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9 hours ago, SpankyMcFarland said:

if we assessed them properly.

And that's an IF! If we can't do it fast enough and well enough, with our trainees here (then there wouldn't be a problem, would it?) what makes us think that it can be done better with totally unknown qualifications worldwide, like Namibia, Vanuaty, Zanzibar what do we know about how they train and learn? How does this logic work, is there any need for reason and logic anymore run, run burn?

This looks like the path to insanity already. Makes no sense at all, rationally. Properly trained individual professionals moving for personal reasons, sure. As a solution to a national crisis, just plain nonsense. Another one.

Edited by myata
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8 hours ago, myata said:

And that's an IF! If we can't do it fast enough and well enough, with our trainees here (then there wouldn't be a problem, would it?) what makes us think that it can be done better with totally unknown qualifications worldwide, like Namibia, Vanuaty, Zanzibar what do we know about how they train and learn? How does this logic work, is there any need for reason and logic anymore run, run burn?

This looks like the path to insanity already. Makes no sense at all, rationally. Properly trained individual professionals moving for personal reasons, sure. As a solution to a national crisis, just plain nonsense. Another one.


The trick is to assess people primarily by their own skills and not where they come from. In Canada’s weird system, the location of your medical school follows you like original sin for the entirety of your career no matter what you achieve. I’ve seen former UK lecturers who were already working as independent internists in Canada waste 3 years in additional residency training here. As I described above, there are highly experienced people already trained to at least Canadian standards in the UK who could be fast-tracked once their knowledge has been tested.

Another problem is that there is often nowhere to get the additional training once it has been required by the College. There’s no joined-up thinking between government, med schools and regulatory bodies. 

Canadian training is good but there’s nothing sacred about it. I have seen superb Canadian graduates from Caribbean med schools. They were excellent because they were highly motivated to learn. We need more doctors yesterday. 

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6 minutes ago, SpankyMcFarland said:

The trick is to asses

The trick, right a good word. That's what it'll come down to, is it? If it takes six years to train a qualified professional, under strict supervision, executing a host of tasks and tests, plus a few years of residency how can we squeeze it in a few months? Can we? Thinking hard ... three.. .two... one.. yes we can, sure!

A sheet of multiple choices, a quick review, certificate in hand and world at your feet go treat and heal whatever and however you know and understand it.  Will some of the newly qualified doctors know how to make an injection? How would we know, from the result sheet?

Will it produce the same result as p.1? What will be the quality standard of the solution? How would we know it? When will we know? I don't think we like thinking here anymore.. if ever did.

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59 minutes ago, myata said:

The trick, right a good word. That's what it'll come down to, is it? If it takes six years to train a qualified professional, under strict supervision, executing a host of tasks and tests, plus a few years of residency how can we squeeze it in a few months? Can we? Thinking hard ... three.. .two... one.. yes we can, sure!

A sheet of multiple choices, a quick review, certificate in hand and world at your feet go treat and heal whatever and however you know and understand it.  Will some of the newly qualified doctors know how to make an injection? How would we know, from the result sheet?

Will it produce the same result as p.1? What will be the quality standard of the solution? How would we know it? When will we know? I don't think we like thinking here anymore.. if ever did.


No, no, not a trick in that sense. Basically, we need to adopt a more meritocratic attitude to all industries in Canada. Look at the appallingly expensive state of our airlines and telecom services, protected from foreign competition. Imagine if Silicon Valley had this attitude to, say, Indian grads. Think about all the talent the US would have missed out on. 
 

Quote

According to a report by Gulf Today, 30% of the Fortune 500 Companies have Indians as their CEOs, which is continuing to display an upward trend. One-third of all the engineers present in Silicon Valley today are from India, and 10% of the entire world’s high tech company CEOs are of Indian origin. Some names of inspiring tech CEOs that immediately spring up are Sundar Pichai of Google and Satya Nadella of Microsoft, who are leading this revolution. Parag Agarwal, CEO of Twitter, is the latest to join this elite club but definitely not the last.


https://globalleaderstoday.online/the-rise-of-indian-tech-ceos-in-the-us/
 

Few foreign medical applicants would mind a more difficult and expensive testing process. Make it as rigorous as you like. The best grads from India are as good as anybody in the world. 
 

At the moment, patients are quietly dying in their beds because they have no access to family doctors. Just because their families generally don’t make a big noise about it doesn’t make it right. 

 

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I have seen so many brilliant IMGs, far better than the average Canadian, unable to do the exams here or get into residencies because of silly technicalities about their training which may have occurred twenty years beforehand. Another roadblock that often affects married female doctors is being out of practice too long and being unable to quickly remedy this situation with refresher courses. We’ve lost superb South African grads this way - a country that produces many of the world’s best ER physicians for obvious reasons. In pathology there is no need for this clinical rule - they’re going to be out of clinical practice for the rest of their careers anyway! - and we have missed out on extraordinary physicians who have been in research. For example, a qualified surgeon who has also done post-grad research in Harvard and Cambridge. Does that person’s primary degree really matter after the training they got at some of the world’s best institutions where they excelled? Should time out of clinical practice in top class research prevent them from applying for, say, a pathology residency? Absurd. Sensible discretion is required. The public have to realize that there is an international marketplace for such talented applicants. If we don’t want them, they’ll be snapped up elsewhere. 

