Medical Student The University Of British Columbia Vancouver, British Columbia, Canada
Background: Cardiovascular disease (CVD) is the leading cause of morbidity and mortality in Canada, placing a substantial burden on the healthcare system. Accurately forecasting workforce demands and aligning residency capacity are, therefore, critical to sustaining optimal and timely cardiac care. This study examines the projected burden of CVD in relation to the current workforce distribution, residency training capacity, and projected workforce supply in cardiology and cardiac surgery in Canada.
METHODS AND RESULTS:
Methods: The prevalence of CVD in Canada for 2005-2021 was obtained from the Institute for Health Metrics and Evaluation (IHME). Workforce counts were retrieved from the Directory of Royal College of Physicians and Surgeons of Canada, with population-adjusted densities calculated by province. Residency program data from 2015 to 2024 were obtained from the Canadian Resident Matching Service (CaRMS). Descriptive statistics and simple linear regression were employed to evaluate the CVD burden, workforce distribution, and residency program trends in cardiology and cardiac surgery in Canada.
Results: The prevalence of CVD in Canada has increased steadily from 3.5 million in 2005 to 5.15 million in 2021, with linear projections of 5.8 million by 2030 and 7.9 million by 2050. Currently, Canada has an average of 37.5 cardiologists and 5.1 cardiac surgeons per million population. Cardiologist density is highest in Nova Scotia (45.4) and Ontario (44.2), and lowest in Prince Edward Island (16.7) with no cardiologists or cardiac surgeons practicing in any of the territories. Cardiac surgery workforce density ranges from 3.7 per million in Newfoundland and Labrador to 7.4 per million in Nova Scotia. Cardiac surgery residency positions have remained stagnant over the past decade, with a mean quota of 10 positions per year (SD 1.6, range 8–13) from 2015 to 2024. Despite consistent interest–averaging 18 applicants annually and 12 ranking as first choice–the number of positions has not increased. In contrast, internal medicine residency programs, which serve as a pathway to cardiology, saw a modest rise in annual quota from 455 in 2015 to 491 in 2024 (mean 463, SD 13.0), though only a small proportion ultimately subspecialize in cardiology.
Conclusion: The rising burden of CVD in Canada is not matched with a growth of the cardiology and cardiac surgery workforce, for which densities are already below the average workforce numbers across high-income countries. Our findings highlight the urgent need to expand residency quotas to strengthen Canada’s cardiac workforce capacity into the future.
