Doc shut out of residency spot

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This article was published 16/05/2013 (4539 days ago), so information in it may no longer be current.

With a medical degree in one hand and a five-year agreement to practise family medicine in Virden in the other, Dr. Jan Roux is frustrated after being denied a residency spot by the Canadian Resident Matching Service (CaRMS).

It has been a nightmare, according to Roux, to get one of the coveted international medical graduate spots in the province despite his agreement with the former Assiniboine Regional Health Authority — now part of Prairie Mountain Health — and several local municipalities.

“It’s been a long, drawn-out process and I’m not sure what I am going to do now,” Roux said. “At some point I have to move on with my life.”

Six years ago, Roux, whose father has practised at the Virden Medical Clinic since 2000, struck an agreement with seven municipalities and the ARHA. The deal had each municipality contribute $10,000 and the ARHA contribute $30,000 — for a total of $100,000 — so Roux could finish training to become a doctor overseas. In return, Roux would practise in Virden for at least five years following a two-year residency.

After graduating from Hungary’s University of Pécs Medical School in July 2012, and subsequently passing the Medical Council of Canada Evaluating Exam, Roux submitted an application to the CaRMS, the service that provides postgraduate medical training matches in Canada.

Due to conflicting school-year schedules, Roux was ineligible to apply for a residency spot in 2012. He could have pursued opportunities elsewhere, but chose to wait and apply for a spot in Manitoba in 2013.

Roux said he contacted provincial Health Minister Theresa Oswald through local Arthur-Virden Progressive Conservative MLA Larry Maguire, requesting some aid as to what additional work or programs he could take part in to ensure he put himself in the best possible position for a spot.

“I took one year to focus on getting my residency, doing everything I could to improve my chances,” Roux said.

He now finds himself in a conundrum: reapply for a residency next year with the same lack of guarantee, or seek other opportunities in Europe.

While he weighs his options, Roux would like to see the CaRMS system in Canada change to make it more conducive to applicants who are willing to work, stay and live in rural areas of the country.

Because he graduated in Hungary, Roux is considered an international medical graduate. While there are 52 family medicine residency spots within the province, Roux said due to his IMG designation he can only apply for about 11 spots.

“I’m trying to fight for everyone else in my situation,” Roux said, adding he knows of other doctors in similar predicaments who want to work and live in Manitoba but were forced overseas to find a residency.

“I’m trying to make it easier for any Canadian studying outside of the country to come back because it’s not, it’s very difficult.”

The 28-year-old looked forward to returning to Manitoba and beginning a long career in Virden. He also desperately wants to pay back all the support he received from the communities and the ARHA.

It was a win-win situation in his mind.

“I viewed (the return for service agreement) as a great opportunity to help out with my tuition fees because I always wanted to come back here (to Virden),” he said.

“It wasn’t a bribe. It was an opportunity for the area and me. They get someone, for sure, for five years and the idea is if I’m here for five years then I’ll probably stay. On my side of things, I wanted to come back here anyway, so it was the right thing to do.”

In order to fix the doctor shortage in Manitoba, it’s paramount, according to Roux, to train people from the province who are more likely to stay and work in smaller communities.

“If you have a shortage of family physicians every year and you have a lot of out of country doctors coming in to fill positions — and there’s nothing wrong with that, that’s how we came to this country — that works, but if you want to fix the shortage, wouldn’t the first step be to train more people in the province?” Roux asked. “People who want to train and stay in this province aren’t getting the opportunity and so you’re not filling the need.”

For her part, Oswald said that’s exactly why the province is investing more in the resident program, adding 13 new rural residencies over the past two years.

Oswald said it would be detrimental to interfere with the placement process.

“There are a lot of people that want to get in, but not everyone does get in,” Oswald said. “It needs to be based on achievement and competency.”

In recent days, the minister has taken heat from Maguire on the issue, but has remained steadfast that the process has to remain merit-based, adding that she will not interfere with Roux’s application.

“At this stage of his development and education, he didn’t match in the residency matching process,” she said.

Maguire questioned how well the physician recruitment program is working when a doctor who is willing to practise in rural Manitoba is denied a residency in the province.

“He has wasted a year in Manitoba after everybody encouraged him to stay here and apply,” Maguire said. “If we want rural doctors, we need to take some of our home-based doctors that have had to go overseas to become trained internationally and make sure that some of them get into these rural spots.”

Maguire’s worried that if the province doesn’t promote locally, doctors like Roux will get a residency in another country and possibly never come back.

RM of Pipestone Reeve Ross Tycoles said the toughest part is, at the end of the day, the area may lose a good young doctor. Pipestone was one of the municipalities that contributed to Roux’s education.

“We thought we had a doctor,” Tycoles said. “We’re disappointed. We have a young guy that is willing to come back and work in the area and now, for reasons we don’t control, that won’t be happening.”

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