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Integrating International Medical Graduates: The Canadian Approach to the Brain Waste Problem

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Part of the book series: Immigrants and Minorities, Politics and Policy ((IMPP))

Abstract

The Canadian health care system has relied both historically and more recently on international medical graduates (IMGs), physicians educated in other countries, to help solve shortages in its health care system, particularly in underserviced rural and remote areas. Throughout the 1970s, roughly a third of Canada’s physicians were IMGs. Although this proportion has dropped to 23 % more recently, Canada still has a sizeable dependence on physicians trained in other countries. The profile of incoming doctors has also shifted. In the 1970s, physicians tended to come from English-speaking countries, such as Ireland and the UK. Similar educational systems and proficiency in English made the process of integration of these IMGs relatively simple since their credentials and training could be assessed according to Canadian standards and most were fast-tracked to achieve Canadian accreditation. More recent IMGs originate from a wider variety of source countries, making English language proficiency and credential equivalency key issues for medical regulators and certifying bodies. Reports of IMGs having difficulty completing the extensive licensing procedure needed to practice medicine in Canada are increasingly common. This process includes passing several costly standardized exams and often two to six more years of postgraduate medical training, to which there is limited access. This chapter draws on interviews with key policy stakeholders as well as IMGs to highlight the challenges to the integration of IMGs in Canada.

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Notes

  1. 1.

    www.IMG-Canada.ca

  2. 2.

    http://www.health.gov.on.ca/english/providers/project/img/img_faq.html

  3. 3.

    http://www.health.gov.on.ca/english/providers/project/img/img_faq.html

  4. 4.

    http://www.healthforceontario.ca/Jobs/AccessCentre/AccessCentreServices.aspx

  5. 5.

    http://www.healthforceontario.ca/Jobs/AccessCentre/AccessCentreServices.aspx

References

  • Aiken LH et al (2004) Trends in international nurse migration. Health Aff 23(3):69–77

    Article  Google Scholar 

  • Alexis O, Vydelingum V (2004) The Lived experience of overseas black and minority ethnic nurses in the NHS in the south of England. Div Health Soc Care 1(1):13–20

    Google Scholar 

  • American Medical Association (AMA) (2003) AMA physician masterfile. American Medical Association, Chicago

    Google Scholar 

  • Association of International Physicians & Surgeons of Ontario (AIPSO) (2000). Barriers to licensing in ontario for international physicians report. http://www.promptinfo.ca/AIPSOBarriers2percent20Junpercent2000.pdf. Accessed 17 Sep 2007

  • Australian Medical Council (2004) Assessment of Overseas Medical Qualifications in Australia. Retrieved November 6, 2007. http://www.amc.org.au/exam.asp

  • Bach S (2003) International migration of health workers: labour and social issues, working paper. International Labour Office, Geneva

    Google Scholar 

  • Baj PA (1997) Evaluation of a programme to train russian émigré nurses. J Nurs Pract 3(1):40–46

    Google Scholar 

  • Barer M, Stoddart G (1991) Toward integrated medical resource policies for Canada. Background document. June. Available at http://www.chspr.ubc.ca/files/publications/1991/hpru91-06D.pdf. Accessed 10 Nov 2010

  • Baumann A, Blythe J (2009) Integrating Internationally Educated Professionals into the Healthcare Workforce. Toronto, ON: Ontario Hospital Association

    Google Scholar 

  • Baumann A, Blythe J, Rheaume A, McIntosh K (2006) Internationally educated nurses in ontario: maximizing the brain gain. Human Health Resources Series, Number 3, Second Edition, Nursing Health Services Research Unit, available at http://www.nhsru.com/wp-content/uploads/2010/11/IEN-Report-2nd-edition11.pdf

  • Bernstein J, Shuval JT (1998) The occupational integration of former soviet physicians in Israel. Soc Sci Med 47(6):809–819

    Article  Google Scholar 

  • Blacket RB (1990) Foreign medical graduates: the experience of the australian MEC. Med J Aust 153(3):125–132

    Google Scholar 

  • BMA (2006) European and international medical bodies. British Medical Association International Department

    Google Scholar 

  • Bourgeault IL (2007) Brain Drain, Brain Gain and Brain Waste: Programs aimed at Integrating and Retaining the Best and the Brightest in Health Care. Special Issue of Canadian Issues/Thémes canadiens, Spring, 96–99

