Canada anesthesia labor shortage

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ambiturner

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Link to CBC article

Saw this in the ASA monitor today - for all our health system’s faults, we do seem to be better at cutting corners than the UK-styled systems.

Should Canada have CRNAs? Personally I think they can solve this with foreign grads or by supervising more than one resident/fellow at a time. But will be interesting to see the discourse.
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I just think it's funny that the monitor in the article about how great crnas are shows the patient being pretty hypotensive for at least 5 minutes and probably overventilated too

Looks like they didn't take the patient's name off it either
 
As a Canadian here, I can say first hand surgeries aren't being cancelled due to lack of anesthesia aside from maybe very small rural centers. Most cancellations are due to lack of OR nurses and postoperative/ICU nurses.

Getting a bunch of CRNAS isn't going to fix that.
 
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Canada still requires 5 full years post med school training ? So a regular 4 year anesthesia docs trained in USA can’t be license in Canada? Or has that changed?
 
aneftp said:
Canada still requires 5 full years post med school training ? So a regular 4 year anesthesia docs trained in USA can’t be license in Canada? Or has that changed?
Click to expand...
Last I checked you needed to do a fellowship to qualify if you were US trained. Maybe that’s changed recently though - some American trained friends have recently gotten jobs in Canada, seems to be the easiest it’s been to get in in years, but they all had done fellowships.

It seems like a great place to work - do your own cases, good work/life balance, nice country/people. Income gap has grown during the anesthesia bull market here though.
 
I have US trained colleagues here and they have done an extra fellowship year to match the 5 year Royal College Requirement.
 
jope said:
I have US trained colleagues here and they have done an extra fellowship year to match the 5 year Royal College Requirement.
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I spoke with some recruiters out in Prince Edward Island (for curiosity sake mostly), and they accept US board certification for credentials and licensure. I think working in some parts of Canada would be great. It’s the currency discount that isn’t as appealing.
 
You can browse through our Province's recruitment site and see if any locum postings work for you. It's a lovely time especially in the Summer here.

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BC Health Careers

Healthy careers start here. British Columbia is moving health care forward, and we want you to be a part of it.
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jope said:
I have US trained colleagues here and they have done an extra fellowship year to match the 5 year Royal College Requirement.
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I don’t think that’s necessary in New Brunswick, Newfoundland and Labrador, and Ontario. Just the other provinces.
 
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GassYous said:
I just think it's funny that the monitor in the article about how great crnas are shows the patient being pretty hypotensive for at least 5 minutes and probably overventilated too

Looks like they didn't take the patient's name off it either
Click to expand...

monitor text is in German. Probably a stock photo. That said, it is on brand.
 
Maybe more Canadian anesthesiologists are now practicing in the USA? Since the market for us docs is so good? Could that be a reason for the shortage?

We had some posts a few years back about vandal anesthesia docs jobs (when USA job market was tight and salaries low) that it was better to practice in Canada. Solo cases, salaries in the 400s which was more appealing than practicing in the USA at the time when salaries were going to the low 300s in many parts of the USA

For a time back in the mid 1990s. My parents doctor colleagues up in Montreal had salary caps. So many overall docs (like 1 in 9) Canadian docs born and trained practiced medicine in the USA but that changed when Canada lifted the pay caps. My parents ortho friends actually stopped working by mid year back those days because he couldn’t make any more money.

So I’m just wondering why the shortage of anesthesiologists up in Canada since it’s not a huge growing populations. And they do bs elective cs on Sundays like we do in the USA.
 
Standing offer to Canada:

American Anesthesiologist, board certified, clean record, good hygiene. Will work all winter alternating one week on at your standard rates - one week unlimited heli skiing. You pay lodging and business class airfare. CV and letters available on request.
 
aneftp said:
Maybe more Canadian anesthesiologists are now practicing in the USA? Since the market for us docs is so good? Could that be a reason for the shortage?

