Workforce In Canada Research Articles

Sociodemographic Characteristics of Internationally Educated Nurses Associated With Successful Outcomes in Canada: Quantitative Analysis.

This article describes the sociodemographic characteristics of internationally educated nurses since the change in the registration examination in 2015. It aims to investigate the association between internationally educated nurses' sociodemographic characteristics and their successful integration into the nursing workforce in Canada. Cross-sectional and secondary data survey questions. This study adopts a cross-sectional and secondary data analysis, utilising data from IENs who engaged with internationally educated nurse initiatives such as the Creating Access to Regulated Employment Centre for Internationally Educated Nurses (CARE) or initiated the registration process with the College of Nurses of Ontario (CNO) in 2015 and after. There were 259 participants, with 155 participants from primary data collection and 104 participants from secondary data sources. Quantitative analysis reveals that most participants are females, under 40 years old, educated in English and hold at least a bachelor's degree in nursing, with 47.3% of internationally educated nurses migrated from India and the Philippines. Significant associations were identified between internationally educated nurses having CARE membership and the currency of nursing practice and their successful outcomes. Recognising and addressing the unique needs of IENs is essential for their successful integration into the Canadian healthcare workforce, thereby ensuring resilience and cultural competence in nursing for the future. This analysis highlights the impact of sociodemographic characteristics of internationally educated nurses on their successful outcomes and underscores the diversity and richness they bring to the healthcare landscape. Since internationally educated nurses continue to experience challenges while integrating into the Canadian nursing workforce, these findings have substantial implications for nursing policy, practice, professional development and research.

Understanding the mental health and intention to leave of the public health workforce in Canada during the COVID-19 pandemic: A cross-sectional study

BackgroundThere is limited evidence about the mental health and intention to leave of the public health workforce in Canada during the COVID-19 pandemic. The objectives of this study were to determine the prevalence of burnout, symptoms of anxiety and depression, and intention to leave among the Canadian public health workforce, and associations with individual and workplace factors.MethodsA cross-sectional study was conducted using data collected by a Canada-wide survey from November 2022 to January 2023, where participants reported sociodemographic and workplace factors. Mental health outcomes were measured using validated tools including the Oldenburg Burnout Inventory, the 7-item Generalized Anxiety Disorder scale, and the 2-item Patient Health Questionnaire to measure symptoms of depression. Participants were asked to report if they intended to leave their position in public health. Logistic regression was used to estimate adjusted odds ratios (aOR) and 95% confidence intervals (95% CI) for the associations between explanatory variables such as sociodemographic, workplace factors, and outcomes of mental health, and intention to leave public health.ResultsAmong the 671 participants, the prevalence of burnout, and symptoms of depression and anxiety in the two weeks prior were 64%, 26%, and 22% respectively. 33% of participants reported they were intending to leave their public health position in the coming year. Across all outcomes, sociodemographic factors were largely not associated with mental health and intention to leave. However, an exception to this was that those with 16–20 years of work experience had higher odds of burnout (aOR = 2.16; 95% CI = 1.12–4.18) compared to those with ≤ 5 years of work experience. Many workplace factors were associated with mental health outcomes and intention to leave public health. Those who felt bullied, threatened, or harassed because of work had increased odds of depressive symptoms (aOR = 1.85; 95% CI = 1.28–2.68), burnout (aOR = 1.61; 95% CI = 1.16–2.23), and intention to leave (aOR = 1.64; 95% CI = 1.13–2.37).ConclusionsDuring the COVID-19 pandemic, some of the public health workforce experienced negative impacts on their mental health. 33% of the sample indicated an intention to leave their role, which has the potential to exacerbate pre-existing challenges in workforce retention. Study findings create an impetus for policy and practice changes to mitigate risks to mental health and attrition to create safe and healthy working environments for public health workers during public health crises.

Building a strong public health nursing workforce in Canada: A continuing education solution.

