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David Raymond Amos @DavidRayAmos
#TrumpKnew#TrudeauMustGo #nbpoli #cdnpoli
http://www.cbc.ca/news/opinion/saudi-medical-residents-1.4784798
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· CBC News· Posted: Aug 15, 2018 11:06 AM ET
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· CBC News· Posted: Aug 15, 2018 11:06 AM ET
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This year, there are 800 Saudis in addition to the 3308 Canadian-government-funded positions, meaning the Saudis comprise about 20 per cent of the 4108 residents in Canadian hospitals. (Radio-Canada/Martin Thibault)
Here's a proposed Canadian reply to the escalating Saudi temper tantrum. Call in the kingdom's ambassador and tell him: Sorry, Mr. Ambassador, but Canadian universities will never again accept Saudi medical residents.
The government could explain that cancelling orders for relatively piddling amounts of wheat and maple syrup is the kingdom's perfect right, subject of course to any contractual penalties. And frankly, we can do without the piddling amount of Saudi oil we import. It's not like we don't have any of our own. The world's not going to come to an end.
But, very sorry, Canada regards the health care of its citizens as a most serious obligation.
We know he's your boss, Mr. Ambassador, and that you're probably terrified of him, but we simply cannot allow a Middle Eastern despot-in-waiting to ever again put public health in jeopardy by yanking 800 Saudi doctors-in-training from Canadian teaching hospitals because he's sulking over a mildly critical Canadian tweet.
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Mohammed bin Salman could put public health in jeopardy by yanking 800 Saudi doctors-in-training from Canadian teaching hospitals. (Charles Platiau/Reuters)So, tell your crown prince that we know he'll keep on torturing critics in public for the grave crime of expressing their opinions, and chopping off people's heads and other body parts (and even crucifying the corpses) for, among other things, witchcraft, and that Saudi employers will continue using foreign workers like slaves, and that Saudi men will keep treating their wives and female relatives as property, and there's really nothing Canada can do about it but express our concern, which, by the way, we will continue to do.
Ultimately, Prince Mohammed bin Salman has the sovereign right to behave like Torquemada in a jalabiya if he chooses.
But we can't play games with Canadians' health, Mr. Ambassador, so your government will have to find another country to use as a training facility for your medical school grads. Shukran, wa maasalaame, princeling.
Wouldn't that be a satisfying message to deliver? It would go over pretty well with the Canadian public, too, I'll wager.
The trouble is, we just can't afford to get up on our hind legs like that. Unfortunately, we need those Saudi medical residents. Unfortunately, we are needy.
Here are the facts, in their shabby splendor:
In Canada, the provincial governments tightly control the number of medical residents – medical school grads who spend three to five years working in Canadian hospitals, qualifying as doctors. Residents are paid relatively poorly, earning something in the area of $65,000 a year, but their services are a vital part of the health care system.
In 2018, the provinces funded 3,308 residency positions. Those residents eventually become fully practising doctors, and governments, which strive to contain medical budgets in our publicly insured system, are always anxious to limit the number of doctors who will eventually be billing the system. Money ultimately trumps public need.
Which brings us to the Saudis.
Saudi medical school graduates arrive with lots of money, and are warmly welcomed. Not only does the Saudi government cover their salaries, it pays Canadian governments for the privilege of training in our hospitals and caring for Canadian patients.
According to Prof. Joe Schwarcz, who specializes in science and public policy at McGill University, the Saudis hand over roughly $100,000 per resident per year. This year, there are 800 Saudis in addition to the 3,308 Canadian-government-funded positions, meaning the Saudis comprise about 20 per cent of the 4,108 residents in Canadian hospitals. Taking into consideration the salaries hospitals don't have to pay them and the money their government pays for their training, those Saudi residents effectively bring $165,000 apiece per year with them, for a total this year of about $132 million.
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Roughly 1,000 medical residents and fellows are being taken from the health-care system, putting a strain on it in the short term. 2:15And in September, Saudi Arabia's crown prince intends to yank them all, and all his money, unless he receives an abject apology from Prime Minister Justin Trudeau for the federal government's criticism of Saudi human rights abuses.
