Prof. David Koff
Chair, Department of Radiology
McMaster University
Chief of Diagnostic Imaging
Hamilton Health Sciences
Hamilton, Canada

Editorial Board Member
IMAGING Management

There are 2100 radiologists in Canada. Approximately 90 residents graduate each year in Canada. The number of Canadian Resident Matching Service (CarMS) spots in the country is around 55. This does not include additional routes to training such as re-entry funding or externally funded residents. So the number graduating to jobs each
year is between 50 and 60.

Public radiology in Canada is stronger than the private sector, as private clinics are not allowed to operate CTs or MRs. Still, 50 percent of imaging (CR, US, breast, BMD) is performed in private clinics. Radiologists are all fee for service and not on salary. The government cannot cut radiology positions in hospitals. There is a strong country based teleradiology structure and nothing is outsourced out of country.

Most new graduates stay in the country. A few used to go to the US to do a fellowship, but with the current economic situation, they try to stay in Canada, and a number of Canadian radiologists who are in the US are trying to come back. In general there is very little economic migration of radiologists from Canada. Free circulation between Québec
and France has not translated into significant movement.

Unfortunately, there are currently more graduates than jobs. Factors include the impact of the economic downturn, radiologists not retiring, PACS and teleradiology filling previous locum requirements and the drop in the government cap, resulting in radiologists working more and for more money rather than hiring young graduates.

Healthcare budget cuts have had a limited effect so far, but this will change, as the government is aiming at reducing radiologists’ income by 15 percent. In Ontario there is a plan to decrease professional fees by 11.5 percent over 4 years, which started this year with a five percent cut, and also delisting of imaging for isolated low back pain, and a 50 percent cut in reimbursement for 3D images.

However, in some subspecialties such as paediatrics and interventional radiology, we are still recruiting international graduates after a fellowship in Canada. Academic positions are less remunerative than in community hospitals, but offer more interesting career perspectives
with education and research opportunities appealing enough to retain good radiologists. Currently there are more applicants for academic radiology positions than places.