I think the federal government has taken some leadership in this role. When a blockage has been identified, there has been funding. An example is the assessment process, which was really run independently by seven regional or provincial jurisdictions, but is now being brought together as one. The national assessment collaboration, which was funded by Health Canada and HRSDC, was an attempt to do this. It came out of the 2004 IMG task force recommendations.
We're still very much piecemeal as far as the remedial activity is concerned. Just to put it into context, the residency programs aren't the only way international medical graduates come into practice in this country. Approximately 1,400 or 1,500, according to the national physician database, enter practice every year. Only half of them enter from residency. The other half enter through provincial programs. Some of them are mentored observerships, while some of them come just straight from the minimum requirement, which is actually the evaluating exam, straight into a practice, with a mentored process.
Each province has a different way of doing this. Standardizing it would be a very useful opportunity, but again it is a resource issue. As Madame Lefebvre pointed out, it involves not only the exams but also this idea of making sure that someone is safe in practice, and therefore having an observed clinical practice. That is perhaps one.
The next step is to try to coordinate this process across the country, because every province is different.