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Thursday, 8 November, 2007

The latest from the CMA

The CMA, now under the leadership of Dr Brian Day, is turning its attention to hospital funding reform and medical school tuition assistance.

A CMA conference discussed hospital funding in late October. Dr Day said that :

We need some significant changes in the way we pay for health care delivery, especially in the institutional setting. We need to make hospitals more efficient and service oriented and treat patients, physicians and hospitals as value centres, not cost centres.
One interesting piece of news from that CMA update is the mention of a "special working group" recently established "to investigate patient-focused funding as it relates to both hospitals and physicians." The group will submit a proposal to the board of directors of the CMA next year, so it appears patient-focused funding won't soon be forgotten. It will be interesting to find out whether any federal political parties take up the cause. (I wrote about Dr Day's patient-focused funding proposal .)

The CMA is also taking a look at governments' role in keeping medical residents' expenses down. In late September, Dr Day :
Many Canadians might not recognize that increasingly onerous medical student debt levels are an important health human resource issue. Concern about medical student debt limits the accessibility of a medical education and may also affect diversity within the medical profession. [...]

A recent survey of residents found that their average accumulated debt has reached $158,000, almost four times the average debt of British medical graduates. Moreover, this level of debt is growing since resident trainees are required to start repaying interest and principal on government student loans immediately following medical school even though 2 to 7 more years of training remain. Residents do receive a relatively modest salary during postgraduate training, but they also have expenses such as mandatory fees. When combined with student loan repayment, this leaves little money for basics or raising a family. [...]

The federal government should allow medical residents to postpone [loan repayments] and allow new graduates to make career decisions based on where they can best contribute, and not on their accumulating debt.

Of course, the issue of med students' rising levels of debt isn't a new one. The results of the last National Physician Survey in 2005 . (See also the that first-year medical school fees have passed $12,000 this year.)

Dr Day is the only person to be featured in an NRM Q&A twice; he first appeared , after he was elected CMA president, and then , when he finally took office.


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