issue, say a position-to-applicant ratio of at least 1.2:1 is needed to provide flexibility. Without it, they say some graduates of Canadian schools will seek training in the US. As well, positions that are not filled in the first round create opportunities for both international graduates and for practising physicians who wish to retrain. “A ratio of 120 positions for every 100 graduates of Cana- year, one-third of the 36 programs dian medical schools should be filled 50% or less of their openings in achieved and maintained,” says CMA the match’s first round. Dr. Alecs Chochinov, President Sunil Patel. a Winnipeg emergency CFMS President Sayeh physician who chairs Minoosepehr says concern the CMA’s Council on already extends well beyond Education and Workthe Class of 2004. “It looks force, says students are like things will be tight for realizing that competithe next 2 or 3 years,” she tion is so tight they said. Minoosepehr, who bemust have a backup comes part of the Univerplan, “and the family sity of Ottawa medical medicine increase may school’s largest ever gradube part of that.” ating class next year, says to- Minoosepehr: Although many day’s students are simply “hoping for the best” members of the Class of “hoping for the best.” There are some wild cards in the 2004 “are terrified” about the upcom2004 match. For instance, it has at- ing match, Banner says the outlook is tracted a record 74 applicants from worse for international graduates seekthe 3 French-language medical ing training. Except in Quebec, they schools, but many of them are likely can apply only for positions unfilled afto drop out of the CaRMS match this ter the first round; this year the second month when they receive offers from round “promises to be very small.” Chochinov thinks the 2004 match Quebec’s postgraduate programs. As well, some applicants will opt for is a sign that the lack of autonomy aftraining in the US, which has a huge fecting physician morale may soon affect students too. “Look at the disensurplus of postgraduate training slots. Although this super-tight match is chantment among practising doctors. proving nerve-racking for the Class of Today, students are getting a taste of 2004, it appears to be having a posi- what’s causing that disenchantment tive impact on family medicine. Ban- before they have their degrees.” ner said applications to FP programs are up by 20% in 2004, with some exCMA Bulletin is produced by the CMA’s periencing a 40% jump. Although it Department of Public Affairs remains to be seen whether these apEditors: Patrick Sullivan, Steve Wharry plications will translate into career choices, it is a marked shift from reComments or suggestions to cent matches that have seen the popucmanews@cma.ca; larity of family medicine plunge. Last 800-663-7336, x2700
Steve Wharry
CMAJ • FEB. 17, 2004; 170 (4)
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