The Society of Rural Physicians of Canada (SRPC) says it's time for a one-size-fits-all medical licence that would allow physicians to practise anywhere in Canada, but licensing authorities are sceptical.
The society, which thinks portable licensure might help ease physician shortages, has pursued the idea for several years. Its cause was bolstered by the Agreement on Internal Trade (AIT) that the provinces and territories signed in 1995, which the society says should ensure mutual recognition of medical licences between jurisdictions. Dr. Peter Hutten-Czapski, the SRPC president, says society lawyers think implementation of the AIT should give doctors free mobility throughout Canada, but it has yet to be enforced.
The AIT allows various professionals to use their certification anywhere in Canada. Although it is now in effect, there is still some debate over whether it can be applied to medical licences, since this type of certification is covered under specific provincial statutes.
Dr. Gary Johnson, executive director of the Federation of Medical Licensing Authorities of Canada, says it isn't possible to develop a one-size-fits-all licence. Currently, provincial and territorial licensing bodies review requests for licensure as they arise. In response to mobility issues raised under the AIT, the federation has prepared a mutual-recognition agreement that has been signed by all regulatory agencies save the Yukon. It spells out explicitly the criteria to be used to grant medical licences.
However, the criteria become somewhat less explicit for general practitioners who have not completed the 2-year family medicine residency that became mandatory 7 years ago. These doctors must demonstrate that they are “in good standing” within their home province and have a “level of competence acceptable to the receiving licensing authority.”
The SRPC thinks this process takes too long and unfairly discriminates against GPs who completed their training before 1994, when the 2-year residency was introduced. It says they should be able to practise anywhere in the country as long as they are licensed in good standing in a single jurisdiction. “If you are competent in 1 jurisdiction then you should be able to move freely,” maintains Hutten-Czapski. “Competency levels are fairly uniform and physician resources are a national issue, so instituting a common Canadian medical licence would make it easier to bring physicians into needed areas.”
However, Johnson maintains that a single licence would make it too difficult to track “bad apples” who are under investigation by a provincial college. “Allowing a physician [who is under investigation] to cross the border and keep practising in another province does not serve the public's interest.”
Hutten-Czapski says this is a nonissue. “There will always be bad apples. The various jurisdictions should be able to communicate well enough to deal with them, and you certainly don't do that by putting up a fence up at the edge of town.”
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