Evidence of meeting #7 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 program.

A recording is available from Parliament.

On the agenda

MPs speaking

Also speaking

  • Jonathan Beddoes  Dean, Faculty of Engineering, University of Manitoba
  • Peter Idahosa  President, Alberta International Medical Graduates Association
  • Pam Nordstrom  Director, School of Nursing, Mount Royal University
  • Joan Atlin  Director of Programs, Toronto Region Immigrant Employment Council
  • Thomas Tam  Chief Executive Officer, SUCCESS

4 p.m.

NDP

Carol Hughes Algoma—Manitoulin—Kapuskasing, ON

You did touch base on the shortage in Canada of physicians, especially in the rural areas, and I think that's extremely important.

I come from northern Ontario, and we've got Elliot Lake and a lot of the remote areas that need physicians. I understand we're here for the foreign credential recognition program, but at the same time, within Canada itself, I'm wondering if you could elaborate on the difficulties of being able to foster our own doctors as well, especially given the fact that we have such a high population of first nations, where there are young people who want to go to school and because of funding caps and programs it is just not working for them to be able to go to school.

4 p.m.

President, Alberta International Medical Graduates Association

Dr. Peter Idahosa

The real problem is that most of the members are eager, are wanting to go to the rural areas to work. But what happens when you pick up.... It's typically unlike what happens with nursing, where you have at least a website after you put in your credentials. Just talking with respect to the college of physicians in Alberta, when you put in your credentials, and they just give you “ineligible” or “eligible”. Being ineligible, the door is slammed on you. Nobody tells you, “Okay, Peter, you have to do one, two, three steps and we'll give you a licence.” You have to go through a bridging program. You now have to figure it out yourself.

As a newcomer to Canada, it's extremely difficult. Sometimes what they do, they're going to have to go to the rural areas, which I did also. I called some of the rural hospitals and asked if they could sponsor me, and talk to the college. I asked them to contact the hospitals I worked at in South Africa, and let them assess me, if they can't talk to me, because it's always online and you can't ever reach anybody. They don't bother to send you if they like....

Some of them contacted me, and the first thing they said is that it's extremely difficult. There is a brick wall. The college has set to make it extremely difficult for foreign-trained doctors to come in, especially if you are here in Canada. I'm not saying we have kind of a different pathway, because they go over, which they do, to get doctors from southern countries, and recruits. But we've got a huge pool of doctors already on the ground in Canada. Most of us are Canadian citizens, but we can't access the pathway because our credentials are not recognized by the college, and they don't give you the reason why.

They tell you you're ineligible. So you now have to figure out what you need to do. If you're lucky enough, you become a clinical associate or a clinical assistant in a hospital, and you work as a physician, but you are not recognized as a doctor.

4 p.m.

Conservative

The Chair Ed Komarnicki

Thank you.

We'll move to Ms. Leitch.

October 25th, 2011 / 4 p.m.

Conservative

Kellie Leitch Simcoe—Grey, ON

Thank you very much, all of you, for your presentations.

I want to say just one thing from a standpoint of correcting the record. I am a member of the Royal College of Physicians and Surgeons. Just so that we are clear, in this country there are provincially based colleges, which provide the regulatory regime for people to become physicians, to practise, and to receive a licence.

That is different from the Royal College of Physicians and Surgeons, in which the examinations take place. There are regulatory bodies by province, just like there are in the United States. You have to take a licence state by state. You do write a national exam, the USMLE, just like we do here in Canada. The process is the same state by state as it is here province by province. Just so we're clear on the process there.

I do have a question, though, for all three members of the panel.

You may be able to answer specifics now, or you may want to submit something to us. Obviously there are concerns about shortages in these areas, and we'd like to ask you first what you believe those shortages are, and what the specific numbers of those shortages are. Also, explain how and through what foreign credentialling programs we could address these shortages.

Second, I would also like to ask you what you think those specific financial challenges are for your profession. I would ask you to be specific as to what that might be. We've heard different reasons for financial challenges from different organizations.

Third, what are your specific recommendations for addressing the shortages, and addressing the financial needs based on foreign credentialling?

As I said, I would like all three of you to answer, and if you are not able to give us a fulsome answer based on the time, I'm respectful of that. Maybe you could submit something to us.

4:05 p.m.

Prof. Jonathan Beddoes

Maybe I'll start.

You've asked a number of very good questions, none of which have simple answers, unfortunately.

Let me try to touch on each of them individually, and remember I'm speaking from the Manitoba perspective, and from the perspective of the engineering profession.

