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Physicians in Canada, 2019Physician supply in Canada continues to outpace population growth.Figure 2 Number of physicians per 100,000 population,by physician type, Canada, 1978 to 2019Number of physicians per 100,000 population3002502015: 229.12019: 241.12001501978: 2200420062008201020122014201620181980078 In 2019, there were 241 physiciansper 100,000 population: 122 familymedicine physicians and 119 specialistsper 100,000. The proportion of family medicineand specialist physicians has remainedrelatively equal since the late 1970s,with family medicine physiciansrepresenting between 50% and53% of the physician workforce.10019Between 2015 and 2019,the number of physicians inCanada increased at a fasterpace than the population.Family medicineSpecialistsAll physiciansSourceScott’s Medical Database, Canadian Institute for Health Information.12

Physicians in Canada, 2019Over the last 5 years, the number of physicians per 100,000 populationhas increased in all but 1 jurisdiction.Figure 3 Number of physicians per 100,000 population,by jurisdiction, 2015 and 2019Number of physicians per 100,000 population300250200 Jurisdictions with the highest numberof physicians per 100,000 populationincluded Nova Scotia and Newfoundlandand Labrador (268 and 260 per100,000 population, respectively).150100500The number of physiciansper 100,000 population inCanada increased by 5.2%between 2015 and .C.Y.T.Canada2019NotesDue to small numbers, data for the Northwest Territories and Nunavut is not displayed individually but is included in theCanada totals.The number of physicians per 100,000 population in Yukon includes only those who reside in the territory. If itinerant physicianswere also included, this would provide a more comprehensive estimate of the total physician supply. CIHI has been working withthe Yukon government to this end.SourceScott’s Medical Database, Canadian Institute for Health Information.13 The number of physicians per100,000 population in New Brunswickincreased by 12.3% between 2015and 2019, representing the largestper capita increase of all jurisdictionsduring that period.

Physicians in Canada, 2019Physician demographicsThe proportion of female physicians continued to rise,particularly among family medicine physicians. The averageage of physicians was slightly lower in 2019 than it was5 years ago.14

Physicians in Canada, 2019The proportion of female physicians increased across all jurisdictions.Figure 4 Percentage of female physicians, by jurisdiction,2015 and 2019Between 2015 and 2019,the number of femalephysicians increased by19.2%, while the numberof male physicians increasedby 5.8%.60%Percentage of female physicians50%40%30% In 2019, 42.8% of physicians werewomen, compared with 39.9%in k.Alta.B.C.Y.T.Canada2019NoteDue to small numbers, data for the Northwest Territories and Nunavut is not displayed individually but is included in theCanada totals.SourceScott’s Medical Database, Canadian Institute for Health Information.15 Quebec and Yukon had the highestproportion of female physicians,at 50.6%, while P.E.I. had thelowest, at 33.1%.

Physicians in Canada, 2019The proportion of female physicians is greater amongfamily medicine physicians than specialists.Figure 5 Percentage of physicians, by sex andphysician type, Canada, 1978 to 2019In Canada, femalesrepresented a largerproportion of familymedicine physiciansthan specialists.100%90%Percentage of physicians80%70% In 2019, 47.5% of family medicinephysicians and 38.0% of specialistphysicians in Canada were female.60%50%40%30%20%10%Family medicine, femaleFamily medicine, maleSpecialists, femaleSpecialists, 042006200819881990198419868219801919780% This pattern varies by province.For example, Quebec had thehighest proportion of femalefamily medicine physicians (56.6%)and female specialists (44.6%)in Canada in 2019. The overall proportion of femalephysicians in the workforce has grownfrom 11.1% in 1978 to 42.8% in 2019.SourceScott’s Medical Database, Canadian Institute for Health Information.16

Physicians in Canada, 2019The proportion of female physicians is higher among younger age groups.Figure 6 Percentage of female physicians, by physiciantype and age group, Canada, 2019Across all age groups,the percentage of femalephysicians was higheramong family medicinephysicians than specialists.100%90%Percentage of female physicians80%70%60% In Canada in 2019, 58.5% of familymedicine physicians and 50.0%of specialist physicians youngerthan 40 were female.50%40%30%20%10%0%Younger than 40Age 40–49Age 50–59Family medicine70 and olderAge 60–69SpecialistsSourceScott’s Medical Database, Canadian Institute for Health Information.17 Among physicians age 60 to 69,more than two-thirds (68.9%)were male; among physiciansover age 70, 84.8% were male.

