As directors and director of the university departments of family medicine in Quebec, responsible for training more than 400 family physicians each year, we are privileged witnesses of the daily commitment of these health professionals.
Like all Quebecers, family physicians experienced the pandemic and faced several professional and personal challenges during this period. They have adapted very quickly to serve you while continuing to train family medicine students and residents in an extremely difficult clinical setting. In addition, despite a fragile situation on the ground, the four departments are committed to increasing the number of doctors in training to meet the needs of the Quebec population.
Medical schools have a provincial mandate to attract 55% of medical students to the specialty of family medicine. However, challenges persist: each year, dozens of residency places in family medicine remain unfilled in Quebec, while places in other specialties are all unfilled. Unfortunately, the political discourse of the past few weeks has hampered efforts to attract medical students to family medicine. We are concerned that the lack of recognition of the work of family physicians further discourages students from choosing our specialty.
We recognize that there are problems of access to a family doctor in Quebec, but this situation cannot be attributed to a single profession in a system where all stakeholders are interdependent.
It should be remembered that the number of places in medical training programs was drastically reduced in the 1990s, which contributed significantly to the shortage of family physicians which is rife today. And since those same years, the Ministry of Health and Social Services (MSSS) has required family physicians to perform specific medical activities that are carried out especially in hospitals (for example: emergencies, CHSLDs, hospitalization, obstetrics), this which limits for a large number of family physicians the follow-up of patients they can do in the office.
During the pandemic, the work of family physicians was noticed. They responded to the needs of the Quebec population by working on patient hospitalization, in CHSLDs, in palliative care, in emergencies, in COVID-19 clinics, in vaccination clinics, and we thank our teams for this effort. extraordinary! Unfortunately, the burnout rate among family physicians has tripled since the start of the pandemic, according to a study by the College of Family Physicians of Canada.
Faced with the prevailing discourse which suggests that family physicians are not yet doing enough, we are seriously worried about the morale of our teams, as evidenced by one of our family physician colleagues who are midwife, following the comments made on the lack of support from family physicians in Montreal: “It is Saturday morning, my only day without work for I do not know how long, and I have already had four telephone contacts with my homeless pregnant patient, who has just contracted syphilis… and two telephone contacts with my elderly patient who has pregnancy cholestasis, who is very anxious, and who would like to avoid inducing her labor… and a call with a social worker who is worried that another of my patients might experience domestic violence… so when I read that we are not working hard enough, I want to cry. ”
We ask the Ministry of Health and Social Services to recognize the tremendous work of family physicians, especially since the start of the pandemic, and their unique contribution to the health of Quebecers. We would like the public discourse of our politicians to share our passion for training the family physicians of the future and encourage students to choose family medicine so that more and more of us are meeting the health needs of the family. Quebec population.
* Marion Dove is Director of the Department of Family Medicine at McGill University; Nathalie Caire Fon is Director of the Department of Family Medicine and Emergency Medicine at the University of Montreal; Éric Lachance is director of the department of family medicine and emergency medicine at the University of Sherbrooke; Sonia Sylvain is Director of the Department of Family Medicine and Emergency Medicine at Laval University.
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