Building a strong public health nursing (PHN) work-force capable of advancing population health and reducing inequities is critical. Though undergraduate nursing education is expected to provide introductory knowledge and practice of PHN in Canada, this is not always sufficient to adequately prepare nursing graduates for the complexity of PHN practice. To be practice ready for the full scope of PHN roles and interventions, new baccalaureate nurses and new registered nurses in public health are required to apply PHN competencies, theory, and knowledge of nursing and public health sciences, and to practice within the mandates of provincial and territorial public health legislation. To advance practice readiness a formal continuing education program is essential to foster these critical roles in PHN. This article describes the development of a postgraduate continuing education program for preparation to practice in PHN.

Is the Medical Oncology Workforce in Canada in Jeopardy? Findings from the Canadian Association of Medical Oncologists' COVID-19 Impact Survey Series.

The COVID-19 (C19) pandemic introduced challenges in all areas of the Canadian healthcare system. Along with adaptations to clinical care environments, there was increasing concern about physician burnout during this time. The Canadian Association of Medical Oncologists (CAMO) has examined the effects of the pandemic on the medical oncology (MO) workforce. A series of four multiple choice web-based surveys distributed to MOs who were identified using the Royal College of Physicians and Surgeons directory and CAMO membership in May 2020 (S1), July 2020 (S2), December 2020 (S3), and March 2022 (S4). Descriptive analyses were performed for each survey, and a Chi-square test (α = 0.05) was used to assess factors associated with planned change in practice in S4. The majority of respondents work in a comprehensive cancer center S1/S2/S3/S4 (87%/86%81%/88%) and have been in practice >10 years (56%/61%/50%/64%). The most commonly reported personal challenges were physical (60%) and mental (60%) wellness. In S4, 47% of MOs reported dissatisfaction with their current work-life balance. In total, 83% reported that their workload has increased since the beginning of C19, and 51% of MOs reported their future career plans have been impacted by C19. In total, 56% of respondents are considering retiring or reducing total working hours in the next 5 years. Since the onset of the C19 pandemic, there are concerns identified with wellness, increasing workload, and job dissatisfaction among MOs, associated with experienced staff who have >10 years in practice. As rates of cancer prevalence rise and treatments become more complex, it is crucial to address the concerns raised in these surveys to ensure that we have a stable MO workforce in the future.

Identification and assessment of factors that impact the demand for and supply of dental hygienists amidst an evolving workforce context: a scoping review

BackgroundThis study involved a scoping review to explore factors influencing dental hygienist demand and supply in high-income countries.MethodsA six-stage scoping review was conducted with separate search strategies tailored to four databases (MEDLINE, CINAHL, Google Scholar, and Google) plus a targeted scan of dental hygienist organization websites. This yielded 2,117 unique citations, leading to 148 articles included in the review.ResultsNearly half of the articles (47%) focused on the United States, with 11% on Canada. Most articles (91%) were in English, alongside 13 in Korean and one in French. Journal articles comprised 62% of the publications, followed by reports/working papers (11%) and websites (11%). Other types included conference abstracts, policy briefs, and presentation slides. Content-wise, 47% were original research, with analysis articles (14%), commentaries (11%), and reviews (8%) also present. The articles were coded into three main categories: workforce characteristics/projections, factor-specific analyses, and workforce opportunities. The articles on workforce characteristics covered demographic, geographic, and employment aspects of dental hygienists, along with projections for supply and demand using simulation modelling and geospatial analyses. Factor-specific articles investigated the (1) working environment, (2) policy/regulatory/training environment, (3) job/career satisfaction and related human resource issues, and (4) scope of practice. The third key category of articles highlighted opportunities for expanding the workforce through alternative models in different sectors/settings (e.g., public health, primary care, long-term care, hospitals, mobile outreach, and non-clinical roles including research, education and leadership) and for a range of vulnerable or underserved populations (e.g., geriatric and pediatric populations, persons with disabilities, those living in rural/remote areas, Indigenous peoples, and incarcerated people).ConclusionsThis review provides a comprehensive documentation of the current state of the dental hygienist workforce, compiling factors affecting demand and supply, and highlighting opportunities for the dental hygienist workforce in Canada and other high-income countries. The findings offer a foundation for future research, highlighting the need for more focused and rigorous reviews and underscoring the necessity of high-quality studies to verify the effectiveness of various interventions and policies. This is crucial to address dental hygienist workforce challenges and ensure the sustainability and effectiveness of oral health care delivery.

