Manitobans are experiencing long wait times for an MRI scan because of a shortage of MRI technologists, staff burnout and a lack of full-time permanent positions among other factors, says the Canadian Association of Medical Radiation Technologists (CAMRT).
Patients booked for an MRI scan at a Winnipeg hospital can face inordinately long wait times (e.g., 40 weeks at Health Sciences Centre). And those wait times also likely impacting Interlake patients, who may need to have the procedure done at a Winnipeg hospital rather than at the Selkirk Regional Health Centre, the only centre providing an MRI scan in the Interlake, said Dayna McTaggart, CAMRT’s provincial manager for Manitoba.
“The most recent wait times published, up to the end of January, show Selkirk having a 10-week wait, which is much less than the wait time for a Winnipeg hospital, but it’s important to note that not all MRI scanners are the same. There are certain exams that wouldn’t be suitable for an MRI in Selkirk and the patient would need to be referred to one of the larger centres in Winnipeg,” said McTaggart. “Overall, I would say the Interlake region and the residents there are in a better position regarding MRI wait times because they have the Selkirk hospital. But there certainly are some people that have be referred to Winnipeg and are affected by the long wait times.”
MRI magnets in a scanner can have different strengths and require different scanning protocols, she said. For example, there is a protocol for patients who have implanted devices and a concomitant level of staff expertise required for such a patient. Those different protocols and different machines could “dictate the facility” to which patients get referred.
It’s uncertain whether the number of Interlake patients being referred to city hospitals for an MRI is being tracked, or how well it’s being tracked, but McTaggart said she knows that physicians’ requests for an MRI are forwarded to a “central intake” where factors such as patient location, current wait times and eligibility for a particular scanner are assessed. The urgency of the required scan is also taken into account. All of those factors – in addition to an MRI technologist shortage – can contribute to waiting times.
CAMRT is the national certifying body for radiological, nuclear medicine and magnetic resonance imaging technologists and radiation therapists. It also advocates for the profession on a range of issues including mental health and wellness, radiation safety and artificial intelligence in medical imaging and radiation therapy.
There are 71.25 full-time MRI positions in Manitoba, according to the province’s Shared Health organization, said McTaggart. CAMRT membership data shows 107 certified MRI technologists in the province, but McTaggart said based on the way the association collects its data, it’s difficult to tell how many of them are currently practising as MRI technologists. Some may have MRI certification but aren’t “currently working in that capacity.” That may have to do with few or no full-time MRI positions available to them.
“That number [107] is up from 103 back in 2022 when Shared Health issued a statement saying in order to decrease wait times at that point to the recommended 8.5 weeks, they would need an additional 11 to 12 full-time positions, which translated to about 15 or 16 MRI technologists, and expecting that not all of them would be employed in a full-time capacity,” said McTaggart. “We can see by our membership numbers that the number of MRI technologists has increased by about only three or four over that two-year timespan, nowhere near the 15 or 16 that we needed back in 2022.”
CAMRT’s best practice guidelines recommend a minimum of two MRI technologists or one technologist and MRI personnel with safety training to operate a scanner, she added. Not having enough MRI staff could compromise safety.
“MRI technologists’ number 1 priority is safetybecause the MRI room is probably the most dangerous room in the entire hospital,” said McTaggart, referring to the power of the machine’s magnet to turn objects into dangerous projectiles. “Any instances of death or serous injury from a projectile usually involves somebody who doesn’t have that training, who inadvertently brings ferromagnetic material into the room, which causes a projectile incident.”
Growing wait times for MRI scans indicate a need to fund more full-time MRI technologist positions as people working in casual or part-time positions are working full-time hours and are getting burned out, she added.
In terms of whether patient conditions worsen over the duration of their wait for an MRI scan, McTaggart said the medical triage system does ensure that a patient deemed in urgent need of a scan is fast-tracked and not placed at the back of the queue. But patients whose conditions are considered less urgent have to wait.
“A lot of them might be dealing with chronic pain or pain associated with their conditions, and they’re experiencing a delay in treatment for their condition because the MRI scan will determine what kind of treatment they should receive,” she said. “There are people living in pain and in distress just waiting to know what their diagnosis is.”
Evidence regarding deaths related to lengthy wait times for an MRI is either unavailable or may not be submitted by health organizations to a research body such as the Canadian Institute of Health Information (CIHI), she added. But it can be logically assumed that “some conditions” could potentially worsen over time because of a delay in getting an MRI and a subsequent intervention that may have been suitable at that time.
