Source: Fraser Institute
Millions of Canadians still lack a regular family doctor, and wait times for specialists remain long. Media coverage often frames the shortage as a recent or post-pandemic problem, but the Fraser Institute’s latest analysis shows the problem is much older. For two decades, Canada has ranked near the bottom among high-income countries with universal health care systems when measured by the number of physicians per population, even after adjusting for age.
In 2003, Canada had about 73 per cent as many physicians as the average of its peer countries. By 2023 that figure had slipped to 70 per cent, the lowest share in twenty years. The gap has been stubbornly consistent despite Canada running one of the more expensive universal systems in the developed world. The country once had one of the higher physician-to-population ratios in the early 1970s after a major expansion of medical training capacity. Policy decisions in the following decades deliberately reduced medical school enrolment and limited the recruitment of international medical graduates out of concern about oversupply. Those choices proved very costly.
Recent increases in first-year medical school enrolment are positive but modest. Canada still graduates roughly half as many new doctors per capita as the OECD average. New graduates also take six to eleven years to complete training and enter practice. International medical graduates make up a significant share of the current workforce, yet the overall net addition of physicians remains low. Between 2022 and 2023, Canada added only 1,364 doctors on a net basis, below the average of the previous decade.
RBC has estimated a shortfall of at least 44,000 physicians by 2028 if Canada wants to approach OECD levels. Current enrolment and graduation numbers offer little reason for optimism that the gap will close quickly. Without more substantial changes — including a larger and faster role for qualified international graduates and continued expansion of domestic training capacity — the relative shortage is likely to persist.
The data makes it clear that this is not a temporary blip. It is a long-term structural problem that has left Canadians with less access to physicians than citizens of comparable countries, even while governments spend heavily on the system. Closing the gap will require more than incremental enrolment increases. It will require a sustained willingness to treat physician supply as a priority rather than a problem that somehow solves itself.