It's relatively clear—at least to me—that there is a shortage of engineering skill in Manitoba. Senior business people and owners of companies have told me directly that they would expand in Winnipeg if they could get engineers. One of the unique things about Winnipeg, of course, is that it's not really on anyone's top ten list of places to live, despite the fact that it's a great place to live. So it's very difficult to recruit people from elsewhere in the country to come to Winnipeg.

There is a shortage of engineers in Manitoba, and that's why the province adopted the provincial nominee program, and targeted foreign-trained engineers to come to Manitoba to help with this shortage.

As for the specific financial challenges some people face when they're recent immigrants, oftentimes their financial wherewithal is very limited. Prior to going to Manitoba, I had extensive experience here in Ottawa at Carleton University, and I was continuously appalled at the number of foreign-trained engineers with very good credentials who, without access to an internationally educated engineers qualification program as we have in Manitoba, would end up taking the entire four-year undergraduate program over again. During that time, they're full-time students, they're not working, they've got a spouse, and they've got children. It's incredibly difficult.

When I speak to these students and ask them why they are doing that, the typical response I get is that they don't want to give up on engineering; either they do this or they're a taxi driver. They don't want to be taxi drivers. But to put them through four years of engineering education where an awful lot of what they're learning is exactly the same as what they have already learned elsewhere overseas—and it is just too difficult for us to recognize it—is incredibly frustrating to me, and I'm sure it's incredibly frustrating to the individuals as well.

It's because of that previous experience here in Ontario that I am convinced that programs like the internationally educated engineers qualification program that we have at the University of Manitoba, which we operate in close collaboration with the provincial regulator for engineering, is such a good idea. It allows the students to get through the program. We aim for one year to 18 months, depending on the individual's background, and that includes a six-month co-op placement with a local employer in an engineering position, for which they are paid by that employer. Frequently they're hired on for a full-time basis by that same person. That reduces the financial challenge quite considerably.

4:05 p.m.

Conservative

The Chair Ed Komarnicki

Thank you. I guess your five minutes are up.

The others haven't had an opportunity to indicate their thoughts, but it was a series of questions, so if you don't get an opportunity later in the questioning to respond to those questions, you might submit those responses to the committee, if you wish.

We'll now proceed to the next round, starting with Mr. Patry.

4:05 p.m.

NDP

Claude Patry Jonquière—Alma, QC

Thank you, Mr. Chair.

Mr. Idahosa, which language did you study medicine in?

4:05 p.m.

President, Alberta International Medical Graduates Association

Dr. Peter Idahosa

I started my studies in English. My basic primary as well as post-primary school and university was in English.

4:05 p.m.

NDP

Claude Patry Jonquière—Alma, QC

Sometimes, people coming from foreign countries to live here run into difficulties and get discouraged. Should people have to take exams?

A little while ago, you compared the best foreign doctors in 2007 and 2008. The results were the same outside Canada. You also said that your analysis showed the training to be similar.

People who come to Canada like you could take exams in order to become a resident in a hospital. They could have a mentor, a guide, a doctor assigned to them. That could replace the three, four or five years they have to do that push some of them out of the profession. Could you see that happening in Canada?

4:10 p.m.

President, Alberta International Medical Graduates Association

Dr. Peter Idahosa

There is no doubt that it's very important that when you're coming into a new environment, especially in Canada, you understand how the system works. But the only issue is that those platforms are not open unless you are trained in the work. If I'm coming in, how do I get into a system in a hospital? It's extremely difficult. You need a licence from the regulatory body. And you are specifically told, it is for “observership”. Observership is not hands-on training. You're just going there to watch and see what's going on. It doesn't make you a good doctor. The regulatory bodies are very reluctant to give you a licence to actually participate, so it becomes very difficult.

4:10 p.m.

NDP

Claude Patry Jonquière—Alma, QC

Personally, I have a problem with opening our doors to a quota and not to everyone. I have a hard time living with that. We let people come from overseas so that they can establish themselves here. I agree that selection should be done before people are let in. Otherwise, they have a hard time working in their field. You mentioned engineering and said how frustrating it is. I understand that. I have a hard time accepting it. I don't know why we would go looking for people outside the country if we are going to treat them like that. That is one of my comments.

Mr. Jonathan—I am not even going to try to pronounce your last name for fear of massacring it—you mentioned language problems just now. You also talked about a co-op program the goal of which is to provide work for people who come here. Can you explain to me how that program works?

4:10 p.m.

Prof. Jonathan Beddoes

I agree with your comment that we let people in based on the training they've had elsewhere, and then when they get here we don't allow them to undertake the occupation for which they've been trained. That is very frustrating. I think one recommendation, which was alluded to earlier, is that Canadian immigration authorities overseas be well aware of the requirements to become registered as a professional in whatever occupation you are in once you get to Canada.