Innovative nursing employment initiatives to strengthen and sustain the health workforce in Canada.

Health systems worldwide are at a critical juncture due to an increasing demand for health services and a diminishing pool of health human resources. While COVID-19 exacerbated nursing deficits, the need to strengthen and sustain the health workforce in Canada was evident decades prior and supported by numerous studies that warned of significant shortages. Post pandemic, building health system capacity has become paramount. This article examines innovative nursing employment initiatives in Canada. It provides a snapshot of federal, provincial and territorial approaches, with a particular focus on Internationally Educated Nurses (IENs) due to burgeoning interest in and competition for their skills and services. However, recognizing that health human resource planning is a persistent challenge, further initiatives are suggested. These include complementary policy development to improve retention and policy frameworks that support proactive long-term strategies to address the cyclical shortage of nurses.

The Physician Anesthesia Workforce in Canada From 1996 to 2018: A Longitudinal Analysis of Health Administrative Data.

A robust anesthesia workforce is essential to the provision of safe surgical, obstetrical, and critical care but information describing the physician anesthesia workforce and volume of clinical services delivered in Canada is limited. This study examines the Canadian physician anesthesia workforce, exploring trends in physician characteristics and activity levels over time. Practice patterns of specialist anesthesiologists and family physician anesthetists (FPAs) working in urban and rural communities were of particular interest. Physicians who provided anesthesia care between 1996 and 2018 were identified using health administrative data from the Canadian Institute of Health Information (CIHI). In addition, data from the Canadian Post-MD Education Registry (CAPER) were used to characterize physicians pursuing postgraduate anesthesia training (1996-2019). Descriptive analyses of physician demographics, training, location, specialty designations, and volume of clinical services were undertaken. Between 1996 and 2018, the anesthesia workforce grew 1.8-fold to 3681 physicians, including 536 FPAs. Over the same time, nerve block services increased 7-fold, and payments for other anesthesia services increased 5-fold. The average age of the anesthesiology workforce increased by 2.3 years and the annual retirement rate was 3%. The workforce has become more gender balanced but remains predominantly male (73% in 2018). The proportion of physicians who were trained internationally (about 30%; 38% in rural areas) remained stable (and higher than that in the overall physician workforce). FPAs provided most anesthesia care in rural Canada and their attrition rate was generally 2- to 3-fold higher than specialists. Physicians in the rural anesthesia workforce provided anesthesia services more intensively over time. Relatively few FPAs who left the anesthesia workforce entered full retirement and they instead contributed other medical services to their communities. This study provides foundational information regarding anesthesia workforce capacity over a 22-year period, including insights into demographics, locations of practice, and clinical volumes. The results do not quantify the gap between service capacity and need; however, they support the need for a national workforce strategy to achieve equitable access to sustainable anesthesia services in Canada, particularly for rural communities.

Primary care nursing competencies in Canadian undergraduate nursing programs: A national cross-sectional survey

AimTo assess the extent to which Canadian undergraduate baccalaureate nursing programs have incorporated Canadian competencies for Registered Nurses in primary care into their curricula. BackgroundCanadian competencies for Registered Nurses in primary care have several benefits, including their ability to inform primary care education in undergraduate nursing programs and to assist in building a robust primary care nursing workforce. DesignWe conducted a national cross-sectional survey of undergraduate baccalaureate nursing programs (n = 74). MethodsThe survey was conducted between April-May 2022. We used a modified version of the “Community Health Nurses’ Continuing Education Needs Questionnaire”. Respondents indicated their level of agreement on a 6-point Likert scale with 47 statements about the integration of the competencies in their program (1 = strongly disagree; 6 = strongly agree). ResultsThe response rate was 51.4%. The overall mean across the six competency domains was 4.73 (SD 0.30). The mean scores of each domain ranged from 4.23 (SD 1.27) for Quality Assurance, Evaluation and Research to 5.17 (SD 0.95) for Communication. ConclusionsThere are gaps in how these competencies are included in undergraduate education programs and opportunities to strengthen education for this growing workforce in Canada.

