Insights into the evolving demographics of anesthesia human resources in Canada

Autor: François Donati, Robert J. Byrick
Rok vydání: 2012
Předmět:
Zdroj: Canadian Journal of Anesthesia/Journal canadien d'anesthésie. 59:335-340
ISSN: 1496-8975
0832-610X
DOI: 10.1007/s12630-012-9670-3
Popis: Planning human resources in any healthcare sector and in anesthesiology, in particular, is a complex task. Human resource planning (HRP) indicators, such as the physician to population ratio, physician utilization, and job vacancy rates, reflect supply and do not consider patients’ needs for physician services. A major component of planning for an adequate future supply of practitioners, in any jurisdiction, is an understanding of factors that contribute to the retention or loss of trainees within the specific province or territory being considered. In this issue of the Journal, Suess et al. provide some unique insights into our understanding of this aspect of supply. They examine the origin and destination of anesthesiology residents who trained in the same city, in two separate university programs, and in two different languages, and who graduated between 1990 and 2010. The past two decades in Canada were seen as a period of widespread shortage of anesthesiologists during which a number of system changes occurred. These system changes affected patients (with growing wait times for surgery) and involved governments (increased expenditures on physician reimbursement and mandated labour mobility acts), hospitals (increased use of the Anesthesia Care Team model), teaching institutions (distributed medical education and new remote university departments and programs), educational and regulatory colleges (increased eligibility of international graduates to Royal College examinations and National Standards for accreditation), and certainly anesthesiologists who devote the best part of their lives to the profession. In Ryten’s report on anesthesia human resources published in 2000—which became the basis of a thorough workforce planning model— it was emphasized that, ‘‘in order to understand the many dynamic factors in play, it is important to examine the flow of anesthesiologists – the ongoing additions and losses to the stock – and equally important, the reasons for the flows’’. In this issue of the Journal, Suess et al. contribute to our current understanding of the determinants of the ‘‘stock of providers’’ trained in Canada. Despite lack of consensus among these components of the system, residency programs within medical schools must decide who should be offered positions in anesthesia and how these physicians should be educated. In making these decisions, universities must respond to the needs of the society they serve, and they must also maintain their internal consistency as institutions devoted to maintaining and generating a body of knowledge in their specific program areas. To simplify the picture, universities can be seen as serving two masters: the students, who seek to complete their education in a specific area; and society, which depends on the skills acquired by the students. When the goals and objectives of both parties merge, no problem exists; programs may choose the brightest most dedicated candidates who will provide the highest quality services to society once their training is finished. In anesthesiology, a fine balance between supply and demand seems achievable. There is no shortage of motivated medical students who F. Donati, MD, PhD (&) Departement d’anesthesiologie, Universite de Montreal, Montreal, QC, Canada e-mail: francois.donati@umontreal.ca
Databáze: OpenAIRE
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