A shortage of health professionals will create big opportunities for the children of the baby boomers.

Dr. Tommy Gerschman has lived his professional life in a hurry. At the age of 27, he's already starting his second year as a resident pediatrician, now stationed at BC Children's Hospital. Gerschman has already completed a four-year undergraduate program in microbiology and done another four years at the UBC medical school. As a resident physician, he routinely works 80 to 100 hours per week, much of it on the wards diagnosing and treating patients under the supervision of an attending physician. For this, he is paid just over $50,000 per year.

"It's not always as glamorous as Grey's Anatomy on TV, but I think it's very rewarding," Gerschman told the Georgia Straight in a recent interview after a shift. "You see your hard work making a difference in people's lives. You get people coming up to you all the time saying, 'Thank you for what you do.'"

In two more years, Gerschman will be eligible to become a full-fledged pediatrician, which will likely result in a whopping pay increase after 12 years of hard slogging. Fortunately for Gerschman and thousands of other young British Columbians, the health-care field is ripe with job opportunities. According to the Canadian Occupational Projection System, which analyzes demand for employment, health will experience the greatest increase by percentage of all jobs in B.C. between 2005 and 2015. COPS projects 3.5 percent annual growth in health-care employment in B.C., with a total of 48,050 new jobs added by 2015.

University of Toronto economics professor David K. Foot specializes in studying the economic impact of demographics. Foot, coauthor of the 1996 bestseller Boom Bust & Echo: How to Profit From the Coming Demographic Shift, speaks with an almost evangelical fervour about the importance of training more health-care workers. He said it's imperative that this occur with the current "echo boom", which he defines as those born between 1980 and 1996.

"I've been carrying on for some time now that we ought to be encouraging the children of the boomers that they ought to be getting into health care," Foot told the Straight in a phone interview from Oregon, where he was vacationing. "I've been arguing we should be getting them into all the different health-care occupations, everything right across the spectrum: orderlies, nursing, cardiology, everything. It takes a long time to train a health-care professional."

Foot said the real pressure on health care will come in the next 10 to 15 years when the baby-boom generation–the largest cohort in the population–moves into its 70s. He pointed out in his book that in 1959, at the height of the baby boom, Canadian women were averaging four children, which meant that Canada had the "loudest baby boom in the industrialized world".

Susan Witter, president of Douglas College, told the Straight that anybody trained as a home-support worker or resident-care attendant already has no trouble finding a job. "Anyone that goes into our psychiatric nursing program, the same thing," she said. "We had about 150 nursing graduates this year. A lot of them had jobs before they graduated. So the health sector is excellent."

Most public postsecondary institutions in the Lower Mainland have recently expanded career training and professional education in health-related fields. There are now nursing degree programs at Douglas College, Kwantlen University College, Langara College, BCIT, and UBC. Vancouver Community College offers entry-level training in many health-care fields and is planning to launch its own nursing degree program in 2008. Capilano College is launching a licensed-practical-nurse program at its Sechelt campus this fall.

In September 2006, SFU began offering a bachelor of arts in health sciences; this September, it will begin to offer a bachelor of science in health sciences. UBC's College of Health Disciplines focuses on interprofessional health education and research, bringing together 15 health and human-services programs. Foot described UBC's approach as a "great idea", saying he expects to see more mixing of health-care occupations in the future. He predicted, for instance, greater demand for people with both nutritional and nursing training.

"I think we're going to see a lot more of that down the road," Foot said. "Many of my students, for example, they don't want to be in these silos. They're very good at thinking creatively, thinking laterally. We ought to be encouraging that."

For his part, Gerschman has spent a lot of time mentoring young people considering careers in medicine. He said it's important to keep options open by researching what's required to apply for medical school, and then taking those prerequisite courses as an undergraduate. "One thing I also recommend is to volunteer in some sort of clinical setting," he added. "It doesn't matter if it's at a hospital or a long-term-care facility, it's just working with people so you get a sense if that works for you. If it's something you're not comfortable doing, you probably have to take a second look. Most of medicine is working with people and interacting with people."

