Employment Challenges of Orthopaedic Surgeons - Canadian Orthopaedic Association

Access to Care

The CIHI Wait Times for Priority Procedures in Canada report that fewer patients who required a hip or knee replacement did not have their procedure done within the recommended 6 months. This data reflects the most recent information available from the 2023 data cycle (Canadian Institute for Health Information. Wait times for priority procedures in Canada, 2024. Accessed August 21, 2024.).

It is well known that wait times for orthopedic surgery in many regions exceed what orthopedic surgeons consider clinically reasonable. The Fraser Institute’s findings indicate challenges for MSK patients, with orthopedic patients experiencing the longest wait times among all medical specialties, averaging 44.3 weeks from GP referral to treatment. (Barua et al., 2023).

Download the 2023 report here.

COA 2020 Employment Snapshot

The COA gathers employment data from the 17 Canadian orthopaedic training program directors, a snapshot “what are they doing now?” update of orthopaedic graduates from the last six years. Below are the most up-to-date statistics based on graduates from 2015-2020, or “recent grads” (current at December 2020): These results are an important tool for human resource planning and advocating for patient access to care.

Download the 2020 data set here.

Key Findings from 2020

– 430 orthopaedic surgeons graduated over the last six years in Canada.
– 127 recent grads are currently seeking full-time employment (“Looking for work”). Of those:
- – 28 are underemployed (locum, research, other) and actively seeking immediate work.
- – 99 are currently on fellowship and will enter the job market imminently (97% are in fellowship year 1 or 2 and 3% are in fellowship year 3 or 4.)
– 72 recent grads are currently working full-time outside of Canada.
– 231 recent grads currently hold a full-time position in Canada.
– The unemployment rate within the graduates of the past six years decreased mainly due to the decrease of residency spots and the increase of graduates working outside of Canada.

Next Steps

Persistent underfunding of MSK care has led to ongoing underemployment among orthopedic surgeons in Canada. Despite slight improvements, there are still more surgeons entering the job market than there are positions available. The reduction in training positions and the rising trend of graduates moving to the U.S. for work further exacerbate the issue.

In a report, the Royal College of Physicians and Surgeons of Canada released findings from their annual Royal College Employment Study (Royal College Employment Study, 2019) based on a survey of medical specialists newly certified in 2017 about their job prospects.

The top six barriers to employment are:

1. Too few available positions in Canada
2. Poor access to job listings
3. Desire or need to stay near family
4. The need for spousal employment
5. Lack of available health care resources (e.g. funding, operating room time)
6. The delayed retirement of established physicians and surgeons (and their general reluctance to share resources)

Review the June 2018 COA Bulletin article to gain a better understanding of the COA’s capacity to address the unemployment crisis in various areas including government advocacy, implementation of a free job board, education through position statements, and others. One of the most impactful interventions undertaken by the COA was advocating for the reduction in residency spots, which resulted in a decrease from 81 R1 orthopaedic matches in 2011 to 53 matches in 2020 (CaRMS). This begs the question whether there will be enough trained surgeons available in the future to serve the needs of the aging population. Further limiting the number of trainees may compromise patient care in future decades.

For more information on Canada’s orthopaedic surgery profile, click here.

Consistent advocacy efforts at various levels of government and in the media is critical. The COA continues to encourage innovative models of care which increase efficiency, as well as advocate for and promote the acceptance of shared practices which allow a gradual transition to retirement for senior surgeons and a gradual entry to the job force for junior surgeons.

For more information on advocacy measures from the COA, click here.

Position Statement on Access to Orthopaedic Care