In 1929, the Parliament of Canada voted to create a statutory body for the teaching profession of trainee doctors. The body will celebrate its 100th anniversary in a few years.

The name of the Canadian medical education professional organization is the Royal College of Physicians and Surgeons of Canada (RCPSC). The word college is used in English for associations, societies, and high schools, but in Korea, it's more commonly used for university colleges. In Commonwealth countries, clinical societies use the word college more than association.

In the U.K., specialists are also referred to as fellows in the sense of fellows of a professional society. However, a fellow is used for full-time doctors or subspecialists in the United States and Korea. In Korea, specialist and subspecialist certificates are awarded by the Minister of Health and Welfare, while in Canada, they are signed by the head of the professional organization of the statutory specialty.

The primary care system is very important in Canada, which has a tax-based healthcare system.

The College of Family Physicians of Canada (CFPC) was founded in 1954 and incorporated in 1968. It is divided into a specialty society for primary care physicians and a generalist society. The unwritten rule is that there should be a 1:1 ratio of family physicians to other specialists, but there is no scientific basis for this.

Training of junior doctors is left to professional organizations without government interference in Canada

In Canada, the national legislature has provided the basis for establishing organizations for training junior interns and residents. These organizations are given full responsibility and accountability for the education of trainee doctors to fulfill their professional and social responsibilities.

The government does not interfere in any way. The same is true for political parties.

The relationship between the Royal College of Physicians and Surgeons of Canada, a professional organization with a 96-year history, and the government is well-established and very stable. It is unlikely that the government will ever issue an executive order to doctors. Under the philosophy of a tax-based healthcare system, the state governments are responsible for the salaries of trainee doctors and their educational expenses. Even the major physician strike in Ontario in the 1980s did not result in any coercive measures by the government, including an order to resume work, an administrative order, or a police investigation.

Canadian physicians are organized and believe it is everyone's responsibility to provide excellent training for junior doctors to create competent physicians who will contribute to Canadian society. The RCPSC, the professional organization for trainee doctor education in Canada, has continued to develop through the profession's efforts without government subsidy or funding from any public agency. Internationally, the organization is a leader in the education of trainee doctors.

The RCPSC is now leading the way in competency-based medical education and is helping to transform medical residency education for the 21st century. The international interest in the education of trainee doctors is quite different from that in Korea.

One reason for this is that specialists use abbreviations, such as the FRCPC (Fellow of Royal College of Physicians of Canada) for internal medicine and the FRCSC (Fellow of Royal College of Surgeons of Canada) for surgeons, to identify themselves as Canadian specialists.

To obtain these titles, they must pay annual dues and maintain evidence of their professional development by entering their portfolios of continuing medical education into a computerized system. Continuing professional development ensures that the relationship between specialists and training centers for junior doctors is continuous, even if these specialists have long been certified. Even after retirement, they must register to use the FRCPC/FRCSC title with their name.

Another difference is that medical societies are members in Korea. In contrast, in Canada, individual doctors are members and must pay individual dues.

Canadian physicians must pay a minimum state license registration fee, medical society (interest group) dues, specialty society dues, and residency training institute dues each year. Each state has separate dues, as each specialty has various interest groups. In developed countries, more organizations are established by these professions, and they are larger in size with more employees. Professional organizations contribute greatly to professionalism and social transparency in addressing the complex issues of modern society.

The RCPSC has a membership of more than 57,000, of which 82 percent (47,121) are active and 11,120 are retired. Seven percent are registered as foreign residents from 57 countries.

The average length of membership is 16 years, with a median age of first membership of 34 years and a median age of 51 years for all members. In 2023, the total number of active physicians in Canada is estimated to be around 93,000. More than half were family physicians, with the other 45,000 presumed to be specialists. That's nearly the same number of active members of the RCPSC.

Korea has a similar number of active doctors, estimated at over 90,000, but Canada has a smaller population of 40 million. The income of Canadian doctors is well-known, with an average range of 150 million won to 200 million won ($103,320-$137,760) in after-tax income.

Canada, with smaller population than Korea, invests 100 billion won in training junior doctors annually

The norm for physicians to pay dues to professional organizations for educating trainee doctors makes me think that trainee doctor education in Canada can’t help but develop. The annual dues Canadian specialists pay for junior doctors’ training organizations is about 44.74 million Canadian dollars, or more than 45 billion Korean won. If you add up the specialty examination fees, specialty education evaluation and certification, maintenance education, investment, and conference registration fees, the total amount is 79.64 million Canadian dollars, more than 80 billion Korean won. In 2023, the RCPSC’s net gains were about 3.6 billion won.

The RCPSC holds nearly 1,200 meetings yearly, ranging from small meetings to the large annual conference and delegate assemblies. This is incomparable to the annual meeting of the Korean Hospital Association’s Training Environment Assessment Committee.

I can't help but think that the gap between Korea and Canada, a country with 40 million people and about 40,000 specialists operating a professional education organization for trainee doctors with a budget of over 80 billion won, will widen instead of narrow.

Even the relatively small College of Family Physicians of Canada (CFPC) spends nearly 20 billion won yearly, which means that the profession's financial contribution to the education of trainee doctors in all clinical specialties, including family medicine, is about 100 billion won annually.

In Korea, with a population of 52 million and about 90,000 active physicians, similar to Canada, how much can the medical community contribute to the education of trainee doctors?