Unemployed, Under-employed Medical Specialists

"This is me on my way out, and he on his way in, able to bill for that transition year. It's good for me, it's good for him, it's good for patients."
John Cameron, 72, orthopedic surgeon, Sunnybrook Health Sciences Centre, Toronto

"We strongly encourage senior surgeons to plan for job-sharing when transitioning towards retirement."
Canadian Orthopedic Association

"It is hard to quantify the wasted resources that are consumed by an unemployed surgeon -- our tax dollars subsidized a decade of medical and residence training for each. Many feel justifiably angry at a system that demanded so much of them during their training."
Commentary, Canadian Journal of Surgery

"Everybody should think about giving back at some point and not hanging on to the bitter end. You don't have to be in the operating room all the time."
Dr. Robin Richards, president, Canadian Orthopedic Association

Errol McGihon / Postmedia  --  Doctors perform knee surgery in an operating room at the Ottawa Hospital-Civic Campus

Dr. Cameron spoke of an interest in mentoring young surgeons curious enough and sufficiently capable in their early professional lives to learn innovative new procedures tending to "make everybody nervous" until they eventually become just another protocol used in medical science correcting and ameliorating wear and tear on the human body. He took Sebastian Tomescu, 32, under his wing as it were, as a postgraduate fellow for a year's probationary period.

And then he invited him to join his practise for another twelve-month period, where they would split the practise. "If you find someone who says, 'I'm going to retire in a few years, why don't you come on and we'll work together and share resources', I think anybody would really jump at that", explained Dr. Tomescu who has witnessed newly trained orthopedic-surgery peers on fellowships, locums (fill-ins for absent doctors) and casual on-call work endlessly with no prospect of a permanent position in view.

Dr. Hamish Hwang published a study of the experience of stressful emergency work taking its toll on surgeons in hospitals. Vernon Jubilee Hospital in British Columbia has chosen a new route; to divide five full-time positions among six surgeons, thus hiring an additional surgeon who would have gone jobless when five were hired. The hospital made that decision in the wake of one of their stressed surgeons having had a major heart attack in 2013.

There is a startling unemployment rate that dates from about five years back, among health specialists. In 2014, 14 percent of graduating specialists and sub-specialists were unable to find full-time posts, according to a Royal College of Physicians and Surgeons survey. Although this is twice the rate of unemployment among the general population, it is an even more dire situation in surgery and other specialties where doctors must be taken on by a hospital where facilities, technology and support staff are provided.

Over half of graduating radiation oncologists and 43 percent of ophthalmologists have been afflicted by an inability to place themselves in full-time work situations. According to the professional certifying College of Physicians and Surgeons, the problem lies in the fact that the number of medical professionals in training applying for the positions that hospitals can afford to offer through limited funding remain a poor match. This is compounded by the fact that older doctors are increasingly loathe to retire.

For the scores of highly trained surgeons and other physicians for whom the search for full-time work remains an elusive struggle, the growing initiatives across Canada to launch work sharing among specialists may be a godsend. The system is analyzing and opening up to dividing practices with a particular emphasis in gradually replacing older doctors with their younger peers, whom they have monitored and encouraged, and assisted in finding their competence level, encouraging them to become more innovative in the process.

At the University of Toronto, Dr. Stan Feinberg, 59, and Dr. Elliot Wakeman, a fourth-year surgery resident at the University, advocate that newly graduated surgeons share practices with those long in the field, anticipating their retirement. Putting theory into practise, that combining of skills-based experience and new enterprise benefits both principals as well as the community at large. Providing mentorship as well as allowing older surgeons a break, and younger ones the opportunity to organize their private lives as well.

As Dr. Hwang in British Columbia says, "In terms of just being exhausted all the time and getting burnt out, this has helped immensely."