In theory – in theory — the disappearance of the Saudi residents won't matter. Schwarcz says the provinces take the position that the 3,308 resident slots it funds are sufficient to meet the system's needs, and that the 800 Saudi residents are all extraneous. In other words, it's nice to have them, but we don't really need them.
But, says Prof. Schwarcz, that's just another of the fictions that go into the illusion that our medical system is providing all Canadians with excellent and timely health care.
"They are said to be extras, but they are not extras. The fact is that the Canadian residency slots by themselves are not enough to service the hospitals properly. Governments have come to depend on the Saudi residents. They are 20 per cent of the working hands of the resident work force, and when we lose them in September, of course patients will feel the loss. Of course there will be consequences."
But, because Canadian medical residents go on to become full-fledged Canadian doctors (unlike the Saudis, who go back home when their residencies are complete), that would necessarily mean creating more permanent positions for specialists and family doctors in Canada, which carries obvious costs for the provinces. Schwarcz says creating more positions is not just necessary, but urgent.
"Our system is short staffed. It's obvious to anyone who looks at the waiting lists and the beds in hospital corridors. How ridiculous is it that some Canadians cannot find family doctors? The basic problem is that there aren't enough doctors in Canada, period."
To start with, provincial governments could offer residency positions to the record 115 medical school grads who were denied spots this year. That's right, 115 qualified graduates from Canadian medical schools were stalled on their road to doctorhood, basically because the government could depend on the Saudis. Then the government could add another 700 positions.
But that would mean finding $132 million somewhere. Far more likely, the federal government will negotiate some sort of face-saving arrangement to soothe the thin-skinned prince.
Because we need to. We need those Saudi residents, just as we need all those General Dynamics factory jobs in London, Ont., where Canadian workers proudly build the billions worth of war machines and weapons platforms – or, as Trudeau likes to call them, "Jeeps"— that help enable Prince Mohammed Bin Salman's campaigns to crush dissent and Shia Muslim nationalism on the Arabian peninsula, particularly Yemen, where the Saudis have escalated a ruinous, bloody civil war.
Bin Salman's army sometimes doesn't do the best job – it managed to slaughter at least 29 schoolchildren in Yemen last week– but you won't hear much about that from Trudeau's ministers.
Discretion, as the Liberals are learning, is profitable. Criticism, however principled, costs money.
This column is part of CBC's Opinion section. For more information about this section, please read this editor's blog and our FAQ.
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David Raymond Amos @DavidRayAmos
Replying to @DavidRayAmos@Kathryn98967631 and 49 others
Methinks CBC and the very snobby Neil MacDonald in particular just pissed off a lot of Canadians N'esy Pas?
http://davidraymondamos3.blogspot.com/2018/08/methinks-cbc-and-very-snobby-neil.html
Methinks CBC and the very snobby Neil MacDonald in particular just pissed off a lot of Canadians N'esy Pas?
http://davidraymondamos3.blogspot.com/2018/08/methinks-cbc-and-very-snobby-neil.html
http://www.cbc.ca/news/opinion/saudi-medical-residents-1.4784798
The Saudi temper tantrum could land one devastating blow — to Canadian health care: Neil Macdonald
Our system depends on some 800 Saudi medical residents
909 Comments
Jennifer McIsaac
Felicia Kinzburg
@Jennifer McIsaac There are also numerous LEGAL immigrants (permanent residents) in Canada, who passed all required medical exams, but are not able to find a resident position for years.
David Amos
@Jennifer McIsaac "Maybe this is a chance to give Canadian medical students a chance to start their careers."
Methinks there are no maybes about it. I believe this is golden opportunity to get our hospitals properly staffed before Baby Boomers such as I need even more of their services. To Hell with the Saudi's and their money. The liberals should make every effort to give Canadian medical students and other foreigners a chance to start their careers in Canada ASAP N'esy Pas?
