Canadian medical residents strike over fees

BMJ 1995; 311 doi: (Published 22 July 1995) Cite this as: BMJ 1995;311:214
  1. PETER VAUGHAN, medical journalist
  1. Ontario

    More than 200 medical residents in the Canadian province of Saskatchewan are on strike in protest over a new $C2200 (pounds sterling1000) tuition fee. The strike began this month after the junior doctors were told that they would be replaced by international medical graduates if they did not pay tuition fees. At issue is whether house staff are students or employees.

    Medical schools across Canada are watching the dispute in Saskatchewan with interest as each looks for new revenue sources.

    Cuts in federal transfer payments mean that health and education are in competition for a share of the same budget.

    Dr Donald Duncan, president of the Professional Association of Interns and Residents of Saskatchewan, said, “Revenue Canada states that we are employees, but Saskatchewan's College of Medicine still refuses to acknowledge that.”

    The residents believe that they contribute more than enough to cover the cost of their education through what Dr Duncan called cheap labour. He said, “We suggest our employment is our training. We don't receive extra education above that. We work 80 to 100 hours a week. We are in contact with faculty about 12 hours out of that time. That's not lectures. We receive no more than really one or two hours a week.”

    Dr David Popkin, dean of the University of Saskatchewan's college of medicine, argues that the residents are full time students. The residents negotiated full time student status with the university in 1992 to avoid the repayment of student loans until they have finished training.

    Dr Popkin said, “The residents feel that they should not be required, even though they are full time students, to pay any portion of their medical education and that the public, the taxpayer, should entirely bear the cost of their medical education.”

    Medical residents' associations in Ontario, Alberta, and British Columbia view the situation in Saskatchewan with a combination of fear and loathing. Dr Scott Woodside, spokesman for the Professional Association of Interns and Residents of Ontario, said, “In our view what is happening in Saskatchewan is unacceptable. They're trying to rewrite history.”

    As federal funds dwindle, provincial education departments want medical schools to come up with more of their own money. One quarter of Canadian medical schools already have a postgraduate tuition fee of some kind.

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