Edited by SpankyMcFarland
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2 hours ago, SpankyMcFarland said:

No, no, not a trick in that sense. Basically, we need to adopt a more meritocratic attitude to all industries in Canada. Look at the appallingly expensive state of our airlines and telecom services, protected from foreign competition

Agree 100%. That would require a fundamental change of pretty much everything, every aspect of operation of even private businesses here that rely on monopolistic structure of the market and absence of competition.

2 hours ago, SpankyMcFarland said:

Sensible discretion is required.

And again, no argument. Who will design and define them though, that's a question. Entrenched and carefree bureaucracy? Tomorrow we may have a slew of multiple choice "doctors" next to impossible to get rid of. After watching it in full color during Covid I wouldn't trust them with a cutting fingernails procedure, let alone admitting a mass of proclaimed physicians purportedly trained in the strangest places of this world (like we have massive immigration from developed countries with stringent standards of training and practice). Because that's what it'll inevitably come done to, if a carefree and happy bureaucracy decides to open the floodgates.

2 hours ago, SpankyMcFarland said:

If we don’t want them, they’ll be snapped up elsewhere. 

It's the public that owns the system. The public has the right to have and set expectations and demands to it. Safety, quality, high standard of service, timeliness, access, reasonable cost. It has no obligation of employment to those in the system, just like in any other profession, nor obviously, to the world. Interestingly, that entrenched bureaucratic systems inevitably come to think that way. That the sole purpose of public is to keep them running.

Edited by myata
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1 hour ago, myata said:

It's the public that owns the system. The public has the right to have and set expectations and demands to it. Safety, quality, high standard of service, timeliness, access, reasonable cost. It has no obligation of employment to those in the system, just like in any other profession, nor obviously, to the world. Interestingly, that entrenched bureaucratic systems inevitably come to think that way. That the sole purpose of public is to keep them running.

The current system, including med schools, has failed to provide enough doctors to see patients. The public have a right to medical care by doctors and many of them aren’t getting that. The examples I highlighted were of doctors more skilled than the average Canadian product. 

Edited by SpankyMcFarland
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1 minute ago, SpankyMcFarland said:

The current system, including med schools, has failed to provide enough doctors to see patients. The public have a right to medical care by doctors and many of them aren’t getting that.

That we can agree on. But within the current, entrenched system to hope for and expect some miracle fixes is a hopeless illusion. We could flood the country with substandard infill and still end up with inferior care compared to places that cared to design and implement their systems so that they work as needed and required by the citizens. You just cannot produce necessary numbers of trained, competent and experienced 21st century professionals in an instant and out of thin air, no bureaucracy has powers like that. But on the paper, sure.

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  • 2 weeks later...

 

Do you believe the federal and provincial governments will be able to fix our broken health care system?

I heard that seven million people are without a family doctor in Canada.  It is obvious band aid solutions will not fix that problem.  

We still have people like the NDP fighting against allowing private clinics from operating even though they might be able to help solve the overworked public system and the important point is people will still be covered by the government.  It is not a pay for service private system.  So why would the NDP oppose allowing private providers from assisting in providing services if it gets the job done and reduces waiting lists?  Is the NDP more interested in ideology or fixing the system so the patients will be helped?   Seems like to me they are more interested in protecting the unions in the public system rather than putting patients first.

________________________-

"Can Prime Minister Justin Trudeau and Canada’s 13 premiers and territorial leaders fix our health care system that decades of federal and provincial governments of all political stripes broke?

Obviously it can’t all be done at once when they gather in Ottawa Feb. 7 to set the stage for a deal where the federal government will increase funding to the provinces and territories in return for conditions on that funding they will have to agree to individually.

The problems go back decades. Fixing them will take years.

The question is whether the agreements arrived at today will point Canadian health care in the right direction, with effective reforms.

Politicians going back decades were responsible for creating the myths that Canada’s health system care is free, publicly-funded and the best in the world.

In reality, our system is expensive compared to other countries around the world with comparable universal health care systems."

GOLDSTEIN: Health care is broken and our governments broke it (msn.com)

Edited by blackbird
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6 hours ago, blackbird said:

I heard that seven million people are without a family doctor in Canada.  It is obvious band aid solutions will not fix that problem.  

For about three years I've been receiving cheerful messages "Couldn't find you a family doctor but still trying!" from a newly revamped public bureaucracy. Automatic too, paid by your taxes. Requested a service? here's one for ya. Gave up, using online access now available thanks to Covid. Expenditures and CEO benefits growing non-linearly in the meanwhile. Need to keep better people.

