Canada

I believe one of the reasons for the extension is because there's a trend of residents not feeling fully prepared when entering practice after just two years. Family medicine is very complex. While specialists can be experts in their scope, family physicians need to know a bit of everything from every scope.

I do agree that pay needs to increase, as access to primary care is the best preventative measure in patients needing the more expensive services less, and family doctors have considerable overhead costs compared to specialists. However, the more lucrative specialties often don't have jobs waiting at the end of them. Sure, you can take an ortho residency with dreams of the high life, but good luck actually finding a job afterwards.

Simply adding a third year of residency would probably deter a few prospective doctors, but if primary care is given the resources respective of its preventative role, it would likely become a more popular discipline. This requires changes throughout the system, though. Yes, provinces have to pay more for services, but localities need to provide the supports to enable an increase of medical students and residents, including housing, and the hiring of doctors and staff to facilitate the learning. I've never once heard a family doctor say they'd like to work more hours in a week, yet some communities turn away physicians because they're "full". Recruiters need to first exist in the first place (thanks, SaskParty), but also understand the needs of their community so adequate service is available.

Canada is way, way short on primary care providers, especially in rural and remote areas, yes. Nurse-practitioners can only fill in so many of the gaps left by the insufficient number of family physicians, and they also take time to train. We have emergency departments closing because of lack of personnel, and it's literally killing people to have to drive forty or more minutes to the nearest hospital that's open when they have a heart attack.

Forcing new physicians to practice for a year somewhere other than a major city would be much more useful than sending them back to school for an extra year.