P.133 Women in Canadian neurosurgery: an update

Background: Women continue to represent a minority of the neurosurgery workforce in Canada. We herein aim to provide an update of the current Canadian landscape to gain a better understanding of the factors contributing to this disparity. Methods: Chain-referral sampling, interviews, personal communications, and online resources were used as data sources. Online survey results obtained from women attending neurosurgeons across Canada were also utilized. Quantitative analyses were performed, including summary and comparative statistics. Qualitative analyses of free-text responses were performed using axial and open coding. Results: We observe a positive trend in the incoming and graduating of female residents across the country, although this trend is lagging compared to other surgical specialties. The proportion of women in active practice remains low. Positive enabling factors for success include supportive colleagues and work environment (52.6%), academic accomplishments (36.8%), and advanced fellowship training (47.4%). Perceived barriers reported included inequalities regarding career advancement opportunities (57.8%), conflicting professional and personal interests (57.8%), and lack of mentorship (36.8%). Conclusions: Women continue to represent a small proportion of practicing neurosurgeons across Canada. Our work highlights several key factors contributing to the low representation of women in neurosurgery and identifies actionable items that can be addressed by training programs and institutions.

Organizational and Institutional Initiatives for the Recruitment, Retention, and Advancement of Black Nurses in the Canadian Healthcare System: A Rapid Review Protocol

Introduction: In response to protests for racial justice, several organizations and institutions have made public declarations denouncing anti-Black racism. One prominent sector emphasizing their commitment to addressing anti-Black racism is health care—more specifically, nursing. To address anti-Black racism, many Canadian organizations and institutions have announced initiatives to recruit, retain, and support the advancement of Black nurses. Our team is interested in charting these initiatives to inform future policy and program decisions related to the recruitment, retention, and advancement of Black nurses. Objective: The objective of this review is to identify and chart evidence of organizational and institutional initiatives related to the recruitment, retention, and advancement of Black nurses in Canada. Inclusion criteria: This rapid review will include sources focused on Black nurses in Canada. Further, this review is focused on the organizational or institutional initiatives that support or facilitate aspects of recruitment, retention, or advancement of Black nurses in the workforce in Canada. Methods: A comprehensive search, developed in collaboration with a library scientist, will be used to locate peer-reviewed and grey literature from select databases and repositories. Databases will be searched from time of inception, and language will be restricted to English and French sources. Title and abstract screening as well as full-text review will each be completed by two independent reviewers. Sources will be included if they meet the inclusion criteria for the population, concept, and context. Data will be extracted by two reviewers using an extraction tool. Data will be reviewed and consolidated before being presented narratively and visually.Protocol Registration: The protocol has been registered with Open Science Framework (OSF) on March 1st, 2023.

The anesthesia workforce in Canada: a methodology to identify physician anesthesia providers using health administrative data

