A dental licence is provincial.
Evidence of meeting #14 for Health in the 45th Parliament, 1st session. (The original version is on Parliament’s site, as are the minutes.) The winning word was spots.
A recording is available from Parliament.
Evidence of meeting #14 for Health in the 45th Parliament, 1st session. (The original version is on Parliament’s site, as are the minutes.) The winning word was spots.
A recording is available from Parliament.
Executive Director and Registrar, National Dental Examining Board of Canada
A dental licence is provincial.
Liberal
Doug Eyolfson Liberal Winnipeg West, MB
Is there portability or flexibility between provinces with a licence to practise dentistry?
Executive Director and Registrar, National Dental Examining Board of Canada
There is. Our certification exam is required by all provinces. You can be portable between the provinces.
Liberal
Doug Eyolfson Liberal Winnipeg West, MB
Let's say I'm a dentist practising in Ontario and I want to practise in Manitoba for a locum. A dental clinic needs coverage for a week. If I wanted to go from Ontario to Manitoba, would I have to apply for a Manitoba licence to do that or would my credentials be recognized to allow me to simply go and work?
Executive Director and Registrar, National Dental Examining Board of Canada
You would have to apply for a licence in Manitoba. Manitoba may have an additional requirement, something like an ethics course. I'm not sure about Manitoba, but it's actually fairly simple to move from province to province.
Liberal
Doug Eyolfson Liberal Winnipeg West, MB
Thank you.
I ask this because I find myself in a similar position. My skills are very portable. I have a Royal College certification in emergency medicine that's recognized in any province. Kenora, Ontario, is a two-hour drive west of me. When they are short, I could hop across the border on a week off and do some shifts. However, I'd have to go through all the steps to apply for an Ontario licence to practice.
Do you agree that Canadians would be better served if there were some co-operation and provinces would recognize each other's licences?
Executive Director and Registrar, National Dental Examining Board of Canada
I would agree with you.
Liberal
Doug Eyolfson Liberal Winnipeg West, MB
Thank you.
Dr. Irwin, thank you for what you do.
I've worked in emergency medicine. I have worked in a lot of departments that see children and adults. Given the low volume of critically ill children, you can imagine that when a critically ill child rolls in, for those of us who don't see too many children, it is, to say the least, anxiety provoking. I appreciate what you do. You're right. They are not just small adults; they have very unique health care needs.
You were talking about the different countries where pediatric training is considered equivalent. Again, is it the provinces that do that, or is it the federal government?
Paediatrician-in-Chief, Department of Paediatrics, The Hospital for Sick Children (SickKids), Representative, Pediatric Chairs of Canada
Currently, the licensing, the CPSO, which would be—
Paediatrician-in-Chief, Department of Paediatrics, The Hospital for Sick Children (SickKids), Representative, Pediatric Chairs of Canada
—our licensing authority in Ontario, would make that determination. There's currently a different pathway that has just changed for U.S. trainees versus others, and then it depends on where you did which parts of your training.
I would really welcome some collaboration and similarity across provinces, especially in pediatrics where we would love to help, where possible, across provinces when there are critical shortages, as you heard, and in some of the provinces where they can't recruit specialists at all in certain areas.
Liberal
The Chair Liberal Hedy Fry
I now go to Madame Larouche.
Ms. Larouche, you have the floor for six minutes.
Bloc
Andréanne Larouche Bloc Shefford, QC
Thank you very much, Madam Chair.
Ms. Dagenais, in one of our previous meetings, we welcomed a dentist who talked about the pressure the new insurance system has created. There's nothing wrong with establishing a system, as long as the public still has access to services. In your opening remarks, you brought up the issue of rural areas.
I got a message from a Sept-Îles resident where dental services are already limited. She said that, while essential for reducing financial barriers, the government's dental care access program isn't suited to isolated communities. There are few participating clinics, and they're overcrowded or located several hours away, making real access to care extremely limited.
First, she says she's covered and has no supplements to pay, but that she can seldom get an appointment.
Second, she says that sometimes, people have to wait several years before they can get an appointment, even for basic care.
Third, she says that people have to travel long distances to reach the clinics, that it's costly, and that it's often incompatible with work or family responsibilities.
Fourth, she says her teeth were needlessly deteriorating, because she can't get regular follow-up appointments.
You talked about labour needs. One of the topics this committee's studying is the question of immigration needs to address the labour shortage in the health care system.
Do you think the government should have looked further into the labour issue before implementing this program and making promises to the public? In the end, the public is disappointed, because we don't have the resources to provide them with the service described in the program.
Executive Director and Registrar, National Dental Examining Board of Canada
I would recommend that governments, professional bodies, universities and organizations like BNED keep working together. That would make it possible to put a plan in place.
Right now, we're receiving a lot of applications and we're administering exams. However, there's no plan for those who pass the exam. They don't know where they'll be working.
We need a plan to make sure rural regions have access to dentists. There are also other disadvantaged groups that need care, such as people with disabilities.
We need a plan to make sure everyone receives proper care.
Bloc
Andréanne Larouche Bloc Shefford, QC
In your opening remarks, you also mentioned that those who had passed the exam had to get up to speed, which can take up to two or three years.
Is that right?
Executive Director and Registrar, National Dental Examining Board of Canada
Canadian universities bridging programs for foreign dentists are two to three years long.
Bloc
Andréanne Larouche Bloc Shefford, QC
Have you heard from people for whom it's more difficult because they fall in a grey area? They might not have the same resources as others, which can cause issues during that two or three-year wait.
Could tax measures be used to support professionals while they're in school or in the process of getting their degrees accepted?
Executive Director and Registrar, National Dental Examining Board of Canada
Essentially, there should be more spots offered in bridging programs.
In 2024, there were 61 spots available, but the National Dental Examining Board of Canada receives between 1,500 and 1,700 requests a year from foreign dentists who want to write our exam. That means a lot of dentists can't get a spot. Their other option is to complete our equivalency process, which is made up of a series of exams, but the success rate is still low and varies a lot. As I said, results can range from 30% to 95%. Many don't complete the process, and more than half of the candidates have to retake the exam.
More spots should be offered for foreign dentists. We need them, but they need support, so that they can succeed and contribute to the profession.
Bloc
Andréanne Larouche Bloc Shefford, QC
Thank you very much.
Dr. Irwin, do you know if SickKids hospital uses interns on internationally funded visas? If so, does it really help meet local needs, knowing most of these students go back home once their training's done? Is that your experience?
Paediatrician-in-Chief, Department of Paediatrics, The Hospital for Sick Children (SickKids), Representative, Pediatric Chairs of Canada
I am part of the University of Toronto, and you previously heard from Dr. Houston. We have a very small subset of the 459 visa trainees she mentioned. You're correct, they do return to their country, but they do not take spots that are available for our Canadian graduates. As you also heard, they are very critical to providing this workforce that is strained right now and expanding our workforce. They definitely do not take the inadequate number of spots that we have currently for pediatric specialty training.
Liberal
The Chair Liberal Hedy Fry
Thank you very much.
We're going to go to the second round, which is a five-minute round.
I'll begin with the Conservatives.
Mr. Bailey, you have five minutes, please.
Conservative
Burton Bailey Conservative Red Deer, AB
Thank you, Mr. Chair.
Dr. Irwin, how many pediatric spots are there across Canada? Is the number under 10?
Paediatrician-in-Chief, Department of Paediatrics, The Hospital for Sick Children (SickKids), Representative, Pediatric Chairs of Canada
That's a great question. That's part of our initiative where we collected the data.
If we look at provincially or publicly funded spots—