Thank you.
I'm the executive director of the Alberta International Medical Graduate Association, also known as the ITP hub. We serve internationally trained physicians across Canada by providing navigation supports and programs and services for the successful integration of ITPs into the health workforce. We're essentially a one-stop shop for every step in the licensure process for all pathways across Canada.
Access to the right supports at the right time matters. Our work is made possible by funding from the governments of Canada and Alberta. We currently have a talent pool of 3,800 active members seeking licensure or alternative careers in health care. We believe every ITP deserves a fair assessment of their skills and knowledge. I'm confident that a timely national process aligning competencies with workforce demands is possible.
A proven approach, utilized by some provinces, is the practice readiness assessment pathway, in which ITPs undergo a clinical field assessment while working under a provisional licence and are assessed for their competence to practise independently. For ITPs who do not meet the eligibility criteria or who meet the criteria but have been out of practice for three or more years, their only options are to return to their countries of origin to practise independently and renew recency or to compete for the limited number of residency seats through our Canadian residency matching system.
Last year, 95% of medical graduates who had trained in Canada matched to residency and could apply for any program of interest. ITPs, however, are not given the opportunity of choice. For comparison, due to the lack of seats, only 48% of ITPs matched. In Alberta, ITPs must demonstrate physical presence during a specified time frame. Ontario recently limited its residency seats to ITPs who have attended two or more years of high school in their province.
These restrictions exclude ITPs from being able to compete broadly. If we are interested in excellence, why are we not letting all eligible ITPs compete for all designated seats? Why are we placing further limitations on a group of individuals who already have limited spots to begin with, at a time when we need physicians?
I have many stories from my 20 years of working with ITPs about how costs of licensure, duplicative and repetitive assessments, and unnecessary and inflexible administrative barriers have led to many experienced physicians not even being able to make it to the plate to be assessed.
One of my most recent Uber drivers was a physician refugee from Afghanistan. He is not pursuing licensure, but he questioned why it's considered unsafe for him to give vaccines. A physician from India, who worked for several years in South Africa, was hired by the municipality of Vegreville, Alberta, but he experienced technical difficulties during his remote therapeutics decision-making exam. A disruption in Internet service and the “one sitting per calendar year” rule meant that he was unable to retake the exam for a year; not only was he out of a job, but the patients of Vegreville were also without access until a replacement could be found.
This year, approximately 40 of our members were denied the ability to compete for residency in Alberta because no window of opportunity is allotted to correct application oversights. Again, it is process over people, and competitive candidates are unable to compete.
This study is a crucial one. We must remove systemic barriers, shift from being exclusive to being inclusive, and streamline processes to allow ITPs to demonstrate their competencies sooner. This means assessing ITPs pre-arrival or upon arrival, determining the scope of practice that aligns with their training and experience, and matching these with health workforce demands.
Let's do better in determining who is able to go directly into independent practice versus who needs partial or full residency training. Let's expand upon the number of approved jurisdictions using evidence-based decision-making, remove redundancy for those applying to CaRMS and offer bridging opportunities to ensure that ITPs are equipped with the necessary supports to work to their full potential and to get doctors where doctors are needed, for the benefit of all of us.
Thank you.
