Towards a better integration of foreign-trained health care professionals

Nursing graduates and doctors trained abroad make up a significant workforce in the Canadian health care system. The Canadian Institute for Health Information (CIHI) published a study stating that out of 82,198 doctors practicing in Canada in 2017, nearly 26% were trained outside the country.

CURRENT SITUATION

The proportion of  doctors trained outside of Canada is different from one province to another. While this average rises to 38% for doctors in Newfoundland and Labrador and to 46.5% for Saskatchewan, the proportion is less important in Quebec. There were always proportionately fewer doctors coming to La Belle Province compared to the other provinces, perhaps due to the French language. They mainly come from France, Lebanon, Vietnam, Egypt and the United States.

The profile of Canadian doctors, published in 2016 by the CIHI (Canadian Institute for Health Information) states that 29% of family doctors have graduated abroad. This proportion is 24% for the medical specialists, and falls to 18% among the surgical specialists. 

A GENEROUS INITIATIVE

Since 2005, the federal government has provided 18 million dollars each year for the Internationally Educated Health Professionals Initiative (IEHPI). The goal is to help them have access to assessments and to training programs, in the hopes of reducing the manpower shortage – even though the number of doctors in Canada continues to grow (+2.9% between 2015 and 2016). The professions covered by this program are medicine, nursing, medical laboratory sciences, medical radiation technology, pharmacy, physiotherapy and, finally, occupational therapy.

… WITH PRACTICAL ACTIONS

This initiative, which brings together the federal government as well as the provinces and territories, post-secondary institutions, professional associations and health care sector regulatory agencies, has seen projects crystallized such as:

establishment of programs for minority linguistic communities, including preparatory courses for examinations;
harmonization work for assessment of IEHPs;
transition programs for various categories of internationally educated health professionals;
design of integration activities (using tutors, mentors).
Funds granted by the IEHPI helped to finance 28 projects in all Canadian provinces and territories and to conclude four agreements with organizations whose goal is to facilitate integration of internationally educated health professionals.

COMPLEXITY OF APPROACHES

Although the Medical Council of Canada makes a significant contribution in assessment of internationally educated doctors, it does not issue the licenses allowing them to practice in Canada. This is up to the professional orders. What are the steps that international medical graduates (IMGs) must take?

In the country of origin

It is good to know that there are certain steps that can be taken by an IMG in his or her country of origin:

  • ensuring that the local diploma has been issued by a recognized faculty;
  • passing a self-evaluation exam online;
  • submitting credentials to the Physician Credentials Repository of the Medical Council of Canada (MCC);
  • passing the Medical Council of Canada’s assessment exam.

Once in Canada

Additional assessments may be required by the Canadian provinces and territories such as the National Assessment Collaboration (NAC) exam or the Medical Council of Canada Evaluating Examination (MCCEE). In addition, postgraduate education is required for granting a license to practice medicine. Once at the end of the tunnel, the IMG should be sure to understand the obligations concerning protection related to medical liability in Canada.

Looking carefully at the complexity of tasks to be undertaken to practice medicine in Canada, it is clear that the IMG must be motivated, well educated, and above all in good company to save time in his or her efforts and to avoid becoming discouraged with the idea of practicing medicine in Canada.

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