Thank you for that question, which I knew was coming, so this is good.
We have been asked this several times before. There are two things. First of all, I cannot speak on the payers' approach to this. The regulatory authorities do not issue billing numbers. They issue a licence to qualify physicians. IMGs, as I said, come from all over the place and from very different training systems. Canadian graduates undergo really thorough assessments in real life with patients in real, live health care situations.
Our approach to this is that IMGs, in order to come to Canada, for the most part—and not all of them—have to undergo a similar kind of in-practice assessment. It is expensive to run, and it's a competitive process. There are probably many more qualified IMGs than those who actually secure a spot for that. Once they had gone through that 12-week process, they would then get a provisional licence under supervision, and there are steps to move them from a provisional to a full unrestricted licence.
You have had presentations from the CMA and the Royal College. The Royal College is developing different mechanisms with the hope of getting these people assessed a little bit faster.
Medical education is a complex and very expensive system. I think it's time to ramp this up, but in order to ramp it up, you must also have the capacity to do the assessments, and right now that is quite challenging.