Response

The Section of Residents of the College of Family Physicians of Canada raises a very good point. Although I am unclear whether they support moonlighting or not, I will presume they do.

I would submit that there is good evidence that residents are capable of moonlighting after successful completion of the Medical Council of Canada Qualifying Examination Part I and 12 months of general basic clinical training. They are permitted to do so in British Columbia and Nova Scotia; in Ontario, however, this was met with substantial resistance from the regulatory authorities and the departments of family medicine. This resistance essentially cut off the right for family medicine residents to meaningfully participate in our pilot.

I also agree that cumbersome barriers based on paternalistic views and not on fact are the biggest problem. At present, flexibility is being introduced in all domains of medicine, especially to entice international physicians to practise in Canada. Why not allow the same flexibility for our own graduates who have shown that they can perform well after a foundational year of clinical training and the national test of knowledge?

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