Now is not the time to be short-sighted.

Writing on the wall I know a resident training in his home province of New Brunswick who will be working in emergency and obstetrics in-hospital when he finishes his residency in a few months. Great. We need that. But he is doing this because the government will not give him a billing number to practise comprehensive family medicine. As a comprehensive family physician he could be delivering babies, doing emergency shifts, and building a practice in the community. There are several physicians in his community who could be retiring in the next few years. The government’s decision seems short-sighted to me—especially now. A few years ago, a Dalhousie family medicine resident who wanted to practise in a small community in Cape Breton, NS, could not relocate there because there were “already 2 physicians” in the community. The fact that one of the physicians was planning on retiring in the next few years and the other was ill did not seem to be considered. Recruitment efforts need to understand the local context and allow for some overlap as senior physicians move away from their traditional practices and young physicians gear up and get established, especially when they are taking over long-standing, large, and complex practices. Not to allow for this is short-sighted. Another physician in New Brunswick, only recently out into practice, is being made to feel unwelcome by her community colleagues because her panel size is average and manageable but only a fraction of the size of their practices, and they do not think she is pulling her weight. She has a panel of 2000 patients. This same sentiment has also been expressed by at least 1 resident, on the opposite side of the country in Alberta, who attended a provincial medical society meeting this past year where physicians indicated that they were unhappy with the work ethic and expectations of the current generation of medical students and residents. Short-sighted again? In this past year at the University of Calgary in Alberta, I sat in an organized medical school session and heard a prominent politician indicate to a large group of medical students that they should not expect to have jobs in that province when they were done training. In recent years, medical school class sizes have been increasing across Canada and in this province; now reductions in class size are being considered. Short-sighted yet again? New Brunswick is increasing its training of medical students with the opening of the Saint John Campus of Dalhousie University’s medical school. At the same time, the province continues to restrict billing numbers, even when communities have thousands of unattached patients and many family physicians have overpaneled practices or are approaching retirement.