Exodus of Saudi medical trainees reveals vulnerability of Canadian health care

The sudden loss of Saudi medical trainees who must leave Canada in the next two weeks will negatively affect patient care, which should serve as a wake-up call to governments to increase the number of funded residency and fellowship positions for Canadian medical students, argues Dr. Matthew Stanbrook in an editorial in CMAJ (Canadian Medical Association Journal).

"Canada's health and education systems must never be vulnerable to spontaneous decisions of a foreign government," says Dr. Stanbrook, a respirologist at Toronto Western Hospital and deputy editor, CMAJ. "Our ability to meet the present and future health care needs of our population, while safeguarding the mission of our academic centres, is not something we can afford to contract out."

The diplomatic row between Saudi Arabia and Canada following a tweet by Canada's minister of foreign affairs has resulted in the immediate withdrawal of 16 000 Saudi students in Canada, including 800 medical trainees, who provide a wide range of care to Canadian patients while gaining valuable skills and experience to help their own citizens.

"As the medical community has responded overwhelmingly with shock, sympathy and support for our Saudi colleagues, academic health centres have been scrambling to adjust service and on-call coverage left vacant. ... The impact this will have on safe and timely health care delivery to Canadian patients remains to be seen, but an effect on physicians and other trainees in these centres in terms of workload and stress is already being felt."

As these spots are internationally funded by the Saudi government, they cannot be filled by the Canadian medical graduates who went unmatched to residency programs earlier this year. The federal and provincial governments must step up to the plate to fund these much-needed residency spots for Canadian medical graduates to enable patients to access medical care.

"The loss of our internationally funded trainees highlights more clearly than ever how valuable they have been," says Dr. Stanbrook. "Our profession and our country must express gratitude for their service and contributions over the years to Canadian medicine and the Canadian people. Canada will continue to welcome internationally funded trainees—including Saudis, as future diplomatic relations allow—but should do so because we want them, not because we need them."