BackgroundSafe and timely anesthesia services are an integral component of modern health care systems. There are, however, increasing concerns about the availability of anesthesia services in Canada. Thus, a comprehensive approach to assess the capacity of the anesthesia workforce to provide service is a critical need. Data regarding the anesthesia services provided by specialists and family physicians are available through the Canadian Institute for Health Information (CIHI) but collating the data across delivery jurisdictions has proven challenging. As a result, information related to the activity of physician anesthesia providers is routinely excluded from annual physician workforce reports. Our goal was to develop a novel approach to identifying and characterizing the anesthesia workforce on a pan-Canadian scale.MethodsThe study was approved by the University of Ottawa Office of Research Ethics and Integrity. We developed a methodology to identify physicians who provided anesthesia services in Canada between 1996 and 2018 using data elements from the CIHI National Physician Database. We iteratively consulted with expert advisors and compared the results with Scott’s Medical Database, the Canadian Medical Association (CMA) Masterfile, and the College of Family Physicians of Canada membership database.ResultsThe methodology identified providers of anesthesia services using data elements from the CIHI National Physician Database, including categories of the National Grouping System, specialty designations, activity levels and participation thresholds. Physicians who provided anesthesia services only sporadically and medical residents-in-training were excluded. This methodology produced estimates of anesthesia providers that aligned with other sources. The process we followed was sequential, transparent, and intuitive, and was strengthened by collaboration and iterative consultation with experts and stakeholders.ConclusionsUsing physician activity patterns, this novel methodology allows stakeholders to identify which physician provide anesthesia services in Canada. It is an essential step in developing a pan-Canadian anesthesia workforce strategy that can be used to examine patterns and trends related to the workforce and support evidence-informed workforce decision-making. It also establishes a foundation for assessing the effectiveness of a variety of interventions aimed at optimizing physician anesthesia services in Canada.

The impact of COVID-19 on the mental health and substance use health (MHSUH) workforce in Canada: a mixed methods study

BackgroundThe increased need for mental health and substance use health (MHSUH) services during the COVID-19 pandemic underscores the need to better understand workforce capacity. This study aimed to examine the pandemic’s impact on the capacity of MHSUH service providers and to understand reasons contributing to changes in availability or ability to provide services.MethodsWe conducted a mixed method study including a pan-Canadian survey of 2177 providers of MHSUH services and semi-structured interviews with 13 key informants. Survey participants answered questions about how the pandemic had changed their capacity to provide services, reasons for changes in capacity, and how their practice had during the pandemic. Thematic analysis of key informant interviews was conducted to gain a deeper understanding of the impact of the pandemic on the MHSUH workforce.ResultsAnalyses of the survey data indicated that the pandemic has had diverse effects on the capacity of MHSUH workers to provide services: 43% indicated decreased, 24% indicated no change, and 33% indicated increased capacity. Logistic regression analyses showed that privately funded participants had 3.2 times greater odds of increased capacity (B = 1.17, p < 0.001), and participants receiving funding from a mix of public and private sources had 2.4 times greater odds of increased capacity (B = 0.88, p < 0.001) compared to publicly funded participants. Top reasons for decreases included lockdown measures and clients lacking access or comfort with virtual care. Top reasons for increases included using virtual care and more people having problems relevant to the participant's skills. Three themes were constructed from thematic analysis of key informant interviews: the differential impact of public health measures, long-term effects of pandemic work conditions, and critical gaps in MHSUH workforce data.ConclusionsThe COVID-19 pandemic has had a substantial impact on the capacity of the MHSUH workforce to provide services. Findings indicate the importance of increasing and harmonizing funding for MHSUH services across the public and private sectors, developing standardized datasets describing the MHSUH workforce, and prioritizing equity across the spectrum of MHSUH services.

Workplace mental health characteristics of the Indigenous workforce in Canada: A descriptive study.

The Indigenous workforce in Canada is challenged by a history of Euro-Canadian colonialism that has presented deleterious health outcomes, including those in the workplace. The aim of this study was to describe the mental health of Indigenous workers in the workplace. We used the Canadian Community Health Survey (CCHS) between 2015 to 2016. Data were analyzed using the Public Use Microdata Files to profile the workplace mental health characteristics of First Nation Canadians (n = 6,297) and Canadians (n = 84,155). We utilized secondary data analysis design. The analyses included descriptive statistics (e.g., means and standard deviations) of self-reported mood disorders (depression, bipolar, mania, dysthymia), anxiety (phobia, OCD, panic) and occupational factors (e.g., demographic, days off work due to an acute mental health condition, job type, and job stress) in indigenous peoples living off-reserve and other Aboriginal settlements in the provinces. We examined the indigenous cohort between the ages of 18-64 who were employed. The sample was 53.1% male, married (34.8%), and obtained a post-secondary diploma or university degree (57.9%). The study reported statistically significant gender and age differences across mood and anxiety disorders (p < 0.05), job stress (p < 0.05) and workload (p < 0.05). To the best of our knowledge, this is the first study to describe the work profile of indigenous populations in Canada across various occupational mental health (e.g., mood disorders, anxiety) and demographic (e.g., age, education attainment) outcomes.

