Our 2019 report features updated data on the job status of newly certified specialist physicians and highlights some of the key enablers and complex barriers to finding employment.
Despite troubling patient wait lists, a number of newly minted medical specialists in Canada face employment challenges at the time of certification.
Since 2011, the Royal College of Physicians and Surgeons of Canada has been collecting data on specialists and subspecialists through:
An initial survey sent to all newly certified specialists between four to 12 weeks following their final Royal College certification examinations.
A follow-up survey sent to those who reported employment challenges in the initial survey. This survey is sent between 12 to 17 months following their Royal College certification.
This 2019 report examines:
- employment patterns of 7,178 newly certified specialists between 2011-18;
- physician employment trends by province;
- how long it took new specialists to secure a post; and
- key enablers and barriers for specialists to finding employment.
Note: this report delves into the employment challenges experienced by specialists and does not look into employment issues that may affect family physicians.

Key findings
Biggest barriers to finding employment
There are a number of complex factors affecting employment, including:
Too few available positions in some specialties
Family matters: desire or need to stay near family
Fewer hires and access to operating room time and resources
Poor access to job listings
The need for spousal employment
The delayed retirement of established specialists
Newly certified anesthesiologist


Newly certified general surgeon
Orthopedic Surgery: A concerning example
- An average of 37% of orthopedic surgeons surveyed by the Royal College reported not having a job at the time of their certification.
- Hip and knee replacements have gone up in Canada by 19% and 14%, respectively. These percentages are likely to continue rising with an aging population (based on fee-for service billing data between 2011 and 2015).
- But limited access to resources (e.g., operating room time, staff, beds) impacts how many orthopedic surgeons can practice and how much work they can do.
- The orthopedic surgeon workforce is aging and there are fewer trainees entering the field.
Will there be enough orthopedic surgeons to meet future patients’ health needs?

Future reports will look deeper
Working with our national and provincial stakeholders, we aim to be a catalyst for solutions on physician employment challenges, and to inform health workforce and career planning. Future reports will explore medical workforce issues such as: do employment patterns affect men and women equally? Is working a locum (i.e., temporary replacement) a deliberate career choice or a stopgap until a permanent post is secured?
Dive deeper into the data and factors
Download our 2019 report
Read our:
Full methodology [PDF]
Media release [PDF]
Media backgrounder [PDF]