Doctors want to leave U.S. How Canada could benefit from brain drain

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John Philpott’s phones and emails are buzzing with American doctors looking to get “the hell out of the United States.”

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Twenty to 30 inquiries a day. “It’s huge,” said Philpott, founder of CanAm Physician Recruiting Inc., a 27-year-old firm whose current job board lists more than 150 open positions across Canada. Family physician in Edmonton (“Guaranteed salary and No Overheads in Fantastic Location”), anesthesiologist in Calgary, obstetrician/gynecologist in Moncton, emergency doctors in “multiple locations.”

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The surge in interest from U.S. doctors is unprecedented, Philpott reports. The opportunity to lure doctors and top-tier medical research talent to Canada, enormous, he and others said.

An apparently sizeable number of American doctors and academics are contemplating fleeing their country in the wake of what some of the nation’s top scientists and medical researchers have called the Trump administration’s “wholesale assault” on science. Canada is often on the opposite end of the equation: Canada pays to educate a doctor, who then relocates to the United States. Now, Canada is among the preferred destinations for this reverse brain drain.

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With the Canadian health-care system in dire need of more doctors, and medical research capacity far below that of the United States, how should the nation respond to this opportunity? According to observers, create a special university hiring tract for highly trained “high flyers,” beef up Canada’s grant funding agencies by bolstering R&D spending, make it easier for American doctors to practise in Canada and launch strategic recruitment campaigns, borrowing from the anti-tariff billboards dotting a dozen U.S. states.

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In the few short months since U.S. President Donald Trump took office, hundreds of millions of dollars in university grants and contracts have been slashed or paused, 20,000 jobs have been eliminated from U.S. health agencies, labs have been defunded and selective cuts ordered to certain areas of research related to sex, gender and reproduction — all under sweeping changes led by health secretary Robert F. Kennedy Jr. and billionaire Tesla entrepreneur Elon Musk.

“There is a lot of concern and incredulity that this is happening,” said Dr. Stephen Archer, director of the Translational Institute of Medicine at Queen’s University in Kingston, who spent a good chunk of his career in the U.S. and who mentors many young American scientists. The cuts, Archer said, are threatening the “lifeblood” of American researchers.

A new poll by the journal Nature found more than 1,200 of them — three quarters of American scientists who responded — said they are considering departing the U.S., with Europe and Canada “among the top choices for relocation,” Nature reported.

The kinds of people that might be available are fairly high flyers

“The kinds of people that might be available are fairly high flyers,” Archer said. The last time this many Americans who might leave their country were in play was during the Vietnam War draft, he added.

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“This is a big deal. It’s not like minor frustration over prior presidents, or differences of opinion with policy. I think people would be in play if you could make jobs available,” targeted for Americans, and with criteria “to ensure you got excellent Americans.”

The recruitment would have to be coupled to a start-up package providing funds needed to launch a Canadian career, he said.

“I think we will definitely get some people,” Archer said. “There’s a disturbance in the force, so to speak. Americans are considering relocation options and career moves they haven’t considered before.”

“For Canada to cash in on this angst, we’d have to deal with the fact that we currently don’t have lots of empty jobs in academic medicine,” Archer said. “We’d also have to come up with the start-up funds newly hired faculty need to build their research labs.”

And therein lies a problem: American spending on health science dwarfs Canada’s: The Canadian Institutes of Health Research’s budget ($1.2 billion in 2020-21) is roughly one-50th the size of the U.S. National Institutes of Health’s trove (US$45 billion in the same period.)

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Canada is being pressured to increase its military spending, which Archer said is a good thing. But the benefits of investing more in research funding would be significant, he said. “You’d be getting highly educated, fully trained people that another country has paid to train.”

Alberta was once home to the Alberta Heritage Foundation for Medical Research, which offered million-dollar-plus start-up funding to lure world-class scientists to the University of Alberta or University of Calgary. “There was a special tract for high-flyers,” which targeted not just America, but also the world, Archer said.

A practising cardiologist and academic, Archer spent time at the University of Minnesota and University of Chicago, moving to the U.S. in the late ‘80s in part for opportunities offered, and in part out of frustration Canada wasn’t doing enough to invest in world-class biomedical research enterprises.

Although he loved his time in America, he moved back to Canada when he’d had enough of America’s “harshness” in the medical sphere, as he recently described, to TVO’s Steve Paikin, like restricting access to care for people with Medicaid.

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He was recruited back to Canada, initially through the Alberta Heritage Foundation and, later, by an offer to become head of medicine at Queen’s.

Still, as a Canadian living abroad, “I had to find a job, compete for that job and negotiate startup money and lab space.”

Today, Queen’s, like nearly half of Ontario universities, is facing a deficit and has a hiring freeze, meaning there are relatively few faculty positions available.

However, “if you made jobs in academic medicine available, and target them at emigrating faculty from the United States, that would go a long way to making Canada seem appealing to Americans,” Archer said.

If you made jobs in academic medicine available, and target them at emigrating faculty from the United States, that would go a long way to making Canada seem appealing to Americans

“Otherwise, if you’re an American citizen applying to Canada you would be behind the eight-ball in terms of your eligibility for a job. We would be obligated to pick Canadians first.”

Implementing a 2017 report led by former University of Toronto president Dr. David Naylor on Canada’s science funding would grow the pie and give Canada capacity to recruit. Naylor’s call for spending one per cent of Canada’s gross domestic product on science would also help carve out funding to recruit mobile and talented Americans, Archer said.