To hope that throwing a few more hundreds of public billions could fix anything here is a hopeless dream no closer than Andromeda galaxy. The system is great as it is already, it simply doesn't need no customers, patients, citizens, just pay you taxes and get lost asap will ya?

Edited by myata
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Yet another issue just raised its ugly head in the health care system.  Global BCTV News just reported doctors are spending a huge about of time on paperwork and miscellaneous duties.  This is cutting into the number of patients they can serve.  Paperwork is a cornerstone of bureaucracy plus computer work for everything.  You couple that with endless procedures and regulations and you have a recipe for disaster.  I believe that is one of the major problems with the public health care system.  Nobody is even  talking about the bureaucracy, administration, and paperwork and computer work associated with everything they do.  This may be one of main reasons why the health care system is struggling to keep afloat.  Another thing about public systems is it is heavily controlled by bureaucrats from the top down.  Nobody can innovate or do anything to speed things up because they will run afoul of the delegated way of doing things.  These problems are likely next to impossible to change in any significant way because they are deeply entrenched in the system.  

People should know the NDP and liberals do not understand these things.  The government has increased the federal civil service by 25% since 2015 when they came into power.  Bureaucracy is big government and that is what they believe in.  So don't expect things to change.  More money will be spent but I will be surprised to see significant changes in the way the system operates.  I have not heard of anything that is going to solve the problem of over a million people not having their own doctor in B.C. for example.  One would think with the years that this problem continued to grow, they would have seen this coming and done things to avoid it.  But the fact they did not stop it from happening is a sign that politicians do not have the answers and since they control the system, how is it going to change?  Meanwhile the NDP is demanding that the public system be expanded and far more people hired as if that is the only problem.  More bureaucracy and more money thrown at a bad system will not fix it.

Edited by blackbird
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  • 2 weeks later...

Here’s another weird thing. Canadian citizens who study medicine abroad (outside Canada and the US) are not treated in the same way in the matching system for residency positions as Canadians who train here. By this I mean they are not always allowed to compete for the same residency positions as grads from Canadian med schools even when their exam performance is superior. It’s surprising to me that such discrimination is legal in Canada. 
 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8463232/
 

Of course the other issue is that we should have enough residency positions to train every Canadian citizen who passes the required exams. At the moment we don’t. 

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Doctors in B.C. are calling for the B.C. government to approve doctor's assistants.  Yet the B.C. NDP gov't is piddling around trying to decide whether to approve them or not.  This is the trouble with a health care system run by politicians.  They love to have studies, appoint committees, hire consultants, and so on instead of getting things done.  Tragic but a fact.  This could have been done many years ago.  The system has been a crisis for many years, maybe decades.  Yet they vacillate and can't make decisions that would help.  I don't hold out much hope.

The also sat on their ass while the terrible shortage of doctors continued to grow and foreign-trained professionals are unable to get certified in B.C. because of all the red tape and high costs of around ten thousand dollars.  This is entirely the politicians fault.  A couple people recently were on the news telling how they are trained doctors (one is a cardiologist) and were working in labouring jobs to survive because they don't have the ten thousand dollars to become certified in B.C.  Some lawyer anonymously stepped forward and donated the money for both of them.  The BC NDP government continues to drag its feet.

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So we are going to throw a few more taxpayer billions at the same entrenched, ineffective and grossly inefficient bureaucracy that has brought us here. The debt will grow, new charges - "services" will appear, MP and executive compensations will see well deserved rises. But wait, the intrigue, the result? Will it be easier to find a family doctor and not from an exotic place (including medical traditions)? Will waiting times and services improve, who wants to guess?

The same bureaucracy that is happy and merry as it is, consuming and burning public dough for which patients and services are unnecessary bother and nuisance. Do the same thing and expect a different outcome. Because you are already at the state of absolute perfection, the best one ever and no meaningful change is necessary (even it was possible, that is not). Smart, according to Einstein but understanding of relativity not really needed to get it.

Edited by myata
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While politicians dither around and refuse to take any significant steps to fix the broken health care system, people continue to die waiting for surgeries, cancer treatments, etc.

"At least 13,581 patients died while waiting for surgeries, procedures, and diagnostic scans in 2021/22 — up from the previous year's total of 11,581."

Premier Smith says no to national health-care 'Digital ID'- Rebel News

What we have now is state-sanctioned death by neglect plus if you don't like it, death by doctor-assisted suicide is available for many.  Over ten thousand a year have already been taking that route. Hitler's Dr. Mengele would like this country.   This is how they manage the budget. 

More money for safe supply and supervised injection sites in places like Vancouver.  Not so much for drug rehabilitation centres.  Many can not access government-funded rehab because of the long waiting lists and don't have the kind of money needed for private rehab centres.

"Dr. Josef Mengele was a German Schutzstaffel (SS) doctor who was in charge of the medical team at the Auschwitz concentration camp where Jews were taken for extermination."

Edited by blackbird
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