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Backgrounder

Recruitment Allowances and Pay Improvements for Military Doctors and Dentists

BG-04.014 - April 26, 2004

Introduction

The Canadian Forces (CF) has an obligation to provide its personnel with the highest standard of medical and dental care both in garrison and on operations. Unfortunately, over the past several years, the CF has experienced significant challenges in attracting and retaining doctors and dentists in uniform. Two factors that have contributed to this situation are:

Nationally, there is intense competition due to a chronic undersupply of physicians in the civilian sector . The McKendry Report, produced for the Ontario Ministry of Health, warned that the aging of the current physician workforce, the decrease in the number of new graduates, and the continued migration of physicians to the United States, would cause the undersupply of physicians to become even more severe in the future ; and

Research has shown that for many communities, financial compensation incentives are is the principle primary tool s for attracting physicians to their areas. For many years, the rates of pay for military doctors and dentists could not compete with their civilian counterparts.

The challenges of recruiting and retaining CF medical and dental officers are is crucial to as the CF is legally bound to provide medical and dental treatment for its members . This responsibility is the same as that of the provinces, in that military doctors and dentists resolve because these individuals act as fulfill the role of general practitioners. Without this direct personnel support, the Canadian military would have a very difficult time meeting its commitments at home and overseas.

Recruitment Allowances

To help address this shortfall, the CF implemented Medical and Dental Direct Entry Officer Recruitment Allowances in April 1999 to encourage the direct recruitment of licensed family physicians, general practitioners and dentists. In June 2003, the existing Recruitment Allowances were modified, offering the CF greater flexibility in attracting medical and dental officers.

A licensed dentist who enrolls in the Regular Force and agrees to serve for four years is eligible for a $25,000 allowance.
A licensed doctor who enrolls as a direct entry officer or transfers from the Reserve Force to the Regular Force is eligible to receive a Medical Officer Recruitment Allowance of
$225,000 if the individual undertakes to serve in the Regular Force for a period of at least four years. This amount was increased from the $80,000 originally put in place in 1999.
A licensed medical doctor who enrolls as a direct entry officer or transfers from the Reserve Force to the Regular Force is eligible to receive a Medical Officer Recruitment Allowance of $80,000 if the individual undertakes to serve in the Regular Force for a period of at least two years;
To increase flexibility, a medical officer who receives the $80,000 allowance who agrees to serve for at least another two years is eligible to receive an additional $100,000.
An officer who enrolls in the Regular Force under the Medical Officer Training Plan (MOTP) is eligible to receive a recruitment allowance on enrollment if the individual agrees to serve as a medical officer in the Regular Force for at least four years after being licensed. The allowance is pro-rated based on how many months of medical school have been completed. It varies from $40,000 if 48 months or more remain to be completed to $180,000 if there are 12 or fewer months of medical training to complete.

If a doctor or dentist becomes no longer qualified to practice before the expiry of the period of service that has been agreed to, the individual will repay the allowance on a pro-rated basis depending on how many months are left to serve in the CF.

If an officer who receives an MOTP allowance fails to become licensed, the individual will repay the entire amount of the allowance.

Pay Improvements

To further assist in attracting and retaining medical and dental officers, the CF also implemented pay improvements as follows:

A 10.13% pay increase, effective April 1, 2001;
A 4.54% pay increase, effective April 1, 2002;
A 2.0 % pay increase, effective April 1, 2003;
An increase in the specialist pay differential to between 8% and 15% for medical and dental officers as of April 1, 2002;
Extension of the specialist pay differential to Lieutenant-Colonels and Colonels who maintain their clinical specialties, effective 1 Ap i r i l 2002.
The creation of a special medical officer differential effective 1 April 2003 in the amount of $6,200 per year for the Regular Force and $17 per day for the Reserve Force; and
The creation of a special dental officer differential effective 1 April 2003 in the amount of $6,200 per year for the Regular Force and $17 per day for the Reserve Force

Since the introduction of these initiatives began in 1999, medical and dental officers have received significant salary increases, for instance the pay of a medical or dental Captain at Incentive Pay Level 5 increased from $ 88,704 to $ 142,176 , a 60 % increase.

These pay improvements established comparability for medical and dental officers with the net earnings of physicians and dentists in private practice.

Current Situation

Despite the extremely competitive labour market for physicians, the base pay improvements and modifications to recruitment allowances over the past three years appears to have helped both recruitment and retention.

For example, where only one qualified physician was attracted to the CF over the period 1999-2002, five physicians have taken advantage of the recruitment allowance in 2003. Similarly, releases of medical officers at the rank of Captain at the end of their obligatory service have decreased from 70% to 61%.

Clearly these results confirm one of the findings of an attitudinal survey, conducted by the Department of Military Psychology and Leadership of the Royal Military College into the factors that contribute to medical officer attrition, that equitable base pay has an extremely high association with the individual's intention to remain in the CF.

Unfortunately, despite these successes, in early 2004 the CF was still short 42 medical officers at the Captain rank (this represents a 42% shortfall). The situation with dental officers, although less severe, is also of concern (13% shortfall at the Captain rank). As a result of these shortcomings, timely and equitable base pay adjustments for medical and dental officers remains a high priority.

The CF needs to maintain its own cadre of doctors and dentists because of the skills they acquire as a result of working and training in the military environment. These physicians and dentists provide medical services to CF members at home as well as participate in and support operational missions at home and abroad. These varied roles require unique abilities and knowledge.

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