The demand for health human resources (HHR) throughout the pandemic highlighted the need to make health workforce planning an area of focus to support jurisdictions in preparing for the future. One of the goals of health workforce planning is to find the balance between current and future health needs and workforce capacity.Reference1 Having the right mix of health care workers at the right place and the right time is necessary to be able to provide high-quality patient care.Reference2 To support these information needs, CIHI is working with stakeholders to generate projections to assist with physician resource planning in Canada as a first step in improved HHR planning for the country.
Projecting physician counts to support HHR planning
Robust health workforce projections depend on high-quality data and industry expertise for accurate interpretation. When these conditions are met, projections are helpful for physician and broader HHR planning. Below are examples of how projections can be used to support decision-makers in assessing policy and intervention options specific to the number of physicians providing care in Canada.
The projections provided here are examples of “what if” scenarios that could occur if different health policy interventions were introduced in Canada. It is important to note that these forecasts are not absolute predictions, but are useful to support a planning agenda so that decision-makers can ensure that the optimal number and types of physicians are available for the population in the future.
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Scenario 1: What if decision-makers increased the number of medical school seats to generate more physicians?
Scenario 2: What if decision-makers increased the number of residency seats to boost the number of practising physicians?
Scenario 3: What if decision-makers were able to project the number of physicians that would be retiring in the future?
Other factors to consider for HHR planning
It can take many years to see the effects of these types of interventions. Planning is critical because the journey to become a practising physician is long. Individuals first complete medical school (ranges from 3 to 5 years in Canada) and then must complete a residency program (2 to 6 years, on average). There are also opportunities to do sub-specialized training after residency (usually between 1 and 3 years). The minimum training time to become a practising physician is 5 years and can take 13 years or more.
Other factors may influence the supply of practising physicians in the workforce, including
- Attrition from medical school and residency
- Immigration of internationally trained physicians who can start practising without additional training
- The number of physicians who leave Canada
- The number of physicians who leave Canada and then return
- Where physicians live and work
- Mortality
Creating the full data picture to help improve HHR planning
CIHI is committed to leveraging data to help improve HHR projections with a goal of ensuring the right mix of trained health care workers to provide high-quality care to Canadians. Quality projections consider both supply and demand. Projections for health care service demand are important to help minimize the gap between population health service needs and health workforce supply.Reference3 Some of the factors that influence need/demand for health care include health care worker distribution, population density, population health status and health care utilization trends.
Learning from other countries about health workforce planning
Canada is not unique in its need to do health workforce projections. Many countries — including those with decentralized health care systems — are investing in these approaches to support needs-based planning for the future. Examples include the following:
- The United States has a national health workforce tool that allows users to view projections of supply and demand for health care workers at the state and national levels.Reference4
- The Australian Government Department of HealthReference5 reports on national workforce trends for physicians, nurses, midwives and oral health providers. These reports contain long-term national workforce projections.Reference6
Canada continues to evolve its HHR forecasting tools to support HHR planning. CIHI is committed to ongoing collaboration and engagement with stakeholders to help with health human resourcing, both domestically and on the international stage.
References
- 1.
- Back to Reference 1 in text
- World Health Organization. Global Strategy on Human Resources for Health: Workforce 2030 (PDF). 2016.
- 2.
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- Waddell K, Wilson MG. Rapid Synthesis: Exploring Models for Health Workforce Planning (PDF). July 2019.
- 3.
- Back to Reference 3 in text
- Simkin S, Chamberland-Rowe C, Bourgeault IL. An integrated primary care workforce planning toolkit at the regional level (part 2): Quantitative tools compiled for decision-makers in Toronto, Canada. Human Resources for Health. 2021.
- 4.
- Back to Reference 4 in text
- U.S. Department of Health & Human Services, Health Resources & Services Administration. (2022). Workforce Projections. Accessed May 15, 2023.
- 5.
- Back to Reference 5 in text
- Australian Institute of Health and Welfare. Workforce: Overview. Accessed July 28, 2023.
- 6.
- Back to Reference 6 in text
- Australian Government Department of Health and Aged Care. Australia’s Future Health Workforce reports. Accessed July 28, 2023.