Building a One Country One Licensure Framework: Applications for the Future of Canadian Space Physicians

Space medicine provides care in the most extreme environment known to humankind. The global space economy is forecast to be a $1 trillion industry by 2040. Its increased utilization will require additional legal healthcare support frameworks. We reviewed the current Canadian medicolegal framework for the capability to adapt to this new demand. Currently, Canadian physicians are required to hold a license in each province they practice. As space medicine encompasses multiple medical specialties and its practice is beyond Canadian provincial jurisdictions, we identified medicolegal gaps in the Canadian ability to provide space healthcare. Geographical licensing restrictions have caused detriment to healthcare provision in remote communities, military medicine, and telemedicine, exacerbated by COVID-19. By examining similarities and solutions from these terrestrial situations, bi-directional translational licensing solutions may be found. Recommendations for an improved Canadian licensing framework targeting provision of space medicine may lead to improving healthcare access and universality for Canadians nationwide.