Methinks there are no maybes about it. I believe this is golden opportunity to get our hospitals properly staffed before Baby Boomers such as I need even more of their services. To Hell with the Saudi's and their money. The liberals should make every effort to give Canadian medical students and other foreigners a chance to start their careers in Canada ASAP N'esy Pas?
David Amos
@Felicia Kinzburg "There are also numerous LEGAL immigrants (permanent residents) in Canada, who passed all required medical exams, but are not able to find a resident position for years."
Exactly and why are they not working for us? Methinks its because of Saudi money N'esy Pas?
Exactly and why are they not working for us? Methinks its because of Saudi money N'esy Pas?
Jamie Thak
@David Amos well as long as you're willing to pay and have your taxes raised then yes! kick the saudi's out.
David Amos
@Jamie Thak Methinks I paid my two bits to see a High Diving Act so I have the right to see a High Diving Act N'esy Pas?
Ian MacDonald
Just more spots for other students.
Lots of countries in the world.
Lots of Canadians wanting to be doctors.
Sure there will be pain, but in the end it will be a growing pain.
Lots of countries in the world.
Lots of Canadians wanting to be doctors.
Sure there will be pain, but in the end it will be a growing pain.
David Amos
@Ian MacDonald "Sure there will be pain, but in the end it will be a growing pain."
Methinks I should be grateful that there is at least one MacDonald that makes sense to me today N'esy Pas?
Methinks I should be grateful that there is at least one MacDonald that makes sense to me today N'esy Pas?
Lieschen Mueller
The Saudi medical residents can easily be replaced. And if any especially female Saudi medical residents want to stay on, we should let them because it would further infuriate the Saudis with their silly theocracy.
David Amos
@Lieschen Mueller Methinks you make a lot more sense than the Yankee lawyer Robert Mueller ever did I would wager that many Canadians would agree that you are credit to your last name N'esy Pas?
Alex Shetsen
Kick the Saudis out. Train Canadians.
@Alex Shetsen I agree
Suki McNally
Thank you for this, it is very illuminating. As a Canadian who has had no family doctor for 6 years I am appalled that Canadian trained doctors are not being given the chance to fill these gaps. If every residency was tied to a position in an under-serviced area the shortages would be fixed in ten years.
It seems so simple, I wonder why it hasn't been implemented.
It seems so simple, I wonder why it hasn't been implemented.
David Amos
@Suki McNally "As a Canadian who has had no family doctor for 6 years I am appalled that Canadian trained doctors are not being given the chance to fill these gaps."
Methinks as a Canadian who has been refused a Health Care card for many years I should be even more upset that you N'esy Pas?
Methinks as a Canadian who has been refused a Health Care card for many years I should be even more upset that you N'esy Pas?
Greg Williams
Here's a novel idea! Why not accept more Canadians into Medical Schools!
Jonathan Lemon
@Greg Williams
If you want to provide good education to the Medical students, with hands on training, you can't just ram through a bunch of more students. You'd have to to increase the capacity of the universities. This means also increasing space, teaching faculty, and support staff.
If you want to provide good education to the Medical students, with hands on training, you can't just ram through a bunch of more students. You'd have to to increase the capacity of the universities. This means also increasing space, teaching faculty, and support staff.
David Amos
@Jonathan Lemon "You'd have to to increase the capacity of the universities"
Methinks there will e more roon with the Saudis gone N'esy Pas?
Methinks there will e more roon with the Saudis gone N'esy Pas?
Jack Jones
This just makes me mad
My kid could not get into Med school here and is being trained in Europe
Now I know why
My kid could not get into Med school here and is being trained in Europe
Now I know why
Matthew Matt
@Jack Jones
there's more to it than just being a canadian
maybe your kid didn't meet the admission requirements?
there's more to it than just being a canadian
maybe your kid didn't meet the admission requirements?
Will Douglas
@Matthew Matt
To start with, provincial governments could offer residency positions to the record 115 medical school grads who were denied spots this year. That's right, 115 qualified graduates from Canadian medical schools were stalled on their road to doctorhood, basically because the government could depend on the Saudis.
============================
Missed this part did you?
