Solving the Family Health Crisis (Part 1 of 3)

Hey All,

Welcome back to Middle Ground; this is the fourth newsletter as part of our 28 policies in the 28-day series ahead of the 2025 Ontario provincial election.

This weekend, I’ll tackle the Family Health Crisis with three policy suggestions that together can help ensure everyone in Ontario has access to a family doctor by 2030.

Today’s first issue will be about foreign-trained doctors.

What is the family health crisis?
4.1 million people in Ontario (nearly 25% of the province) do not have a family doctor. This problem is expected to worsen by 2030 as another 2,400 family doctors retire, leaving over 7 million people without a family doctor.

Even for those who do have a family doctor, it often isn’t convenient to visit them. 1 million people have a family doctor more than 50km from their home, and 150,000 have a family doctor more than 200km from their home. 

What makes this all scarier is that 75% of deaths in Ontario are from chronic diseases. These deaths can be avoided or delayed with proper diagnosis, monitoring and planning with a family doctor.  

The lack of family doctors is not just a problem for specific individuals; it's a massive societal issue. Poor health creates additional social and financial burdens, putting more stress on our social systems, resulting in more ER visits and overloading our hospitals. It’s estimated that 15% of ER visits are issues a family doctor could deal with, and another 20% are for issues that a family doctor could have prevented. Simply put, we could reduce the burden on hospitals by 30%+ by ensuring everyone has a family doctor.

How can foreign-trained doctors help?
It is estimated that over 10,000 foreign-trained doctors in Ontario aren’t currently allowed to practice medicine. 

In 2024, 931 foreign-trained doctors with credentials recognized in Canada applied but didn’t receive a residency spot. Residency is required training before a doctor can practice without supervision. 

Ontario has already launched Practice Ready Ontario, which helps foreign-trained doctors gain the qualifications necessary to practice in Ontario. The problem is that this program only intends to train and re-certify 100 doctors by the end of 2025. 

Ontario has a wealth of medical professionals, but our inability to create a system with the capacity to train and certify enough foreign-trained doctors is a root cause of the current shortage of doctors in the province.

Are foreign-trained doctors reliable?
Many Ontarians don’t know that nearly a third of family doctors in Ontario are trained outside of Canada. This includes many Canadians who train in the UK or US before returning to Canada. 

There is no evidence that foreign-trained doctors are any less reliable than those trained in Canada, as they are required to pass numerous tests before being allowed to practice in Canada.

How can we solve the problem? 
There are several chokepoints in the existing system but two specific ones can immediately help get more people a family doctor:

1. Expanding Practice Ready Ontario - If the program is able to retrain 300 doctors per year within 5 years, we could have 1500 more doctors. A condition of the program is that these doctors need to serve rural areas and with 200 municipalities currently without a doctor, this can help provide support to those communities in need and reduce the burden on urban centers. 

2. Provide financial incentives for family doctors to take on more residency students. Last year, 150 domestically trained doctors and 931 foreign-trained doctors applied but didn’t get a residency. If we can get 500 more residency positions a year in Ontario, we can add 2500 new doctors in the next 5 years, completely counteracting the impact of the 2,400 retiring doctors.

Further Reading:

• Ontario Family Physicians Report

• Geographic Insights

• 2008 Government Report on Internationally Trained Doctors

Onwards and Upwards,

Liam Gill

P.S. - Please share this with as many people as possible to help grow our community and help us hold our elected officials responsible for implementing these policy initiatives.