Thank you very much, Madam Chair. I really appreciate the opportunity to appear once again before this committee on behalf of the Medical Council of Canada.
As Madam Lefebvre noted, we really do not have a single Canadian licensing system; rather, we have 13 independent jurisdictions. While there is a Canadian standard, each jurisdiction still has the ability to make multiple exceptions.
The Medical Council of Canada was actually founded in 1912 to establish a single acceptable national qualification for these jurisdictions for the practice of medicine in Canada.
At this moment in time we have heard of the Canadian standard and the acceptability of the examination process to each of the 13 jurisdictions. Each graduate from a Canadian medical school must take our examinations prior to entering clinical practice. As Dr. Varastehpour noted, international medical graduates must complete one or more of the Medical Council's examinations to be eligible for licensure.
Each province and territorial regulatory authority determines which examination comprises the minimal requirement for licensure. Every year, over 12,000 candidates, both Canadian graduates and international medical graduates, take Medical Council examinations. These assess medical knowledge, clinical skills, and professional behaviours required of an independently practising physician.
After passing the final examination, the qualifying examination, part II, and meeting all other credentialing requirements, the candidate is awarded the licentiate of the Medical Council. It is one of the requirements that provincial and territorial regulators require before issuing a physician a licence to practise in Canada.
The council has taken the lead on several successful collaborations with the Government of Canada, through Human Resources and Skills Development Canada, Health Canada, as well as partner medical organizations. We've worked together on measures to more easily integrate international medical graduates into practice in Canada.
One such collaboration resulted in the launch of the Physician Credentials Registry of Canada. This is a collaboration between the Medical Council and the Federation of Medical Regulatory Authorities of Canada, and it has received funding through HRSDC. It is a national repository for source-verified credentials. We've been operating this now at the Medical Council since 2007 and are processing approximately 380 diplomas and credential documents per month.
Physicians can submit their documents prior to emigrating to Canada, and international medical graduates applying to one or more jurisdictions can choose to share their verified credentials with multiple organizations at once through the repository, saving both time and effort. While time for verification depends on the source institution abroad and the type of document, the average is approximately 81 days for medical degrees and 108 days for verification of postgraduate education. Of course, there are countries in the world where this is not feasible, Afghanistan being one and Iran another. We do have alternative methods to be able to demonstrate that an individual has graduated from an institution in these countries.
At the moment, the repository is only available to international medical graduates, but our intention is to open it up to Canadian physicians.
The opening of an account with the repository is only the first step for international medical graduates. The second step, as the presentation by Dr. Varastehpour noted, is the Medical Council evaluating exam. The reason for this is that some countries around the world do not have accreditation processes. We in Canada and the U.S. have a joint accreditation process for medical schools that is quite rigorous. Therefore, the need for assessment of physicians' knowledge was considered essential, and in 1979 the Medical Council collaborated with the Government of Canada to offer this examination abroad. Unfortunately, it was only offered through embassies and consulates in about ten places around the world. Since 2008 we have had a computer-based test, now offered in 73 countries at 500 sites, so candidates do not have to travel outside of their country of origin to take this examination.
The examination was always intended for international medical graduates prior to their emigration to Canada. However, at the present time, 50% of those taking our examination do so from inside Canada. Our data show that if a candidate fails this examination one or more times, she or he has a low probability of completing the licensing process, probably less than 35%, as opposed to passing this examination the first time, when the person then has a more than 75% chance of completing the licensing process.
We believe that the federal government should benefit by requiring potential licensure applicants to provide evaluating examination results for consideration at the time of their immigration application.
Dr. Varastehpour is correct that this is an expensive examination. We do it through a delivery system. However, we are also offering a self-assessment examination based on that exam, which individuals can take. We have multiple forms for this. It costs $60 to take this over the Internet, and the individuals get feedback on whether or not they would be successful.
The other aspect of assessment, of course, is the clinical skills. We've been in a collaborative partnership of national medical organizations and the various governments to provide an assessment of clinical skills. These are the communication skills and diagnostic skills.
The final area where we have collaborated has been to establish a national registration process that can be done through the web. This process could start prior to candidates coming into the country as well.
I'll close there. Thank you, Madam Chair.