    Google Scholar 

  • Bourgeault I.L, Neiterman E, LeBrun J, Viers K, Winkup J (2010) Brain gain, drain and waste. The Experiences of IEHPs in Canada. Released Oct 2010 & available for download: www.healthworkermigration.com

  • Canadian Institute for Health Information (CIHI) (2001) Canada’s health care providers. http://secure.cihi.ca/cihiweb/dispPage.jsp?_Page=AR_35_E. Accessed 17 Sep 2007

  • Canadian Institute for Health Information (CIHI) (2003) Supply, distribution and migration of Canadian physicians, 2002. CIHI, Ottawa

    Google Scholar 

  • Canadian Medical Association (CMA) (2007) Statistical information on Canadian physicians. http://www.cna.ca/multimedia/CMA/Content_Images/Inside_cma/Statistics/09GradCountry.pdf. Accessed 28 June 2007

  • Canadian Medical Association (CMA) (2008) Statistical information on Canadian physicians. http://www.cma.ca/multimedia/CMA/Content_Images/Inside_cma/Statistics/09GradCountry.pdf. Accessed 28 June 2008

  • Canadian Press (2005) Foreign-trained doctors, nurses get a boost. Canadian television, 26 April 2005

    Google Scholar 

  • Citizenship and Immigration Canada (2005) Facts and figures: immigration overview-permanent and temporary residents. http://www.cic.gc.ca/english/resources/statistics/meu-fact.asp. Accessed 28 June 2007

  • Dauphinee DW (2005) Physician migration to and from canada: the challenge of finding the ethical and political balance between the individual’s right to mobility and recruitment to underserved communities. J Cont Educ Health Care 25(1):22–29

    Google Scholar 

  • D’Cruse S (1996) Welcome to Britain? Nurs Times 92(39):28–29

    Google Scholar 

  • Dicicco-Bloom B (2004) The racial and gendered experiences of immigrant nurses from Kerala, India. J Trans Cultural Nurs 15(1):26–33

    Article  Google Scholar 

  • Eggertson L (2005) News at a glance: international MDs. Can Med Assoc J 172(11). doi: 10.1503/cmaj.050489

  • Factourovich A et al (1996) Psychological adjustment among soviet immigrant physicians. Isr J Psychiatry 33(1):32–39

    Google Scholar 

  • Fair Access to Regulated Professions Act (2006) Fair access to regulated Professions and Compulsory trades act. 2009, c. 22, ss. 97 (1), 104 (1). Available at http://www.e-laws.gov.on.ca/html/statutes/english/elaws_statutes_06f31_e.htm. Accessed 20 Oct. 2011

  • Fooks C (2003) Moving Towards National Resource Planning in Canada: Still Looking for a Home, CPRN/RCRPP

    Google Scholar 

  • General Medical Council (2003) Registration for doctors who qualified in Australia, Hong Kong, Malaysia, Singapore, South Africa, and the West Indies. General Medical Council

    Google Scholar 

  • General Medical Council (2003). Website. http://www.gmc-uk.org/. Accessed 27 June 2007

  • Groutsis D (2003) The state, immigration policy and labor market practices: the case of overseas-trained doctors. J Ind Relat 45(1):67–86

    Article  Google Scholar 

  • Hawthorne L, Birrell RJ (2002) Doctor shortages and their impact on quality of medical care in Australia, People and Place. 10(3):55–67

    Google Scholar 

  • Human Resources and Skills Development Canada (HRSDC) (2005) Website. www.hrsdc.ga.ca/en/cs/comm/hrsd/news/2005/050425bb.shtml. Accessed 17 Sep 2007

  • Immen W (2004) Canada urged to integrate foreign-trained MDs. The globe and mail. 18 Feb 2004

    Google Scholar 

  • Ishi T (1987) Class conflict, the state, and linkage: migration of nurses from the philippines. Berkeley J Sociol 37(1):281–312

    Google Scholar 

  • Jablonski J (2012) Employment status and professional integration outcomes of IMGs in Ontario. Master’s Thesis, Department of Epidemiology and Community Medicine, University of Ottawa. Available at: http://hdl.handle.net/10393/20685

  • Kronfol N, Sibai A, Rafeh N (1992) The impact of civil disturbances on the migration of physicians: the case of Lebanon. Med Care 30(3):208–215

    Article  Google Scholar 

  • Martin W (2004) Canadian midwifery regulators consortium’s research plan for a national midwifery assessment strategy. B.C.:College of Midwives of British, Columbia