Physicians in Canada, 2019The average age of physicians declined slightly over 5 years.Figure 7 Average age of physicians in Canada,by jurisdiction, 2015 and 2019The average age ofphysicians in Canadadeclined slightly from50.0 years in 2015 to49.4 years in 2019.5452Average physician age5048 Overall in 2019, the jurisdiction withthe highest average age of physicianswas P.E.I., at 52.1 years, and thejurisdiction with the lowest averageage was Alberta, at k.Alta.B.C.Y.T.Canada2019NoteDue to small numbers, data for the Northwest Territories and Nunavut is not displayed individually but is included in theCanada totals.SourceScott’s Medical Database, Canadian Institute for Health Information.18 Between 2015 and 2019, the averageage of physicians decreased in P.E.I.,Nova Scotia, Ontario, Manitoba andBritish Columbia, was virtually stablein Newfoundland and Labradorand Quebec, and increased inall other jurisdictions.

Physicians in Canada, 2019Internationalmedical graduatesCanada continues to gain internationally trainedphysicians. More family medicine physicians thanspecialists received their MD degree outsideof Canada.19

Physicians in Canada, 2019More than a quarter of physicians in Canada wereinternationally trained.Figure 8 Percentage of physicians with internationalMD degrees, by jurisdiction, 2015 and 2019Percentage of physicians with international MD degrees60%50%The percentage ofphysicians who receivedtheir MD degree outsideof Canada has remainedrelatively stable since 2015,ranging from 25.7% in 2015to 26.4% in 2019.40% Saskatchewan and Alberta had thelargest proportions of internationallytrained physicians (50.8% and 35.3%,respectively), while Quebec andP.E.I. had the smallest (9.0% and16.1%, .2015Man.Sask.Alta.B.C.Y.T.Canada2019NoteDue to small numbers, data for the Northwest Territories and Nunavut is not displayed individually but is included in theCanada totals.SourceScott’s Medical Database, Canadian Institute for Health Information.20 Between 2015 and 2019,the proportion of internationallytrained physicians in Ontario,Alberta and British Columbiaincreased by between 3% and5%, while it decreased in allother jurisdictions.

Physicians in Canada, 2019In recent years, more family medicine physicians thanspecialists received their MD degree outside of Canada.Figure 9 Percentage of physicians with internationalMD degrees, by physician type, Canada, 1978 to 2019Percentage of physicians with international MD degrees40%Over one-quarter (26.4%) ofCanada’s physicians receivedtheir MD degree outsideof Canada.1978: 33.4%2019: 30.0%30%1978: 31.6%2019: 22.7%20% The percentage of internationallytrained family medicine physiciansin Canada increased from 28.7% in2015 to 30.0% in 2019, while thepercentage of specialists remainedstable during that period, at 22.7%.10%Family medicineSpecialistsSourceScott’s Medical Database, Canadian Institute for Health Information.211862042012All 2198901991961984198219819819800%1978 In each of the last 15 years, morefamily medicine physicians thanspecialists received their MD degreeoutside of Canada.

Physicians in Canada, 2019More internationally trained physicians received their MD degreein South Africa than in any other country.Figure 10 Top 10 countries of MD graduation forinternationally trained physicians licensed in Canada,by physician type, 2019South AfricaPhysicians from SouthAfrica, India and theUnited Kingdom made up28.1% of all internationallytrained physicians inCanada in 2019.Country of MD graduationIndiaUnited Kingdom In 2019, family medicine physiciansaccounted for 56.9% of allinternationally trained physicians.IrelandUnited 2,000Number of physiciansFamily medicineSpecialistsSourceScott’s Medical Database, Canadian Institute for Health Information.222,500 South Africa was the top countryof graduation for internationallytrained family medicine physicians,while India was the top countryof graduation for internationallytrained specialists.

