B.C. can’t compel foreign-trained doctors to work in rural areas without passing a law that protects constitutional rights
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A B.C. Supreme Court judge has ruled that the B.C. government has been illegally compelling Canadian doctors who went to medical school abroad to temporarily work at specific clinics, including in rural or remote areas.
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Justice Matthew Kirchner has ruled the Health Ministry lacks the authority in law to require international medical graduates to agree to work in a specific area in return for getting a key B.C. training slot known as a residency.
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B.C. has been requiring “return of service” obligations for those foreign-trained Canadian doctors since 2006 under a policy decision.
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If they fail to complete the service, family doctors face penalties of at least $500,000 and specialists $900,000, based on 2018 numbers, according to the decision.
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Kirchner, recognizing his ruling could affect staffing at rural hospitals and remote clinics, suspended his ruling for at least 60 days.
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“I appreciate this declaration may impact on existing and certainly on future return of service obligations,” he wrote. “That, in turn, may impact on physician availability in remote or underserviced areas of the province.”
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He said it may be appropriate to suspend the declaration longer to allow the province to address the lack of a law. He gave the parties 60 days to make submissions, “including whether a longer suspension is necessary and ought to be granted.”
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The Society of Canadians Studying Medicine Abroad had filed a petition arguing the policy violated the Charter of Rights and Freedoms, including the right of Canadians to live where they choose without government interference.
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Rosemary Pawliuk, a retired lawyer who heads the society, said it remains to be seen what that decision means for doctors already serving their obligations and the 58 graduates scheduled to begin theirs next July. The contracts require family doctors to work in specified clinics in rural and remote areas of B.C. for a minimum of two years. It’s three years for specialists.
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“If I were one of those doctors, I’d be heading to a lawyer’s office for a legal opinion on whether they can tell me if I can have my freedom back or if I’m stuck somewhere I didn’t choose to live,” she said.
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On Monday, Health Minister Ravi Kahlon said a new law is possible, if needed to continue to recruit doctors for rural areas.
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“We will look at the legislation and we will ensure that the policies we have since 2016 will remain,” he said at the Union of B.C. Municipalities conference in Vancouver. “And if that requires legislation, that’s what we’ll do.”
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Most doctors fulfil the obligation, “so the overwhelming majority have followed what they need to do,” he said.
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By the end of 2026, more than 700 doctors in the residency training program will have participated in a return of service in over 100 B.C. communities, a ministry spokesman said in an email.
