Road to specialist physician jobs in Canada not always smooth

Despite the need for specialist physicians, the road to securing a job is not easy, particularly in specialties without the ability to practice in private offices or clinics, such as critical care and some surgical specialties, according to new research in CMAJ (Canadian Medical Association Journal) https://www.cmaj.ca/lookup/doi/10.1503/cmaj.251882.

“This study sheds light on the complex and often opaque nature of the hiring process for physicians applying to resource-intensive jobs in Canada,” writes Dr. Nada Gawad, a general surgeon at The Ottawa Hospital and assistant professor, University of Ottawa, Ottawa, Ontario, with coauthors.

Barriers include a perceived lack of full-time jobs, lack of access to job listings, desire to stay near family, need for spousal employment, and lack of resources like funding and operating room time.

This study of physicians in Canada by specialists at the University of Ottawa and the University of Alberta provides insight into the lived experiences of physicians seeking work across the country. The research team interviewed trainees, recent graduates, program directors, and division chiefs from across Canada between 2021 and 2022 to understand hiring decisions for resource-intensive specialties and to develop suggestions to help people navigate the hiring journey.

The researchers identified 5 themes from the interviews: the process is difficult to navigate and poorly defined, hiring decisions emphasize perceived fit of the candidate and lack transparency, bias and inequity occur, mentors who take active steps to help with employment influence success, and perspectives differ across the different groups of interviewees.

“Although proactive and networked candidates were more likely to succeed, the emphasis on ‘fit’ in hiring decisions introduced an additional layer of complexity,” explained the authors. The emphasis on fit was particularly problematic as it is vague and subjective, and can work against equity, diversity, and inclusion (EDI). “Our findings, along with previous research in this area, suggest that reliance on ‘fit’ risks undermining EDI efforts. Specifically, fit may disadvantage candidates from diverse or underrepresented backgrounds, perpetuate homogeneity, and limit the pool of innovative perspectives and skills.”

Participants also pointed out that job postings were often formalities only, with a preferred candidate already identified. “Institutional preference for current hiring practices may contribute to applicant frustration and unintentionally result in inequitable and noninclusive physician hiring,” the authors write.

“These findings highlight the opportunity for improvement at the individual, program, institutional, and national levels to promote transparency and equitable access to employment opportunities among physicians.”

To help navigate the hiring process,

• Trainees should consider their career goals early and network, contact institutions where they may want to work, and find mentors;
• Training programs should host sessions on the job-hiring process and give advice on how to build a strong job application;
• Hiring institutions should post future jobs once the need is identified and describe the type of candidate being sought;
• National resident associations and speciality societies should host job hiring information sessions and create best-practice guidelines for job hiring.

“Addressing the challenges cited by participants requires a multilevel approach, including integrating formal career-planning curricula into residency; establishing transparent, best-practice hiring guidelines; and developing centralized job repositories,” the authors conclude.

An article on physician advocacy https://www.cmaj.ca/lookup/doi/10.1503/cmaj.250995

explores the motivation for Canadian physicians to engage in advocacy and how they integrate into their professional identities to improve the health and lives of people in Canada.