Scaling success: The next big challenge for medical training

We spend a lot of time talking about what’s broken in Ontario healthcare.Those conversations matter.But it’s equally important to recognize what we're doing well.One of Ontario’s greatest healthcare strengths is its postgraduate medical education (PGME) system.Take the University of Toronto. In 2025, U of T trained 3,492 resident physicians.For comparison, Mass General Brigham—the largest teaching hospital system affiliated with Harvard Medical School—trains approximately 2,500 residents. That means U of T alone trains roughly 40% more residents than one of the world's most recognized academic health systems.And U of T isn’t the only success story.McMaster University: 1,291 residentsUniversity of Ottawa: 1,217 residentsWestern, Queen’s, Toronto Metropolitan University, and NOSM all make critical contributions as well.Every resident requires years of supervision, teaching, mentorship, assessment, and clinical experience provided by thousands of faculty physicians, administrators, hospitals, community practices, and family medicine teaching sites across Ontario.Despite operating in a publicly funded healthcare system with fewer resources than major U.S. academic centres, Ontario's universities train an extraordinary number of resident physicians.If you’ve contributed to this system as a faculty physician, preceptor, administrator, or resident, take a moment to appreciate what you’ve helped build.Distributed medical education plays a major role in this success.Over the past two decades, residency training has expanded far beyond academic hospitals/clinic into community hospitals, smaller clinics, and rural communities—allowing Ontario to increase training capacity while exposing residents to the communities they will ultimately serve.But this success creates the next challenge.Ontario is expanding medical school enrolment and residency positions. The question is how.Many of the clinical sites that make distributed training possible are already at capacity. Further growth will require:New clinical training environments.Better support and incentives for physicians to become educators.Expanding learner capacity in existing sites without compromising educational quality.How can Ontario grow its residency training while preserving the quality and distributed training model that has become one of its greatest strengths?Dr. Haroon Yousuf is an internist in Hamilton and was recently voted in as OMA president-elect. This item originally appeared on LinkedIn.

Scaling success: The next big challenge for medical training

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