To start with, provincial governments could offer residency positions to the record 115 medical school grads who were denied spots this year. That's right, 115 qualified graduates from Canadian medical schools were stalled on their road to doctorhood, basically because the government could depend on the Saudis.
============================
Missed this part did you?
Matthew Matt
@Will Douglas
no i read it willie.
but thanks for being redundant
no i read it willie.
but thanks for being redundant
Jonathan Lemon
@Jack Jones
You misunderstand the issue. The Saudis are here training as residents - they have already earned the medical degree. Residents are not taking spots from potential medical students. If your kid did not get into med school here, it was that his/her application or interview was strong enough. Many students going to Med school now have a graduate degree (either a Master's or PhD), so it is definitely a very competitive process to get accepted to Canadian medical schools.
You misunderstand the issue. The Saudis are here training as residents - they have already earned the medical degree. Residents are not taking spots from potential medical students. If your kid did not get into med school here, it was that his/her application or interview was strong enough. Many students going to Med school now have a graduate degree (either a Master's or PhD), so it is definitely a very competitive process to get accepted to Canadian medical schools.
Jonathan Lemon
@Jonathan Lemon
whoops....." it was that his/her application or interview was NOT strong enough..."
whoops....." it was that his/her application or interview was NOT strong enough..."
Jack Jones
@Matthew Matt
Full scholarship
4.0 average
Aced the MCAT
She made it into a prestigious medical school in Europe and is now on full scholarship over there! Starting 3rd year.
I am angry as a Canadian that we have LOST this valuable asset to our country.
PS
When she finishes Med School she would have practiced IN CANADA!
Full scholarship
4.0 average
Aced the MCAT
She made it into a prestigious medical school in Europe and is now on full scholarship over there! Starting 3rd year.
I am angry as a Canadian that we have LOST this valuable asset to our country.
PS
When she finishes Med School she would have practiced IN CANADA!
Jonathan Lemon
@Jack Jones
Sounds like she didn't pass the interview stage? There is a lot more than grades and MCAT that is evaluated during the interviews.
Sounds like she didn't pass the interview stage? There is a lot more than grades and MCAT that is evaluated during the interviews.
Jack Jones
@Jonathan Lemon
See my reply
See my reply
Jonathan Lemon
@Jack Jones
Also, many students applying to medical school have the same fantastic grades and MCAT scores as your daughter.
Also, many students applying to medical school have the same fantastic grades and MCAT scores as your daughter.
Jack Jones
@Jonathan Lemon
She is top of her class and on full scholarship in Europe
Was recently published in CMAJ for her research as an undergrad!
She would serve us well as a physician in Canada
Mostly because she IS a Canadian who would have practiced in Canada
She is top of her class and on full scholarship in Europe
Was recently published in CMAJ for her research as an undergrad!
She would serve us well as a physician in Canada
Mostly because she IS a Canadian who would have practiced in Canada
Hassan Mahmmood
@Jack Jones really our med system relies on Saudis? Either our led system is insanely corrupt or grossly mismanaged . I lean towards the corruption part. I find it hard to believe we have a shortage when last year a Canadian med committed suicide because he was rejected for the last three years. Sad
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Jamie Thak
@Jack Jones you're missing the point. these are grads from med school getting residency spots. your kid didn't get into medical school for other reasons, not because the Saudi's got in. They aren't in medical school.
Jamie Thak
@Jack Jones again has nothing to do with the Saudis. but i agree with your point
Karen King
@Jack Jones
It's hard to get into med school, you have to be the best, she may be good but clearly not good enough.
Meanwhile there are seats set aside for foreign students, foreign meaning anyone that is not a Canadian, these seats will be filled and maybe just maybe they will then stay in Canada where as the Saudies will not and probably cannot.
It's hard to get into med school, you have to be the best, she may be good but clearly not good enough.
Meanwhile there are seats set aside for foreign students, foreign meaning anyone that is not a Canadian, these seats will be filled and maybe just maybe they will then stay in Canada where as the Saudies will not and probably cannot.
