THE CLASS OF 1989 AND PHYSICIAN SUPPLY IN CANADA

Background: ''The Class of 1989'' is a study of 1722 people who were a warded an MD degree by a Canadian university in 1989. This paper repor ts on migration, specialty choices and patterns of post-MD training in order to assess the contribution of the graduating cohort to the phys ician workforce of Canada. Methods: A longitudinal study was conducted over 7 years after graduation to trace the current location, the post -MD training history and the professional activity of the graduating c ohort. Several medical professional and educational associations in Ca nada and the United States provided year-by-year information on field and location of post-MD training, certification achieved, whether in p ractice and location of practice through to spring 1996. Information f rom all sources was linked to a list of 1989 medical school graduates. Results: From entry to medical school through to 7 years after gradua tion the cohort was diminished by about 16%. The main reason for loss was migration to other countries: 193 graduates (11.2%) were outside C anada in 1995-96. Internal migration was extensive also; for example, by 1995-96 relatively few of the graduates were located in Newfoundlan d or Saskatchewan. Of the 1516 graduates active in Canada in 1995-96, 878 (57.9%) were in general practice/family medicine, and only 638 (42 .1%) were practising or training in a specialty. Interpretation: The ' 'yield'' of the Class of 1989 for Canada's physician workforce is insu fficient to meet annual physician inflows from Canadian sources to ser ve population growth and to replace retiring or emigrating physicians. As output from Canada's medical schools drops even further, the gap b etween requirements and supply will grow even wider.