No doubt about it, the transition from medical school to residency is an exciting time. So too is the transition from residency to practice. But these are often very difficult times financially. Luckily, there are various federal and provincial/territorial programs that can help ease your financial burden as you take the first important steps of your medical career.
Governments have devised programs that incentivize young physicians to practise where they are most needed, often in rural and remote locations. You may have heard of them: return-of-service programs and recruitment/retention incentives. From the physician’s point of view, these programs can be a way to get financial relief by helping fill the gaps in health care in Canada.
Below is a breakdown to help you decide whether one of these programs might be for you.
Return-of-service programs are all different, but they always hinge on your commitment to practise in an underserved community for a specific length of time. In exchange for signing a return-of-service agreement, you receive a benefit such as:
- relief on your student loans
- a grant or bursary
- a training opportunity (e.g., residency spots for foreign-trained medical graduates)
Return-of-service agreements are legal contracts. If for some reason you can’t fulfill your commitment, you will have to repay some or all of the associated costs.
Let’s look at a few examples of these programs:
Ontario’s Resident Loan Interest Relief Program applies to federal loans and loans from any province/territory that haven’t been consolidated into bank loans. If you enroll in this program, you won’t have to pay principal (the amount you borrowed) or interest on your student loans during your residency and for 30 days after completion. In other words, repayment is put on hold and no interest will accumulate during that time. In exchange, you must commit to working in the province of Ontario for five years at the end of residency. This program is available for all specialties.
To attract physicians from out-of-province, Prince Edward Island offers grant money with a return-of-service commitment. For example, in exchange for a three-year commitment, family physicians receive from $50,000 to $115,000, depending on which eligible location they work in. Specialists may be eligible for grants as well when positions become vacant.
British Columbia has a couple of programs for international medical graduates (IMGs). One is the Post-Graduate Medical Education IMG Program, in which the province will fund the residency training of qualifying IMGs in exchange for two years (family medicine) or three years (other prioritized specialties) of service in a priority B.C. community.
Recruitment and retention incentives
Provinces and territories also attract physicians to fill healthcare gaps in another way: by offering incentive payments.
For example, in Saskatchewan, the Rural Physician Incentive Program offers incentives to new family medicine graduates (including IMGs) if they establish a practice in a rural or remote Saskatchewan community. There are some specific criteria you have to meet for this program, but the gist of it is that you’ll get an incentive payment each year that you stay; the payment starts at $10,000 and increases each year of practice for up to four years.
In British Columbia, as part of the Recruitment Incentive Fund, medical residents transitioning to practice who commit to filling a vacancy in an eligible rural community will receive an incentive of between $5,000 and $20,000, depending on the community’s level of isolation. If the physician doesn’t stay for at least one year, they will have to repay the incentive.
A few tips before you commit
This all might sound pretty enticing, especially to someone starting their career with six figures of debt to pay off, but there are some important things to consider before you jump at one of these programs. Here are some tips to help you make an informed decision:
1. Review return-of-service contracts with a professional.
Your provincial or territorial medical association will likely be able to help with your return-of-service contract. But getting a lawyer to review it can help you better understand the terms and clauses, and the penalties if you break the contract. Also, be sure to look closely at the conditions for things like maternity leave — every program will handle it differently.
2. Consider the lifestyle.
Rural or remote practice can be really rewarding — many of these small communities have limited access to health care, and one physician can really make a difference. You’ll get to know your patients, inside and outside the office. But the rural life has its challenges, too. Resources and support staff may be in short supply, and extra responsibilities like long on-call hours and lots of administrative tasks may fall heavily on your shoulders.
Also, you may be living far from your family and friends, and the breadth of services and activities you’re used to may not be available in a small community. If you have a family, you’ll also have to figure out whether your spouse will be able to find work and where your kids will go to school.
3. Do your research.
Thankfully, there are a lot of things you can do to arm yourself with the knowledge you’ll need to make the right decision. Consider visiting the community to see what it feels like (good vibes are a real thing), and chat with any colleagues who have done a locum in the area. And don’t forget to talk with your MD Advisor* about how much you’ll be able to save by participating in one of these programs. Getting the math right will give you an accurate sense of how worthwhile it will be.
Return-of-service and incentive programs in Canada
If you’d like to explore what programs are available to you as a physician in Canada, you can start here:
- B.C. Clinical Anesthesiology Fellowship
- Post-Graduate Medical Education International Medical Graduate Program
- Practice Ready Assessment — BC
- Re-entry Program
- Recruitment Incentive Fund
- Family Medicine Resident Bursary
- Prairie North Health Region employment incentives
- Retention Fund
- Rural Physician Incentive Program
- Specialist Recruitment Incentive
- Northern Physicians Retention Initiative
- Northern and Rural Recruitment and Retention Initiative
- Resident Loan Interest Relief Program
Prince Edward Island
Newfoundland and Labrador
* MD Advisor refers to an MD Management Limited Financial Consultant or Investment Advisor (in Quebec), or an MD Private Investment Counsel Portfolio Manager.
The above information should not be construed as offering specific financial, investment, foreign or domestic taxation, legal, accounting or similar professional advice nor is it intended to replace the advice of independent tax, accounting or legal professionals.