Once again, a significant number of family medicine positions remained vacant following the first round of the 2024 Resident Matching Service (CaRMS). Of the 528 positions offered, 91 (17%) were not taken. , while in other specialties, only 6 out of 441 (1%) remain. Are we really surprised? I do not think so. We receive the results and we get back to work to try to pick up a few more residents in the second round in April.
The fact remains that only 50% of our externs end up practicing family medicine (and not 55%) and that there is a shortage of 1000 to 1400 family doctors in Quebec, depending on the method used.
CaRMS results and valorization efforts
Is the promotion of our specialty still possible after so many years of disappointing results? My answer is yes and for several of my colleagues too, but be careful, we will not get there without a serious reflection process shared by all stakeholders. The National Consultation Table on the Promotion of Family Medicine was created for precisely this purpose: to think together, make diagnoses, but above all find solutions. The goals are ambitious, but in my opinion achievable. Time is running out, however, if we hope to fill the significant deficit of family doctors within a few years.
Despite the gigantic work underway and the desire of the participants to be able to propose concrete solutions, there are irritants which will neutralize the efforts invested by this National Consultation Table, which I would call the “devaluing ones”. These are often more powerful than our promotional actions. Numerous examples are linked to the Barrette era (2014-2018), which led to the major disinterest of students in family medicine, and, we will not hide it, of several practicing doctors.
Political discourse and its predictable effects
It is clear that our elected officials have not yet learned that denigrating family doctors in any way in the public arena only makes the situation worse. Students are very sensitive to this. That 13,000 vulnerable patients are waiting is distressing, and we must find solutions to quickly integrate them and ensure follow-up.
But why still publicly and barely veiledly place the “fault” on family doctors rather than seeing how to remedy the problem with the competent authorities? Make the situation public, sure, but why not talk about the significant effort demonstrated by family doctors to meet the needs of the GAP (First Line Access Counter), which exceeded the targets, and the complicity family doctors in the search for solutions?
A “I am confident that we will be able to remedy this situation in collaboration with our family doctor partners” from the Minister of Health would have changed everything. Politicians are usually adept at turning a negative situation into a positive factor. This would, in the midst of the CaRMS classification period, have provided reinforcements for the efforts made by family medicine programs, unions and even the ministry, which demonstrates, it seems to me, a real desire to improve the student recruitment situation. .
And what about the effects on our practicing doctors! The minister’s desire to increase the supply of front-line services and improve their management is a laudable goal, but the mere fact of imposing it by regulation leaves a bitter taste for family doctors, who are struggling, despite exhaustion for many, in order to ensure adequate services to the population, services that go well beyond the first line. Rather than wanting to reduce the autonomy of family doctors at all costs, the government would do well to encourage dialogue and innovation in order to improve practices.
It may not make the headlines, it may not count from an electoral point of view, but it should provide lasting and effective solutions.
Family doctors are on the ground and carry out their tasks to ensure that our health system can function as best as possible, but above all, we are there for our patients, for their health, whether in the office, at emergency, CHSLD, hospital or any place where our services are required. The patient will always be at the center of our actions and our priorities.
Fair recognition of family medicine by the government and all colleagues in other specialties, practice conditions promoting work and development as well as real interprofessional collaboration are determining elements for winning back students and medical students.