As some of you have no doubt read, Naturopathic medicine has recently come under considerable criticism in Canada
for lacking the extended residencies common in allopathic medical education.
Naturopathic Doctors ourselves have long recognized, in our own private discussions within the profession, of the need for such a residency system. We are, in fact, nearly universally in favor of such a system. The reason one is not established however, is very simple. It is purely financial.
Naturopathic Medicine in Canada remains almost entirely outside of the systems of massive subsidies that exist for medical care. I recently uncovered a document published by the Government of Canada about a decade ago, containing two estimates of the cost of allopathic medical education. In the 2002 report of the Standing Senate Committee on “Social Affairs, Science and Technology, The
Health of Canadians – The Federal Role” the cost of medical education in Canada at that time was reported as $65 000 annually, or approximately $260 000 for a four year program, roughly $86 000 and $343 000 respectively in 2019 dollars, accounting for inflation. A second report, entitled “Rapport du groupe de travail sur le développement d’une formule d’analyse des propositions des institutions du CNFS en vue de la Phase III (2008-2013)” gives a slightly lower figure of between $45 000 and $73 500 in 2007 dollars, or approximately $54000-$87000 in 2019 dollars, adjusted for inflation, annually.
This however is only part of the cost of medical training in Canada. Postgraduate Medical training, or residency, is also heavily subsidized, like all aspects of medical care in the country, including both training and a salary. This too was studied by the above report. Medical residencies can be hard to compare, based on their different lengths and trainings, but we will focus on Family medicine, since it seems to be as directly comparable to Naturopathic medicine as possible in the two professions.
According to Public Health Agency of Canada’s 2005 Landscape of Community Medicine report, the cost of residency training in Alberta ranges in 2003-4 from $99 184 per year to $119 683 per year, or approximately $126 000 to $151 000 inflation adjusted to 2019 dollars. Let us use the lower estimates for comparison’s sake. For a two year family medicine residency, the total cost would be approximately $252 000.
In total, using lower cost estimates based on the above paper adjusted for inflation, we get subsidies of approximately $595 000 for the education of an allopathic physician in Canada. Afterwards of course allopathic doctors also receive the ability to bill provincial health agencies for their services. Medical tuition can vary widely between medical schools, so I have decided that my undergraduate University should serve as an entirely arbitrary model. Tuition at the U of C faculty of Medicine is 15012.18 annually for a three year program or $60 048.72. Tuition for postgraduate medical education is $485.23 per term, capped at $979.46 annually. These two sources together (assuming a two year residency) raise an additional $ 62 007.64. This brings the total funding for allopathic medical education to $657 000.
The tuition at my Alma mater, the Canadian College of Naturopathic medicine has tuition fees of, in 2019, $23 970. For a completed four year program, the cost is $95 880, all of which is paid by the student. Naturopathic medicine gets a few grants for research, but is almost entirely student supported.
These figures $657 000 versus $95 880, is the funding available for the medical education of each profession. Of this, Naturopathic is entirely private (even if provided from Student loans, which must be repaid) and all but approximately 62 000 is publicly funded, and never repayable for the student.
I of course have excluded the costs of Undergraduate, as well as supplies, textbooks and living expenses in this analysis. I’ve also excluded differentials in research funding allocations (spoiler, we get almost nothing in comparison).
As I said, Naturopathic medicine, in our own internal discussions, we have frequently alluded to our own need for residencies and other organized graduate medical education. The existence of such a residency in allopathic education is completely dependent on the approximately $600 000 subsidies each medical student gets.
If Naturopathic is expected to meet similar levels of education, we must be presented with similar levels of public funding.
Image Credit: https://commons.wikimedia.org/wiki/Medicine#/media/File:BloodPressure2.jpg