Which is the best province for a Canadian physician to start a family?

Are today’s young Canadians doctors choosing to pursue their careers and also have babies? Indeed, do they have the supports and options available to viably make that choice? Across all groups in Canada, according to the Angus Reid Group, Canada’s fertility rate hit its lowest rate in recorded history for a second consecutive year in 2023. Whether the low availability and high cost of childcare (for groups like doctors not generally eligible for subsidies) or many other cited reasons like economic and environmental concerns, or just too many alternative focuses in their lives—family just isn’t happening like it used to. There is no Canadian data specific to doctors, but the current and ongoing decreased fertility rate is a world-wide phenomenon.So what are Canadian governments and provincial medical societies doing to support young doctors who do choose to have children? And what are the best places to work as a doctor and have a family in Canada, ranked in order from best to worst?The results may be surprising.Every province provides some kind of parental support program for doctors—with the exception of Quebec, where it is provided by the provincial medical society. Physician parental leave funded by medical societies (ranked from most to least generous)1. Québec Parental Insurance Plan (QPIP) The new QPIP introduced in 2025 expands flexibility and enhances leave options for Québec residents, including physicians. Highlights include:Extended total benefit period (up to 78 weeks shared) and increased maternity leave (now up to 20 weeks) Unique to Quebec, physicians who are Québec residents apply via the official QPIP portal, not the medical federation.2. Prince Edward Island—Medical Society of PEI (MSPEI)Benefit: $2,500/week (as of April 1, 2025)Duration: 26 consecutive weeksEligibility: Active MSPEI member, 20+ weeks qualifying PEI earnings; locums excludedCovers: Birth, adoption, surrogacy; inclusive of same-sex couplesEarnings Limit: Outside income >$2,000 biweekly reduces benefit dollar-for-dollar. (The child support payments are taxable but the MSPEI helps with calculating and filling out the tax forms).3. Nova Scotia—Doctors Nova Scotia (DNS)Benefit: $2,000/weekDuration: 26 weeks (can be spread over 52 weeks)Eligibility: ≥$50,000 billed in prior 12 months; NS residentCovers: Birth, adoption, surrogacy, pregnancy loss ≥20 weeksInclusive: (i.e. same-sex, adoption, dual physicians): YesEarnings Limit: Max $1,200/week external income4. Ontario—Ontario Medical Association (OMA)Benefit: Up to $2,000/week (75% of avg income)Duration: 22 weeks (birth parents), 17 weeks (non-birth parents)Eligibility: Active OHIP-billing physician; apply within 12 monthsCovers: Birth, adoption, surrogacy, stillbirthInclusive: Yes Earnings Limit: Max $3,000/week 5. Saskatchewan—Saskatchewan Medical Association (SMA)Benefit: 50% of average weekly income, up to $2,000/weekDuration: Up to 20 weeksEligibility: Licensed, self-employed; ≥26 weeks in practice; not eligible for EICovers: Birth, adoption, surrogacyInclusive: YesEarnings Limit: Max $4,000/week before reduction6. Newfoundland & Labrador—NL Medical Association (NLMA) Benefit: $1,500/weekDuration: 17 weeks (can start up to 8 weeks pre-birth)Eligibility: CPSNL-licensed physician, ≥6 months practiceCovers: Birth, adoptionInclusive: Yes (same-sex, adoptive)Salaried physicians: May get EI + top-up. (This is not the case in some other provinces).7. British Columbia—Doctors of BC Benefit: Up to $1,300/week (based on ~55% of income)Duration: 17 weeksEligibility: Fee-for-service, LFP, locum, or non-salaried; earnings threshold ~$123,000 for max benefit Covers: Birth, adoption, surrogacyInclusive: YesPart-Time Option available8. Manitoba—Doctors Manitoba Benefit: Up to $1,200/week (~60% income)Duration: 17 weeksEligibility: Active physician or Professional Association of Interns and Residents of Manitoba (PARIM) resident in ManitobaCovers: Birth, adoptionInclusive: YesEarnings Limit: Max $1,000/week during leave9. Alberta—Alberta Medical Association (AMA)Benefit: $1,074/weekDuration: 17 consecutive weeksEligibility: Physician must not be working during leave; funded via Alberta HealthCovers: Birth, adoptionInclusive: YesNote: No earnings allowed during benefit periodFor medical students and others who aren’t eligible for the above, there is a Federal Government benefit available. Most provinces stipulate that you can’t apply for both if you ARE eligible for the provincial.Federal Employment Insurance Parental Benefits pay 55% of insurable income, with a max of $695/week (2024 figures). The benefits continue up to 40 weeks (35 max for one parent). They can be extended, up to 69 weeks at 33% pay. Eligibility requires 600 insurable hours, with EI contributions required. It covers birth, adoption and is same-sex inclusive.Some consistent threads can be seen across all provinces. The plans are all accessible for same-sex couples, adoptive parents and surrogates. Medical society benefits generally require recent billing activity or full licensure. Salaried physicians may not qualify for society programs but may be eligible for EI or top-up schemes. And some provinces allow earnings during leave (up to a threshold), while others do not.But there are other factors to take into consideration, like relative income. Relative income can be tricky to calculate because some provinces, like B.C., have added new payment models that can double or even triple income for the family physicians in the group, and those increases have not been calculated yet in the data. But here’s how it looks: Current earnings for doctors (average of all specialties including Family Medicine) are basically impossible to calculate currently because numerous provinces have recently introduced new payment models. For example, B.C.’s new longitudinal care payment model—which doubles or triples previous Family Medicine income—is not yet reflected in the data, meaning the ranking may be misleading. Regardless, the Canadian Institute for Health Information (CIHI) 2022-2023 National Physician Database has Prince Edward Island docs earning an average (specialties plus family medicine) of $411,562, followed by Alberta ($409,927); Ontario ($388,557); Saskatchewan ($382,671); Manitoba ($366,702); Quebec ($336,533); Newfoundland and Labrador ($322,700); New Brunswick ($314,969); B.C. ($310,966) and Nova Scotia ($302,019).Then there are details like the relative cost of housing. According to the Canadian Real Estate Association’s most recent 2025 figures, average home prices by province looks like this (compare to the national average of $701,800):British Columbia: $959,058Ontario: $861,719Quebec: $547,985Nova Scotia: $493,136Prince Edward Island: $410,980Manitoba: $410,233Saskatchewan: $357,300New Brunswick: $361,329Newfoundland & Labrador: $337,608Where should young docs looking for both family and career go? All in all, it looks like B.C. and Ontario are pretty tough places to work as a doctor, have kids and pay for housing, while Atlantic Canada—especially P.E.I.— is much easier. Even with the pay increases not reflected in the CIHI figures, we all know that the cost of living, childcare and business expenses, all these things have risen steeply in those provinces in the same period of time.The parental supports provided by the various provinces are an important help. But how much do they influence a young couple planning their future and deciding whether they can manage a family?

Which is the best province for a Canadian physician to start a family?

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