Physicians in Canada, 2019Physician paymentsand utilizationThis section contains information on physician serviceutilization and on payments to physicians that areadministered through the provincial and territorialmedical care plans. This data is for 2018–2019.23

Physicians in Canada, 2019How much are physicians paid?The cost of physician services in Canada can be understood by examining totaland average clinical payments to physicians, the types of services paid for,and information about the providers and recipients of these services.Since 2009, CIHI has reported average gross clinical payments made to physiciansby provincial/territorial medical care plans. These payment amounts are calculatedas the sum of all gross clinical payments (fee-for-service [FFS] and alternativepayments) divided by the total number of physicians reported to CIHI by thejurisdictions. In addition to total average payments per physician, CIHI publishesa series of specialty-level payment indicators, including distribution of payments,standard deviations and average payments with monetary cut-offs.24

Physicians in Canada, 2019Total gross clinical payments to physicians increased to 28.2 billion in 2018–2019.Figure 11 Total gross clinical and FFS payments tophysicians, Canada, 1999–2000 to 2018–2019 28.2 billion 30Payments in billions of dollars 25 20.5 billionFFS clinical paymentsto physicians reached 20.5 billion in 2018–2019,while alternative paymentsreached 7.7 billion. 20 In 2018–2019, total clinicalpayments to physicians increased3.0% over the previous year to 28.2 billion; this is the secondlowest increase since 1999–2000. 15 10 5Total gross clinical payments ( billions)NotesFFS: Fee for service.Excludes Nunavut. Nunavut does not report to the National Physician Database.Imaging and laboratory specialists are not included.SourceNational Physician Database, Canadian Institute for Health Information.259018–2011820011720–21620FFS clinical payments ( 0 0 Total clinical payments to physiciansin Canada have increased 13.4%over the past 5 years.

Physicians in Canada, 2019Average gross clinical payments to physicians have increased 3.4% over 5 years.Figure 12 Average gross clinical payments to physicians,by jurisdiction, 2014–2015 and 2018–2019The average gross clinicalpayment per physician inCanada was 347,000 in2018–2019, a 3.4% increaseover 2014–2015. Somejurisdictions saw increases,while others saw decreases. 400,000Average clinical payments to physicians 350,000 300,000 250,000 200,000 150,000 Quebec saw the greatest 5-yearincrease in average gross payment,from 310,000 to 345,000 (11.2%). 100,000 50,000 a.B.C.Y.T.Canada2018–2019NotesDue to the greater proportion of short-term, visiting and locum physicians and their lower associated payments in certainsmaller jurisdictions relative to larger ones, in an attempt to improve comparability, CIHI has agreed to calculate the averagepayment per physician for P.E.I. using only permanent in-province physicians, and for Yukon using only physicians whose totalgross payments are at least 60,000.Data is not available for the Northwest Territories or Nunavut. Nunavut does not report to the National Physician Database.Imaging and laboratory specialists are not included.SourceNational Physician Database, Canadian Institute for Health Information.26 New Brunswick saw the largest 5-yeardecrease in average gross payment,from 302,000 to 294,000 (-2.7%).

Physicians in Canada, 2019The average gross clinical payment per surgical specialist was higherthan that per medical specialist and per family medicine physician.Figure 13 Average gross clinical payments, by physicianspecialty, Canada, 2018–2019OphthalmologyThoracic/cardiovascular surgeryNeurosurgeryUrologyTotal surgical specialtiesGeneral surgeryOtolaryngologyOrthopedic surgeryAnesthesiaInternal medicinePlastic surgeryObstetrics/gynecologyDermatologyTotal medical specialtiesTotal physiciansNeurologyPediatricsPhysical medicinePsychiatryFamily medicine 791,000 588,000 558,000 500,000 490,000 466,000 444,000 438,000 437,000 407,000Family medicine 394,000 392,000Medical specialists 385,000Surgical specialists 363,000Total medical specialists/ 347,000total surgical specialists 316,000Total physicians 296,000 289,000 282,000 280,000 0 200,000 400,000 600,000 800,000Average gross clinical paymentNoteSpecialty-level information for Saskatchewan, Alberta and the Northwest Territories at the level needed for this analysis wasnot available. Nunavut does not report to the National Physician Database.SourceNational Physician Database, Canadian Institute for Health Information.27By combining FFS data withphysician-level alternativepayment data, CIHI is ableto report comprehensiveaverage payments perphysician by specialty. The average gross clinicalpayment per family medicinephysician was 280,000. The average gross clinicalpayment per medicalspecialist was 363,000. The average gross clinicalpayment per surgicalspecialist was 490,000.

