Dr. Corina Ciolacu
I knew from a very young age that I wanted to be a physician, but my journey to becoming a family doctor in Canada was not just difficult—it was riddled with systemic obstacles that prevent qualified doctors from practicing and exacerbate our healthcare crisis.
Originally from Romania, I immigrated in 2008, expecting to take a few exams before entering the medical system. Instead, it took me seven years to secure a residency spot. I was one of the “lucky ones.” In 2015, out of over 1,000 internationally trained doctors in B.C., only 52 were accepted into residency. The barriers were overwhelming, ranging from excessive exams to shifting requirements that changed mid-process, leaving many physicians in limbo.
Some exams are necessary to ensure competence, but others seem designed purely to create bottlenecks. The result? Many internationally trained doctors, despite being highly skilled, are permanently shut out of the system while Canada faces a dire physician shortage. This is a paradox we cannot afford.
Now practicing as a family doctor with a focus on pain management, I see firsthand both the strengths and critical weaknesses of our healthcare system.
For family doctors, the Longitudinal Family Physician (LFP) payment model has been an improvement, but it remains restrictive. My practice is still under fee-for-service because more than 30 percent of my patients come by referral—a threshold that disqualifies me from LFP. This limitation reduces flexibility for physicians and limits patient access to essential and diverse care.
During residency, I worked with a family physician in North Vancouver who specialized in pain management. She helped patients function better without opioids or anti-inflammatories. Seeing a patient say, ‘I can sleep better, I can stand longer, I’m not in so much pain’—that’s incredibly rewarding. I want to serve more pain patients, but under LFP, I can’t do both pain management and my longitudinal family practice. This model, while beneficial, still needs significant expansion to accommodate the reality of diverse medical practices.
The system is failing patients, too. Just today, I saw a young man in his twenties who has suffered from chronic pain since a car accident at age seven. Despite multiple surgeries, he was suffering from daily pain with very limited function. He was told nothing more could be done. After starting pain management with me, he was able to play hockey again. He still has some pain, but he has regained his quality of life. These cases prove that comprehensive care is possible—if only the system allowed more flexibility and access to specialized treatments.
At the end of the day, we need more doctors. Family physicians are drowning in patients, specialists have unacceptable wait times, and diagnostic services are stretched far beyond capacity. And yet, internationally trained doctors who could help fill some of these gaps face a system so bureaucratic and slow that many never get the opportunity to practice. The government has long been aware of these shortages. The need for more doctors was identified 30 years ago, yet not enough was done. Now, we’re in crisis mode, applying band-aid solutions to a failing infrastructure.
In addition to these systemic failures, the financial and administrative burden on family doctors is unsustainable. Each day, I juggle multiple roles: IT technician troubleshooting flawed electronic medical records that aren’t integrated, a scribe handling excessive insurance paperwork, an accountant managing rising overhead costs, and even a lawyer navigating legal concerns. Running a private practice has become an exercise in survival, with skyrocketing expenses and a growing shortage of qualified staff. If the government truly values primary care, it must provide more support for office overhead and administrative burdens to prevent physician burnout.
Despite these challenges, I remain committed to my patients. Seeing babies grow up, helping someone regain function—these moments remind me why I became a doctor in the first place. But passion alone cannot fix a broken system. We need real, long-term solutions to ensure that both patients and doctors are given the care and support they deserve.
Dr. Corina Ciolacu is a family doctor based in North Vancouver