Systemic barriers exist in health care in Canada for immigrant health professionals



COVID-19, News, Health, Humanitarian emergencies, Migration & Refugees, North America, opinion, TerraViva United Nations


Immigrant health professionals have a lot to offer Canadian society, but often face barriers.

Toronto, Canada, August 27, 2021 (IPS) – Albert Einstein said: “In the midst of every crisis lies a great opportunity. The year 2020 has been a year of crisis for many sectors in Canada, particularly the health care sector. The health care system was under great pressure from long waiting lists for family physicians, specialists and immunization clinics, and intensive care units were operating at a high level of capacity.

The People’s Health Charter describes health as a reflection of a society’s commitment to equity and justice. Equity in health is not complete without equity of opportunities for health professionals from all walks of life to practice medicine.

Canada’s healthcare system has faced many challenges including, but not limited to, long wait times, geographic disparities, an aging population, and limited access to personal physicians and specialists. The COVID-19 pandemic has further highlighted gaps in healthcare and how opening up career paths for internationally educated doctors on the front line can only be beneficial.

The Canadian demographic model is changing due to globalization and immigration policies – hence the importance of diversity. There are more and more Internationally Trained Physicians (DMTIs) who can work in Canada’s healthcare system, but find it difficult to continue their careers after moving to Canada due to bureaucratic obstacles. and others. ITMDs can contribute to our health care system alongside Canadian graduates. They also provide culturally appropriate care and language skills in demand of Canada’s increasingly diverse population.

Systemic barriers exist in Canadian health care for immigrants; therefore, inequity in the system must be corrected by providing culturally sensitive services. ITMDs can ensure equal opportunity to contribute to health services (i.e. indigenous community, aging population, immigrants and migrant workers).

There is a growing demand for healthcare talent around the world. Canada will face increasing competition with other countries to attract such a talented and skilled workforce. Without appropriate pathways for ITMDs to pursue their careers in Canada, ITMDs will eventually choose to migrate to countries that would allow them to have fair and clear pathways into the health system that will use their expertise.

Systemic barriers and inequalities exist and, as a result, over 13,000 immigrant physicians are not called “doctors” in Canada. Only 26.4% of the total number of physicians in Canada are internationally educated medical graduates.

However, in Ontario, hospital care is overwhelmed by an estimated backlog of nearly 257,000 surgeries. In addition, Canada is 12th lowest among OECD (Organization for Economic Co-operation and Development) countries for the number of physicians per 1,000 population. This implies the need for more physicians in Canada, which can be achieved by opening up more opportunities for the thousands of international medical graduates in Canada to practice medicine.

However, it can be said that the number of physicians increased by 1.8% compared to 2018, with a total of 5.2% between 2015 and 20191. In addition, the number of international medical graduates becoming family physicians in Canada grew from 28.7% in 2015 to 30% in 20191. Can this be interpreted as an increase in opportunities for internationally trained physicians? The answer to this question requires further exploration of the residency matchmaking opportunities and processes. Internationally trained specialists with many years of training and expertise choose to do family medicine in Canada as the process becomes extremely difficult for specialists to take their respective courses in Canada. This is also evidenced by the fact that ITMDs represent only 17% of practicing surgical specialists, compared to 30% of practicing family physicians.

In addition, we cannot ignore that international graduates with specialized training in certain countries only are recognized to pursue Royal College certification in their respective specialties. However, graduates with specialized training from all other countries must undergo compulsory residency training despite years of experience in their respective fields.

A recent survey conducted in 2021 by the Internationally Trained Medical Doctors program at Ryerson University showed that 35% of international graduates who took the survey have passed all necessary licensing exams but have not yet been able to obtain a residency position. Similarly, 47% of immigrants with foreign post-secondary health credentials are underutilized: they are either unemployed or working in non-health occupations that only require a degree. high school education. In addition, the World Health Organization predicts a global shortage of around 18 million healthcare workers by 2030, with some consequences for patients, economies and communities. This shortage could fuel global competition for skilled health workers.

Internationally trained and licensed physicians have different access to opportunities to meet the demands of practicing medicine compared to those trained in Canada. Although most immigrant physicians are required to complete additional residency training here, places available are very limited. In 2020, only 418 ITMDs were granted residency positions, while 2,895 Canadian-trained medical graduates were matched with residency programs. At the end of the match, 56 residency positions were vacant, including 49 in family medicine. In addition, of the places reserved for ITMDs, a majority were filled by Canadians who traveled abroad to study medicine. On the positive side, however, 83% of Canadians agree that we should be doing more to ensure that internationally trained physicians have a fair and reasonable opportunity to practice medicine in Canada.

Hopefully soon we will reach a point where we ITMD can look back and say our time has finally come! Policymakers must take into account existing barriers and take action to use the skills of immigrants to meet the demands of our society. ITMD, let’s stay strong together, tomorrow is a new day! Diversity matters. Together, let’s act now to make our Canadian health care system focused on equity and accessible to all.

  • The authors are from Asia, the Middle East, Africa and South America.
  • The co-authors are Drs Bhuiyan S, Azam S, Krivova A, Orin M, Mukoko P, Radwan E, Adelekan O, Abdulhameed M, Mehrotra M, Anuradha D, Gaby V, Tasnim N, Abolurin A, Dare A, Telchi J, Mariano K, Bukhari S.


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