With more than one million people in Canada employed in health occupations it is crucial to understand who they are, their work patterns and how their workforce is evolving is vital in planning for the future of health care in Canada. CIHI's five reports provides the data of seven Canadian major health professions.

In a series of five new reports released December 1, 2008, the Canadian Institute for Health Information (CIHI) provides the latest available and most comprehensive data in Canada about the supply, distribution, migration, education, demographic trends and work patterns for seven major health professions. The reports highlight changes in workforce trends over several years for physicians, registered nurses, licensed practical nurses and registered psychiatric nurses, as well as recent data for occupational therapists, physiotherapists and pharmacists.

"More than one million people in Canada are employed in health occupations, working together as part of a health care team," says Francine Anne Roy, Director of Health Resources Information at CIHI. "The services offered by these workers are critical to the health and well-being of Canadians. Understanding who they are, their work patterns and how their workforce is evolving is vital in planning for the future of health care in Canada."

More women entering health care workforce

Women are increasing their role in health care delivery, with more entering the health care workforce. While women make up 47% of the total Canadian labour force, they account for 80% of health care workers.ⁱ New CIHI data show an increase in female participation in traditionally male-dominated professions, such as physicians and pharmacists. In 2007, 56% of family physicians younger than 40 were women, compared to 16% of family physicians 60 and older. Similarly, 64% of pharmacists younger than 40 in 2007 were female, compared to only 27% of pharmacists 60 and older.

Professions such as nursing, physiotherapy and occupational therapy continued to remain predominantly female in 2007, ranging from 93% for licensed practical nurses to 78% for registered psychiatric nurses.

Age, gender and work patterns vary by profession

The average age of physicians was 49.6 in 2007, the highest among the seven health care professions examined. In comparison, occupational therapists and physiotherapists were the youngest health care professionals in 2007, with average ages of 38.9 and 41.2, respectively, while pharmacists and regulated nurses had average ages of 43.3 and 44.8, respectively.

Where data were available, results showed that the average age increased over the past five years for many of the professions. The average age of physicians increased from 48.3 in 2003, to 49.6 in 2007. In 2003, the average age of registered nurses and registered psychiatric nurses was 44.5 and 46.2, compared to 45.1 and 47.2 in 2007.

For occupational therapists, physiotherapists, regulated nurses and pharmacists, women were more likely than men to report part-time status. For example, 38% of female physiotherapists reported part-time status compared to 14% of male physiotherapists. As well, in the regulated nursing workforce, 32% of women reported part-time status compared to 19% of male regulated nurses. Among part-time regulated nurses, 17.5% of females reported working for multiple employers, compared with 23.2% of their male counterparts.

"Understanding work patterns by age and gender is important for health planning purposes," says Deborah Cohen, Manager of Health Human Resources at CIHI. "For example, female occupational therapists and physiotherapists work fewer hours in their 30s and 40s compared to their male counterparts. This is important to recognize in a field dominated by female professionals, in order to be able to plan resources to meet the needs of the population."

United Kingdom top source for internationally educated professionals

The rate of internationally educated health care workers in Canada varied by profession examined. Of all of the occupations examined (excluding pharmacists for whom data are not yet available), physicians and physiotherapists had the highest percentage of internationally trained professionals (22% and 15%, respectively). In 2007, close to 7% of the regulated nursing workforce was educated outside of Canada.

Overall for the six health occupations examined, internationally trained health care workers were most likely to have received their education in the United Kingdom, the United States, India, the Philippines, South Africa, Ireland and Hong Kong.

Top highlights from each profession

Regulated nurses

Regulated nurses represent the largest group of regulated health professionals in Canada and include three distinct professions: registered nurses (RNs), licensed practical nurses (LPNs) and registered psychiatric nurses (RPNs). Registered nurses account for 78% of the total regulated nursing workforce, compared to 21% for licensed practical nurses and 2% for registered psychiatric nurses (registered psychiatric nurses are regulated separately in Manitoba, Saskatchewan, Alberta and British Columbia).

Registered nurses

• The growth rate of this workforce was steady at close to 2% per year over six years, with a workforce of 257,961 RNs in 2007.
• There were 782 RNs per 100,000 Canadians, a number which remained relatively steady since 2005. The highest ratio previously recorded was 824 per 100,000 in the early 1990s.
• The average age of RNs in 2007 was 45.1, compared to 44.5 in 2003.
• The average age of new RN graduates (those who were in the workforce in 2007 and graduated between 2005 and 2007) was 26.5, up from 23 in 1980.
• Since 2003, the number of nurse practitioners nearly doubled across the country, to 1,346.
• 63% of RNs worked in the hospital sector and 14% worked in the community health sector.
• 8% of the RN workforce in 2007 was educated outside of Canada.

