Canada and UK must stop taking African doctors.

does, however, “show the danger of a specialty relying on 1 operation,” says Ross. And he admits that new graduates are having a “tough time finding work” in Canada and the US. Dr. Stephen Fremes, head of cardiac surgery at Sunnybrook and Women’s College Health Sciences Centre in Toronto estimates that 10 to 15 newly certified cardiac surgeons in Canada are currently without full-time work. Ten cardiac surgeons were certified this year. One of Fremes’ trainees has a job lined up for next year but 3 others, including Dr. Fuad Moussa, are still seeking full-time positions. Moussa says that as far as he knows there are no jobs in Canada for the country’s 18 newly certified cardiac surgeons. Moussa, who is currently working as a fellow at Sunnybrook, is considering, reluctantly, a move to another country. He started to get “alarmed” about the employment situation in his second year of training. Now, at 36, with 19 years of post-secondary education, a wife, 3-year-old child and $30 000 in debt, he faces an uncertain future. Fremes says training may need to change so cardiac surgeons can perform other surgeries, such as vascular. He says replacing fee-forservice with salary is another option for increasing opportunities for young surgeons. Meanwhile, another 14 cardiac surgeons are due to be certified in 2006 and 13 in 2007. With the decrease in CABGs, there are also reports of shorter wait times in some provinces. In Ontario there are virtually no wait times, reports Fremes. The most recent figures indicate that wait times for CABG after acute myocardial infarction (AMI) declined from 43 days (1997–2000) to 12 days (2001–02). In Quebec, where the number of CABG procedures declined from 12 031 in 1997 to 11 621 in 2003, the median wait time from AMI to CABG declined 45.6% (from 33 days in 1997 to 18 days in 2002), reports Dr. Louise Pilote at McGill University in Montréal. In Alberta, waiting lists for open heart surgery have plummeted in the past 5 years, from 450 cases and over a year wait, to 150 cases and a 6-week wait. — Barbara Sibbald, CMAJ NE W S