Finding a Job in Nova Scotia el-hawary.jpg

Ron El-Hawary, M.D., M.Sc., FRCSC
Halifax, NS

As early as medical school, my long-term goal was to find an orthopaedic job in Canada, preferably in my hometown of Halifax, Nova Scotia. This affected my choice of residency programmes as I realized that, if "Plan A" was successful, the years of residency would be my best opportunity to spend time in another part of the country.

After my second paediatric orthopaedics rotation at the University of Western Ontario (during PGY-3), I felt that this sub-specialty was my true passion. By early into my fourth year of residency, I contacted Dr. Joe Hyndman, who is the Chief of Paediatric Orthopaedics at the IWK Health Centre in Halifax. He encouraged me to pursue a fellowship in paediatric orthopaedics as he felt that a job might be available in Halifax within a few years. After residency, I spent one year of fellowship with Dr. Tim Carey in London and one year of fellowship at the Texas Scottish Rite Hospital (TSRH) in Dallas. During this time, I remained in contact with Dr. Hyndman who was becoming more and more confident of a potential job for me in Halifax.

While in the United States for fellowship, I realized just how much demand there is for paediatric orthopaedic surgeons. The reason for this is that the population of surgeons in this sub-specialty is rapidly aging and that there are fewer people applying for these fellowship positions. Every week, the fellows at TSRH received at least one job posting from across the United States. These opportunities spanned from Maine to Hawaii and were certainly quite attractive financially. While my co-fellows were signing lengthy contracts (that of course were carefully reviewed by their lawyers), I was relying on my "gentleman's agreement" with the group in Halifax. The Americans couldn't understand why I wanted to return to Canada, let alone without a formal contract signed. This influence coupled with the fact that some recent Canadian graduates were having difficulty finding academic positions in Canada swayed me to explore, briefly, the paediatric orthopaedic job market. There were rumours of other paediatric opportunities in Canada, but I was surprised by the uniform lack of formality in the entire process.

Fortunately, everything worked out well for me to return to Halifax. Despite this, the entire process of finding a job can be stressful and several of my young colleagues have been quite disappointed with the process. The unfortunate reality is that despite the growing wait lists for surgery and the aging population (both patients and surgeons), several highly trained new graduates have not been able to find academic jobs in Canada. Even with two years of fellowship experience, several of my contemporaries have been unable to find suitable jobs in this country. It doesn't make sense that bright young surgeons who have had excellent educations in Canada, and who are very loyal to the country, end up at prestigious American centres because of the lack of jobs in our country. We simply cannot afford to allow this to continue and we should do everything that we can to retain Canadian trainees in our country once they have graduated.

It seems that finding a job in Canada is related to being in the right place at the right time. I was a beneficiary of this system however; in general, it is not the fairest system for everybody. In addition to the obvious solution of increasing resources from the government and from hospitals, a more formalized system of posting jobs and interviewing candidates should be implemented. The Canadian Orthopaedic Association could be instrumental in helping coordinate this. With the growing public demand for orthopaedic surgeons in this country and the relatively few orthopaedic trainees, our goal should be to have enough positions available for all of our Canadian graduates to stay and work in our country. As we all know, it's a great place to live and to work.

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