He said he is often asked how he copes with seeing so many sick children every day. His response: kids who are ill tend to get better, and even those with chronic diseases tend to make the best of their situation. "You can see a lot of resiliency and positive energy in children," Gerschman said. "If you can feed off that and help them enjoy that to the maximum, I think that's very rewarding to be a part of. I think at the end of the day, you know, there is always at least one child that has made me smile or have a laugh or something like that. That's one of the great things about working with kids."

He said that when he began medical school in 2002, only 128 students were admitted into the program and the acceptance rate was approximately 15 percent. As of next month, UBC will have doubled medical-school enrollment. Gerschman added that his class had a lot of diversity, including one student in his 50s. "Most people come from [a] life sciences [background], but we have people who've done philosophy, economics, history," he said. "We've had people who've gone through law school and come to medicine."

Emma Heukelom discovered her career path in health care while receiving treatment at Lions Gate Hospital in North Vancouver as a high-school student. In a phone interview with the Straight, she recalled how she was helped by two compassionate nurses after suffering a blackout and passing out on the floor. Heukelom, now 22, told them that she wanted to be a nurse but was worried that she would freak out over the sight of too much blood. The nurses told her she would get over it.

"It was just the right touch," Heukelom, now a fourth-year UBC nursing student, said. "It was something that just felt right."

Heukelom took science courses during her first two years of university, and in her third year at UBC started her nursing education. She said that her high-school biology has helped her succeed. She also recommended that prospective nursing students take some undergraduate pharmacology and pathology courses.

As part of her nursing education, Heukelom recently provided home care to seniors in Richmond. "I didn't have any bad experiences, actually," she recalled. "They're so receptive to you, and they really appreciate the care."

Part of the work included changing dressings and ensuring that the seniors took the proper medication. She said she would "definitely" recommend nursing to some of her friends, but not to those who don't like getting dirty or who can't handle bad smells. "It is tough work," she conceded. "It is emotionally draining."

Heukelom thinks her program focuses too much on learning about communication when the people who enter the program already have those skills. "We'll have lots of three-hour lectures on that stuff, but I won't have enough time to learn how to insert an IV properly in the lab," she said. "That was a bit of a surprise. That's one thing I would wish was quite different, I think. So do a lot of my peers, actually."

Economist David Foot says Canada faces a shortage of health workers.

However, she also said that the professors are very supportive. "They're just always there for you when you need them," Heukelom said. "That's my favourite part of it."

The nursing shortage has received a massive amount of publicity in the media. But shortages in other health-care fields haven't generated nearly as much attention. Pat Bawtinheimer, dean of VCC's school of health sciences, told the Straight that there is a strong demand for medical-office assistants, medical-transcription services, and nursing-unit clerks. She said that the clerks are doing work that was historically done by many nurses, even though it doesn't fall within their job description.

Bawtinheimer said that a nursing-unit clerk will follow through on a doctor's request for X-rays, medications, and blood tests, and ensure that a patient's diet is changed. "In this job, you can't afford to make too many errors because even a decimal point misplaced could make the difference in medication," she said. "It's very detail-oriented, but it's certainly a great job. And of course, this is another one of the strategies that they're using to try to work with the nursing shortage."

In May, the canadian Association of Occupational Therapists and the British Columbia Society of Occupational Therapists presented a report to the B.C. government describing a severe shortage of professionals in this field. It noted that the Vancouver Coastal Health Authority is "scrambling" to find occupational therapists in the provincial hip and knee program, the provincial hand clinic, rehabilitation services for the frail elderly, and in a driver rehabilitation program.

B.C. has fewer than half the number of educational seats in occupational therapy as Ontario, and fewer than a third of the number of seats as Quebec. "Longstanding problems also exist in trying to recruit occupational therapists for specific work settings such as child development centres," the report stated. "Occupational therapy private practices as well have difficulty filling positions to meet demands for serving individuals with brain injuries sustained in motor vehicle accidents."

The federal-government Web site Jobfutures.ca cites the average hourly earnings, employment outlook, and unemployment rate for many health-care jobs. This includes occupational therapists, medical laboratory technicians, physiotherapists, pharmacists, dietitians, and nutritionists. In almost every instance, the hourly earnings are significantly higher than the average rate for all occupations; the employment outlook is described as "good" through to 2009; and the average unemployment rate in each category is far lower than the overall unemployment rate.