We had some posts a few years back about vandal anesthesia docs jobs (when USA job market was tight and salaries low) that it was better to practice in Canada. Solo cases, salaries in the 400s which was more appealing than practicing in the USA at the time when salaries were going to the low 300s in many parts of the USA

For a time back in the mid 1990s. My parents doctor colleagues up in Montreal had salary caps. So many overall docs (like 1 in 9) Canadian docs born and trained practiced medicine in the USA but that changed when Canada lifted the pay caps. My parents ortho friends actually stopped working by mid year back those days because he couldn’t make any more money.

So I’m just wondering why the shortage of anesthesiologists up in Canada since it’s not a huge growing populations. And they do bs elective cs on Sundays like we do in the USA.
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Heck I’d consider working in Canada for roughly the same as I make now if it means I could escape our insane political climate in the USA for awhile.
 
It won’t be as huge a difference in pay as you’d expect in raw numbers.

Canadian anesthesiologists earn 500k-700k CAD which is 350-500k USD with the current unfavorable exchange rates.

The bigger problem is if you are a US citizen due to tax laws, you cannot benefit from the tax savings by running a professional corporation like most Canadian doctors, and thus will be subject to 50%+ marginal tax rates.
 
NICMAN said:
Also, don’t they use CAAs for anesthesia staffing in Canada?
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They use an "anesthesia assistant", which is either an RN or RRT with one year additional training. It is similar to but not nearly as academically rigorous as the American CAA programs.
 
jwk said:
They use an "anesthesia assistant", which is either an RN or RRT with one year additional training. It is similar to but not nearly as academically rigorous as the American CAA programs.
Click to expand...


We have an anesthesia tech who was an “anesthesia assistant” in Australia. Smart guy and fantastic tech.
 
ambiturner said:
Last I checked you needed to do a fellowship to qualify if you were US trained. Maybe that’s changed recently though - some American trained friends have recently gotten jobs in Canada, seems to be the easiest it’s been to get in in years, but they all had done fellowships.

It seems like a great place to work - do your own cases, good work/life balance, nice country/people. Income gap has grown during the anesthesia bull market here though.
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It’s my understanding that a fellowship to get you at 5 years of training only qualifies you to sit for the royal college exams. US medical licenses and board certifications are not recognized in Canada (FM being an exception). You have to take all the royal college exams to get licensed to practice.

Can anyone confirm this?
 
Sandman0300 said:
It’s my understanding that a fellowship to get you at 5 years of training only qualifies you to sit for the royal college exams. US medical licenses and board certifications are not recognized in Canada (FM being an exception). You have to take all the royal college exams to get licensed to practice.

Can anyone confirm this?
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Depends on province, institute, professors, need etc.
If you go rural they'll take anyone.
If you're a big researcher, a prof may take you on an academic license that requires renewal and publications etc then pay you dog****.
To get a plush job in decent area, yes you need the exam. Its very different and very hard to pass
 
I lived in Canada between age 14-26
It’s nice, diverse, multicultural etc
But I do not believe that it’s comparable to the U.S in terms of market and opportunities for anesthesiologists (and other professions).

That’s why myself and my parents decided to move to the U.S. we migrated peak recession but still did ok.

I don’t think it would have been possible other way around.

it was hard on my father especially as he migrated in in his mid 50s.

He was lucky enough to do a lateral transfer within his company and relocate to a rural US town (population less than 30k). Still lives there and retired last year.

He’s happy overall and has a decent nest egg.

He doesn’t miss it.

At the end of the day, your life is what you make it to be. Country, location, community etc is not that important.

Also, GDP per capita of Canada is equal to Kentucky. Nothing against Kentucky but it’s certainly not NY, FL Texas or California. People don’t realize how small Canada really is and how dependent it is on the US.
And there is no such thing as free lunch. You’re going to pay for services one way or the other.
 
AKMD_1984 said:
Also, GDP per capita of Canada is equal to Kentucky. Nothing against Kentucky but it’s certainly not NY, FL Texas or Cal
Click to expand...
You can't really compare gdppc of an entire country with cherry picking certain states.

