Too Many Doctors? Foreign Medical Graduates and the Debate over Health Care Accessibility in Canada, c.1976–1991

Although the last decade has been dominated by commentators lamenting the national shortage of medical practitioners, only a generation ago policy makers concluded that most Canadian provinces had too many doctors. As a consequence, provincial ministers of health placed new restrictions on the licensing of foreign-trained health professionals. Assisted by the 1976 Immigration Act, Canada suddenly witnessed a precipitous drop in the number of newly licensed, foreign-trained doctors, a dramatic reversal of the previous decade which had seen over 10,000 physicians immigrate and take up practice in this country. The 1980s was notable for a variety of health care initiatives aimed at relocating the diminishing number of foreign physicians to underserviced areas, some of which were struck down as contravening the new Charter of Rights and Freedoms. This paper will examine the period of 1976-91, when, after two decades of relatively liberal immigration and licencing policies, Canadian provinces introduced new measures to restrict the scope of practice of incoming foreign-trained doctors and to divert them to underserviced areas. The paper will explore these health policy debates in order to understand better the context of the landmark Barer-Stoddart Report (1991), which concluded that a new interprofessional mix of health care practitioners was needed to reform, and make more accessible, the Canadian health care system.