May 18, 2024

Healt Hid

Because health is very important to us

Opinion: International medical grads could help fix doctor shortage

4 min read

All that stands in the way of these qualified MDs going into practice is access to post-graduate residency training.

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The physician shortage in Canada is urgent and must be addressed. This longstanding challenge has been exacerbated by factors such as an aging population, increased demand for health-care services and physicians’ preferences to practise in urban areas. Shortages are impacting Canadians across the country, but rural and underserved communities often bear the brunt with long wait times, reduced access to specialized care and, in some cases, no access to health care at all.

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The proposed solutions have included creating new categories of health-care professionals, building new medical schools and changing how medicine is taught. However, these are largely long-term strategies which will not address the current and urgent needs of Canadians now.

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As physicians, former medical school administrators and now senators, we would suggest that there is a cost-effective, efficient and immediate solution to addressing physician shortages: increasing and expanding licensure for International medical graduates (IMGs).

International medical graduates are permanent residents and Canadian citizens who have completed their initial medical degree (MD) outside of Canada. Many immigrant IMGs are highly skilled and experienced clinicians with years of medical practice in their home countries. For such an IMG, with credentials verified and having completed the Medical Council examination, all that stands in the way of their entering practice is to successfully complete a “practice ready assessment” (PRA). This evaluation usually takes about three months.

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Other IMGs are younger Canadians who have gone abroad for their medical school training, as well as immigrant IMGs with limited clinical experience. All that stands in the way of these IMGs is access to post-graduate residency training. For family medicine, this training currently takes two years, at most three.

So, to address the country’s urgent need for physicians we propose the following immediate actions:

1. Ensure timely access to practice-ready assessment in every province, and in medical specialties and family medicine;

2. Increase the number of post-graduate residency training positions for IMGs who are Canadian citizens or permanent residents.

3. Consider reallocating the training capacity now taken up by “visa trainees” to residency training for IMGs who are Canadian citizens or permanent residents. (Visa trainees, who return to their home countries after training, currently constitute 59 per cent of IMGs in postgraduate training, although most are in fellowships of some kind.)

4. Utilize “return of service” agreements so that, as much as possible, and with appropriate supports, IMG physicians settle and provide medical care in rural or under-serviced communities.

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A clinically experienced IMG who can access a practice-ready assessment could be prepared to work in a number of months. An IMG with access to a family medicine residency program can enter practice in a few years, and will also provide medical care while in training.

We don’t need to build new medical schools that will take decades before producing a single physician ready to practise.

IMGs who are permanent residents and Canadian citizens are already here. They are keen to enter the Canadian health-care system. With the relatively inexpensive and timely interventions we have described, this can be done safely and efficiently. As we continue to work through the myriad components and complex changes needed to solve the current health-care crisis, here are pieces of the puzzle that are already in our hands.

Jan Sheppard Kutcher has extensive experience as a consultant working on issues of international qualifications recognition. Stan Kutcher and Mohamed-Iqbal Ravalia are members of the Senate of Canada.

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