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Short-term solution

By Sharon Gray

Granting provisional licenses to new primary care physicians does not lead to long-term retention of international medical graduates (IMG) in Newfoundland and Labrador, according to a new study led by Dr. Maria Mathews, associate professor of health policy/health care delivery in the Faculty of Medicine.

The study shows that within one year of receiving a full medical license, most IMG leave the province. However, retention rates were no worse than for Canadian medical graduates, who are defined as fully-licensed graduates of Canadian medical schools outside of Newfoundland and Labrador.

This study was published in the July 22 issue of Open Medicine, a peer-reviewed, independent, open-access general medical journal.

Dr. Mathews and her colleagues assessed the relationship between type of initial practice license and retention time by comparing retention of international medical graduates, Canadian medical graduates and fully-licensed medical graduates of Memorial University. They found that out of the 77 IMG who began practicing as primary care physicians in the province between 1997 and 2000, 5.2 per cent were still in the province in 2004. The retention rate for Canadian medical graduates was 5.3 per cent – a median retention time of 22 months.

Provisional licensure enables IMG to practice in under-serviced communities while completing their licensing requirements. It is used as a recruitment strategy to help alleviate the shortage of primary care physicians in rural communities in Newfoundland and Labrador, and elsewhere in Canada. Until this study, however, little has been known about whether the policy has an impact on physician retention in Newfoundland and Labrador.

In 2004, IMG formed 23 per cent of the physician workforce in Canada. Saskatchewan and Newfoundland and Labrador employ the highest proportion of IMG, where they represent 61.7 per cent and 44.5 per cent of the physician workforce, respectively.

The study concludes that provisional licensing provides only a short-term solution to ongoing physician shortages in Newfoundland and Labrador – but that eliminating it would be detrimental to the health care system.