B.C. says only 1.5% of doctors breach return-of-service agreements.
The B.C. Health Ministry says an “overwhelming majority” of physicians fulfil their contracts to work in areas of need after the province funds their training.
This comes on the heels of the province suing a family doctor for about $525,000, alleging she breached an agreement to work in an “area in need of physicians” in B.C. in exchange for the province funding her residency.
The notice of claim was filed April 21 in B.C. Supreme Court against Dr. Laxsanaa Sivananthan, a family doctor who now practises medicine at a clinic near Toronto.
The Health Ministry said just 17 of 1,163 — or 1.5 per cent — of physicians with such agreements in B.C. have failed to fulfil their contracts since 2016.
In physician return-of-service arrangements, the province funds a set number of residency training positions and assessments. In exchange, participants must practise two to three years in a B.C. community where physicians are needed. (There are no return-of-service programs that fund undergraduate medical school.)
Internationally trained family physicians can complete a Practice Ready Assessment program, which, since 2015, has placed 363 doctors in 78 B.C. communities.
Under the international medical graduate program, which Sivananthan enrolled in, there are 58 positions annually, with the majority, 52, focused on family medicine and six specialty positions, including internal medicine, pediatrics and psychiatry.
Participants train and work in B.C. while completing residency at UBC, after which family doctors complete two years and specialists three years of return service in “communities of need.”
The government’s online contract sample for family physicians says the province funds UBC’s faculty of medicine for the costs of the participant’s postgraduate medical education at approximately $155,000 annually, including the participant’s salary and benefits.
According to the notice of claim, in 2020, Sivananthan graduated from an Irish medical school not recognized by Canadian medical accreditation bodies.
In May 2021, she entered into a “return of service” agreement that stipulated B.C.’s Ministry of Health would pay for the cost of her residency at UBC and in return, in her last year, she would obtain a placement with a Vancouver Coastal Health Authority recruiter.
The petition alleges Sivananthan completed her residency on June 6, 2025, and contrary to the contract, told the B.C. government she had “no intention” of securing a doctor placement in the province.
She subsequently acknowledged the repayment amount would be owed, but has not met demands for $525,725 for the cost of her residency plus interest, according to court records.
On Nov. 4, 2025, she instead received a certificate of registration to practice medicine from the College of Physicians and Surgeons of Ontario.
Contacted at a Toronto clinic on Thursday, Sivananthan said she is limited in what she can say as the matter is before the courts, but that her intention was always to fulfill the requirements of her return-of-service agreement in British Columbia.
Due to “unforeseen family obligations,” she said, she relocated to Ontario.
“I am working with the Ministry of Health to resolve this matter as soon as possible, including repayment of the funds associated with the agreement,” she said.
Sivananthan said some of the communications about the issue occurred during “a difficult period when my family was managing a personal loss,” and she regrets any confusion or concern this may have caused.
“My goal has always been to provide the highest-quality care to the vulnerable Canadians I am fortunate to support, and I remain deeply committed to caring for all my patients,” she said.
The Ministry of Health, in a statement on Wednesday, said that in the 17 of 1,163 instances across all its programs where physicians failed or were unable to fulfill their contracts, most elected to repay the costs associated with their training or assessment under the contract.
“Only four have resulted in legal action through the court,” the ministry said.
Doctors of B.C., which represents about 16,000 physicians, residents, and medical students in B.C., said the association is unable to comment on this issue due to the legal action.
The Health Ministry manages the program, including the agreements, the finances and the contracts, according to the association.