New graduates are going to look long and hard at practicing out of the country or in the lowest tax jurisdiction in Canada.  As you clearly stated, they are very motivated and aren't stupid.  It takes a long long time to become a physician and there simply isn't enough TFSA or RRSP room to make up for those years spent in education.  If the graduate has a family, i.e. they decided to have children before mid to late 30s age, then their spouse has likely sacrificed their career and potential retirement savings as well. There is a big difference between being able to start saving at 25 years old vs 35, which is when many specialists begin to practice.  Plus, there may not be as many jobs available in Canada as many current physicians will likely be forced to defer retirement to make up for the increased taxes.