David Amos
@Jack Jones "This just makes me mad"
Methinks any Canadian with two clues between their ears should be mad too N'esy Pas?
![Jack Jones]()
Methinks any Canadian with two clues between their ears should be mad too N'esy Pas?
Jack Jones
@Karen King
No
Sorry
She is good enough
I know of other students who got in because their dad is a doctor
No
Sorry
She is good enough
I know of other students who got in because their dad is a doctor
David Amos
@Jonathan Lemon "it was that his/her application or interview was NOT strong enough..."
Methinks that Mr Jones was far more polite to you than many other Proud Canadian Fathers would be N'esy Pas?
Methinks that Mr Jones was far more polite to you than many other Proud Canadian Fathers would be N'esy Pas?
Peter Frinton
The handy financial benefits of hosting Saudi medical residents aside, they can be replaced.
Each year, Canadian medical graduates have to compete to get residency positions. Countless foreign nationals apply as well, and are largely turned down for lack of slots.
So very quickly, recent graduates and experienced physicians from the Caribbean, Ukraine and Croatia, India, South Africa and myriad other countries will fill the gap. What won't be likely filled is the $135 million support gap. That's $4/ Canadian- I think we can afford that.
Each year, Canadian medical graduates have to compete to get residency positions. Countless foreign nationals apply as well, and are largely turned down for lack of slots.
So very quickly, recent graduates and experienced physicians from the Caribbean, Ukraine and Croatia, India, South Africa and myriad other countries will fill the gap. What won't be likely filled is the $135 million support gap. That's $4/ Canadian- I think we can afford that.
Dwight Williams
@Peter Frinton
Anybody from any sane regime is better.
Anybody from any sane regime is better.
David Amos
@Dwight Williams I concur
Cindy Fordyce
International student doctors should be extras in the system - they should not be used as part of the system. Canada is short of doctors and yet our own medical students can't get residencies. Cdn students should be all available spots and international students should be a plus to all teaching hospitals/facilities.
Kerry Thurston
@Stan Roberts
You get it.....many don't.
Canadian patients will ultimately pay the price.
You get it.....many don't.
Canadian patients will ultimately pay the price.
David Amos
@Kerry Thurston Perhaps you don't get it. Methinks we are already paying bigtime N'esy Pas?
Danny Tanker
The Saudi temper tantrum could land one devastating blow — to Canadian health care:"
No matter, we stand out ground and don't bow to this 1st century regime.
No matter, we stand out ground and don't bow to this 1st century regime.
David Amos
@Danny Tanker Exactly
The Saudi temper tantrum could land one devastating blow — to Canadian health care: Neil Macdonald
Our system depends on some 800 Saudi medical residents
Here's a proposed Canadian reply to the escalating Saudi temper tantrum. Call in the kingdom's ambassador and tell him: Sorry, Mr. Ambassador, but Canadian universities will never again accept Saudi medical residents.
The government could explain that cancelling orders for relatively piddling amounts of wheat and maple syrup is the kingdom's perfect right, subject of course to any contractual penalties. And frankly, we can do without the piddling amount of Saudi oil we import. It's not like we don't have any of our own. The world's not going to come to an end.
But, very sorry, Canada regards the health care of its citizens as a most serious obligation.
We know he's your boss, Mr. Ambassador, and that you're probably terrified of him, but we simply cannot allow a Middle Eastern despot-in-waiting to ever again put public health in jeopardy by yanking 800 Saudi doctors-in-training from Canadian teaching hospitals because he's sulking over a mildly critical Canadian tweet.
Ultimately, Prince Mohammed bin Salman has the sovereign right to behave like Torquemada in a jalabiya if he chooses.
But we can't play games with Canadians' health, Mr. Ambassador, so your government will have to find another country to use as a training facility for your medical school grads. Shukran, wa maasalaame, princeling.
Wouldn't that be a satisfying message to deliver? It would go over pretty well with the Canadian public, too, I'll wager.
Dependence on Saudi residents
The trouble is, we just can't afford to get up on our hind legs like that. Unfortunately, we need those Saudi medical residents. Unfortunately, we are needy.
