Changes in Newfoundland medicine:
A 50-year perspective
by Dr. Ian Rusted
In the last issue of MUNMED, Dean Emeritus Dr. Ian Rusted outlined the development of medical services in the province up to 1965. In this article, he continues this historical perspective on health care issues with a look at the development of bursary programs.
After a hesitant start in 1945-46, Newfoundland began a formal bursary program for medical students in 1959. An average of about four medical graduates per year entered the Newfoundland Register from 1960-64. Of 15 bursary recipients qualifying in 1963 or earlier, 11 had fulfilled their obligations or were doing so, and 19 had entered the Newfoundland Register by 1964. Many others chose not to be subsidized, although some did return to Newfoundland. Most medical graduates, from both groups, either did not go to the more rural areas or went but did not remain there for more than a year or two. These graduates did, however, make a great different in temporarily meeting the province's needs.
In the late summer of 1963 I submitted a brief to the minister of health that included these comments on an expanded bursary program and the supply of doctors.
"An adequate supply of doctors is a problem that is currently causing concern in many parts of the world... (and) we appear to be reaching a point where our traditional sources in Great Britain and Ireland can no longer be depended upon. We must therefore consider (a) importing physicians from faraway countries such as India, Pakistan and Hong Kong with the certain knowledge that most of these physicians will be remaining for only a limited period... or (b) we must encourage or induce more Newfoundlanders to study medicine at currently available medical schools, or (c) we must begin to plan a medical school of our own.
"It is my suggestion that we increase our efforts to produce results with the second... while actively considering the problems relating to the third plan. It seems to me shortsighted and unrealistic for us to continue paying the travel expenses of young doctors from South Africa, Turkey, Formosa, Korea, etc. If they are going to remain in Newfoundland only long enough to obtain their registration and then move elsewhere.... I believe we have spend several thousand dollars each year for the past 10 years in this fashion, (money) that could have been used to much better advantage to assist in training the increasing numbers of Newfoundland students now attending university.
"While paying tribute to the existence and achievements of the present bursary program, I suggest that it should be extended to second and third-year pre-medical students at Memorial University, conditional upon their obtaining satisfactory marks...."
The minister, Dr. James McGrath, took my letter to Premier Smallwood and results were swift and substantial: the bursary program was expanded to include full maintenance and education costs during three years of pre-medical courses (in St. John's) and four years of medicine (or dentistry), beginning in the academic year 1963-64.
One of the main results of the 1963 bursary plan and subsequent free tuition -- reinforced greatly by the prospect of a medical school in Newfoundland -- was a change in attitude towards accessibility of university and medical education, especially in the minds of outport students. Opportunities for health care professionals in Newfoundland during this period were greater than at any time in our history. In addition to the financial aid already noted, students began to have access -- also for the first time in history -- to federal and provincial student aid, which soon reduced the attractiveness of bursaries.
In carrying out a study of all 138 bursary recipients attending various medical schools from 1959-76, I compared this with the smaller number of bursary recipients after Memorial University began to accept medical student in 1969, at which time virtually all qualified applicants remained in Newfoundland for their medical education. The number of this second group of bursary recipients (73) was smaller because student aid became available and most students preferred this, leading to the end of the bursary plan.
Among the most striking results of this analysis is the fact that of the 138 Dalhousie and other bursary recipients (1959-76), 55 per cent are no longer in Newfoundland and, of the remainder, only eight per cent (11 individuals) are in rural areas. By comparison, 40 per cent (29) of the 73 bursary recipients who graduated from Memorial's medical school are in rural areas.
In the next issue of MUNMED Dr. Rusted will conclude his historical perspective on health care in the province.
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