Guest Editorial

CCFP — do these four little letters mean anything?

I was thinking about getting my CCFP (certificate, college of family physicians) but the article in NRM (Jan 15 issue) turned my stomach and gave me a solid second thought.

Only two years after graduating as a general practitioner the rules changed. I was no longer considered a 'qualified' family doctor. Studies were quoted stating that a two-year residency produces superior family doctors. Other studies showed quality of practice being equal between GPs and FPs five years from graduation. However, if the latter is true, why produce inferior specimens and wait five years for maturity? Why not offer a specialist equivalent

four-year family practice degree instead? By this faulty logic, we would produce even better family doctors, right? By the way, if this is done, the current CCFP will of course be obsolete and inferior.

My colleagues who have their CCFP discourage me from getting it. The College had to absolve a huge percentage of members who were unable to afford the time and/or cost of CME to keep their certificates. Why would I want to pay inordinate dues and take extra training to receive the same income? I'm told by my colleagues with CCFPs that the extra year of residency was a waste of time and money.

In my humble opinion, the extra year of residency and other crude policies were introduced by short thinking politicians and doctors who now avoid accepting responsibility for the current family practice crisis. There was an active collaboration to reduce the supply of family doctors. The extra year of residency immediately withdrew an entire graduating year of family doctors from active practice to 'save the system money.' Also, medical school enrolment fell as a result. We see now where this type of thinking has brought us.

My job opportunities have been restricted because I missed a mere one year in training. Isn't it enough that I was forced as a student to work 72 hours straight on call with half-an-hour sleep for less than minimum wage? At the time, I was told it was a rite of passage and that my income in future would compensate. I graduated into a

down-turned economy and my income has changed little in seventeen years. I earned the right to practise as a family doctor through the sheer amount of hours worked in medical school alone. This should be more than enough to compensate for the extra year of residency. Things have changed for residents since my day and I'm thankful that on call is now restricted to one day in four for residents, and that they're sent home after a night on call. That did not exist in my time.

Throwing more obstacles at physicians who want to practise family medicine is only worsening the doctor shortage in Canada. Foreign graduates also have had a very hard time trying to qualify to practise here. Recent publicity about the plight of IMGs, however, has sparked a public outcry and, as a result, our new agreement in Ontario tries to make it easier on them. But isn't it time to fight for our home grown experienced GPs who cannot apply to work in their communities because they're considered underqualified?

— Dr Nick B Cuberovic, Oakville, ON

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