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Objective Our aim was to compare the incidence and outcomes of civil legal cases in Canada involving international medical graduate (IMG) physicians to physicians who graduated from medical schools in Canada or the US. Design We conducted a retrospective cohort study with multilevel, multivariate modelling of civil legal cases against physicians licensed to practise in Canada. Setting We used the Canadian Medical Protective Association’s national repository of medicolegal case data. Participants We extracted data on physicians’ demographic characteristics, geographical characteristics and undergraduate medical education. Outcomes Outcomes included physician medicolegal case rates (the number of civil legal actions a physician is involved in per year) and case outcomes (when a case proceeds and is either dismissed, settled or proceeds to trial). Our multilevel models examined associations between physician factors and the rate of civil legal actions and the distribution of civil legal outcomes. Results The case rate model included 433 038 physician-year observations from 98 960 physicians (2015–2019), with 7657 civil legal cases (mean case rate per physician-year 0.0221; 98% had no cases). Case rates did not differ significantly between IMGs and Canadian/US graduates (p=0.0516). The case outcome model included 8046 cases (2016–2023). Unadjusted, cases favoured the plaintiff slightly more often for IMGs (39.1% vs 36.6%, χ² (2, N=8046)=14.03, p<0.001, Cramér’s V=0.04), but IMG status was not associated with case outcomes after adjustment (OR 1.135, 95% CI 0.977 to 1.319). Conclusion Our study suggests that where physicians receive their medical degree has no effect on their level of medicolegal risk in civil legal actions in Canada.
Sherif et al. (Mon,) studied this question.