A Convergence of Circumstances : New Canadian MDs in Abeyance at a Critical Time of Need

"These are not medical students. These are fully trained doctors at the end of their training."
"Everything should be done to ensure they can practise medicine and care for patients in the face of this pandemic."
Dr.Emily Stewart, President, Resident Doctors of Canada

"We are a resource in this time of need that could be mobilized on an expedited basis. We can help, please let us."
"[With the delay announcement] our futures became uncertain. The futures of the Canadian physician supply chain became uncertain."
Concerned Family Medicine Residents

Tyler Anderson, National Post

Over two thousand Canadian doctors freshly schooled in medicine and its practise are reacting with disbelief at the news that their final exams to certify them have been suspended as a result of yet another reaction to the COVID-19 pandemic which has seen governments mandate stringent measures on ensuring that people do not gather in large numbers in fear of the novel coronavirus transmission.

Finishing two to five years of on-the-job training in their fields, the residents must pass exams to enable them to be qualified by either the Royal College of Physicians and Surgeons (for specialists), or the College of Family Physicians of Canada (for general practitioners). Both of these agencies have announced that the exams are to be delayed; written tests and face-to-face evaluations in view of the risk of spreading the virus.

Tentative plans are for the rescheduling of the March exams to the last week of April and early May for the Royal College, as long as the situation does not further deteriorate dramatically. Provincial regulators are being pushed by the two colleges and the residents' association to issue provisional licenses to enable the new physicians to get into practise, while awaiting the final exams.

Processing that many temporary licenses in one fell swoop has never occurred previously, but these are unusual times. There is an absolute and express need for more doctors to be able to join the medical community in view of dire shortages of both medical personnel and equipment to handle the growing epidemic of viral transmission. Yet having finished medical school, the students are considered doctors who must still undergo five-year residencies to become specialists and two-year programs to qualify as family practitioners.

Medical staff work at a computer terminal as they prepare for the opening of the COVID-19 Assessment Centre at Brewer Park Arena in Ottawa, during a media tour on Friday, March 13

Once the specialty exams have been passed, the college of physicians and surgeons in each province then awards the licenses permitting doctors to practise independently. The two certifying bodies are adamant that they cannot safely conduct exams bringing large numbers of residents and evaluators together, given the federal government's recommendation that Canadians isolate themselves.

"To quickly adopt a new exam delivery process with no previous logistics plan is extremely complex and risks the validity of the exam", explained Bruce Kvern of the College of Family Physicians, though they are exploring the potential of other options for the exams to be completed expeditiously, outside of using Internet-based technology to have the exams remotely held.

For security and technical reasons, it is not envisioned that the four-hour written test could be delivered at  home, while the oral portion is a multi-station process with the resident interacting with a mock patient posed by a practising family doctor in an evaluative procedure.