P.E.I. will have to improve recruitment, hire up to 50 new doctors to support medical school: report

UPEI's medical school will eventually require 135 doctors to devote 20 per cent of their work time to teaching, according to a consultant's report looking at what it will take for Prince Edward Island's health-care system to support the new facility.

The report from Spindle Consulting, released on Friday, projects that without changes in recruitment, retention and doctor complement levels, the province will fall short of having the required number of doctors on hand to participate in teaching duties.

"Historic physician recruitment and retention rates across all disciplines will have to be increased in order to attract and deploy new physician hires that are needed to run the medical school in the first nine years of its operations," the report states.

By 2033, when enrolment is projected to peak at 80 undergraduate and 58 post-graduate medical students, the province will need to have 40 to 50 additional doctors who are prepared to serve as part-time instructors.

That would be on top of doctor positions the province will require to support population growth and replace physicians who are retiring or otherwise leaving the system.

The projection for staffing includes 23 doctors the report suggests should be hired by the time the medical school opens next fall.

Health P.E.I.'s interim CEO Corinne Rowswell said Friday that physician recruitment efforts are already underway to make up for the shortfall.

Corinne Rowswell, the interim CEO of Health P.E.I., says the province is already aggressively recruiting doctors to avoid having a shortfall. (Steve Bruce/CBC)

"We do have significant health-care system challenges, and recruitment and retention is a real challenge and an issue and top of mind for all of us. The roads do lead to aggressive recruitment and retention," she said. "This [report] is a mathematical model and it gives us some planning assumptions and where we have to go with it. This is a start of the conversation with the engagement with our physician community."

Almost half the extra doctors who must be brought into the system should be internal medicine specialists — and the province is currently experiencing a critical shortage of those.

P.E.I. currently has 293 full-time equivalent positions for doctors, of which 50 are vacant.

If the teaching demands for 2033 were placed on today's physician complement, more than half the doctors now working on P.E.I. would be required to teach part-time at the medical school.

This is a concept rendering of the new home of UPEI's medical school, as well as related health-care faculties. It's still under construction north of the main campus on University Avenue in Charlottetown. (Submitted by UPEI)

The demands when the school launches next year will be much lower, because early classes for med students can be conducted online from a remote location — in this case, UPEI's partner in the medical faculty project, Memorial University in St. John's.

The need for staff will start ramping up by year three when the first cohort of students moves out of the classroom and into the health-care system to study.

Dr. Preston Smith, the new dean of UPEI's faculty of medicine, is confident the medical school will help drive the province's recruitment efforts.

UPEI's dean of medicine, Dr. Preston Smith, says medical schools can be an effective recruiting tool for physicians. (USask)

"We already know that doctors are saying [they're] more interested in coming to P.E.I. because there's going to be a medical school," he said. "With the medical school and Health P.E.I. working together aggressively around recruitment and retention, I believe we'll bring doctors in faster than we have in the past."

Concerns have been raised by the P.E.I. Medical Society, by the former CEO of Health P.E.I., and by opposition politicians that the demands for instruction could place too much additional strain on the province's health-care system at a time when it's already struggling to provide access to care for patients.

The report estimates additional salary costs for doctors teaching in the school by the ninth year of operation would be nearly $30 million, with UPEI covering $12.8 million as instructional costs and the province paying $18.7 million in clinical costs.

Those figures don't include overhead, benefits or fee-for-service billings, so overall costs are expected to come in significantly higher.

Health P.E.I.'s budget for in-province physicians in the current fiscal year is $152 million.

Concerns have been raised that the demands for instruction at the medical school could place too much additional strain on P.E.I.'s health-care system. (Ken Linton/CBC)

The report also estimates it would cost $26 million to upgrade medical facilities in the province to be able to incorporate student learners into the health-care system.

But Health P.E.I. says it's still in the process of calculating additional capital costs that will come with ramping up staffing within the health-care system to the point where it can support the medical school.

Students will need more housing

The report notes that, given the lack of housing in P.E.I., the province will have to secure 30 housing units for medical students completing medical rotations at locations outside Charlottetown where they would be based.

The province will also have to expand its residency program from the current 11 spaces to provide between 21 and 25 spots for medical graduates to complete their training in P.E.I.

UPEI says it still hasn't mapped out the details regarding how residencies will operate once the medical school opens, except to say that existing residencies P.E.I. operates through Dalhousie's medical school will switch over.

In order to recruit and retain the doctors required to teach, Spindle's report says UPEI and the province would have to develop a "favourable and reasonable" compensation model, while UPEI needs to strengthen its relationship with the physician community and engage them "in the development of the medical school as an historic opportunity."

Overall, Health P.E.I. and the university are banking on the new medical school providing a boost to doctor recruitment efforts.

School will start as a satellite campus of MUN

The university plans to launch its medical program by taking in 20 undergraduate students next year, initially operating as a satellite campus for the medical program at Memorial University.

By 2026, UPEI plans to offer a joint medical degree with Memorial once the program receives approval from the Maritime Provinces Higher Education Commission.

Initially, UPEI said its medical school would take in its first cohort of students in the fall of 2023. That date has now been pushed back twice.

The first phase of Spindle's report was obtained by CBC News through an access-to-information request last year. Friday's release involved the full report.

'First, do no harm' 

In a statement, the Medical Society of P.E.I. said it remains "deeply concerned" about the number of physicians needed for the medical school and called for improved communication between the province and health professionals.

Dr. Krista Cassell, president of the Medical Society of P.E.I., says the organization remains 'deeply concerned' about physician recruitment. (Kerry Campbell/CBC)

"Teaching is important to many physicians, as it can bring much professional satisfaction and may help to recruit more physicians to the Island," said the society's president, Dr. Krista Cassell. "At this time, however, many interested physicians are already fully occupied with patient care and believe that teaching should not compromise our ability to provide medical attention for Islanders.

"As we say in medicine, first do no harm."

Margot Rejskind, executive director of the UPEI Faculty Association, said she hadn't seen the final Spindle Consulting report yet, but was disappointed with how the university went about releasing it.

"We're disappointed that UPEI's approach to the release of this information has been to brief stakeholder groups separately without providing the report to them, while also prohibiting those groups from disclosing the information provided until the report was released," she said. "This seems incongruent with UPEI's public commitments to greater transparency."