Does Canada need more med schools?

In journalism, a single instance of something is unremarkable. Two instances? That's more interesting but still not quite newsworthy. Three's the magic number, like in Goldilocks, baseball and Schoolhouse Rock. Once you hit three -- boom! -- you've got a trend.

By that measure, the talk about establishing new medical schools or medical school campuses in Canada definitely qualifies as a new trend.

The reason for all the chatter, I believe, is that we live in an era when Canada's relatively low number of medical school and residency spots have come under increased scrutiny (Canada has more med schools than the US relative to the two countries' populations, but US schools are typically larger so the ratio of population to medical students in the two countries are similar) and the government of the day seems to be under constant pressure to train more physicians.

But when it comes to expensive, labour-intensive projects like establishing and running an entire medical school or even just a medical school satellite campus, the question always is: does the potential payout warrant the investment? In other words, do the following ideas for new Canadian medical schools hold water?

NORTH YORK, ONTARIO
York University's new president, the Egyptian engineer Mamdouh Shoukri, made waves not long after his appointment last year by announcing he wanted to start a medical school at York. "That is the future - to be a complete and comprehensive university. That is what my mandate is all about," he told the Globe and Mail.

Tony Keller, writing on the Macleans OnCampus website last year, expressed his approval: "If there’s going to be a new medical school in Ontario, the only logical place to put it is in the GTA, or close to it."

Considering York's proximity to the University of Toronto, the fact that its nascent Faculty of Health is still very young, and that the Ontario government just spent a bunch of money starting another new medical school, the Northern Ontario School of Medicine, it remained unclear for most of last year whether Dr Shoukri's proposal will get beyond the planning stages.

But despair not! Just last month, after Dr Shoukri gave a speech at Toronto's Empire Club, the province's health minister, George Smitherman, told the Toronto Star, "When President Shoukri came to see me, I told him I thought the idea had merit but I wasn't going to be its champion. The more I've thought about it, the more I've become its champion; it's an innovative approach to training doctors rooted in the community."

The latest news is that York would mostly train family physicians to work on community-based health prevention and health promotion (though Dr Shoukri has said the goal is to ultimately develop a world-class medical and neuroscience research centre). In a CBC radio interview last fall, Dr Shoukri also mentioned the possibility of starting the school in a limited capacity, with a small mandate in the first several years only to certify the credentials of foreign-trained medical graduates, and then later to expand into a full-fledge medical school.

As time goes on, the chances of seeing a York University School of Medicine appear more and more likely.

COQUITLAM, BRITISH COLUMBIA
A local proposal to open a medical school campus in Coquitlam isn't nearly in as advanced a stage as the one at York. The sole mention of the idea recently was a quote from a city councillor in a local newspaper: "Coun. Mae Reid, who chairs Coquitlam's Riverview committee, said the city's 50-year economic development plan envisions a medical school campus..." No further explanation, unfortunately. Coquitlam isn't far from Vancouver's downtown, so perhaps the idea is to open a satellite campus of the University of British Columbia's medical school? (Also: 50 years?! Some ambitious city planning, eh?)

GATINEAU, QUEBEC
A local lobby group is trying to rally support for a new French-language medical school satellite campus in Gatineau, across the river from Ottawa. Outaouais à l'urgence Phase 2 announced at a news conference (PDF, French only) last month that it had recently proposed the idea to McGill and the University of Quebec. "They told me there is a great interest for the project," Dr Gilles Aubé, one of the local doctors pushing for the campus, told CBC News.

A petition supporting the proposal has collected over 40,000 signatures already. Proponents have cited two similar projects that were launched in the last few years -- in Trois-Rivières, with the University of Montreal, in 2004; and in Chicoutami, with the University of Sherbrooke, in 2006 -- and Health Minister Philippe Couillard sounds receptive to the idea.


Photo: Dr Donald Rix Northern Health Sciences Centre, at the University of Northern British Columbia (medical campus affiliated with the University of British Columbia's Faculty of Medicine). This is probably the most interesting medical school campus in Canada, architecturally speaking.

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