A lack of planning in the Ford government’s expansion of Ontario’s medical schools forced the province to enroll dramatically fewer students than it had planned, the auditor general has found.
As part of its plans to improve access to primary care, the government announced the number of places available at Ontario’s medical schools would be substantially increased.
Part of the plan included the creation of two new medical schools at Toronto Metropolitan University and York University.
The rush to fulfil the promise of new medical schools, however, appears to have left the government ignoring warnings from the sector that there were not enough training opportunities to accommodate new students.
Auditor General Shelley Spence found the government did not consider expanding existing schools instead of building new ones, and did not “document an analysis of key considerations to support their expansion decision.”
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In particular, the government failed to listen to warnings from leaders at its medical schools that there is “currently a limit on the amount of family medicine training that can occur, with current sites and preceptors already at full capacity.”
That warning came in November 2023, the auditor general found, but the government pressed ahead with its plan.
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As the government moved forward, it found the warning had been true and was forced to scale back its plan. By the end of the current academic year, medical schools will have rolled out 44 per cent fewer family medicine seats than they had originally planned as a direct result of the blockade.
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“The majority of the family medicine seat expansion is expected to be rolled out starting in the 2026/27 academic year,” the auditor general concluded.
Parliamentary Assistant to the Minister of Health Anthony Leardi couldn’t say on Tuesday why the ministry had not taken into account the need to have training options for medical graduates, forcing it to slow down its expansion plans.
“We set ourselves a goal, it’s a very high goal, we’re going to try to meet that goal,” he told reporters. “We’re heading towards that goal, we’ve already increased the number of doctors being trained and graduated in the province of Ontario.”
The auditor general found a lack of analysis from the government for its medical school expansion plan meant the level of funding required to create more training sites was not properly assessed.
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That’s important because postgraduate family medicine students generally require two years of training at a site which supports residencies for students.
An internal memo referenced by the auditor general noted “medical schools have been clear that without infrastructure investments [in new family physician training sites], the ability to continue to expand family medicine positions will be constrained after 2025.”
As a result, by the end of the current year, medical schools will have rolled out 115 new family medicine seats, 89 (or 44 per cent) fewer than the number they had planned.
“Medical schools identified the lack of sufficient family physician training sites, such as PCTCs, as the primary reason for rolling out fewer seats than planned,” the auditor general wrote.
Despite the report’s findings, Leardi suggested more seats could have been added.
“Could we graduate more? Yes, we’d be happy to,” he said.
“I think that when you’re actually increasing the number of doctors being trained and educated in Ontario, that indicates a very successful plan.”
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The report also found Ontario had not specifically set up any performance indicators to show whether its increase in medical seats was actually helping connect more people to the health-care system.
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