In addition to patients negatively affected by wait times, McTaggart said MRI technologists themselves are feeling distressed and exhausted.
“We want to do our part and help patients get the scans they need in a timely manner, and this is contributing to MRI technologists volunteering for overtime, which in turn increases their burnout. They’re not getting days off,” she said. “And we also have a large pool of casual employees. The stories I’m hearing from them is that they’re picking up hours equivalent to full-time employment. We’re seeing a huge reliance on part-time and casual staff to fill the [staffing] void, and that overtime work also results in exhaustion and burnout.”
Burnout leads to increased leaves of absence and sick time and, ultimately, people opting to leave the profession or the province. Even though a technologist in a casual position might be working full-time hours, they’re denied the range of benefits that come with full-time positions.
Based on discussions CAMRT has had with MRI technologists, there have been delays in filling vacant MRI positions or some vacancies aren’t being posted, said McTaggart. A job search she said she conducted for MRI positions in Shared Health resulted in one posting for a casual position.
CAMRT has a number of solutions to improve the health system to make it more attractive for retaining and recruiting MRI technologists. McTaggart said CAMRT met with provincial health minister Uzoma Asagwara in February to discuss the major issues facing MRI technologists and medical radiation technologists (MRTs).
The association asked the government to consider offering MRI training in rural communities with return-of-service agreements and to consider implementing employer-supported training for MRTs to become MRI technologists – the MRI specialty requires an additional 8.5 months of training at Red River College – along with a job to step into upon graduation. Currently, MRTs who want to take MRI training have to either opt for an unpaid leave of absence or resign from their job.
Training institutions in some Canadian jurisdictions don’t require MRI students to have prior certification as an MRT, and that could entice those wishing to go straight into MRI training to leave Manitoba altogether.
A lack of permanent MRI positions in Manitoba only makes the province less attractive to people who want to become MRI technologists, and McTaggart said they’re seeing decreased interest in the program as a result of unavailable positions.
“Shared Health has been quite vocal in saying that Manitoba’s number of MRI technologists per million population is higher than the national average. But we know we don’t have enough … because the demand for MRIs is ever-increasing year after year. We have patients who previously wouldn’t have been suitable for an MRI that are now qualifying due to advancement in the scanner itself or medication to ease anxiety,” she said. “We’re not seeing a temporary surge in MRI demand due to the closures during COVID. This is a permanent fixture in our healthcare environment where physicians are relying on MRIs for diagnoses. We can’t look at temporary staffing solutions; we need to look at permanent staffing solutions.”
The recent provincial budget specifically noted that the government will invest in MRI services for northern communities. A $1-million-dollar investment will be made in 2024-2025 for a mobile MRI and the installation of a “second permanent” MRI at Thompson General Hospital.
That announcement, said McTaggart, has given her hope that wait times for MRIs will start to fall.
“There certainly is hope that with additional machines available to patients, they’ll be able to decrease wait times. There was also some mention in the budget about investments in recruitment and retention and of allied health as a whole,” she said. “They didn’t necessarily indicate MRI technologists and MRTs individually as they did for some other professions, but my hope is when the government is making investments into equipment it has considered the fact that the equipment needs to be run by professionals, and that we need to invest in those people, as well, which hasn’t always been the case.”
A spokesperson for Shared Health said wait times for outpatient MRIs at the Selkirk Regional Health Centre were approximately 14 weeks at the end of February. That represents the maximum length of time 90 per cent of patients waited for an MRI. Wait times for outpatient CT scans were 21 weeks.
He declined to say whether wait times at Winnipeg hospitals affect Interlake patients, but said urgent and emergency scans are “always prioritized” and people experience “very little to no wait.”
“Patients referred for a less urgent, elective scan can expect to wait longer and are placed on a wait list for their needed service,” he said. “Those who are willing to travel to another site may be able to receive their test sooner as wait times and wait lists do vary by location and patient volume.”
There were 8,724 MRI scans and 18,573 CT scans completed in Selkirk in 2023, he said, and those volumes “exceed” volumes from previous years.
“Work is underway to further expand capacity for these scans across the province in order to address wait times,” said the spokesperson.
He declined to say how many certified MRI technologists there are in the Interlake-Eastern Regional Health Authority, whether more are needed and whether wait times for MRIs are leading to the worsening of patients’ conditions or death.
