Addressing the Shortage of Doctors in Canada: Challenges for Immigrant Physicians and Government Initiatives

Introduction

Canada is currently facing a shortage of doctors, and one potential solution to address this issue is to allow immigrant doctors to join the workforce. However, there are several barriers that hinder the integration of international medical graduates (IMGs) into the Canadian healthcare system. In this article, we will explore the challenges faced by IMGs in Canada and compare them to the situations in the United States and the United Kingdom. Additionally, we will discuss the initiatives taken by the Canadian government to resolve this issue.

In the previous 10 years, Canada has had a population growth of over five million people, but during that same period, the country has only added 167 medical residencies. As a result, many Canadians are finding it more and more difficult to have regular access to a family physician.

A piece published by CBC News in late January states as much, adding that “more than 6.5 million Canadians do not have regular access to a family doctor”. For Canadians, the country’s population expansion has had significant ramifications because it has coincided with a number of variables that are working against the availability of family doctors across the nation.

According to Government of Canada figures from December 2022, immigrants make up “one out of every four healthcare sector workers” in Canada.

In reality, when broken down by profession, immigrants constitute the following percentage of all healthcare professionals in Canada:

  • 23% of registered nurses
  • 35% of nursing aides and associated occupations
  • 37 percent of pharmacists
  • 36% of physicians.
  • 39 % of dentists
  • 54% of dental technologists and associated occupations

A Good video to wathc is by CTV News which discusses the issue and the dire crisis we Canadian Citizens are in!

Barriers Faced by International Medical Graduates in Canada

Despite the shortage of doctors, IMGs in Canada encounter numerous obstacles when attempting to practice medicine. The most significant barriers include:

  1. Licensing and Certification: IMGs often face complex and lengthy processes to obtain the necessary licenses and certifications required to practice medicine in Canada. This includes passing the Medical Council of Canada Evaluating Examination (MCCEE) and the Medical Council of Canada Qualifying Examination (MCCQE).
  2. Language Proficiency: Proficiency in English or French is crucial for effective communication with patients and colleagues. IMGs must demonstrate their language skills by passing the International English Language Testing System (IELTS) or the Canadian English Language Proficiency Index Program (CELPIP).
  3. Residency Matching: IMGs face intense competition when applying for residency positions in Canada. The limited number of available spots and the preference given to Canadian medical graduates make it difficult for IMGs to secure a residency position, which is a prerequisite for practicing medicine in the country.
  4. Lack of Canadian Experience: The lack of Canadian clinical experience is often viewed as a disadvantage for IMGs. Canadian healthcare institutions and employers may prioritize candidates with local experience, which can create additional barriers for immigrant physicians.

Comparison to the United States and the United Kingdom

While Canada faces challenges in integrating IMGs into the healthcare system, the situations in the United States and the United Kingdom differ in some aspects:

In the United States, IMGs must complete a series of examinations, including the United States Medical Licensing Examination (USMLE), to obtain a license to practice medicine. However, the demand for physicians in certain areas of the US has led to the creation of specific programs that facilitate the entry of IMGs into the workforce.

In the United Kingdom, IMGs must pass the Professional and Linguistic Assessments Board (PLAB) examination to practice medicine. However, the UK has implemented initiatives such as the International GP Recruitment Programme to address the shortage of general practitioners.

These intitatives have seen healthcare workers transition in UK or USA healthcare system smoothly and easily, which creates and impact to the country they are living while not wasting time in menial survival jobs as seen in Canada.

Government Initiatives in Canada

The Canadian government recognizes the importance of addressing the shortage of doctors and improving the integration of IMGs into the healthcare system. Several initiatives have been implemented to resolve these issues:

  1. Provincial Programs: Some provinces have established programs to facilitate the integration of IMGs. For example, the Practice Ready Assessment program in British Columbia provides a pathway for IMGs to obtain a license to practice medicine in the province.
  2. Increased Residency Positions: The Canadian government has increased the number of residency positions to accommodate more IMGs. This allows them to gain the necessary Canadian clinical experience and enhances their chances of obtaining a license to practice medicine.
  3. Bridge Training Programs: Bridge training programs have been developed to help IMGs adapt to the Canadian healthcare system. These programs provide additional education and training to address any gaps in knowledge or skills.
  4. Streamlined Certification Processes: Efforts have been made to streamline the licensing and certification processes for IMGs. The Medical Council of Canada has introduced the National Assessment Collaboration examination, which combines the MCCEE and MCCQE into a single assessment.

 A few more intiative by goverment of Canada to address the Doctors shortage

Beginning at the federal level, in addition to investing in international credential recognition, Canada hopes to attract more foreign-trained doctors to the country through category-based Express Entry draws.

Category-based drawings, introduced in May 2023 by IRCC, are a type of Express Entry draw designed to attract more foreign nationals with experience in critical job sectors across Canada. IRCC is prioritizing five professional areas through these draws, including healthcare.

Finally, at the provincial level, medical schools in three provinces are taking steps to either expand medical training spaces or open new medical schools entirely. CBC News has published a report outlining all of these agreements.

Ontario: The province has committed to adding 449 postgraduate medical training spaces over the next five years.” Of these, 154 positions “are expected to come online later” in 2024 at various medical schools across the province.

Prince Edward Island (PEI): The University of PEI plans to build a new medical school in the fall of 2025.

British Columbia (BC): Simon Fraser University has announced plans to open a new medical school on its Surrey campus in 2026.

Conclusion

The shortage of doctors in Canada can be alleviated by effectively integrating immigrant physicians into the healthcare system. However, numerous barriers hinder the progress of IMGs. While there are similarities in the challenges faced by IMGs in Canada, the United States, and the United Kingdom, each country has implemented different initiatives to address the issue. The Canadian government’s efforts to increase residency positions, establish provincial programs, and streamline certification processes are steps in the right direction. By continuing to address these barriers, Canada can benefit from the skills and expertise of immigrant doctors, ultimately improving healthcare accessibility for all.

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