Occupational therapists, for instance, earn $26.27 per hour on average across Canada, compared to the overall average wage of $18.07 per hour. Their unemployment rate is four percent compared to a national average of seven percent, according to the site. Pharmacists, who currently have no unemployment according to the site, earn $32.47 per hour on average across the country. Registered nurses in Canada earn an average of $25.92 per hour, and have an unemployment rate of just one percent. In B.C., a first-year, level-one registered nurse makes $27.17 per hour, and a level-one nurse with nine years' experience is paid $35.67 per hour, according to a wage grid on the British Columbia Nurses' Union Web site (www.bcnu.org/).

Analyst Linda Choy studies data from hospitals across the country.

Andrew Ramlo, a director of the Vancouver-based Urban Futures Institute, told the Straight in a phone interview that he is forecasting a big increase in demand for preventive health services, including physiotherapy, nutritional counselling, and chiropractic care. "That's in large part because we are becoming more aware of our health," he said. "I go see a physiotherapist about once a month, whereas a few years ago I wouldn't have considered it."

The alternative-health sector has become more popular as well in recent years. Two years ago, Statistics Canada reported that 22.6 percent of British Columbians 12 years and older had used some form of alternative treatment in 2003. The top choice across the country was chiropractic care, followed by massage therapy, acupuncture, homeopathy, and naturopathic treatments.

Another big area of expected growth is health-information services. One of the biggest challenges facing the health-care system is gathering data and sharing it among health-care providers to reduce medical errors and "adverse events". In 2004, a study published in the Canadian Medical Association Journal reported that there were between 9,250 and 23,750 "preventable deaths" in Canadian hospitals every year. The same study reported that there are approximately 185,000 "adverse events", of which almost 70,000 are "preventable".

Linda Choy is just one example of someone who found work in this field. Several years ago, she was living in Burnaby and working in accounting, but started researching different programs on the Internet because she had an interest in health care. Choy told the Straight in a phone interview that she stumbled upon the two-year health-information-services-program at Douglas College, which seemed like a good match for her skills.

"It appealed to me to get into the health industry, and that I didn't need a science background–and I enjoy working with numbers," Choy said.

She acknowledged her education was "really important" in helping her land a job in Toronto as an analyst with the Canadian Institute for Health Information. Now she analyzes data from hospitals, including readmission rates and information on adverse events. She said that hospitals with significantly higher readmissions in comparison to their peer hospitals might want to review their discharge processes, and look for improvements.

"The main goal is to get informed, and try to improve processes in terms of the data quality, but also in health policies," Choy said.

In 2006, BC STATS, the B.C. government's statistical agency, published a review of the labour markets in health care and social assistance. It noted that in 2005, $12.8 billion was spent on public health care in B.C., which included the cost of hospitals, paying doctors' fees and other professionals' fees, and the cost of government-subsidized prescription drugs. Another $5.5 billion went to private expenditures for dental care, physiotherapy, other health-care professionals, and medications.

The report noted that patients are being discharged at a much earlier stage nowadays, which means they may receive daily home visits from health-care workers. There is also a growing reliance on home care, meals on wheels, and other such services. "Some of these services are being provided by private agencies, or in smaller community-based facilities, rather than in large public institutions, and many of the people doing these jobs are employed on a part-time basis," the report noted.

Perhaps given these circumstances, it's no surprise that VCC's Bawtinheimer stated that home-support resident-care attendants almost always find jobs after completing the program. In every class of 36 students, she said, there is usually at least one person who trained as a physician or nurse in China.

"An RN educated in China who is not able to work here as an RN will come into our program–even our care-aid program–because it gives them the opportunity to first work in health care to get a sense of what the health-care system is like in British Columbia, and to practise their English-language skills," Bawtinheimer said. "From there, these people often will move into a practical-nursing program or will take an RN program."

Foot predicted that in the coming years, Canada's health-care system will become much more reliant on immigrants after the kids of the baby boomers–members of the "echo" generation–have moved into the work force. Unlike many occupations–such as back-office accounting, professional services, sales, and manufacturing–it's virtually impossible to outsource the care of Granny and Grandpa to people living in India or China. This should ensure plenty of job security for future doctors and nurses, including Gerschman and Heukelom.