Here are the facts, in their shabby splendor:
In Canada, the provincial governments tightly control the number of medical residents – medical school grads who spend three to five years working in Canadian hospitals, qualifying as doctors. Residents are paid relatively poorly, earning something in the area of $65,000 a year, but their services are a vital part of the health care system.
In 2018, the provinces funded 3,308 residency positions. Those residents eventually become fully practising doctors, and governments, which strive to contain medical budgets in our publicly insured system, are always anxious to limit the number of doctors who will eventually be billing the system. Money ultimately trumps public need.
Which brings us to the Saudis.
Saudi medical school graduates arrive with lots of money, and are warmly welcomed. Not only does the Saudi government cover their salaries, it pays Canadian governments for the privilege of training in our hospitals and caring for Canadian patients.
According to Prof. Joe Schwarcz, who specializes in science and public policy at McGill University, the Saudis hand over roughly $100,000 per resident per year. This year, there are 800 Saudis in addition to the 3,308 Canadian-government-funded positions, meaning the Saudis comprise about 20 per cent of the 4,108 residents in Canadian hospitals. Taking into consideration the salaries hospitals don't have to pay them and the money their government pays for their training, those Saudi residents effectively bring $165,000 apiece per year with them, for a total this year of about $132 million.
The National
Canada's medical system impacted by Saudi recall of students
00:0002:15
In theory – in theory — the disappearance of the Saudi residents won't matter. Schwarcz says the provinces take the position that the 3,308 resident slots it funds are sufficient to meet the system's needs, and that the 800 Saudi residents are all extraneous. In other words, it's nice to have them, but we don't really need them.
But, says Prof. Schwarcz, that's just another of the fictions that go into the illusion that our medical system is providing all Canadians with excellent and timely health care.
"They are said to be extras, but they are not extras. The fact is that the Canadian residency slots by themselves are not enough to service the hospitals properly. Governments have come to depend on the Saudi residents. They are 20 per cent of the working hands of the resident work force, and when we lose them in September, of course patients will feel the loss. Of course there will be consequences."
- Saudi Arabia pulls its medical patients from Canadian hospitals
- Saudi Arabia to sell off Canadian assets and stop buying Canadian wheat and barley
But, because Canadian medical residents go on to become full-fledged Canadian doctors (unlike the Saudis, who go back home when their residencies are complete), that would necessarily mean creating more permanent positions for specialists and family doctors in Canada, which carries obvious costs for the provinces. Schwarcz says creating more positions is not just necessary, but urgent.
"Our system is short staffed. It's obvious to anyone who looks at the waiting lists and the beds in hospital corridors. How ridiculous is it that some Canadians cannot find family doctors? The basic problem is that there aren't enough doctors in Canada, period."
To start with, provincial governments could offer residency positions to the record 115 medical school grads who were denied spots this year. That's right, 115 qualified graduates from Canadian medical schools were stalled on their road to doctorhood, basically because the government could depend on the Saudis. Then the government could add another 700 positions.
But that would mean finding $132 million somewhere. Far more likely, the federal government will negotiate some sort of face-saving arrangement to soothe the thin-skinned prince.
Because we need to. We need those Saudi residents, just as we need all those General Dynamics factory jobs in London, Ont., where Canadian workers proudly build the billions worth of war machines and weapons platforms – or, as Trudeau likes to call them, "Jeeps"— that help enable Prince Mohammed Bin Salman's campaigns to crush dissent and Shia Muslim nationalism on the Arabian peninsula, particularly Yemen, where the Saudis have escalated a ruinous, bloody civil war.
Bin Salman's army sometimes doesn't do the best job – it managed to slaughter at least 29 schoolchildren in Yemen last week– but you won't hear much about that from Trudeau's ministers.
Discretion, as the Liberals are learning, is profitable. Criticism, however principled, costs money.
This column is part of CBC's Opinion section. For more information about this section, please read this editor's blog and our FAQ.
About the Author
https://www.cbc.ca/news/canada/ottawa/medical-graduates-residency-shortage-1.4536706