Abortion services and providers in Canada in 2019: results of a national survey.

Background:Since 2016, abortion care has undergone several important changes, particularly related to the provision of medical abortion using mifepristone. We aimed to document characteristics of the abortion care workforce in Canada after the update of clinical practice guidelines of mifepristone use for medical abortion.Methods:We conducted a national, web-based, anonymized, bilingual (English/French) survey. We collected demographics and clinical care characteristics of physicians and nurse practitioners who provided abortion care in 2019. Between July and December 2020, we distributed the survey through professional organizations, including The College of Family Physicians of Canada and The Society of Obstetricians and Gynaecologists of Canada. We present descriptive statistics.Results:Overall, 465 respondents representing all 10 provinces and 3 territories in Canada completed the survey. Of these, 388 (83.4%), including 30 nurse practitioners, provided first-trimester medical abortion, of which 350 (99.4%) used mifepristone. Two hundred and nineteen (47.1%) respondents provided first-trimester surgical abortion, 109 (23.4%) provided second-trimester surgical abortion and 115 (24.7%) provided second- or third-trimester medical abortion. Half of respondents reported fewer than 5 years of experience with any abortion care. Respondents reported providing a total of 48 509 abortions in 2019, including 32 345 (66.7%) first-trimester surgical abortions and 13 429 (27.7%) first-trimester medical abortions. In Quebec, only 1918 (12.5%) of reported abortions were first-trimester medical abortions. Primary care providers provided 34 540 (71.2%) of the total abortions. First-trimester medical abortions represented 44.4% (n = 2334) of all abortions in rural areas, as opposed to 25.6% (n = 11 067) in urban areas.Interpretation:The increased availability of medical abortion facilitates abortion access, especially in primary care and rural settings, and where surgical abortion is not available. Rejuvenation of the workforce is a critical contributor to equitable access to abortion services.

Impact of the COVID-19 Pandemic on the Health Workforce in Canada.

Healthcare workers are the foundation that keep our healthcare systems running. The recent COVID-19 pandemic has placed unprecedented demands on Canada's health workforce. The Canadian Institute for Health Information has compiled data and information to help inform how the pandemic has impacted healthcare workers and the care Canadians received. This article deliberates on the many challenges of the pandemic, such as safety and access to personal protective equipment, faced by healthcare workers along with its impact on health workers and the health care system. The article also shares how the system responded to protect the health workforce and boost capacity by expanding provider roles and adapting new ways of delivering services, including quickly adapting to virtual care.

Foreign-trained early-career doctors and dynamics in Nigeria: Findings from the charting studies

