The taxi weaves through the old streets of Sherbrooke, where October leaves spiral down onto the cobblestones. It’s been three hours since I left Montreal, and Dr. Marie Fontaine has agreed to meet me during her lunch break—the only window in her 12-hour workday.
“I’m sorry, it’s the car today,” she laughs, inviting me into her sedan parked behind the community clinic. “Sometimes it’s the only quiet place.”
At 42, Fontaine represents a growing demographic in Quebec’s healthcare system: physicians who are scaling back hospital work or leaving the province entirely. Last year, the Quebec College of Physicians reported that 403 doctors either retired early or relocated to practice elsewhere—a 27% increase from pre-pandemic levels.
“I reduced my hours last spring,” Fontaine tells me, unwrapping a sandwich she likely won’t finish. “Twenty years ago, I imagined retiring from this same hospital. Now I’m not sure I’ll last another five years.”
The exodus comes as Quebec’s healthcare system struggles under unprecedented pressure. According to data from the Ministry of Health and Social Services, emergency room occupancy rates across the province averaged 138% capacity through September, with some Montreal-area hospitals routinely exceeding 200%. What began as a pandemic-related crisis has evolved into something more structural and seemingly intractable.
“Look at any healthcare metric in the province—wait times, orphaned patients, staff turnover. Everything is moving in the wrong direction,” says Dr. Vincent Demers, president of the Quebec Federation of General Practitioners. “When doctors begin leaving faster than we can train them, we’ve entered a dangerous feedback loop.”
The numbers tell a stark story. Quebec needs approximately 1,000 more family physicians to meet current population demands, according to a recent report from the Canadian Institute for Health Information. Meanwhile, nearly 650,000 Quebecers remain without a family doctor—about 8% of the population.
At McGill University Health Centre, Dr. Sarah Cohen has watched the transformation unfold over two decades. “New doctors graduate with the same idealism we all had,” she explains during a call between patients. “But they’re entering a system that’s already in crisis mode. They’re burning out faster, and many are choosing paths that were once considered unconventional—private practice, virtual care platforms, or moving to provinces with more manageable workloads.”
The situation appears particularly dire in Quebec’s rural communities. In Abitibi-Témiscamingue, a northwestern region spanning over 65,000 square kilometers, nearly half the population lacks consistent primary care. Local officials have turned to extraordinary measures, including housing subsidies and signing bonuses reaching $40,000 for physicians willing to commit to the region.
“We’re competing not just with Montreal or Toronto, but with healthcare systems across North America,” explains Richard Vallée, health services coordinator for the Abitibi Regional Health Authority. “Young doctors today want work-life balance, and our system currently demands significant sacrifice.”
Back in Sherbrooke, I accompany Dr. Fontaine as she walks back to her clinic. The autumn air carries a chill that wasn’t there this morning. She stops momentarily, pointing to a construction site where a new medical complex is taking shape.
“More beds won’t solve this,” she says softly. “We need to completely rethink how we organize care. How we support physicians and nurses. How we define success.”
The provincial government has not remained idle in the face of the crisis. Last year, Health Minister Christian Dubé announced a sweeping reform plan titled “Plan santé,” promising $5.2 billion in new healthcare investments over five years. The initiatives include bonuses for doctors taking more patients, expanded nurse practitioner roles, and digital health innovations.
But many frontline providers remain skeptical. “The reforms address symptoms, not root causes,” argues Dr. Mathieu Rousseau, an emergency physician who recently relocated to Ontario after 12 years in Montreal. “The administrative burden in Quebec has become untenable. I was spending 40% of my time on paperwork instead of seeing patients.”
This sentiment echoes throughout conversations with healthcare workers across the province. A survey conducted by the Quebec Medical Association found that 71% of respondents cited administrative workload as a primary source of professional dissatisfaction—ranking above compensation concerns.
For patients, the consequences are increasingly visible. Claudette Morin, 68, sits in a Tim Hortons in Trois-Rivières, describing her three-year search for a new family doctor after hers retired. “I manage three chronic conditions with specialists, but have no one coordinating my overall care,” she explains. “Last month I waited nine hours in emergency for something that could have been handled in a 15-minute clinic visit.”
The situation has sparked innovation and adaptation. Community pharmacists have expanded their scope of practice, now managing medication adjustments for certain conditions. Virtual care platforms have proliferated, though access remains uneven, particularly for older patients and those in remote areas.
At the University of Montreal’s School of Public Health, Professor Réjean Hébert has studied healthcare workforce dynamics for over 25 years. “What we’re witnessing isn’t unique to Quebec, but certain factors here have accelerated the crisis,” he notes. “Our centralized governance model can be slow to adapt, and the linguistic requirements—while culturally important—do limit our recruitment pool compared to other provinces.”
As dusk settles over Sherbrooke, Dr. Fontaine completes her afternoon clinic. She looks exhausted but still takes time to greet each staff member before leaving. When I ask what keeps her going despite the challenges, she pauses thoughtfully.
“There are still moments when medicine is exactly what I dreamed it would be,” she says. “When I can truly help someone navigate illness or suffering. Those moments are becoming rarer, but they’re why most of us went into medicine in the first place.”
Whether Quebec can reverse its doctor exodus remains uncertain. What’s clear is that addressing the crisis will require more than additional funding or incremental reforms. It demands reimagining the relationship between healthcare providers, the system they work within, and the communities they serve—a transformation that must happen before the exodus becomes irreversible.
As my train pulls away from Sherbrooke station, I think about Dr. Fontaine and thousands like her across the province—dedicated professionals caught between their calling and a system that increasingly makes that calling difficult to answer. Their stories reveal not just a healthcare crisis, but a profoundly human one.
