Canada’s emergency rooms are losing the doctors who staff them.
A new study published in the Canadian Medical Association Journal (CMAJ) paints a stark portrait of an emergency medicine workforce in distress: one in ten emergency physicians have left their specialty, while nearly half of those who remain have cut their hours or stepped back from clinical work to manage burnout. The findings arrive at a moment when hospital emergency departments across the country are already straining under record overcrowding, chronic staff shortages, and wait times that have grown measurably worse with each passing year.
The study draws on a survey of 410 emergency physicians, and its language is notably unsparing. Respondents described a health-care system they consider “broken,” burdened by “unrealistic societal expectations” and “insurmountable workplace challenges.” For many, the authors write, “the future of emergency medicine was hopeless, with no possibility of recovery.” That is not the language of ordinary professional dissatisfaction. It reflects something deeper — a moral distress that the researchers say is now placing patient safety at risk.
Burnout levels among respondents remain, in the study’s own phrasing, “substantively unchanged” since the height of the COVID-19 pandemic, when emergency rooms absorbed simultaneous waves of COVID patients and seasonal respiratory illness, pushing staff and infrastructure to their limits. That the profession has not recovered from that period — that emergency physicians are, if anything, more demoralized now than they were then — speaks to the structural nature of the problem. This is not a temporary staffing shortage or a lingering pandemic hangover. It is a system struggling to meet demand it was never designed to handle at this scale.
The numbers behind the departures are worth sitting with. Of 410 survey respondents, 41 reported having left emergency medicine altogether: 25 moved to a different area of medical practice, 10 retired, and six left clinical medicine entirely, meaning they stopped treating patients. Among the 351 who completed the full survey and remained in emergency medicine, 163 — 46 per cent — said they had reduced their working hours. The researchers themselves caution that the sample size limits the degree to which these findings can be generalized to the entire emergency physician workforce, and that incomplete follow-up from the original 2020 cohort may introduce some bias. Even so, the direction of the data is clear and consistent with what emergency departments across the country are reporting on the ground.
The broader context makes those figures harder to dismiss. A 2024 CBC News investigation found that one in every five Ontario hospitals with an emergency room or urgent care centre experienced an unplanned closure that year — closures that had been rare before the pandemic. Meanwhile, a recent report from the Canadian Institute for Health Information (CIHI) found that one in ten Canadians admitted to hospital during the 2024–25 fiscal year spent more than 48 hours waiting in the emergency department, a figure that represents a 12-hour increase compared to six years earlier. CIHI attributed the deterioration to limited hospital capacity, difficulties accessing primary and community care, and the pressures of an aging population.
That last factor — the aging population — connects directly to one of the study’s specific recommendations. The CMAJ authors call on governments and health institutions to invest in specialized geriatric emergency care, a gap that has grown more consequential as older Canadians make up a larger share of emergency visits. More broadly, they argue for closing gaps in patient care across the system and expanding staffing capacity to address needs that currently funnel into the ER by default, often because there is nowhere else for patients to go. The emergency department, in this framing, is absorbing the failures of every other part of the health-care system — primary care, long-term care, community mental health — and the physicians who work there are paying a personal price for those accumulated failures.
Some provincial governments have moved to address parts of this problem. Ontario has expanded the scope of practice for pharmacists and paramedics, allowing them to treat certain patients in community settings rather than directing everyone to an already-crowded ER. British Columbia has opened dozens of new urgent and primary care centres designed to divert lower-acuity cases away from emergency departments. These are meaningful steps, and they reflect a genuine recognition at the provincial level that the status quo is unsustainable. But the CMAJ study suggests that the pace and scale of those interventions have not yet translated into relief that emergency physicians can feel in their daily working lives.
The crisis in emergency medicine does not exist in isolation. It intersects with the broader primary-care gap — millions of Canadians still lack a family doctor or nurse practitioner — and with the underfunding of long-term care that leaves elderly patients occupying acute-care beds they no longer need while others wait in hallways. Canada’s universal health-care system was built on the premise that access to medically necessary services should not depend on a person’s ability to pay, and that premise remains worth defending. But defending it requires honest reckoning with the conditions under which the people who deliver that care are working. When emergency physicians describe their profession as hopeless and leave in significant numbers, that is not a human-resources footnote. It is a warning about the system’s capacity to keep its foundational promise.
One respondent’s words, quoted in the study, leave little room for ambiguity: “This is the worst crisis that anyone could imagine. We are no longer able to provide the care that is required. Our system is inadequate.” Whether that assessment prompts the scale of response it demands — from federal and provincial governments alike — remains to be seen.
