Madam Chair and committee members, thank you for this opportunity to speak to you today on labour mobility and international medical graduates.
I would like to say that I would be happy to answer questions in both official languages.
I am addressing you today on behalf of FMRAC and its 13 members, the provincial and territorial medical regulatory authorities. You may be more familiar with them under the name “College of Physicians and Surgeons of”, and then tack on the name of a province; in Quebec it's Collège des médecins du Québec. They are statutory bodies established by provincial or territorial legislation to serve the public's interest by setting standards of practice and of professional conduct and by determining the qualifications for licensure and for maintenance of licensure.
You will have before you a copy of the latest draft of the FMRAC Agreement on National Standards for Medical Registration in Canada, dated October 21, 2009. And since it's out for consultation with our members, and hopefully approval by their respective councils, there will be a few more changes, but these are not expected to be substantive.
When the recent changes to chapter 7, on labour mobility, of the Agreement on Internal Trade came, medical regulators were already developing national standards for registration of physicians. The timelines have been somewhat accelerated as a result of the need to come into compliance with the AIT. This, while not always a bad thing, does present some challenges.
Since the AIT mandates that no extra requirements can be made of physicians who already hold a licence to practise in a Canadian jurisdiction and who want to move to another jurisdiction within the country, standardization will in fact enhance labour mobility. When we are done, most likely by the end of summer 2010, all medical regulatory authorities in Canada will approach licensure in the same way.
The need for definitions in our document that I've shown you cannot be overemphasized. I have to show you another document. My president didn't want me to do this, but I'd already printed it so I told him I would anyway. This is a 76-page document that we developed last spring, entitled “Inventory of Medical Licensure Terminology in Canada: Definitions, Descriptions, Conditions and Provisions”. It describes more than 125 different categories of licensure, both full and provisional. It has served to highlight the degree of variability across the country and has galvanized FMRAC and its members towards standardization.
There has long been a “gold” standard for physician training in Canada that leads to a full licence in every jurisdiction. We are proposing to now call it the “Canadian” standard.
This agreement, among all medical regulatory authorities, covers not only the Canadian standard, but additional standards for recognition of international medical graduates seeking licensure in Canada.
Medical regulatory authorities agree that IMGs who do not meet the Canadian standard will initially be eligible for a provisional licence. Section three, on pages 5 and 6 of your document, outlines the conditions that must be met prior to the issuance of a provisional licence.
Section four addresses how a physician can move from a provisional to a full licence. Details about the assessment of competence and the types of restrictions that will apply to a provisional licence are part of the ongoing work of the medical regulatory authorities under the coordination of the FMRAC.
I cannot stress this enough. The intent is for every medical regulatory authority across the country to apply the same categories and definitions for full and provisional licences, to require the same conditions prior to initial licensure, and to require the same conditions for any subsequent change to the status of a physician's licence.
A nationwide agreement on what constitutes a full and a provisional licence will achieve the goal of the AIT. Even physicians with provisional licences will have enhanced mobility if every jurisdiction uses the same categories, assuming the receiving jurisdiction has the resources for the supervision requirements and other conditions that may exist as part of that provisional licence.
The work we are doing to standardize licensure processes also assists in standardizing foreign credentials recognition.
Medical regulators in this country can already proudly point to foreign credential recognition taking a matter of a few weeks—much less time than the one year prescribed in the recently announced pan-Canadian framework that we heard about last week. Our members have worked and continue to work tirelessly to help IMGs become licensed and find training and work in health care. In fact, in recent times, in several provinces, the majority of new physicians registered have been international medical graduates.
Provincial and federal departments of labour and of health are very aware of the intensity with which medical regulators across Canada are developing a renewed national standard for physician registration, one that includes a common approach to the recognition and licensure of IMGs, as well as to the output of our Canadian system.
Medical regulatory authorities are tasked by governments to ensure that physicians provide safe and effective care. They must walk a fine line between expectations for quality care and for access to any service at all.
Thank you. We would be pleased to answer any questions.