Dear Editor, This letter examined the Challenges of Residency Training and early-career doctors (ECDs) in Nigeria (CHARTING) I and II data. The CHARTING studies aimed to determine the proportion of foreign-trained medical and dental graduates among ECDs in Nigeria in addition to their country of attainment of a first medical degree. The CHARTING study is the most extensive study examining demographic, workplace, and mental issues among ECDs in Nigeria to date.[1–4] The two CHARTING datasets (CHARTING I and II) showed a similar but low proportion of foreign-trained human resources among ECDs in Nigeria. Out of the 730 ECDs assessed in CHARTING-I, only 24(3.3%) were foreign-trained. Similarly, of the 633 ECDs assessed in CHARTING-II, only 50(8.0%) were foreign-trained doctors [Table 1]. Most were trained in institutions in the Middle East (Sudan and Egypt), Eastern Europe (Russia and Ukraine), the Far East (China), and the Caribbeans [Table 2].Table 1: Foreign and Nigeria-trained early-career doctors in chartıng-I and chartıng-II studiesTable 2: Country of training of foreign-trained early-career doctors in NigeriaWhile brain drain signifies loss of workforce,[5] the presence of foreign medical graduates (FMGs) seen in these datasets indicates some brain gain of about 3.3% in 2019 and 8.0% in 2020. However, a study conducted in 2005 reported that FMGs comprised 23–28% of the medical workforce in Canada, Australia, the United Kingdom, and the United States of America.[6] Most of these developed nations depend on foreign-trained doctors to fill postgraduate residency positions as the number of locally-trained doctors does not meet their needs. In addition, the reliance of developed nations on FMGs shows that these (developed) nations have the political will and resources to expend on making up for the inadequacy of the nations’ locally trained doctors. In contrast, many African countries including Nigeria have in recent times experienced a consistent and enormous exodus of their health human resources.[7] Brain drain is currently a significant challenge of human resources for health in Nigeria. Nigeria has about 70,000 registered medical doctors, half of whom currently practice outside its shores.[5] While there is gross inadequacy in the doctor–patient ratios in Nigeria, the nation’s political will and capacity to retain its locally trained doctors and attract foreign-trained doctors is very low. It is pertinent to note that the immigration of foreign-trained medical and dental graduates into Nigeria may not always be due to economic advantage, but likely to returnees seeking Nigerian medical and dental council certification. The reason for the scarcity of foreign-trained ECDs in Nigeria could include the unattractiveness of the Nigerian health-care sector to foreign-trained doctors or the difficulty they encounter in getting licensed by the Medical and Dental Council of Nigeria or even gaining admission into residency training. It may also be that it is mainly home-trained doctors who could cope with the rigors associated with training in Nigerian health-care institutions. Our data suggest that Nigeria relies predominantly on home-trained doctors to fill up its meager physician–patient ratio of about 1:6000 in Nigeria.[5] Both CHARTING (I and II) datasets demonstrated that home-trained ECDs appear to remain a significant constituent of the ECDs workforce (96.7% and 92.0% in 2019 and 2020, respectively) in Nigeria. Thus, foreign-trained ECDs may not be a significant restocking opportunity for the Nigerian health system.[8] Unfortunately, while Nigeria has difficulty attracting ECDs, an increasing number of ECDs are leaving the country for greener pastures. Nigeria expends resources on its medical schools and residency training in the country for training of medical personnel, who conversely migrate to other nations without a corresponding influx from other countries. Another interesting angle to these CHARTING (I and II) datasets is that while Nigeria exports to Western Europe, and North America, she (Nigeria) imports doctors from other African, South-East Asian, and Caribbean countries. However, the importation of ECDs into Nigeria is very low at 3.3% in 2019 and 8% in 2020: this highlights the weak potential of importing ECDs as a source of meeting Nigeria’s health system demand. This deficit in key health-care personnel for the ailing health-care system of Nigeria should be a major source of concern for the government and people. Therefore, efforts should be made to make training and service enticing to both locally and foreign-trained doctors to improve the health and socioeconomic indices in the country. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.

Investing in Canada’s nursing workforce post-pandemic: A call to action

Nurses represent the highest proportion of healthcare workers globally and have played a vital role during the COVID-19 pandemic. The pandemic has shed light on multiple vulnerabilities that have impacted the nursing workforce including critical levels of staffing shortages in Canada. A review sponsored by the Royal Society of Canada investigated the impact of the pandemic on the nursing workforce in Canada to inform planning and implementation of sustainable nursing workforce strategies. The review methods included a trend analysis of peer-reviewed articles, a jurisdictional scan of policies and strategies, analyses of published surveys and interviews of nurses in Canada, and a targeted case study from Nova Scotia and Saskatchewan. Findings from the review have identified longstanding and COVID-specific impacts, gaps, and opportunities to strengthen the nursing workforce. These findings were integrated with expert perspectives from national nursing leaders involved in guiding the review to arrive at recommendations and actions that are presented in this policy brief. The findings and recommendations from this policy brief are meant to inform a national and sustained focus on retention and recruitment efforts in Canada.

