For over a year, we have been witnessing media outings from leaders linked to the Université du Québec (UQ) network who are calling on the government to create a new faculty of medicine in the province. In the June 29 edition of Dutythe UQ president says his network would propose “a model focused on family medicine and regional practice,” citing “the social responsibility to do better” in response to the needs of the Quebec population. He says a faculty of medicine led by UQ would train 200 additional family doctors per year in the very near future.
The situation of medical staff in Quebec is indeed worrying, particularly in family medicine. Moreover, the government continues to invest significant resources in training the next generation. But since resources are not unlimited, we must ask ourselves what is the best use to be made of them. Should we create a fifth faculty of medicine? Or should we add resources to the faculties that already train doctors for Quebec? What investment would best meet the needs of the population?
Let’s see what the facts say.
On the one hand, in view of the significant needs, and following requests from the Quebec government, the four faculties of medicine in Quebec have increased admissions from 830 to 1,165 students between 2018 and 2024, which represents an increase of more than 40%. This is an unprecedented increase in the history of medical training in Quebec and, in this regard, we are by far the most proactive province in Canada. This will allow a net addition of several hundred additional physicians in the years to come, the majority of whom will be family physicians. These increases can be achieved quickly, by faculties of medicine whose programs already benefit from the mandatory accreditation that is awarded by recognized organizations.
On the other hand, these increases in cohorts have required mobilization not only of medical schools, but also of the entire health network. Indeed, clinical training represents up to 80% of the time of medical training, which causes significant pressure on the environments hosting internships, which take place in already overloaded care units. This is the main bottleneck in the training of more doctors.
Everyone agrees that significant efforts must be made to address the glaring shortage of front-line medical staff in all regions of Quebec. In this sense, the proposal made by the President of UQ to train doctors in the regions is excellent, and that is exactly what the Faculty of Medicine of the Université de Montréal has been doing… for 20 years now!
This “new” model—training physicians in the regions for the regions—has already proven itself: 25% of graduates from our Mauricie campus chose to practice in the region, and 72% chose family medicine as their specialty. Today, Quebec’s four medical schools welcome more than 15% of their students to one or another of the medical campuses located in Gatineau, Rimouski, Trois-Rivières, Lévis and Saguenay. In addition to this training offering, there are 51 university clinics run by university family medicine groups (GMF-U), which are present in all regions of Quebec.
It should also be noted that training on regional campuses costs two to three times more. Existing faculties, thanks to economies of scale, can offer this training in the region at a lower cost to taxpayers than the proposal presented by UQ.
Furthermore, the UQ network’s proposal to have a faculty of medicine reserved for training in family medicine would be confronted with a reality that is not the responsibility of training environments: unless there is a change in legislation, nothing would prevent a student graduating from this faculty from continuing their training in a specialty residency, in Quebec or elsewhere in Canada, or from opting for private practice.
Physicians trained today in Quebec are already prepared to face the challenges of frontline care, an aging population, diversity and social inequalities. Our programs are the envy of other societies, including the significant training in the regions and in family medicine. Quebec’s four medical schools have always demonstrated social responsibility towards the needs of the Quebec population. They will continue to serve the common good in all its population complexity.