By DOCTOR C:S., M.D.

MONTREAL
oetors on strike? The members of
D the wealthiest profession here
in Canada on strike? Not exactly, but
almost. Doctors at their first profession-
al level — interns and residents — have
formed their own union, a real one and
not an ‘‘association,’’ and they are fight-
ing and bargaining collectively with
much competence and militancy.

It is a healthy development — for im-
mediate goals, and perhaps will aid the
new generation of doctors to identify
themselves more with the people tha
with money. Not any less significant is
the fact that probably the first militant
union struggle in North America by doc-
tors as workers is taking place in Que-

_ bec, in Montreal.

Who are ‘“‘interns’’ and ‘‘residents’’?

After graduation from medical school,
a doctor performs a year of internship.

During this period, he is called an
intern. He acquires practical knowledge
of medicine, surgery, etc. After this
year, the doctor can establish himself
as a general practitioner (G.P.), or con-
tinue work toward a specialty in medi-
cine: this requires four additional years

of work in a hospital. During this period .

of added apprenticeship, the doctor is
called a ‘‘resident,’’ of the first, second,
third or fourth year. At the end of this
_ period, after having been qualified as a
specialist, he must pass written and
oral exams of the Quebec College of
Doctors and Surgeons. If he wants to
practice in Canada as a whole, he must

pass similar exams given by the Royal

College of Doctors and Surgeons in Ot-
tawa.

In Canada, it is only Quebec which
has this regional requirement. :
PACIFIC TRIBUNE—FRIDAY, JULY 31—Page 4

During his internship, the intern ex-
amines patients, takes down their medi-
cal histories, diagnoses their condition,
and uses the medical laboratories and
diagnostic services where necessary,
and prescribes a treatment under the
supervision of a senior physician.

The residents are classified accord-
‘ing to their years of service: Resident
I-IV; the latter is the fifth year, if the
year of internship is counted. The Col-
lege of Physicians and Surgeons of Que-
bec lays down the general or individual
requirements during this period. Every
year -carries a great responsibility. A
resident IV can accept consultations, he
can carry out research, and in certain
cases he must undertake original re-
search in a related university program.
A Resident III-IV must also instruct in-
terns, prepare seminars for hospital

medical personnel, direct specific ex-'

ternal clinics, etc.
In short, he works as a physician,

‘but without a physician’s salary. He is

always obliged to work at night, with
the same compensation as the interns.
He probably is on his feet all night, and
is expected to give a seminar for the
hospital medical personnel the next
morning. There is no rule which per-
mits residents to take a break. Their
only hope is a sympathetic chief.

With this background, we now pass
on to the demands of the Montreal Res-
ident Physicians Union.

The principal question is the interns’
and _ residents’ professional _ statute,
which relates particularly to these prac-
tical demands: breaks in order to com-
pensate for long duty-hours at night and
equal salaries with their colleagues in
Ontario. Their demands are justified.
But in spite of the affirmations of the

hospital directors, the fact is that in-
terns and residents are not ‘‘students,”’
as can be seen from the description of
their duties. They are physicians prac-
ticing in the context of a hospital en-
vironment.

The fact that they are in training
does not alter this ‘statement. Every
physician, as in other professions and
trades, is in training through the en-
tire period of his active life. Supervi-
sion and consultations are permanent
elements in medical practice. It could
be pointed out too that residents give
medical testimony in legal cases, for
which they receive the princely sum of
$5-6. r

A major fact, generally ignored in
the description of hospital situations, is

that 60% of the interns and residents in.

Quebec are foreign doctors from Europe
and Asia. This is comparable to the

-rest of Canada, but it could be higher

in Quebec due to the unique require-
ment which exists here: a license to
practice medicine is granted solely to
Canadian citizens. That means a delay
of five years...five years of ‘‘scab”
work as an intern or resident.
e

In all of Canada, immigrant Afro-
Asian physicians face the greatest ob-
stacles in order to obtain a completely
professional license. Because of the dif-
fering levels of medical training? No.
Because of race. They have to pass a
series of admission exams after having
studied in a Canadian university when
they arrive in Canada, if they are for-
eign medical graduates. But they are
graciously permitted to work as an in-
tern for a year in a hospital, to do the
work of a physician for a fraction of a
physician’s salary.

An intern presently is paid $4,425 an-’

nually and a Resident IV receives '
$6,700.

_ The Federation of Quebec Resident

Physicians is asking (1970-71) for an J
tern, $5,500 as a base salary plus 1/250t0

_ of the base salary for extra duty, 2”

for a Resident-IV, $10,950 as a bas®
salary plus 1/250th of the base salary
for extra duty. The government has ©
fused to consider the three major poin!s
in dispute: (1) the residents’ and I
terns’ statute; (2) an acceptable bas!¢
salary scale; (3) compensation for @*
tra duty. That is why the FQRP, follow”
ing the mandate given by the membel
ship, found it necessary to cease doing
extra duty; this started February 1. ;
Three big hospitals have ordered 4
‘Jock-out’’—Maison-neuve, Notre-Dame
and St. Justine (the three biggest
French hospitals). The latest definitio”
of a resident given by the Quebec Col
lege of Physicians and Surgeons and the
Faculties of Medicine is that the youné
physician renders professional services:
but ‘‘as part of a medical team in the
context of a hospital of instructio®
agreed upon by the College.” . :

_ Whatever is the definition, or the dif
ficulties raised by the government, the
fact remains that there is a group 2
young. professionals demonstrating 4
strong, militant opposition to one of the
most powerful sectors of society, and
they merit the support of the public. j

When I myself embarked on®a medi-
cal career, I never would have fore
seen it so quickly, but I now am seeing
the start of a movement. It has comé
and it is a reality.

— from COMBAT, newspaper of the -
Cemmunist Party of Quebec, Mon-
treal. Translated frem the French
by Tom Foley.