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National Specialty Trends
NSS HRH Dialogue
Ottawa, June 2, 2017
Lynda Buske
Manager, CAPER
Topics to be covered
• Pan-Canadian Physician Resource Planning
Tool
• Trends in CAPER data
• Trends in employment data
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What is the Pan-Canadian Physician
Resource Planning Tool?
• Arose from FMEC-PG recommendation to “produce the right mix, distribution and number of
physicians to meet societal needs”
• CDM directed CHW to work with AFMC to
examine ways to advance this recommendation.
• Formed Physician Resource Planning Task Force
(PRPTF) co-chaired by Ontario and AFMC
• Multi-stakeholder membership (govts, faculties of
medicine, national medical organizations)
• One key objective - develop pan-Canadian
physician resource planning tool
What is PRPAC?
• Reports to the F/P/T Committee on Health
Workforce (CHW)
• Multi-stakeholder membership as before.
• Co-chaired by Ontario and AFMC.
• A Technical Steering Committee reports to
PRPAC and is co-chaired by Ont & CAPER.
Physician Resource Planning Advisory Committee
(formally known as PRPTF)
Activity Status
• Conference Board of Canada was successful
vendor for both Phase 1 and 2.
• Phase 1- develop physician supply tool to provide
jurisdictions & medical educators with future
supply projections to 2035 by specialty.
• The supply model is complete but remains in test
phase; not yet shared with deputies & deans.
Tracks flow of MDs from medical school to
retirement by prov/terr, specialty, gender, age.
• Users can build scenarios of increase/decrease
undergrad, mix in postgrad, attrition rates, etc. 5
Activity Status (cont’d)
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• Phase 2 - develop physician focused population
health needs based model.
• Methodology will take into account physician
utilization patterns, disease prevalence, and
population demographics with ability to modify
future rates.
• In addition to projected supply, this phase will
project the number of physicians needed for
future population health needs.
• Complete model (phase 1 & 2) will be finished
by spring 2018.
What is CAPER?
CAPER: Canadian Post-MD Education Registry
- Mission: To be the definitive source of national
longitudinal information and analysis on trainees
within the Canadian postgraduate medical
education system.
- Established in 1986
- Funded by national medical organizations,
prov/terr and federal governments
- Directed by CAPER Committee with input from
CAPER Advisory Group
- Housed at AFMC & staffed by AFMC employees
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CAPER Products and Services
• Annual Census of postgraduate trainees
• Specialty, legal status, age, gender, MD
school
• Longitudinal analyses
• Tracking into practice
• Provincial/specialty specific reports
• Fact sheets
• Custom requests (50-100 per year)
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First year postgrad
Postgrad exits
Practice location 2 yrs later
Longitudinal analyses possible with CAPER
Specialty Age/gender
Faculty of medicine
Country of MD degree
- Traditionally track 2, 5, 10, 15, 20
years out.
- In future, will track all years.
Medical
Students
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35
%
37
%
35%
38
%
39
%
43
%
41
%
49
%
43
%
44
%
65
%
63
%
65
%
62
%
61
%
57
%
59
%
51
%
57
%
56
%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
% Female % Male
Exiting Post-MD Surgical trainees by
gender (excludes visa trainees)
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Proportion of all residents (ministry funded) by
broad specialty, selected years.
0% 10% 20% 30% 40% 50% 60%
Surg spec
Lab spec
Med spec
FM
1995 2000 2005 2010 2016
12 -10%
-8%
-6%
-4%
-2%
0%
2%
4%
6%
8%
10%
12%
14%
2010 2011 2012 2013 2014 2015 2016
Derm Psych Ophthal Gen surg Diag Rad FM Ortho
Percentage change from previous year in number of ministry funded postgraduate trainees
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• Large Urban Centres are census metropolitan areas
with population of at least 100,000
• Small Cities are tracted census agglomerations with
urban core population of 50,000 – 99,999
• Towns are untracted census agglomerations with urban
core population of 10,000 – 49,999
• Rural Places are metro influenced zones outside of
census metropolitan areas and census agglomerations,
as well as the Territories
Source: Postal Code Conversion File (PCCF) Reference Guide, Statistics Canada, 2014.
Working Definitions: Large Urban Centre,
Small City, Town and Rural Place
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0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
University of latest post-MD training
Large urban Small city/town Rural
2011 Family Medicine postgrad exits five
years later by school and location type
Source: CAPER and CMA Masterfile
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IMGs trainees by country of MD degree, 2015 (excluding visa trainees)
16 FSA, i.e. first 3 digits of postal code. May contain
more than one physician from the exit cohort.
Practice locations of 2011 General
Surgery exit cohort, 5 years later
N=57 MDs
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Practice locations of 2011 Rheumatology
exit cohort, 5 years later
FSA, i.e. first 3 digits of postal code. May contain
more than one physician from the exit cohort. N=20 MDs
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Practice locations of 2011 Psychiatry exit
cohort, 5 years later
FSA, i.e. first 3 digits of postal code. May contain
more than one physician from the exit cohort. N=140 MDs
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Practice locations of 2011 Gastrology
exit cohort, 5 years later
FSA, i.e. first 3 digits of postal code. May contain
more than one physician from the exit cohort. N=26 MDs
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Physician opportunities in Canada (excluding locums and part time)
Selected specialty Posted opportunities,
Nov 2016
2015 postgrad
exits
Family Medicine 1543 1334
Cardiology 33 66
Dermatology 63 29
Diagnostic Radiology 47 116
Emergency Medicine 69 50
Geriatric Medicine 59 14
Paediatrics (incl subspec) 83 206
Psychiatry 152 147
General Surgery 22 93
Obstetrics/Gynecology 32 102
Orthopaedic Surgery 7 95
20 Total Canadian opportunities = 2734 Total 2015 postgrad exits = 3201
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Year Fellows
(excl visa)
All Residents
(excl visa)
% Fellows
2009 559 11,081 5.0%
2010 625 11,821 5.3%
2011 683 12,467 5.5%
2012 787 12,951 6.1%
2013 848 13,379 6.4%
2014 882 13,685 6.5%
2015 991 13,999 7.1%
Trends in number of fellows in postgraduate
training (excluding visa trainees)
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$
Thank you!
www.caper.ca
@capercanada
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