Evidence of meeting #36 for Human Resources, Skills and Social Development and the Status of Persons with Disabilities in the 41st Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was health.

A recording is available from Parliament.

On the agenda

MPs speaking

Also speaking

  • Danielle Fréchette  Director, Health Policy and External Relations, Royal College of Physicians and Surgeons of Canada
  • Robert Sutherland  President, Canadian Dental Association
  • Euan Swan  Manager, Dental Programs, Canadian Dental Association
  • Pat Vanderkooy  Manager, Public Affairs, Dietitians of Canada
  • Noura Hassan  President, Canadian Federation of Medical Students
  • Chloé Ward  Vice-President, Advocacy, Canadian Federation of Medical Students
  • Christine Nielsen  Executive Director, Canadian Society for Medical Laboratory Science
  • Marlene Wyatt  Director, Professional Affairs, Dietitians of Canada

4:50 p.m.

Conservative

The Chair Ed Komarnicki

Thank you for your presentation. I'm sure everyone here is familiar with the yo-yo and the effect. The point was well made.

We will now turn to Christine Nielsen, who I think appeared before this committee in our study of foreign credentials.

It's good to see you again to present on this issue as well. Please go ahead.

4:50 p.m.

Christine Nielsen Executive Director, Canadian Society for Medical Laboratory Science

Thank you for having me back.

I would like to thank the committee for inviting the Canadian Society for Medical Laboratory Science to appear once again today. My name is Christine Nielsen. I am the executive director for the society, which is located in Hamilton, Ontario.

The CSMLS is the national certifying body and professional association for over 14,000 medical laboratory professionals in Canada. Medical laboratory technologists, or MLTs, conduct complex laboratory tests on blood, body fluids, and body tissues, and they also interpret results. These tests provide critical information about your health.

As a group, our profession is the fourth-largest health care profession in Canada, which is incredible, considering we know that relatively few Canadians know who medical laboratory professionals are or know about the important work that we do.

Medical laboratory professionals play an extremely vital role in the Canadian health care system, generating over 440 million lab test results every year.

Doctors depend on these laboratory test results to accurately diagnose and treat illness and to monitor patient health. Canada is presently facing a nationwide shortage of medical laboratory technologists. Our current supply of new graduates will not be sufficient to address the shortages. Our organization predicts that, alarmingly, nearly half of Canada's medical laboratory technologists will be eligible to retire in the next ten years. This shortage will undoubtedly directly affect patient safety.

For over a decade, we have been alerting decision-makers that the number of seats in medical laboratory technology programs is simply not sufficient to produce enough new graduates to replace those who will leave the workforce. The domestic supply is simply too low.

Since 2000, governments have taken steps to address the shortage by opening new education programs and increasing capacity in others. This is a positive development, but the retirements coming simply will not equal the number of new graduates. In addition, funding for programs has been provided for the classroom portion only, with little thought or interest in funding clinical placement education.

As with all health professionals, clinical training is a vital component of medical laboratory science education. Completion of a clinical placement is mandated by the accreditation body, and our students cannot graduate from their programs without completing a clinical placement.

This brings me to the issue of internationally educated medical laboratory technologists, or IEMLTs. As the shortage continues to grow, Canada receives hundreds of self-identified IEMLTs through immigration every year. About 200 apply for evaluation with the Canadian Society for Medical Laboratory science.

Practice varies significantly across the globe, and it is a requirement that all practitioners in Canada meet the rigorous entry-to-practice requirement, putting patient safety first at all times. A system that allows for additional training or practise in the Canadian context that is accessible, affordable, and reliable is imperative. We recognize and applaud the federal government for its continued work to accelerate and expand the assessment of internationally educated health professionals, and we look forward to continuing the momentum.

We're excited to hear about proposed changes to the immigration system that may require credential assessments pre-arrival. This step will allow newcomers to better understand the process and be matched to Canada before they get here. We were very pleased to see the recent announcement of the launch of the foreign credential recognition program loans pilot, and we hope that through this initiative, medical lab professionals will benefit as well.

We recently released key research findings on barriers faced by internationally educated health professionals in fulfilling their entry-to-practice standards in Canada. This project was funded by the Government of Canada's foreign credential recognition program and involved four other professions. The research highlighted that without a doubt the integration of internationally educated health professionals has benefited from recent attention and investment in the past several years, but it is also clear that internationally educated health professionals will benefit from further initiatives that will help to ease the future impact of our health human resource problems.

In addition to greater opportunities for clinical placements, it was clearly indicated by internationally educated health practitioners that a number of supports would definitely expedite the integration process. The majority of survey respondents were not able to participate in formal bridging or mentorship programs. Instead, they have to develop their own ad hoc system in Canada to help navigate the tenuous first few years of their careers in Canada.

Another report we released concluded that bridging programs shorten the time for internationally educated medical technologists to become certified in Canada, decrease their financial hardships, increase their taxation contributions, and expedite their integration into the Canadian workplace.

Targeted long-term sustainable investments are needed for the bridging programs. Success rates on the national exam are clearly higher for those who complete bridging programs.

Currently there is but one bridging program in Canada that serves 11 students a year with clinical placements, and it's located in Hamilton. With targeted investment, qualified professionals can enter the workforce more quickly to provide laboratory testing to Canadians.

In conclusion, I would like to highlight three broad categories of action as recommendations. First, develop additional training and support suited to the needs of internationally educated health professionals before and after licensure. Second, investigate how to improve the overall access and availability of clinical placements. Third, conduct future research into the reasons why a number of applicants do not complete the assessment process and ultimately fail to become licensed and work in their professions.

Strong investments today will help to ease the future impact of the shortage of medical laboratory technologists tomorrow.

Thank you.

4:55 p.m.