If you factor in health insurance costs, which is 0, there isn't as much difference as you are making out...

Cost of living is in general lower

Add in, you're less likely to be murdered, raped or be confronted with a gun or experience hard drugs in your community, well it's starting to even out now...
 
PpfSuxTube said:
You can't really compare gdppc of an entire country with cherry picking certain states.

If you factor in health insurance costs, which is 0, there isn't as much difference as you are making out...

Cost of living is in general lower

Add in, you're less likely to be murdered, raped or be confronted with a gun or experience hard drugs in your community, well it's starting to even out now...
Click to expand...
1. Cost of Healtcare is not zero in Canada. You pay that in taxes. In US you have a choice. You can get no insurance, mediocre insurance or excellent insurance.
2. US has plenty of nice and posh areas. You answered your own question. It depends where you live.
 
AKMD_1984 said:
1. Cost of Healtcare is not zero in Canada. You pay that in taxes. In US you have a choice. You can get no insurance, mediocre insurance or excellent insurance.
2. US has plenty of nice and posh areas. You answered your own question. It depends where you live.
Click to expand...
I didnt ask any question.
I told you you don't understand gdppc.
 
???
You make no sense. If you didnt ask a question, then I didnt answer you either. You made a statement, and I was correcting you that U.S. is a far more heterogenous country with 11 x the size and 90% of its population does not reside within 100 miles of Canadian border.
And comparison of U.S. states are routinely done with countries - especially Texas and California. These states, by themselves have larger economies than major countries. The comparison is used to bring perspective.
 
nimbus said:
Canada needs more medical schools, not CRNAs. One of my friends came to the US for medical school because she was shut out of medical school in Canada.
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That is correct.
Ohio has more schools than all of Canada.
 
nimbus said:
Canada needs more medical schools, not CRNAs. One of my friends came to the US for medical school because she was shut out of medical school in Canada.
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In order to do that they will need to spend more money. New doctors mean more fees and more fees mean higher total costs. Something it seems the central planners are unwilling to entertain in any meaningful way which is why all the discussion of substitutes like CRNAs.

I’m not seeing the appeal for US MDs or CRNAs to cross the border either.
 
AKMD_1984 said:
I lived in Canada between age 14-26
It’s nice, diverse, multicultural etc
But I do not believe that it’s comparable to the U.S in terms of market and opportunities for anesthesiologists (and other professions).

That’s why myself and my parents decided to move to the U.S. we migrated peak recession but still did ok.

I don’t think it would have been possible other way around.

it was hard on my father especially as he migrated in in his mid 50s.

He was lucky enough to do a lateral transfer within his company and relocate to a rural US town (population less than 30k). Still lives there and retired last year.

He’s happy overall and has a decent nest egg.

He doesn’t miss it.

At the end of the day, your life is what you make it to be. Country, location, community etc is not that important.

Also, GDP per capita of Canada is equal to Kentucky. Nothing against Kentucky but it’s certainly not NY, FL Texas or California. People don’t realize how small Canada really is and how dependent it is on the US.
And there is no such thing as free lunch. You’re going to pay for services one way or the other.
Click to expand...
So your dad didn’t get a Canadian pension? And USA social security ?

We have lots of Canadian friends in Florida. Next door neighbor did teaching for 10/12 years (she quit in her 30s and moved down here 13 ago so has a small pension to draw from when she’s older. Plus she gets USA socials security down the road as well.
 
shadowblade said:
I mean this is blatantly incorrect.

Canada has 17 medical schools. Ohio has 7.

California has 16.

Canada certainly needs more medical schools, but is at the same per capita as california, considering the similar populations.
Click to expand...


A few of the schools in California are just a few yrs old (CUSM, Kaiser, cal northern, and UC Riverside). For whatever reason I know a lot of native Californians who attended med school at Chicago Med and MCOW. Maybe they are out of state friendly.

