The number of unfilled residency positions for medical school graduates hit a new high in Quebec this year, and slightly fewer recruits than last year will be starting the final phase of their training on July 1.
These are worrying signs that efforts to attract the next generation of doctors in Quebec, especially family physicians, are falling short of their potential. But it’s also not surprising after years of restrictive measures and in the wake of last fall’s showdown over a new pay model and working conditions in particular.
Preliminary data was published last week by the Canadian Resident Matching Service, known as CaRMS, showing 4,029 students found residencies nationwide, including 1,858 future family doctors.
The initial breakdown showed that of 181 spots left open after two rounds of placements, the lion’s share were in Quebec. Of 42 unfilled posts in specialties from anesthesiology to urology, 24 were in Quebec as of April 21. Of 139 vacant places in family medicine, 126 were in Quebec on the same date. The information will be updated by CaRMS next week to reflect any last-minute matches.
But even though more residencies might get filled, the results are disappointing in a province where 1.5 million Quebecers don’t have a family doctor and nearly a quarter of existing practitioners are over 60.
The Fédération des médecins résident(e)s du Québec (FMRQ) said the total number of residents in all specialties dipped this year to 879 from 943 last year, despite the government upping enrolment in medical schools and opening up more residency positions.
Dr. Louis-Charles Desbiens, president of the FMRQ, attributes the drop to the fallout from Bill 2, the special law adopted last autumn to foist a new compensation model on doctors.
Physicians pushed back, saying the changes would make their practices untenable. The government eventually backed down after scores of doctors threatened to leave Quebec and dozens of clinics warned they would have to close.
All this was playing out when medical students were applying for residencies last fall.
“It’s clear to us that the climate of confrontation we saw discouraged a lot of graduates and created a lot of uncertainty,” said Desbiens.
But Bill 2 was only the last straw after years of new constraints on young doctors that deterred many from family medicine, said Dr. Chakib Setti, president of the Association des jeunes médecins du Québec.
“On the one hand, it’s serious, it’s alarming. But on the other hand, we were sounding the alarm beforehand,” said Setti. “So unfortunately, it confirms what we thought would happen.”
New physicians in Quebec have to get a special permit dictating where they can work. They also have medical responsibilities for the first 15 years of their practice, like working in long-term care, birthing centres or emergency rooms. No other province has such obligations.
On top of that, Quebec passed Bill 83 last year, threatening fines against young physicians who try to leave the public system or the province.
“These are approaches that cause fear among young students and young residents, and blocking them doesn’t do anything,” said Setti. “You can double, you can triple the number of residencies that exist, but if on the other hand your work conditions are restrictive, are punitive, there are sanctions left and right for this and that, and if on the other hand your neighbours, other provinces in Canada … do everything to attract residents, this is what happens.”
The Fédération des médecins omnipraticiens du Québec (FMOQ), which represents family physicians in the province, said its own analysis of the most up-to-date CaRMS results reveals that 448 residencies in family medicine were filled in Quebec out of 554 available. It calculates 106 positions are left empty in Quebec compared to just 10 posts that are open after two rounds of matching in all the rest of Canada.
This is worse than in previous years. According to the FMOQ, there were 63 open spots after last year’s match, when 458 new graduates were placed. In 2024, there were 68 unfilled residencies and 444 matches. In 2023, there were 72 empty posts and 442 recruits. Year after year, this unrealized potential adds up.
The FMOQ is likely to discuss ongoing challenges in drawing and retaining new blood to family medicine at its convention next week.
Although disheartening, the CaRMS data emerged as the Collège des médecins du Québec reported a net increase of 350 doctors registered to practise as of March 31, compared to the same time last year. Of them, 150 are family doctors, 168 are specialists and 32 have a restrictive permit.
This is positive news given that Quebec is short about 2,000 doctors and hundreds had vowed to leave during the clash with the government over Bill 2. Physicians retiring, going private or moving out of the province have at times outnumbered new recruits in the past few years.
But Setti noted that for each older family physician who retires, it takes two or three to fill their shoes, given young doctors have extra medical duties that limit the number of hours they can see patients in clinics.
Despite the number of empty residencies this year, Desbiens remains hopeful for the future.
Many graduates simply chose not to apply last fall and could seek a spot next year after prolonging their studies, he said. The dust may also finally settle on last year’s bruising skirmish now that there’s been a change of health minister and premier — as well as with a fall election on the horizon.
“We have to re-establish trust with the government that is completely broken, rebuild bridges and most of all create a dialogue with the medical profession,” said Desbiens. “There’s an opportunity to repair relations and get results that are more positive for Quebecers next year.”
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I started at The Montreal Gazette in 2000 as an intern. Since then I have covered the National Assembly and courts, worked on the assignment desk and written editorials, before debuting as city columnist in 2017.