Vulnerabilities in the Nursing Workforce in Canada: The Anatomy and Physiology of Nursing Workforce Challenges and Potential Solutions for Better Planning, Policy and Management.

The COVID-19 pandemic has laid bare the underlying vulnerabilities of the Canadian nursing workforce more clearly than ever before. In this commentary, I highlight how the roots of the present vulnerabilities of the nursing workforce lie in part with the complex and adaptive nature of the nursing workforce system. I also propose systemic solutions to address these vulnerabilities through enhanced foundational data on the nursing workforce. These data can be adopted across the range of Canadian nursing workforce stakeholders to create high-quality, interactive and iterative planning, policy and management processes.

15 2020 CaRMS Residency Match Confirms Popularity of Pediatrics

Abstract Primary Subject area Medical Education Background Longitudinal data about the interest in, and competitiveness of, pediatric postgraduate training in Canada has not been reported. Objectives 1. To describe the results of the 2020 CaRMS pediatric residency match with respect to application rates, first-choice discipline choices, and succesful match rates by gender. 2. To examine the trend of these indices over the past decade. Design/Methods Data from the 2020 Canadian Residency Matching Service (CaRMS) pediatric residency match was evaluated and compared over the past decade. Residency match data from other programs was also used for some comparison reporting. Results Of a total pool of 2998 Canadian medical graduate (CMG) applicants in 2020, 305 (10.2%) applied to pediatrics, and 17 of these latter applicants (5.6%) applied solely to pediatrics. In the first iteration CaRMS match, pediatrics was the first-choice discipline for 177 CMG applicants (6.0% of all first choices). Pediatrics has been consistent as a first-choice discipline over the years: 5.9% (2017), 5.5% (2015), and 6.1% (2013). Of the 155 first-year positions offered in pediatrics this year, all were filled. Of those CMGs who matched to pediatrics in 2020, the specialty was the first-choice discipline for 128 applicants (92.8%) and the second-choice discipline for 9 applicants (6.5%). There were clear gender differences noted. Pediatrics accounted for 8.3% of female and 3.2% of male first-choice disciplines. Of the 135 females whose first-choice discipline was pediatrics, 101 matched to that first choice (74.8%). Of the 41 males whose first-choice discipline was pediatrics, 26 matched to that first choice (63.4%). Since 1995 (at CaRMS’ inception), the rates of first-choice discipline choice by gender have been quite stable (Table 1), with females consistently higher than males, while the first-choice discipline matching rate by gender have varied (Figure 1). Forty CMG applicants whose first-choice discipline was pediatrics matched to an alternate discipline choice and nine went unmatched, suggesting that pediatrics continues to be a competitive discipline. The pediatric rate of first-choice discipline matching to another alternate choice of 22.6% (40/177) is comparable to Anesthesia (22.1%; 34/154), Ophthalmology (26.7%; 20/75), and Otolaryngology (20.9%; 9/43). Conclusion Pediatrics continues to be a top specialty choice for graduates of Canadian medical schools, according to data from the 2020 CaRMS match. There are gender differences noted in the choice of pediatrics as a first-choice discipline, and in the successful match rate to pediatrics programs. The rate of successful first-choice discipline matching by gender have varied over time, with the past two years showing significantly greater matching success for females. These trends in the CaRMS pediatric data have implications on discipline recruitment and the pediatric workforce in Canada, and merit further exploration.

Unmet Needs for Geriatric Medicine and Care of the Elderly Physicians Work Force in Canada.

Although the current low workforce availability of care of the elderly (COE) physicians, geriatric medicine specialists, and geriatric psychiatrists is undeniable, the ongoing demographic shift means this situation will only worsen. This evolving crisis is outlined clearly in the article “Updated Inventory and Projected Requirements for Specialist Physicians in Geriatrics” by Basu et al. found in this issue of the Canadian Geriatrics Journal.