Licensed practical nurses

• The LPN workforce increased nearly 10% since 2003, to a total workforce of 69,709 LPNs, or 211 per 100,000 Canadians.
• The average age of LPNs was 43.9 in 2007, a decrease from 44.4 in 2003. This is the only regulated nursing profession showing a decrease in average age.
• The average age of new graduates (those in the workforce in 2007 who graduated between 2005 and 2007) was 31.1, compared to 23.1 in 1980.
• 46% of all LPNs were employed in hospitals and 40% were employed in nursing homes and long-term care.
• 2% of the LPN workforce in 2007 was educated outside Canada.

Registered psychiatric nurses

• The total RPN workforce was 5,124 in 2007, representing 51 RPNs per 100,000 population (four western provinces only). The RPN workforce increased less than 1% between 2003 and 2007.
• In 2007, 23% of RPNs were male, the largest proportion of the nursing professions.
• The average age of the RPN workforce was the highest of all three regulated nursing professions. The average age of the RPN workforce was 47.2 in 2007, compared to 46.2 in 2003.
• The average age of new RPNs (those in the workforce in 2007 who graduated between 2005 and 2007) was 29, compared to 24.2 in 1980.
• RPNs worked mostly in the hospital sector in 2007 (41%), while 26% were employed in the community health sector.
• 7% of the RPN workforce in 2007 was educated outside of Canada.

Occupational therapists (OTs)

• Based on an average age of 38.9, OTs were a young health profession that was predominantly female (92.5%) in 2007.
• 8.1% of the OT workforce was educated outside of Canada, with just less than half of these having obtained their education in either the U.S. or the U.K.
• 41% of OTs worked fewer than 36 hours per week.
• 84.5% of OTs were direct service providers.

Pharmacists (only eight jurisdictions)

• Pharmacists in selected provinces were mostly female. Nova Scotia had the highest proportion of female pharmacists (68.7%), while Newfoundland and Labrador had the lowest (48.1%).
• More than 75% of pharmacists worked in the community setting, while fewer than 20% worked in hospitals.
• More than 92.3% of pharmacists within the participating jurisdictions had a baccalaureate degree as their current academic credential in pharmacy.

Physicians

• There were 63,682 active physicians in Canada in 2007; this represented an increase of 7.1% between 2003 and 2007. Over the same five-year period, the Canadian population increased by 4.2%.
• The total ratio of physicians to 100,000 population increased from 187 in 2003, to 192 in 2007.
• For the fourth year in a row, the number of physicians returning from abroad was greater than the number moving abroad (142 versus 122).
• 39% of all family physicians were female, compared to 28.5% of specialists.
• The average age of doctors in Canada continued to rise, reaching 49.6 in 2007. The average age of family physicians was 48.9 and the average of specialists was 50.5.
• 22% of the physician workforce in 2007 was educated outside of Canada.

Physiotherapists

• The physiotherapist workforce increased 11% over the past six years from 14,471 in 2001, to 16,108 in 2006, compared to growth in the general population of 5.2%.
• Physiotherapists were predominantly female (78.7%).
• 40% of physiotherapists worked in a hospital setting, while 60% worked in professional practice, community or other settings.

About CIHI

The Canadian Institute for Health Information (CIHI) collects and analyzes information on health and health care in Canada and makes it publicly available. Canada's federal, provincial and territorial governments created CIHI as a not-for-profit, independent organization dedicated to forging a common approach to Canadian health information. CIHI's goal: to provide timely, accurate and comparable information. CIHI's data and reports inform health policies, support the effective delivery of health services and raise awareness among Canadians of the factors that contribute to good health.

Reports

Information about:

• Supply, Distribution and Migration of Canadian Physicians, 2007
• Workforce Trends of Occupational Therapists in Canada, 2007
• Workforce Trends of Physiotherapists in Canada, 2007
• Workforce Trends of Pharmacists for Selected Provinces and Territories in Canada, 2007
• Regulated Nurses: Trends, 2003 to 2007
• Watch a presentation highlighting these reports

Figures and Tables

• Figure 1. Average Age by Profession, 2007

  Notes
  MD: medical doctor.
  RN: registered nurse.
  LPN: licensed practical nurse.
  RPN: registered psychiatric nurse.
  OT: occupational therapist.
  PT: physiotherapist.

  Physicians (MDs):
  Excludes residents and non-licensed physicians who requested that their information not be published as of December 31, 2007.
  Includes physicians in clinical and/or non-clinical practice.
  For those physicians for whom date of birth was not available, ages were calculated using year of MD graduation with age at MD graduation equal to 25 years.
  Data as of December 31, 2007.
  Source: Scott's Medical Database, Canadian Institute for Health Information.

