Quebec's medical residents are
fuming over the province's new plan to curb rural doctor
shortages — a plan which will impose restrictions
on where these new doctors can practise.
The plan is called PREMS (which
roughly translates to 'regional medical staffing plan')
and it aims to limit the number of new doctors in some
areas (typically urban) and force residents to move
to other (generally rural) regions if they want to work.
"It might sound like a good thing
to prioritize where residents should settle," says Dr
Martin Bernier, president of the Association of Medical
Residents of McGill University. "But forcing many residents
to settle in isolated areas is counterproductive."
Dr Philippe Couillard, the provincial
health minister, launched a press release in early December
in which he listed the places facing the direst MD shortages
— and they were primarily rural. Dr Bernier has
a startlingly different diagnosis of the situation.
He believes that the doctor shortage is most acute in
the outskirts of Quebec City and in Laval and Longueuil,
two cities near the island of Montreal.
The PREMS plan uses a point system
to divvy up residents. Each region is allotted points
for each of its fulltime practicing physicians. Then
the Health Ministry prepare an annual projection of
each region's demand for medical services. The government
would then look at the difference between the points
and their projection and decide where residents should
work.
Dr Bernier feels that the PREMS
plan will move doctors away from areas with teaching
hospitals and harm physician education in the longterm.
"There is a myth that university hospitals are running
well," he says "But there isn't nearly enough teaching
staff for the number of residents and medical students."
Residents are set to sit down with
Dr Couillard in the New Year and they hope some of their
concerns will be addressed before the province's 400
residents head off on their own in the spring of 2005.
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