Quebec’s medical specialists ratify tentative deal with province, ending years-long negotiations
Posted April 23, 2026 6:16 pm.
Last Updated April 24, 2026 5:39 pm.
Quebec’s medical specialists have voted 86 per cent in favour of an agreement in principle with the provincial government, ending a three-year long negotiation saga.
The Fédération des médecins spécialistes du Québec (FMSQ) said 125 delegates ratified the deal during a special general meeting Thursday night.
The approval means Quebec’s specialist physicians will now move forward under a new framework agreement following the expiry of their previous contract on March 31, 2023.
The initial agreement was reached Monday afternoon. Negotiations between the government and the FMSQ resumed earlier this month after being suspended for several weeks.
In an email sent to FMSQ members Friday morning, federation president Vincent Oliva characterized the agreement as a victory.
“The renewal of our framework agreement is the result of two years of hard work, mobilization, and collective determination,” Oliva wrote. “Today we are reaping the rewards.”
What’s in the deal?
According to the FMSQ, the agreement includes an 11 per cent increase in the envelope the Federation uses to pay its members.
This is the first pay increase specialists have received since 2012.
Most specialists in Quebec are paid per medical act rather than a fixed salary. The FMSQ is the organizational body that distributes those funds.
“The ‘envelope’ is basically the mass amount of money that is annually transferred to the Federation,” FMSQ executive committee member Dr. Arsène Basmadjian told CityNews.
The five-year collective agreement will tie two per cent of the overall envelope increase to collective targets. Specialists have agreed to adding 80,000 new appointments, representing an increase of 10 per cent.
“We want to see more patients and to take care of more patients,” Basmadjian said. “The problem is the lack of tools.”
The Federation has also agreed to government targets for a reduction in the number of patients waiting for more than one year to see specialists and for reducing the number of cancer patients waiting for surgery for more than 56 days.
The government in turn will invest $900 million to increase surgical capacity by 45,000 operations by 2028-29, digitize appointment systems and increase administrative and clinical staffing.
About $140 million will also be earmarked for improving access to specialized care in areas like mental health, geriatrics, neurology and alternatives to hospitalization.
Five per cent of the envelope increase is reserved for reducing income gaps between higher- and lower-paid specialties, Basmadjian said.
Equally, three per cent will go to supporting medical clinics, like helping cover rising costs like rent and staff salaries. Around one per cent will be dedicated to research funding.
Outside the pay increase, Quebec will invest $75 million to fund department heads, most of whom have been “doing this work pro bono,” according to Basmadjian.
The deal also included a vow from the National Assembly to not use its powers to nullify a negotiated contract — an ability that was initially included within the controversial Bill 25 (formerly Bill 2).
“The government will not apply the article, which is very important to us,” Basmadjian said.
The province has also committed to not invoke section 209 of Bill 25 which penalizes private organizations for violating privacy regulations. The Federation will continue its legal action to have an arbitration mechanism.
Government open to collaboration for ‘the first time in many years’
In an email obtained by CityNews that was sent to FMSQ members Friday morning, the Federation said that it would look to “rebuild bridges with the Ministry of Health and Social Services (MSSS) and Santé Québec.”
The collaborative mood between the Federation and the province had been one-sided for many years, according to Basmadjian.
“Let’s be clear, it’s not a new attitude, it’s something we’ve wanted for forever,” he said.
But the April agreement has finally ushered in what Federation leaders are reading as reciprocity.
“For the first time in many years, we see that the government is actually thinking along those lines,” he said, “that we want to work in collaboration and not in confrontation.”
On Thursday, Quebec Premier Christine Fréchette, argued that with this agreement, “we are taking a step that no other government has taken in the past.”
“For the first time, we are introducing performance targets into the compensation of medical specialists, particularly regarding access to specialist appointments and surgeries,” she wrote on X.
Treasury Board President France-Élaine Duranceau, described the process as “rigorous, firm, and responsible.”
“We have made commitments that respect Quebecers’ ability to pay and established performance targets for specialist physicians to better meet patients’ needs,” she wrote.
Automatically index pay to inflation and give specialists a seat at the table, members say
The first reactions CityNews were met with when asking cardiologists Dr. Raja Hatem and Dr. Christopher Labos was relief.
“I’m very happy it’s finally done,” Hatem said.
“It’s been years in terms of the negotiations,” Labos added.
But aside from a respite to lengthy pay disputes, Labos said Quebec specialists aren’t gaining much considering the over 10-year gap since their last bump.
“This is really just about maintenance more than anything else,” Labos said, adding that other longer-term fixes will be needed to avoid drawn-out negotiations in the future, like indexing pay automatically to inflation.
Specialists had originally asked a 17 per cent increase over five year, before that was dismissed by then-Premier François Legault as “unreasonable.”
The FMSQ then lowered its demands in the fall before accepting the latest counter-offer from Quebec at 11 per cent.
Despite progress in rolling back some of the powers granted to the government under Bill 25 — long criticized by physicians as unfair — Hatem said there’s still work to do when it comes to giving specialists a real seat at the table.
“The more you involve doctors in different projects like the digitization of the healthcare network the more successful these programs become,” the Sacré-Cœur hospital physician said.
He is referring to Quebec’s ongoing digital overhaul of medical records, with a pilot project set to launch in May.
Both specialists and family doctors had stepped away from its development as part of their use of pressure tactics linked to protesting Bill 25.
“We need to be back with the administrators to decide where the healthcare system is going,” he added. “And we need to give doctors a bigger role in decision making when it comes to the direction of our hospitals.”
— With files from La Presse Canadienne