  Regulated Nurses:
  In 2007, the College of Registered Nurses of Manitoba submitted aggregate tables for sex and average age.
  The RPN workforce of the four western provinces represents the total RPN workforce in Canada.
  Source: Regulated Nursing Database, Canadian Institute for Health Information.

  Pharmacists:
  Data for Quebec, Manitoba and Nunavut were not available.
  Findings do not include New Brunswick or the Yukon, as year of birth was not collected/submitted.
  CIHI data will differ from provincial regulatory authority and territorial government data due to the CIHI collection, processing and reporting methodology. The Methodological Notes provide more comprehensive information regarding the collection and comparability of Pharmacist Database data.
  Source: Pharmacist Database, Canadian Institute for Health Information.

  OTs:
  Quebec data were not available.
  Average age for the Manitoba workforce was provided by Manitoba Health (n = 453).
  CIHI data will differ from provincial and territorial data due to the CIHI collection, processing and reporting methodology.
  The Methodological Notes provide more comprehensive information regarding the collection and comparability of Occupational Therapist Database data.
  Sources: Occupational Therapist Database, Canadian Institute for Health Information, and Manitoba Health.

  PTs: Nova Scotia data were not available. Regulatory data were not available from the Northwest Territories and Nunavut, as there were no licensing authorities in these territories.
  Aggregate totals for age bands were provided by Manitoba Health for registrants in Manitoba (n = 665).
  CIHI data will differ from provincial and territorial data due to the CIHI collection, processing and reporting methodology.
  The Methodological Notes provide more comprehensive information regarding the collection and comparability of Physiotherapist Database data.
  Sources: Physiotherapist Database, Canadian Institute for Health Information, and Manitoba Health.

• Figure 2. Age Distributions in Health Care Professions, 2007

  Notes
  MD: medical doctor.
  RN: registered nurse.
  LPN: licensed practical nurse.
  RPN: registered psychiatric nurse.
  OT: occupational therapist.
  PT: physiotherapist.

  Physicians (MDs):
  Excludes residents and non-licensed physicians who requested that their information not be published as of December 31, 2007.
  Includes physicians in clinical and/or non-clinical practice.
  For those physicians for whom date of birth was not available, ages were calculated using year of MD graduation with age at MD graduation equal to 25 years.
  Data as of December 31, 2007.
  Source: Scott's Medical Database, Canadian Institute for Health Information.

  Regulated Nurses:
  In 2007, the College of Registered Nurses of Manitoba submitted aggregate tables for sex and average age.
  The RPN workforce of the four western provinces represents the total RPN workforce in Canada.
  Source: Regulated Nursing Database, Canadian Institute for Health Information.

  Pharmacists:
  Data for Quebec, Manitoba and Nunavut were not available.
  Findings do not include New Brunswick or the Yukon, as year of birth was not collected/submitted.
  CIHI data will differ from provincial regulatory authority and territorial government data due to the CIHI collection, processing and reporting methodology. The Methodological Notes provide more comprehensive information regarding the collection and comparability of Pharmacist Database data.
  Source: Pharmacist Database, Canadian Institute for Health Information.

  OTs:
  The Quebec data for this figure were taken from the Health Personnel Database, which reports the number of active registered OTs (2007 data as of March 31, 2008). Therefore, the data for Quebec may include different membership categories for registrants.
  Aggregate totals for age bands were provided by Manitoba Health for registrants in Manitoba (n = 453).
  CIHI data will differ from provincial and territorial data due to the CIHI collection, processing and reporting methodology.
  The Methodological Notes provide more comprehensive information regarding the collection and comparability of Occupational Therapist Database data.
  Sources: Occupational Therapist Database, Health Personnel Database, Canadian Institute for Health Information, and Manitoba Health.

  PTs:
  Nova Scotia data were not available.
  Regulatory data were not available from the Northwest Territories and Nunavut, as there were no licensing authorities in these territories.
  Aggregate totals for age bands were provided by Manitoba Health for registrants in Manitoba (n = 665).
  CIHI data will differ from provincial and territorial data due to the CIHI collection, processing and reporting methodology.
  The Methodological Notes provide more comprehensive information regarding the collection and comparability of Physiotherapist Database data.
  Sources: Physiotherapist Database, Canadian Institute for Health Information, and Manitoba Health.

• Figure 3.1. Male Health Professionals-Part-Time and Full-Time Status, 2007

  Note
  This figure includes only regulated nurses, occupational therapists and physiotherapists.

  Regulated Nurses:
  In 2007, the College of Registered Nurses of Manitoba submitted aggregate tables for sex and average age.
  The RPN workforce of the four western provinces represents the total RPN workforce in Canada.
  Source: Regulated Nursing Database, Canadian Institute for Health Information.

