Dear fellow citizens,
As the Chairs of Quebec’s university family medicine departments, we are responsible for training over 400 family doctors each year. We also witness first-hand the dedication of these health professionals. Like every Quebecer, family doctors have faced many professional and personal challenges during the pandemic. They have rapidly adapted to serve our healthcare needs, while continuing to train students and family medicine residents in difficult clinical circumstances. Despite the fragility of the situation, our four family medicine departments remain deeply committed to increasing the number of family doctors in training, to meet the Quebec population’s healthcare needs.
Quebec’s faculties of medicine are mandated by the provincial government to attract 55% of medical students to the family medicine specialty, each year. While significant progress has been made, challenges persist. Every year, dozens of family medicine residency training spots remain vacant in Quebec, while positions in other medical specialities are filled. Unfortunately, the political discourse in recent weeks is undermining our efforts to attract medical students to family medicine. The absence of public recognition of family doctors and the work they do further discourages students from choosing this essential speciality. We know that access to family doctors is a dire problem in Quebec. The source of the problem, however, cannot be attributed to one specialty in a system where all healthcare professionals are interdependent.
It is very important to remember that the drastic reduction in the number of entry-level positions in medical schools in the 1990s has played a major role in the shortage of family doctors that continues to this day. And, since then, the Ministère de la Santé et des Services sociaux (MSSS) has required family doctors to take on specific medical activities within hospitals (i.e., emergency departments, CHSLDs, hospital care units, obstetrics), which further limits the number of patients many of Quebec’s family doctors can see in their offices.
During the pandemic, the contributions of family doctors has been remarkable. They have responded to our population’s needs, working in hospitals, CHSLDs, palliative care, emergency rooms, COVID-19 clinics and vaccination clinics. We would like to take this opportunity to sincerely thank all our teams for their extraordinary work, which has made a huge difference. At the same time, and very unfortunately, the rate of burnout among family doctors has tripled since the onset of the pandemic, according to a study conducted by the College of Family Physicians of Canada.
In a context where the prevailing discourse suggests that family doctors are still not doing enough, we are very seriously concerned about our teams’ morale. In the words of one of our family medicine obstetrical colleagues, following comments that suggested family doctors in Montreal are not taking on enough responsibility:
It’s Saturday morning — my one day off work since I don’t know how long — and I have already had four conversations with my homeless pregnant patient, who just contracted syphilis… two phone calls with an older prenatal patient who has cholestasis of pregnancy, is very anxious and is hoping to avoid an induction of labour… and a phone call with a social worker who is worried that another one of my patients is facing domestic violence … And then I read that we’re not working hard enough… and I want to cry.
We ask that the MSSS recognize how incredibly hard our family doctors have been working — particularly since the start of the pandemic — and their unique contribution to our population’s health. We want to see our passionate commitment to training our future family doctors reflected in our politicians’ public discourse, to encourage students to pursue careers in family medicine so that the number of family doctors available to meet Quebec’s healthcare needs can continue to grow. Thank you.
Chair, Department of Family Medicine, McGill University
Nathalie Caire Fon
Chair, Department of Family Medicine and Emergency Medicine, Université de Montréal.
Chair, Department of Family Medicine and Emergency Medicine, Université de Sherbrooke.
Chair, Department of Family Medicine and Emergency Medicine, Université Laval.
November 5, 2021