HSS1101E Determinants of Health

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HSS1101E Determinants of Health

• March 26, 2009 - Health Care Providers Workers
  Organizations, part 2 The Brain Drain

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Midterm 2

• Marks are now posted on the class website
• Average was 88

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Today.

• What is the brain drain?

Movement of trained people from a population
where theyre needed to a place with greater
resources
Re health care The draining of health
professionals from one country or place to
another.
Drain can be between countries or within a
country.
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Why Do HCW Move?

• Remuneration
• Living conditions / security
• Opportunity for family
• Intellectual wastage

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Remember the Romanow Report

• Recommendation 18 The Health Council of Canada
  should develop a comprehensive plan for
  addressing issues related to the supply,
  distribution, education and training,
  remuneration, skills and patterns of practice for
  Canadas health workforce.
• Recommendation 47 Provincial, territorial and
  federal governments and health organizations
  should reduce their reliance on recruiting health
  care professionals from developing countries.

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UK data
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Medical School Enrollment

• Enrollment increased significantly over past few
  years
• Same trend seen in OECD (except for USA and NZ)
• Number of applicants remained constant
• Therefore, number of applicants per med school
  position dropped from 5 in 1998 to 4.1 in 2005

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Midwives

• Not well established (yet) in Canada
• Not covered by Medicare
• Regulated in 6 provinces and 1 territory
• Ontario has 90 student positions per year
• 2 of births in Canada feature midwife as primary
  care giver

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Migration of Doctors Within Canada

• BC has been only province to have continuous
  positive net migration over last 2 decades
• Ontario has been a net gainer until recently
• Alberta is currently increasing fastest
• Younger doctors are more likely to move
• Specialists are more likely to move
• Immigrant docs are more likely to move
• Anglophones more likely to move
• Nursing data show similar patterns

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How Does a Foreign MD Work in Canada?

• Called International Medical Graduates or IMGs
• Must hold advanced medical degree from a
  university deemed acceptable by Foundation for
  Advancement of International Medical Education
  and Research (FAIMER)
• Proof of language proficiency (English or French)
• Must pass Medical Council of Canada Evaluation
  Exam (MCCEE)
• Can be taken outside Canada

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How Does a Foreign MD Work in Canada?

• Depending on province, must re-do post-graduate
  training (residency)
• Must complete supervised clinical training to be
  licenced
• In short, IMGs can enter the system in 2 ways
• Via special IMG programs that seek post-grad
  spots set aside for them
• Competing with Canadian medical grads for PGY-1
  positions through CaRMS

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Terms

• PGY post graduate year (ie., residency)
• CaRMS Canadian Resident Matching Service
• Non-profit organization
• Provides computer matching between PGY applicants
  and spots throughout the country
• Can also access US system, which is called ERAS

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IMGs and CaRMS

• The number of positions offered to IMGS through
  CarMS has increased over the last few years
• 23 in 1995
• 39 in 2000
• 80 in 2005 (0 in Ontario)
• 353 in 2008 (179 in Ontario)

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Videos

• http//www.youtube.com/watch?v6vVdgVJY1Z8
• 4 minutes
• About Filipino nurse
• http//www.youtube.com/watch?vME-ICeVKukA
• 21 minutes
• About drain in Malawi

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Monday

• Guest lecture on Globalization