WHEREAS the Alberta Provincial Government has recognized a shortage of physicians, particularly in smaller centers and rural areas, and has initiated the Rural Physician Action Plan; AND WHEREAS some communities have offered recruitment and retention incentives to physicians up to and including the provision of locally funded medical clinics, staffing, free or subsidized housing and transportation, all at the expense of the local taxpayer; AND WHEREAS these incentives have led to an ever increasing inter-community rivalry to meet or exceed the incentives offered by other communities, thereby making recruitment even more difficult for communities without financial ability; AND WHEREAS taxpayers already pay taxes to both the provincial and federal governments for the provision of universal health care services and are now being asked to pay a third time to provide these incentive packages; AND WHEREAS there are limited Physician Student Training positions at both the University of Alberta and the University of Calgary; AND WHEREAS physician recruitment and retention initiatives can be enhanced by increasing the number of Physician Student Training positions at the University of Alberta and the University of Calgary because the pool of available physicians who could be deployed to Alberta rural communities would increase;

THEREFORE BE IT RESOLVED that the Alberta Association of Municipal Districts and Counties urge the Government of Alberta to accept responsibility for all aspects of health care in the Province of Alberta, including the recruitment and retention of health care professionals in smaller centers and rural communities, up to and including necessary funding for clinics, housing and staff; AND FURTHER BE IT RESOLVED that the Alberta Association of Municipal Districts and Counties request Alberta Advanced Education to fund the University of Alberta and the University of Calgary in an appropriate manner that will allow for an additional 150 student positions to be trained annually at each university to address the physician shortage in rural Alberta.

Across Alberta, communities and health regions compete to attract doctors, offering housing, vehicles, clinics and other incentives. The richer or more desperate municipalities are offering high incentives, while provincial government health funding seems to be more focused on the larger centres. In the early days of this government the cry of equal health care for all Albertans was heard, but has never been realized. Yet health regions and municipalities alike are frequently struggling to attract and retain physicians and other health professionals, and some hospitals have devolved into health centres. Physician incentives and the Ambulance issues are fraught with similar challenges. Municipalities and regional health authorities are deeply enmeshed in both, offering money, housing, vehicles, land and buildings to attract and retain physicians. The physician’s issue, like the ambulance issue, is a health responsibility, and therefore is a provincial responsibility, which should be taken over immediately. A level of consistency and uniformity is desirable and surely achievable in placing physicians in Alberta. The current welcome wagon approach of offering incentives is obviously inadequate. The complexity of factors other than finances also have to be considered, such as physician training, licensing off shore doctors for rural practice, hospital privileges, the impact on ambulance services, the College of Physicians and Surgeons, and the realistic expectations of the physicians themselves. Clearly this requires a global comprehensive strategy that should be developed by the government of Alberta, to provide a long-range solution covering the whole province. The problem is far larger than any one municipality or regional health authority. Accessible health care for all is attainable, even if the more desirable goal is equal universal health care. The Government of Alberta can further play a role in attracting more physicians to rural Alberta by working with the Universities of Alberta and Calgary to expand the available number of Physician Student Training Positions. There are presently limited to 100 positions at the University of Calgary and 125 at the University of Alberta. The University of Calgary’s number one priority for the last three years has been to increase this level, but have not been able to follow through despite the capacity to accommodate extra Physician Student Training Positions. Alberta Advanced Education can take appropriate action to address the physician shortage in the Province. A positive step would be to provide sufficient funding and in a manner that will allow for 150 physician student positions to be trained at the two institutions.

The September 29, 2008 update on the Governments Health Action Plan noted that new funding for education seats resulted in additional spaces in universities, colleges, and technical institutes across the province. In order to meet the demand and labour market needs set out in the Health Workforce Action Plan, 40 per cent of the new spaces are in the health care sector including registered nurses, doctors, licensed practical nurses, x-ray technicians and medical laboratory technologists. Further, the Alberta government is making it easier for internationally educated health professionals to find work in their field. Health Career Centres in Edmonton and Calgary offer a range of services to help doctors, nurses, pharmacists and other health professionals who received their training outside of Canada navigate the registration and licensing processes. Centres are located at the Bredin Institute Centre for Skilled and Internationally Trained Professionals in Edmonton (www.bredin.ab.ca) and Directions for Internationally Educated Health Professionals Bow Valley College in Calgary (www.directionsforimmigrants.ca). Rural Albertas Development Fund has approved a pilot project involving third year Alberta medical students. The project requires students to spend at least eight months learning about medical practice in rural communities from doctors already living and working there. Outside of this pilot project, students currently spend one month in rural communities as part of their medical education. Studies in other jurisdictions with similar programs show that longer exposure time in a rural setting leads to more students choosing to work there after graduation. The University of Calgary and the University of Alberta are developing a proposal to continue this Integrated Clinical Clerkship program which forms the basis for virtual campus and rural mentoring. Similarly, the Rural Physician Action Plan (RPAP) continues to support and encourage medical students to complete at least one rotation in rural communities. The AAMDC will continue to look for opportunities to support the initiatives of RPAP. The AAMDC will continue to work with all levels of government to address the need for medical personnel in rural Alberta especially as the Province works toward a new governance models. Resolutions 11-08S, 24-06F, 23-06F, 12-06F and 13-05F also address this issue.