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“The nice thing about investing in science is it improves life,” Archer said. It’s no boondoggle. “The payback to government through taxes and innovation are very quick,” he said. It’s been estimated that for every dollar spent on funding science, governments reap $6 to $11 in economic benefits.

There’s no evidence of a widespread migration north of American doctors, skeptics have remarked on social media. However, 347 physicians working in the U.S. registered with Philpott’s agency over the last year; 141 were added in the last three months alone.

Over the last two years, the College of Physicians and Surgeons of Ontario introduced new “registration pathways” for doctors trained in the U.S. Among other changes, the updates allow American board-certified physicians to practise independently without the need to complete additional training or exams.

Between 2023 and the end of 2024, the college registered 351 American physicians following the policy changes. From January to April 1 of this year, it received registration applications from 260 doctors from a broad range of specialties “who are all educated (and most of whom are currently practising) in the U.S.,” the college said in a statement to National Post.

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While every province has a “pathway” for American doctors, only Ontario, Nova Scotia, New Brunswick and Saskatchewan will fully license them without any Canadian training or certification required. A similar new bylaw in British Columbia is under consultation.

Family doctors trained and certified in the U.S., as well as three other “approved jurisdictions” — the United Kingdom, Ireland and Australia — can get automatic certification from the College of Family Physicians of Canada (CFPC) with no exams required. Once certified, any province can give them a full licence.

“Compared to 2018, in 2024 there is close to a 300 per cent increase in the number of (certifications) awarded via this route (198 in 2018 versus 775+ in 2024),” college president Dr. Carrie Bernard said in a statement to National Post. There was also a dramatic increase in applications from the U.K. in the years following Brexit.

“The CFPC welcomes American family doctors, as we always have,” Bernard said. “Every additional family physician certified by the CFPC means another doctor caring for more Canadians.”

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The nice thing about investing in science is it improves life

Philpott said he’s hearing from U.S. doctors working not only in family medicine, but also emergency medicine, general surgery, pediatrics, psychiatry, ob/gyn — “all specialties, right across the board, from California, Arizona to Florida, New York to the Midwest.” Highly sub-specialized physicians, like the internal medicine doctor from Cincinnati who specializes in respiratory medicine and is into robotics who called Philpott earlier this week, are rarer. “Super-specialized guys” could have a hard time being placed, he said. Far less so for those working in areas facing severe access issues, including emergency medicine.

“I was talking to one of my staff, she was talking to an emerge doc yesterday,” Philpott said. “And the doctor said, ‘Listen, I’m coming; I’m coming tomorrow. ASAP. Put me wherever.’”

Canadian and American doctors practice the same medicine and the same principles, Archer said. “The accreditation of medical schools is done by the same agency, so there’s a lot of similarity.”

“And Canadian physicians, although this might be controversial, are reasonably well-paid, relative to American physicians,” he said. While there are major exceptions to the rule for some specialties, most American doctors wouldn’t be taking a pay cut to come to Canada, he said.

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The doctors “shaken loose by policy rather than ideology” are more likely to be research-oriented doctors, and more likely to be specialists, Archer said.

“Whereas, if you are a family doctor or even a specialist who’s simply practising medicine, you might not like the current administration, but whether there is NIH funding or not doesn’t affect your day-to-day practice of medicine,” he said.

Family is a huge reason to say put, as well as loyalty to one’s country, he said. Those doctors may be less motivated to leave.

Still, luring top-tier academics would take “bundles of money” and university jobs, Archer said. It would be technically easier, on the other hand, to recruit practising doctors, mostly by ensuring that American doctors are considered on par with Canadian doctors, Archer said.

“Advertising and promoting that idea of, ‘We welcome you in Canada, and we’ll make sure that we expedite your licensure and help with moving you to Canada,’ could free up lots of very talented physicians who are not researchers but who would help our health-care system.”

Archer likes the idea of a formal advertising campaign, like the Canadian government’s billboard campaign warning “hard-working” Americans they will be hurt by tariffs.

Maybe not billboards, Archer said, but a campaign about people relaunching their medical careers in Canada, along with the appropriate government liaison to contact.

University of Ottawa global health epidemiologist and science communicator Raywat Deonandan says Canada should pull out all the stops. “U.S. doctors are fleeing upstream to Canada like spawning salmon,” he posted on X. “Put the nets out and catch them all. Offer them everything: money, tax breaks, Raptors tickets, whatever it takes!”

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Deonandan’s post got some pushback, because of what he considers a lack of imagination. “(Some people responded), ‘Our institutions are so chronically underfunded, where could we possibly find the money to entice top U.S. talent?’ I find that unimaginative, because if you want them, you’ll spend the money.”

“The other pushback was fairness, which I thought was odd,” Deonandan said. “Some people are saying, ‘Why bring out all the bells and whistles and lures for foreign talent when we’re not rewarding our local talent?’

“I find that short-sighted, because it’s like a sports team: If you try to win the cup, you have to attract the free agents and then use whatever success you get from winning the cup that season to build your team up afterwards.”

Canada’s health system has its own major challenges. “But it’s a matter of casting the net widely enough so that you get a fair number of the American specialists who are motivated by what we have, and not by what we don’t have,” Deonandan said.

“It’s not just about the money,” he added. “I think some (Americans) are seeing that already — seeing a more stable political environment, a socialized medical care system and less ideological divide.

“Believe it not, we have less of that here than in the U.S.”

National Post

This is the latest in a National Post series on How Canada Wins. Read earlier instalments here.

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