  Occupational Therapists:
  Quebec data were not available.
  CIHI data will differ from provincial and territorial data due to the CIHI collection, processing and reporting methodology.
  The Methodological Notes provide more comprehensive information regarding the collection and comparability of Occupational Therapist Database data.
  Source: Occupational Therapist Database, Canadian Institute for Health Information.

  Physiotherapists:
  Nova Scotia data were not available.
  Regulatory data were not available from the Northwest Territories and Nunavut, as there were no licensing authorities in these territories.
  Findings do not include data from Quebec, as primary employment full-time/part-time status was not collected in this jurisdiction.
  Findings do not include data from Manitoba, as gender by full-time/part-time status was not available.
  CIHI data will differ from provincial and territorial data due to the CIHI collection, processing and reporting methodology.
  The Methodological Notes provide more comprehensive information regarding the collection and comparability of Physiotherapist Database data.
  Source: Physiotherapist Database, Canadian Institute for Health Information.

• Figure 3.2. Female Health Professionals-Part-Time and Full-Time Status, 2007

  Note
  This figure includes only regulated nurses, occupational therapists and physiotherapists.

  Regulated Nurses: In 2007, the College of Registered Nurses of Manitoba submitted aggregate tables for sex and average age.
  The RPN workforce of the four western provinces represents the total RPN workforce in Canada.
  Source: Regulated Nursing Database, Canadian Institute for Health Information.

  Occupational Therapists:
  Quebec data were not available.
  CIHI data will differ from provincial and territorial data due to the CIHI collection, processing and reporting methodology.
  The Methodological Notes provide more comprehensive information regarding the collection and comparability of Occupational Therapist Database data.
  Source: Occupational Therapist Database, Canadian Institute for Health Information.

  Physiotherapists:
  Nova Scotia data were not available.
  Regulatory data were not available from the Northwest Territories and Nunavut, as there were no licensing authorities in these territories.
  Findings do not include data from Quebec, as primary employment full-time/part-time status was not collected in this jurisdiction.
  Findings do not include data from Manitoba, as gender by full-time/part-time status was not available.
  CIHI data will differ from provincial and territorial data due to the CIHI collection, processing and reporting methodology.
  The Methodological Notes provide more comprehensive information regarding the collection and comparability of Physiotherapist Database data.
  Source: Physiotherapist Database, Canadian Institute for Health Information.

• Figure 4. Percentage of Internationally Trained Health Care Workers by Profession, 2007

  Notes
  MD: medical doctor.
  RN: registered nurse.
  LPN: licensed practical nurse.
  RPN: registered psychiatric nurse.
  OT: occupational therapist.
  PT: physiotherapist.

  Physicians (MDs):
  Excludes physicians where place of MD graduation is unknown.
  Excludes residents and non-licensed physicians who requested that their information not be published as of December 31, 2007.
  Includes physicians in clinical and/or non-clinical practice.
  Data as of December 31, 2007.
  Source: Scott's Medical Database, Canadian Institute for Health Information.

  Regulated Nurses:
  The RPN workforce of the four western provinces represents the total RPN workforce in Canada. Source: Regulated Nursing Database, Canadian Institute for Health Information.

  OTs:
  Quebec data were not available.
  Findings do not include data from Alberta, as the country of graduation for basic education in occupational therapy is not collected.
  CIHI data will differ from provincial and territorial data due to the CIHI collection, processing and reporting methodology.
  The Methodological Notes provide more comprehensive information regarding the collection and comparability of Occupational Therapist Database data.
  Source: Occupational Therapist Database, Canadian Institute for Health Information.

  PTs:
  Nova Scotia data were not available.
  Regulatory data were not available from the Northwest Territories and Nunavut, as there were no licensing authorities in these territories.
  Findings do not include data from Quebec, as country of graduation for basic education was not collected in this jurisdiction.
  CIHI data will differ from provincial and territorial data due to the CIHI collection, processing and reporting methodology.
  The Methodological Notes provide more comprehensive information regarding the collection and comparability of Physiotherapist Database data.
  Source: Physiotherapist Database, Canadian Institute for Health Information.

• Figure 5. Percentage of Female Medical Specialists, 2007

  Notes
  Physicians: Excludes residents and non-licensed physicians who requested that their information not be published as of December 31, 2007.
  Includes physicians in clinical and/or non-clinical practice.
  Specialist physicians include certificants of the Royal College of Physicians and Surgeons of Canada (RCPSC) and/or the Collège des médecins du Québec (CMQ).
  All other physicians are counted as family medicine, including certificants of the College of Family Physicians of Canada (CFPC).
  Specialists in Newfoundland and Labrador as well as Nova Scotia, New Brunswick, Saskatchewan and the Yukon also include physicians who are licensed as specialists but who are not certified by the RCPSC or the CMQ (that is, non-certified specialists).
  Data as of December 31, 2007.
  Source: Scott's Medical Database, Canadian Institute for Health Information.

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