‘A hopeless situation’: Lack of residency spots in BC frustrates some UBC medicine students

Some UBC medicine students have voiced concerns over the lack of available postgraduate residency spots after the BC NDP promised to build a second medical school in the province.

Last October during the provincial election campaign, Health Minister Adrian Dix announced plans to build a new medical school at SFU in order to expand BC’s healthcare workforce and develop training that meets the needs of Indigenous communities. There have been no updates to this proposal since the campaign.

Billy Zhao, the president of the Medical Undergraduate Society, expressed appreciation for the NDP’s interest in addressing the shortage of medical professionals in BC, but said that the government’s proposal would make the application process for residency programs more competitive.

Each year, graduating UBC medical school students must apply for a residency training program to become a certified physician who can practice. A majority of applicants get matched to a supervising practitioner, but those who don’t are forced to put a pause on their careers.

“You have unmatched students in the system that want to further their training. But then they can't do that just because there aren't enough spots,” he said.

Instead of building a second medical school, Zhao believes the province should simply fund more residency positions.

“I would think, number one, is to utilize the resources that the province already has. And that's medical students that've already finished their training but can't become an independent practitioner because of residency spots,” he said.

Jack Yuan, a fourth-year med student who is currently applying to residency positions, gave a similar perspective in an interview with The Ubyssey.

“Faculty have expressed that we are already pinched for clinical opportunities for [UBC’s] 288 medical students. It would be hard to imagine where another cohort of medical students would be placed,” he said.

“With more students on a particular service, there is often less opportunity for learning.”

The BC Ministry of Health did not address these concerns in a written statement sent to The Ubyssey.

According to the Ministry, the number of those who go unmatched has declined significantly in recent years.

In 2020, 98 per cent of those who applied in the first iteration, or round of applications, were matched to a program. During the second iteration, that number jumped to 100 per cent.

Some who went unmatched in the first round chose to not apply a second time, however.

“A small number of [Canadian medical graduates] unmatched in the first iteration choose not to apply in the second iteration of [Canadian Resident Matching Services]. This may be for a number of reasons including because their desired specialty is not available in the second iteration,” the Ministry’s statement read.

Still, the province acknowledges that going unmatched continues to be discussed.

“The issue continues to be monitored on Pan-Canadian platforms including the F/P/T Committee on Health Workforce.”

Even if the province adds more residency spots, Zhao said that problems within the BC healthcare system will still exist. “The medical system is very complex. There's a lot of moving parts,” he said.

“[It’s hard] for me to say if it's one simple solution ... because one sort of action can lead to many many downstream reactions.”

Mental health challenges

Going unmatched can be discouraging for recent graduates, particularly because these individuals often struggle to find alternative jobs.

“It’s such a hopeless situation. You're basically overqualified for all other types of jobs,” Zhao said.

The experience can also have impacts on people’s mental health.

A 2020 study conducted by Dr. Basia Okoniewska at the University of Calgary found that those who went unmatched expressed feelings of disbelief, grief and self-doubt, among other negative emotions. Some even described their mental state as depressed.

“Going unmatched can often be devastating, to say the least,” said Yuan.

Yuan added that the possibility of going unmatched is in the back of everyone’s minds, but that this has helped reduce the shame around it.

“The thing is that, really, it can happen to anybody. So the nice thing is that the stigma around going unmatched is going down a little bit.”

In a written statement, Dr. Ravi Sidhu, associate dean of postgraduate medical education at the faculty of medicine, outlined several services, including a clinical elective course for unmatched students to gain experience to strengthen their application, one-on-one career planning meetings and the Physician Health Program, a faculty-specific counseling service.

“We recognize that the matching process can be a stressful period during a medical students’ journey to becoming a doctor,” he wrote.

Yuan believes that the medicine faculty’s support services have helped, however.

“[UBC Medicine Student Affairs] has a very good handle on the process, and are there to support you until you do match to a residency program.”