If you look per capita, Ohio has a population of 11.8mil, California 39.5mil, and Canada 41mil. Canada should have 24 medical schools to have the same number of medical schools per capital as Ohio.
 
Last edited:
shadowblade said:
I mean this is blatantly incorrect.

Canada has 17 medical schools. Ohio has 7.

California has 16.

Canada certainly needs more medical schools, but is at the same per capita as california, considering the similar populations.
Click to expand...
You’re correct. I meant to compare Ontario with Ohio. Not Canada.
But the issue overall shortage of schools and no private schools or DO schools.
 
aneftp said:
So your dad didn’t get a Canadian pension? And USA social security ?

We have lots of Canadian friends in Florida. Next door neighbor did teaching for 10/12 years (she quit in her 30s and moved down here 13 ago so has a small pension to draw from when she’s older. Plus she gets USA socials security down the road as well.
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He qualifies for nominal social security benefits from Canada and US because he worked 10 + years in both but I don’t think it’s that much. He did delay his SS withdrawal date to increase monthly amount though.
He has an online teaching (business management certifications and credit equivalence for immigrants) to supplement his income. Even that is more of a hobby than a full time than active business. It’s more to keep his mind occupied.
 
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The other issue is it is very difficult for qualified foreign trained physicians to go babk and work in Canada. US isn’t easy either but I believe Canada is far more difficult.
 
nimbus said:
Ohio has always been a great state to be from if you want to become a doctor. Given its population it has a ton of medical schools. And it has every tier of medical school so there is something for everyone.
Click to expand...
It is indeed a great state and undervalued IMO especially the three big cities. I spent 7 years there (training plus work).
But didn’t like the weather and still has a few big healthcare systems with exclusive AMC contracts compared to open market - so made a move to Texas. But I was doing really well there financially. Cost of living was nice.
 
PpfSuxTube said:
You can't really compare gdppc of an entire country with cherry picking certain states.

If you factor in health insurance costs, which is 0, there isn't as much difference as you are making out...

Cost of living is in general lower

Add in, you're less likely to be murdered, raped or be confronted with a gun or experience hard drugs in your community, well it's starting to even out now...
Click to expand...

your salty tears are practically hitting my keyboard
 
AKMD_1984 said:
It is indeed a great state and undervalued IMO especially the three big cities. I spent 7 years there (training plus work).
But didn’t like the weather and still has a few big healthcare systems with exclusive AMC contracts compared to open market - so made a move to Texas. But I was doing really well there financially. Cost of living was nice.
Click to expand...
Ohio is one of those states who could /can still hit 50k plus a week for locums as well. Big money in Ohio.

Too cold for me. But people live there for various reasons. Middle class people have better benefits to work in Ohio vs Florida or Texas.
 
ambiturner said:
Last I checked you needed to do a fellowship to qualify if you were US trained. Maybe that’s changed recently though - some American trained friends have recently gotten jobs in Canada, seems to be the easiest it’s been to get in in years, but they all had done fellowships.

It seems like a great place to work - do your own cases, good work/life balance, nice country/people. Income gap has grown during the anesthesia bull market here though.
Click to expand...

CPSO - Alternative Pathways to Registration for Physicians Trained in the United States

www.cpso.on.ca www.cpso.on.ca

Pediatric fellowships were filled with a number of Canadians who went abroad and trained in the US before the alternative pathways.
 
Harpoon1 said:
You missed the point I guess. No need to get into it.
Click to expand...
What point did I miss? That you think the cost of health care to the avg joe in Canada (taxed or other form) is equivalent to the US?

Or was it the safety of one country versus the other?
Or that there about 7000x more crna?
 
PpfSuxTube said:
Breathe buddy it's ok. You don't know what you are talking about. Parliament is prorouged. Read a bit more
Click to expand...
You seem quite triggered and opted to response.

I'll wait for the plastic knife attack with a "sorry abooot that" lol
 
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