Canadian provinces are so short of oncologists that some are asking regulatory bodies to allow foreign trained specialists to treat cancer patients without first having to pass Canadian specialist examinations. The province of Saskatchewan has already been granted permission to waive the normal procedures in this way.
An estimated 126 radiation and medical oncologists are needed in Canada, according to a report by Dr Andrew Padmos, head of the Cancer Care Program and commissioner at the Queen Elizabeth II Health Sciences Centre, Halifax, Nova Scotia. The report was prepared for the Canadian Strategy for Cancer Control, which is being developed by the Canadian Cancer Society and National Cancer Institute; the Canadian Association of Provincial Cancer Agencies; and Health Canada, the federal health department. Quebec province alone needs 60 radiation oncologists.
The shortages have forced 2759 cancer patients from Manitoba, Ontario, Quebec, and Newfoundland to seek treatment at US centres over the past 18 months. The human resources planning group of the Canadian Strategy for Cancer Control says acute and chronic shortages of key staff have been experienced on occasion in most areas of Canada and in most cancer disciplines over the past 20 years. This has resulted in delayed treatment for some patients “or divergence from the acceptable standard of care for others.”
The Saskatchewan Cancer Agency has been given special approval by the provincial health minister to bring in foreign certified cancer specialists lacking certification by the Royal College of Physicians and Surgeons of Canada. Other provinces—such as Ontario, British Columbia, and Quebec—are trying to arrange similar plans to meet their staff shortages. The Royal College of Physicians and Surgeons of Canada sets the standards for oncologists nationwide, except in Quebec, which has its own specialist examinations. There are currently 612 medical and radiation oncologists certified by the Canadian college.
Approval for such schemes is not unanimous. Dr Robert Pearcey, president of the Canadian Association of Radiation Oncologists, calls them “a dangerous precedent,” while Dr Glen Goss, president of the Canadian Medical Oncologists Association, says bringing in foreign specialists is “not the desirable method of meeting your manpower needs. It would be better to train Canadian graduates.”