Pan-Canadian licensure: Potential impact on the rural physician workforce

Area of Science:

• Medical Workforce Planning
• Rural Health Policy
• Physician Licensure

Background:

• Rural physician shortages persist across Canada, impacting healthcare access in underserved communities.
• Existing provincial/territorial licensure restrictions create barriers for physicians seeking to practice in multiple Canadian jurisdictions.
• Concerns exist that pan-Canadian licensure might inadvertently worsen rural shortages by facilitating physician movement to urban centers.

Purpose of the Study:

• To identify factors influencing rural physician practice patterns.
• To assess the impact of licensure on rural physicians' decisions to remain in or leave rural practice.
• To evaluate the potential of pan-Canadian licensure to address rural physician workforce challenges.

Main Methods:

• An environmental scan of reports from key medical groups (past 10 years) was conducted.
• Membership surveys from the Society of Rural Physicians of Canada and the Canadian Medical Association were analyzed (Fall 2022).
• Data focused on factors influencing rural practice decisions and perspectives on national licensure.

Main Results:

• Key factors driving physicians from rural practice include inadequate infrastructure, lack of locum coverage, insufficient team-based care support, and high workload-related wellness issues.
• Licensure restrictions were identified as significant barriers preventing rural physicians from practicing in multiple provinces or territories.
• Survey respondents strongly supported the implementation of pan-Canadian licensure.

Conclusions:

• Pan-Canadian licensure shows promise for enhancing physician recruitment and retention in rural and underserved areas.
• It offers potential flexibility for physicians to practice in multiple jurisdictions, addressing critical health workforce needs.
• Addressing non-licensure-related factors (infrastructure, support, workload) remains crucial for rural physician retention.