How does our language and training component work? As I said, we have a mandatory co-op program, which is part of the IEEQ program at the university. We work in very close collaboration with local industry to place each student with a local industry that's associated with the training they've had. That's a paid assignment for that person. So financially it's very good for them, but it's also primarily important from the “getting experience” point of view.

With regard to the language and cultural part, almost all the immigrant students who come to us in this program have some English-language abilities, some more than others, but their language abilities specifically with respect to engineering technology may be weaker. So we have worked with each individual student and the various applied-language experts at the university to try to raise their language skills up to the level required for entry into the profession.

We also have a mandatory course as part of the program, which is called “Practicing Professional Engineering in Canada”, so that they understand the regulatory framework within which engineering works in Canada, which is oftentimes very different from what they might be used to in their country of origin.

So we focus not only on the technical skills, which are clearly important, but on all of the other skills you need to be successful in the workforce.

4:10 p.m.

Conservative

The Chair Ed Komarnicki

Thank you.

Mr. Patry, your time is gone.

We'll move now to Mr. Shory.

4:10 p.m.

Conservative

Devinder Shory Calgary Northeast, AB

Thank you, Mr. Chair.

And thank you, witnesses, for coming this afternoon. I have to admire your passion and I can also feel your frustration in this process.

I won't waste too much time speaking of other things and I will come to the question directly.

Mr. Idahosa, I'll start with you because you also have lived through this problem. I want you to quickly go through what you had to go through and how long it took. And when we talk about the medical profession specifically.... I'm from Calgary, and in Alberta there is a shortage of almost 2,500 doctors, whereas we have almost 1,100 foreign-qualified doctors. And when we talk about foreign qualifications, we are not only talking about the individuals who came from overseas. Canadians also go out of the country to get their education.

So coming back to your profession--and talking about taxi drivers--there are some people who say that the best place to have a heart attack might be in the back seat of a taxi because the chances are a doctor is driving the taxi. It sounds funny, but it is true that the professionals have to go through all this.

You are also very actively involved in the organization, I know that. I also want you to tell us if any improvement has been made from the earlier days when we talked about coordination between different provincial bodies. Does the pan-Canadian framework help, and what more can be done? And considering the shortage of doctors, is there any appetite or is there any capacity to speed it up? What exactly should we be doing when we talk about shortening the processing time? And would this pre-certification, which you also touched on, help the professionals when they come to Canada?

4:15 p.m.

President, Alberta International Medical Graduates Association

Dr. Peter Idahosa

Thank you, Mr. Devinder Shory.

Just briefly, my life is a two-page book. It's very easy, it's not a long one. I graduated in 1996 in Nigeria. I wrote exams and I passed the exams and moved to South Africa because I wanted to be a very good doctor.

During that process I applied to immigrate to Canada. And luckily in 2007 my immigration came through, and I moved here. But prior to that I already took the Canadian evaluation exams, the QE1 and then the QE2.

But right off the bat most people told me that Canada is a dead end for a physician; it's extremely difficult to get licensed. But it's a country I've always loved, I've looked for, and it's something I've dreamed about and I want to settle. I look at obstacles as stepping stones. You don't need to shut the door, no matter what people say. So I said I'd put in my head and I would come in. But I wasn't told that by immigration; it was a personal decision and I am ready to face the consequences, and that's what is happening.

So back to the other question with regard to the pan-Canadian framework, we were extremely happy when we saw that the Canadian government decided to address it. It's very welcome.

Our members are a bit disillusioned, because I think it's the Canadian government, the political leaders, who have to make the decisions. We're a little disillusioned with the college, because we've lost faith in them. I come in.... Give me a licence and let me address the physician shortage. I want to contribute. This is my home. My kids will be born here. Where am I going to go? I can't go to the U.S. This is Canada. I love being in this country, but you're shutting the doors on us. You don't want to give us a pathway. Show us a pathway so we can go through. So the pan-Canadian framework is good.

Let it be an all-encompassing body that will bring together the college as well as the people whose lives are affected--that is us, the IMGs--and discuss a pathway. You cannot sit in the college in Edmonton and make a decision about people's lives without sitting with them, and that's what's happening.

We want the government to play an active role, because they are more neutral. And I believe, for this gathering today, they are not happy about what's going on. But the college has not deemed it fit to call the association and ask if they could sit and let's pool on that. We are close to 2,500 unlicensed physicians in Alberta, and that is a disaster. And 80% of us are family physicians.