The state of the health workforce in Canada, 2022

Take a closer look at health workforce data, including historical trends.

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• In 2022, the suppliesFootnote ii of physicians, regulated nurses, pharmacists, occupational therapists and physiotherapists grew at varying rates. Nurse practitioners (NPs) continued to have the highest annual growth rate at about 9%, while the annual growth rate of registered nurses (RNs) slowed (1.1% in 2022 compared with 2.5% in 2021). On a larger scale, the average annual growth of family physicians and pharmacists slowed over the past 10 years (from 2.9% between 2013 and 2017 to 1.8% between 2018 and 2022 for family physicians, and from 3.4% to 2.2% for pharmacists).
• The long-term care sector continued to see losses in the number of direct care nurses. Approximately 2,500 fewer direct care nurses were employed in long-term care in 2022 compared with 2021 (5.1% decline). The number of RNs in direct care employed in hospitals declined by over 800 (0.6% decline).
• The average full-time-equivalent value for family medicine physicians and specialists — a measure of the average physician practice — rebounded to pre-pandemic levels in 2021–2022 at the pan-Canadian level after dipping the year prior.
• Internationally educated health professionals made up a sizable proportion of the workforce in 2022, with more than a third of pharmacists and more than a quarter of physicians being international graduates. While the proportion of nurses who are internationally educated has traditionally been lower than that of other professionals, in 2022 they made up an average of 12% of newly licensed nurses across the provinces and territories, a 4% increase from 2017.
• Surges in health care job vacancies (doubling since the start of the pandemic to 120,140 in 2022–2023) suggest that demand for health care is outpacing the gains in supply. Job vacancies for personal support workers (30,800 vacant positions; 25.7% of all health care vacancies), registered nurses and registered psychiatric nurses (28,000; 23.3%) and selected mental health workers (21,360; 17.8%) accounted for two-thirds of all health care job vacancies in 2022–2023.
• In 2021–2022, an unprecedented amount of hospital overtime was logged by staffFootnote iii (over 26 million hours, equivalent to more than 13,000 full-time positions). The highest rates of overtime were observed in intensive care and in mental health and substance use inpatient units.
• NPs are often an important source of primary care for rural/remote populations, but the proportion of this workforce employed in these areas has been steadily declining over the past decade (18% in 2013 compared with 14% in 2022). For pharmacists, the share of the workforce in rural/remote areas declined only slightly, from 11% to 10% in the same time period, while the proportion of physicians remained stable (about 13% of family medicine physicians and 2% of specialists).
• As the population in Canada ages and needs for health care increase, the number of nurses in direct care roles may not be keeping pace. In 2022, there were 52 nurses in direct care roles per 1,000 older adults in Canada, compared with 59 in 2013. A decline was also observed for family medicine physicians and specialists (from 7.0 to 6.5, and from 6.2 to 5.6, respectively).

Policies targeting recruitment, retention and optimization of scopes of practice have been increasingly adopted across the country.Reference1,Reference2 Here are some examples:

• Almost all provinces and territories have expanded scopes of practice for pharmacists to include assessing and prescribing medication for certain minor ailments, with some jurisdictions empowering pharmacists to renew and extend prescriptions. In some jurisdictions, RNs have also been granted new prescribing powers.
• Efforts to increase physician capacity have taken the form of increasing medical training seats, with some jurisdictions offering tuition bursaries in return for service commitments. While these offerings are associated with a time delay due to the length of physician training, many provinces have established or enhanced incentive programs in rural communities.
• Most jurisdictions have modified policies to expedite registration for health care workers, including provisions and programs to streamline internationally educated nurse entry to the health workforce. A number of provinces have taken their search for health workers abroad.