Physicians in Canada, 2019The average gross clinical payment varies across Canada.Figure 14 Average gross clinical payments, by physiciantype and jurisdiction, 2018–2019CanadaFamily medicine (FM)FM: 280,000MS: 363,000SS: 490,000Medical specialists (MS)Surgical specialists (SS)N.L.FM: 217,000MS: 346,000SS: 475,000Y.T.FM: 274,000MS: 230,000SS: 591,000B.C.FM: 221,000MS: 338,000SS: 487,000N.W.T.FM: n/aMS: n/aSS: n/aAlta.FM: n/aMS: n/aSS: n/aNun.FM: n/rMS: n/rSS: n/rMan.P.E.I.FM: 327,000MS: 429,000SS: 590,000Que.FM: 309,000FM: 274,000MS: 404,000Sask. MS: 388,000Ont.SS: 478,000FM: n/a SS: 512,000FM: 310,000MS: n/aMS: 344,000SS: n/aSS: 489,000N.S.FM: 225,000MS: 283,000SS: 400,000 The average gross clinical payment perfamily medicine physician ranged from 217,000 in Newfoundland and Labradorto 310,000 in Ontario. The average gross clinical payment permedical specialist ranged from 283,000in Nova Scotia to 404,000 in Quebec. The average gross clinical payment persurgical specialist ranged from 400,000in Nova Scotia to 512,000 in Manitoba.N.B.FM: 227,000MS: 342,000SS: 422,000Notesn/a: Specialty-level information for Saskatchewan, Alberta and the Northwest Territories at the level needed for this analysis was not available.n/r: Nunavut does not report to the National Physician Database.Due to cell suppression at the specialty level, the average payment for medical specialists in Yukon includes only payments to pediatric specialists.Due to the greater proportion of short-term, visiting and locum physicians and their lower associated payments in certain smaller jurisdictions relative to largerones, in an attempt to improve comparability, CIHI has agreed to calculate the average payment per physician for P.E.I. using only permanent in-provincephysicians, and for Yukon using only physicians whose total gross payments are at least 60,000.Canada figures exclude Saskatchewan, Alberta, the Northwest Territories and Nunavut.SourceNational Physician Database, Canadian Institute for Health Information.28

Physicians in Canada, 2019Physician full-time equivalentsAnother metric that can be used to analyze physician payments and supply is thefull-time equivalent (FTE). The FTE is used to adjust the total count of physiciansto reflect their activity based on their clinical payments.Historically, CIHI published an FTE indicator based on FFS payments only. Since thelate 1990s, there has been considerable migration from FFS to alternative payments.As a result, CIHI has developed an enhanced FTE indicator that focuses on a physician’sfull clinical payments by including both FFS and alternative payments to physicians andreplaces the former FTE indicator that used only FFS payment data.The aim of the FTE indicator remains the same: to produce statistics that arecomparable in 3 dimensions — over time, across jurisdictions and across specialties.A full description of the FTE indicator methodologies is provided in the NationalPhysician Database Methodology Notes document in appendices C and G.29

Physicians in Canada, 2019Average gross clinical payment per FTE physician includesboth fee-for-service and alternative payments.Figure 15 Average gross clinical payment per FTE physician,by physician type and jurisdiction, 2018–2019Average clinical payment per FTE physician 800,000 700,000The FTE methodology usespayments as a proxy foractivity and computes FTEsthat reflect clinical activityfor each given specialty. 600,000 The average payment perfamily medicine FTE in Canadain 2018–2019 was 327,000. 500,000 400,000 300,000 200,000 100,000 0N.L.P.E.I.N.S.N.B.Family medicineQue.Ont.Man.Medical specialistsSask.Alta.B.C.CanadaSurgical specialistsNotesFTE: Full-time equivalent.Saskatchewan and Alberta FTEs are based on fee-for-service payments only.Imaging and laboratory specialists are not included.Data is not available for Yukon, the Northwest Territories or Nunavut. Nunavut does not report to the National Physician Database.SourceNational Physician Database, Canadian Institute for Health Information.30 The average payment permedical specialist FTE in Canadain 2018–2019 was 400,000, andthe average payment per surgic

5 Physicians in Canada, 2019 More information The following physician products are available on CIHI's website: Physicians in Canada, 2019 (report) A profile of physicians in Canada, 2019 (infographic) Supply, Distribution and Migration of Physicians in Canada, 2019 (data tables, historical data tables, methodology notes) National Physician Database, 2018-2019 (payments and .