Conservative

The Chair Ed Komarnicki

Thank you very much for that.

We'll start the first round with Madame Boutin-Sweet.

May 7th, 2012 / 4:55 p.m.

NDP

Marjolaine Boutin-Sweet Hochelaga, QC

Thank you, Mr. Chair. Thank you, ladies.

I think that, when they choose health sciences, most young people want to become physicians or nurses. Those professions are more popular. They don't really think about becoming dieticians or working in a laboratory.

Based on what you have told us, there is risk of having a surplus of physicians in the future, but also of having a shortage of people in other medical professions that are less recognized. What kind of methods can the federal government use to promote some of those professions, so that the young people who choose the health care field can learn more about them? That's an important question I ask everyone. I will add other points to it.

Loan forgiveness has been discussed. Could similar measures be implemented to encourage young people to choose certain careers over others?

The same goes, locally speaking, for first nations. Would it be possible to promote certain professions over others—which may take less time to learn—since you were saying that the consequences will be seen only in 5 to 10 years?

I would like to know what you think about that.

5 p.m.

Vice-President, Advocacy, Canadian Federation of Medical Students

Chloé Ward

If we have a national database that looks at what the heath care needs of Canadians are, not just for medical physicians but also for nurses, dietitians, and other allied health care providers, we can identify what the needs are in different specialties. We can then align our medical doctor training spots, along with our other allied health care provider training spots, to meet those needs. If we have a continuous database from which to make long-term projections, we can appropriately incentivize and target high school students, medical students, and different groups during their training processes so they enter the fields we need them to go into.

5 p.m.

President, Canadian Federation of Medical Students

Noura Hassan

I would like to add something.

Mentorship is very important, and it begins as soon as students start their studies. It is known that people studying in medicine often have mentors from that profession. We all know that's why medicine students often come from wealthy families or have parents who are doctors.

So it is important to have mechanisms for attracting young people from disadvantaged communities, or young people from rural areas who are not necessarily underprivileged. In fact, it is known that people from remote rural areas tend to practise in those areas more than urbanites. Therefore, such a strategy should be adopted.

When it comes to the federal government, it would need to fund organizations that already do that. We know that some faculties of medicine have invested a lot of money into mentorship programs. They meet with young people from remote rural regions and high school students to educate them about medicine. Those mechanisms are already in place, but they are not well-funded. It's a matter of encouraging the development and promotion of those programs.

5 p.m.

Conservative

The Chair Ed Komarnicki

Ms. Vanderkooy, did you have a comment?

5 p.m.

Manager, Public Affairs, Dietitians of Canada

Pat Vanderkooy

Yes, I did. I entirely agree with what our other two respondents have said. They have essentially highlighted that we need to pull together the information that is out there but that we haven't ever really looked at really. What are the true needs to serve the health of Canadians? Where do we have to specialize? Just like physicians, dietitians specialize as well. Do we need more dietitians in public health? Do we need more of them in the pediatric wards? Do we need them in palliative care? We don't know.

The mentoring and the geographic area—we also experience that. As dietitians, and I believe the medical laboratory technologists are in a similar situation, we don't really need to recruit more people to our education programs. There are lots of students wanting to get into university-accredited dietetics and nutrition programs. The problem is that among these keen students, who fought to get into these competitive programs, who needed high marks to get in and then did their four years, only about half of them get practicum training.

So in fact there are plenty of people out there who want to be dietitians, and after four years of university, unfortunately, there are quite a few people out there who are disappointed that they can't become dietitians. That, bizarrely, occurs in the face of vacancies, and in ten years' time there will be lots of vacancies.

So what are we going to do? There is no funding. If you're a dietitian who is really busy going out to your patients and then you are asked to do training, but there's no coordination and there's no extra budget for people to do the training, your accountability and your productivity statistics will look horrible if you spend time with students, and yet you're expected to train students.

5:05 p.m.

Conservative

The Chair Ed Komarnicki

Thank you.

Ms. Nielsen, you had a comment you wanted to make.

5:05 p.m.

Executive Director, Canadian Society for Medical Laboratory Science

Christine Nielsen

I have just a final comment that can't be underestimated. The entry-level salary for a medical laboratory technologist is probably a tenth of what an entry-level physician will make. So to take the same group and suggest that they become medical lab technologists, when they're expecting six-figure salaries...it's not going to happen.

I've been told by a dear friend who's a lawyer that if you ask any law school class, it's full of people who failed GMATs, because a lot of people have decided they want a professional career and there are very few of them in Canada; doctors and lawyers are the two professions people naturally gravitate towards. I have a better understanding when you tell me that people going into medical school come from affluent areas primarily, because 6 to 12 years of school is a long haul for someone who comes from a working-class background. It may not be possible for such a person.

So I think it's not quite as easy as saying you can redirect a family physician down to the lab or over to dietetics, when our salary scales don't hit six figures, unless you're in senior management.

5:05 p.m.

Conservative

The Chair Ed Komarnicki

Your time is up, but we used a lot of that just for commentary.

5:05 p.m.

NDP

Marjolaine Boutin-Sweet Hochelaga, QC

It's fine.

5:05 p.m.

Conservative

The Chair Ed Komarnicki

All right.

Mr. McColeman.

5:05 p.m.

Conservative

Phil McColeman Brant, ON

Thank you for being here and providing some very useful information.

Ms. Vanderkooy, I'd like to pick up where you left off on the practicum side, but before I get there, I would like one clarification in terms of your comments. You talked about the internationally educated individuals and the bridging program at Ryerson, saying it graduates about a hundred graduates. You're saying that bridging program is funded.

Is it funded federally or provincially?

5:05 p.m.

Manager, Public Affairs, Dietitians of Canada

Pat Vanderkooy

I'll let Marlene answer.