Health Committee on April 1st, 2010

[Dr. Ali Varastehpour]

The majority of foreign-trained doctors, even those who are successful through their licensing exams, do not get a position. As a matter of fact, I will tell you about one of my colleagues who is very, very bright. I personally vouch for her. She is like a computer, literally. The whole Canadian system cannot produce somebody like this lady, and she got a job at post-match, like a charity. It is barely in family medicine. The reason is that Canadians are not really interested.

[Patrick Brown, Conservative, Barrie, ON]

I only have five minutes and I'm just trying to get the numbers out.

Do we know what the numbers are in Ontario right now, or in any of the provinces?

[Dr. Ali Varastehpour]

I can probably answer you that the majority are not successful. I don't have numbers.

[Patrick Brown, Conservative, Barrie, ON]

I heard someone mention to me that it was about 700 who had passed each year and there are only about 175 foreign-trained residency spots. Does that number seem correct in Ontario?

[Dr. Ian Bowmer]

Madam Chair, the province of Ontario actually funds 200 international medical residency slots per year, and that's not including other positions that might be available. That is a number I do know.

[Patrick Brown, Conservative, Barrie, ON]

How many pass? 175 and 200 are very similar, but how many people have passed equivalency exams for a foreign-trained medical doctor? If it's 200 we have no problem, but if it's 1,000 then we have an issue.

[Dr. Ian Bowmer]

This is a paradox in Canada. We don't actually work on provincial statistics. When we're looking at the match, we look at Canadian statistics at the match level--

[Patrick Brown, Conservative, Barrie, ON]

Do we have Canadian statistics on that?

[Dr. Ian Bowmer]

We know that... I mean, Mr. Boone has--

[Jim Boone]

There are approximately 1,600 IMGs that go through the match process on an annual basis. There are more in the system, but because they're waiting on exam results and things, they don't all go through with the first iteration of the match. Based on 1,600 people, approximately half of those people are repeat IMGs who have not been matched.

[The Chair, Conservative, Joy Smith]

I think Fleur-Ange Lefebvre would like to make a comment as well.

[Dr. Fleur-Ange Lefebvre]

Some of these international medical graduates should not be considering entering a residency, they should be entering provisional licensure practice. That's where we are now focusing our efforts. However, that is also extremely resource-intensive and capacity-intensive.

[The Chair, Conservative, Joy Smith]

Thank you.

We'll now go to Monsieur Malo.

[Luc Malo, Bloc, Verchères—Les Patriotes, QC]

Thank you, Madam Chair.

Good morning, everyone.

Some members still have questions about the federal government's role in managing health human resources. Personally, I do not have any more questions. You are quite aware that it is the responsibility of Quebec and the other provinces. Out of the goodness of my heart, I would like to give you my speaking time. Do with it what you please: keep it for yourself, give it to your colleagues or to the witnesses. Consider it a gift from me, either for April Fool's Day or Easter.

[Some hon. members]

Oh, oh!

[The Chair, Conservative, Joy Smith]

Well, happy Easter to you too, Monsieur Malo, and what a gift that is. I will be so kind as to give it to Mr. Tilson.

[David Tilson, Conservative, Dufferin—Caledon, ON]

Thank you, Madam Chair.

I thank Mr. Malo as well for his Easter gift.

I have a question for Dr. Varastehpour. You said some words that I hope I heard wrong, but which I'd like you to clarify. You used the words “some people buy their way”. I'd like to pursue that with you. What did you mean by that?

[Dr. Ali Varastehpour]

Yes, indeed. What I meant by that is, as Dr. Bowmer just mentioned... First of all, the cost of exams is higher from the time that he remembers, but that's a different issue. You have to take the EE, QE1, and the QE2 to be licensed. You need the EE and QE1 in order to be theoretically, on paper, eligible to apply for residency positions.

However, there are visa students who have bilateral agreements signed between the Government of Canada and their governments. I even know a person who told me he was being supported by his own family. That's what he said. I don't know if that's true or not. They intern at any residency program they pick and choose. The score is not an issue. Language is not an issue. Clinical skills are not an issue. I've met some of them who don't even understand the comments of the physician, the question or the answer. This is a wide-open fact. I'm surprised that you don't know about it.

I wrote to every department chair in Canada, including one in Ottawa. I got the rudest answer from Ottawa. She said they had no positions. I e-mailed again that on their web page I see people from Argentina, Sri Lanka, and India. Is it you don't have positions for IMGs or you don't have positions? For God's sake, you're the director of the residency program in neurology at the University of Ottawa. What kind of answer is that? She e-mailed that we don't have positions for residency, just get out, leave me alone.

I wrote to Quebec and I got a very interesting answer. I got this answer I think from Toronto as well. Are you seeking a funded position, or do you have funds? The translation: Do you have a million dollars in the bank, or do you want to work and get paid?

This is what I'm talking about. It is not that there are no positions. There are plenty of positions, more than the pool of IMGs probably. That's because not all of the IMGs are up to the market; it's a fact. Some need help, some don't know the language, some forgot medicine--I don't know. But there are a lot of intelligent IMGs, more intelligent than I am.

[David Tilson, Conservative, Dufferin—Caledon, ON]

Well, you're suggesting it's a system of the rich, and if that's the case--

[Dr. Ali Varastehpour]

It is.

[David Tilson, Conservative, Dufferin—Caledon, ON]

--how can that be changed?

[Dr. Ali Varastehpour]

That is very simple: through legislation. Can you do something like this in the United States, in England, in Sweden, in any developed country? Can you do that? No, and I don't know how they do it in Canada. All our advisory members in the Alberta IMG association said not to bring it up. Why? It is because this is money that is given to the department chairs.

For example, say I'm a program director in internal medicine, in neurology, or whatever. I use that money to finance, supposedly, my research. The question is, if my proposal is not worth funding by the Canadian Institutes of Health Research, why in heaven do I have to do research on the soft money, and if I need soft money, why can't I pay it from my own salary and my staff salary?

This is what it is costing us, and this is what a UN expert uses in calling Canada a racist country. Those are not my words. I quoted it, and I gave you the copy, to show that there is a racial bias in this country. That is what she says from her own experience touring Canada.

Was I clear in answering your question?

[David Tilson, Conservative, Dufferin—Caledon, ON]

I appreciate your elaborating on it. Those are serious allegations. You have explained them to a degree, and we need to pursue that further.

I have another question, to both you, sir, and to Dr. Martin, perhaps.

I heard some testimony in the immigration committee about programs being provided by the federal government to help upgrade foreign doctors coming to this country. This would be in association with the medical associations, because you have to have the medical people onside to do this; it can't just be the federal government. As well, programs were being provided for other professions, such as engineers or what have you--not just doctors, but other professions. The comment was made, or evidence was presented--and I can't remember by whom--that the greatest resistance from the associations was from the medical associations. The most resistance to--

[The Chair, Conservative, Joy Smith]

Mr. Tilson, we're running out of time, so can you--

[David Tilson, Conservative, Dufferin—Caledon, ON]

Do you know anything about that?