    Google Scholar 

  • Martineau T et al (2002) Briefing note on international migration of health professionals: leveling the playing field for developing country health systems. Liverpool School of Medicine, Liverpool

    Google Scholar 

  • McIntosh T, Torgerson R, Klassen N (2007) The ethical recruitment of internationally educated health professionals: lessons from abroad and options for Canada. Canadian Policy Research Network, Ottawa

    Google Scholar 

  • Medical Council of Canada (2007) Website. https://www.mcc.ca/SelfAssessment/english/Introduction.html. Accessed 17 Sep. 2007

  • Medical Council of Canada (2011) Website. http://www.mcc.ca/en/exams/self_admin.shtml. Accessed 20 Oct. 2011

  • Mick S, Lee S (1998) Les Medicins Francais aux Etats-Unis. Cahiers de Soc. et de Demograph Med 38(4):253-69

    Google Scholar 

  • Ministry of Training, Colleges and Universities (2002) Facts are in! a study of the characteristics and experiences of immigrants seeking employment in regulated professions in Ontario. Ministry of Training, Colleges and Universities. Summer 2002. http://www.edu.gov.on.ca/eng/document/reports/facts02.pdf. Accessed 20 Oct. 2011

  • Mullan F (2005) The metrics of the physician brain drain. New England J Med 353:1810–1818

    Article  Google Scholar 

  • Mullan F et al (1995) Medical migration and the physician workforce: international medical graduates ad American medicine. JAMA 273(19):1521–1527

    Article  Google Scholar 

  • CBC News Online (2004) Attracting skilled immigrants: The struggle to lure trained foreign workers. CBC News Online, 14 Sep 2004

    Google Scholar 

  • Ontario Regulators for Access (2011) Website. http://www.regulatorsforaccess.ca/. Accessed 20 Oct. 2011

  • Ontario Regulators for Access Consortium (2004) Steering committee of ontario regulators for access fact sheet. Available at: http://www.regulatorsforaccess.ca/docs/FactSheetfin.pdf

  • Quinn J, Mensah E, Hnilicova H, Bencko V (2011) Iraqi physician brain drain in prolonged conflict. N Iraqi J Med 7(10):88–98

    Google Scholar 

  • Remennick L, Ottenstein-Eisen N (1998) Reaction of new soviet immigrants to primary health services in Canada. Int J Health Serv 28(3):555–574

    Article  Google Scholar 

  • Robinson V, Cary M (2000) skilled international migration: indian doctors in the U.K. Int Migr 3810:89–108

    Article  Google Scholar 

  • Secretariat, Council of Ontario Universities (2005) OPAS receives funding to help foreign-trained professional upgrade skills. Council Highlights, Feb 2005

    Google Scholar 

  • Sullivan P (2005) CMA challenges IMG Facts before commons committee. Can Med Assoc J Available online. http://www.cma.ca/index.php?ci_id=10018542&la_id=1. Accessed 20 Oct 2011

  • Sullivan P (2005) CMA’s concern over HR issues growing, annual meeting proves. Can Med Assoc J Available online. http://www.cma.ca/index.cfm?ci_id=10028212&la_id=1&topstory=1. Accessed 20 Oct. 2011

  • Task Force on Access to Professions and Trades in Ontario and Cumming, P. N (1990) Report of the task force on access to professions and trades in Ontario. The Task Force, p 59

    Google Scholar 

  • Task Force Two. A Physician Human Resource Strategy for Canada (2005) Executive summary, Canada’s physician workforce: occupational human resource data assessment and trends analysis. Canadian task force two. a physician human resource strategy for Canada: Ottawa

    Google Scholar 

  • World Health Organization (WHO) (2003) Strengthening nursing and midwifery. In: Report by the secretariat, 56th world health assembly, Geneva

    Google Scholar 

  • IMGO. Website Info

    Google Scholar 

  • Yelaja P (2000) Rejected in Canada, doctors head south. Toronto Star 30 Dec 2000

    Google Scholar 

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Correspondence to Ivy Lynn Bourgeault .

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Bourgeault, I.L., Neiterman, E. (2013). Integrating International Medical Graduates: The Canadian Approach to the Brain Waste Problem. In: Triadafilopoulos, T. (eds) Wanted and Welcome?. Immigrants and Minorities, Politics and Policy. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-0082-0_10

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