Evidence of meeting #8 for Health in the 45th Parliament, 1st session. (The original version is on Parliament’s site, as are the minutes.) The winning word was programs.

A video is available from Parliament.

On the agenda

Members speaking

Before the committee

Alexander  Medical Advisor, As an Individual
Naik  Chief Executive Officer, Medical Council of Canada
Pawliuk  President, Society for Canadians Studying Medicine Abroad
Munkley  Physician, Society for Canadians Studying Medicine Abroad
Anand  Physician, As an Individual
Barnum  Senior Manager, Data, Canadian Post-M.D. Education Registry
Slawecki  Advisor, Canadian Medical Foundation, Internationally Educated Health Professionals in Canada

11:25 a.m.

President, Society for Canadians Studying Medicine Abroad

Rosemary Pawliuk

As Doug said, there are 3,500 of us studying abroad, and 800 graduate every year. Last year, there were fewer than 200; there were 181. We've had as few as 119 of those 800 apply to come back to Canada, not because we don't want to but because the barriers are so significant, and we're so unwelcome.

International medical graduates, IMGs, are segregated from graduates of Canadian medical schools when applying for residencies. IMGs are limited, for the most part, to a small number of residency positions in a small number of medical disciplines. In B.C., out of 30 disciplines, we are able to apply to four, most in family medicine and only on the condition that when we're done licensing, we have to work where we're told.

This is why so few people come back home. They feel unwelcome. They feel they're second-class citizens, and it hurts. It's simply not viable. This is after we have proven we have the knowledge and skills expected of graduates. These barriers exist despite having proven equivalency.

We advocate for equal opportunity. Once substantial equivalency has been proven, every Canadian who meets the Canadian standard should have equal access to apply for resident physician jobs. We also advocate for uniform exams. A lot of negative stereotypes have arisen, such as that our constituents are rich kids, which is simply not true. As a matter of fact, most of our constituents are not from well-off families.

The one thing I want to advocate most strongly for is the revocation of bulletin 230. We have raised how sensible it is to have more doctors practising. Resident physicians provide necessary medical treatment. They get on the bus and they're working the first day. They're working right away.

When we asked the faculties of medicine for more residency positions, even privately funded ones, we were told the faculties simply do not have the capacity to train more doctors. That's why we made an application for the revocation of bulletin 230 in 2019, but it's been sitting, despite problems. There has been nothing but stalling.

Residency positions are jobs. Residencies provide necessary medical services. They're paid under a collective agreement. The Immigration and Refugee Protection Act requires that before a work visa is issued to a foreigner, the employer has to go through the labour market impact assessment to prove that foreigners are not taking away jobs from Canadians.

In 2010, The faculties of medicine convinced Service Canada and Immigration, Refugees and Citizenship Canada that they should not require this assessment, so foreigners come in and take residency positions and fellowship positions and displace the 1,000-plus people Viren was talking about.

The Chair Liberal Hedy Fry

Ms. Pawliuk, your time is up. Thank you. You can fill it in during the question and answer segment.

11:30 a.m.

President, Society for Canadians Studying Medicine Abroad

Rosemary Pawliuk

Yes, I'd like that, if you want to hear it.

The Chair Liberal Hedy Fry

Now I will begin the question and answer segment.

The first round is a six-minute round. The six minutes include the questions and answers. I will do the same here. I will give you a one-minute prompt and a 30-second prompt.

We'll begin with the Conservatives.

I have Mr. Mazier for six minutes, please.

11:30 a.m.

Conservative

Dan Mazier Conservative Riding Mountain, MB

Thank you, Chair.

Thank you to the witnesses for being here today.

Dr. Naik, did the federal immigration department consult with the Medical Council of Canada on this year's federal immigration levels plan?

11:30 a.m.

Chief Executive Officer, Medical Council of Canada

Viren Naik

They did not.

11:30 a.m.

Conservative

Dan Mazier Conservative Riding Mountain, MB

Did the federal immigration department ask for any data on the current capacity of Canada's health care system with regard to this year's immigration levels plan?

11:30 a.m.

Chief Executive Officer, Medical Council of Canada

Viren Naik

No, they did not.

11:30 a.m.

Conservative

Dan Mazier Conservative Riding Mountain, MB

My next questions are for the Society Of Canadians Studying Medicine Abroad.

Is the federal immigration department approving permits that allow foreign doctors to train in Canada through the visa trainee program?

11:30 a.m.

President, Society for Canadians Studying Medicine Abroad

Rosemary Pawliuk

Yes. That's without the LMIA process, so there's no analysis of the impact on Canadians. They are allowing it despite our objections and despite our application. They are ignoring our application to insist on finding out what the impact on Canadians is.

11:30 a.m.

Conservative

Dan Mazier Conservative Riding Mountain, MB

Once these visa trainees complete their medical training in Canada, do they stay to practise here, or are they required to return to their home countries to practise?

11:30 a.m.

President, Society for Canadians Studying Medicine Abroad

Rosemary Pawliuk

Under their contracts with their sponsor, they're required to return to their home country. Most of them do, but some of them ignore their contract and stay.

11:30 a.m.

Conservative

Dan Mazier Conservative Riding Mountain, MB

Why is the federal government approving work permits for foreign doctors to train in Canada under the visa trainee program only to send them home afterwards while thousands of qualified Canadians studying medicine abroad can't secure a training spot here?

You both can answer.

11:30 a.m.

President, Society for Canadians Studying Medicine Abroad

Rosemary Pawliuk

That's a darn good question. Why are they doing that?

We know this came about through the request of the faculties of medicine of Ontario, supported by the others.

What's happening is that the faculties earn $100,000 on an application. That's what they charge each year to these foreign physicians. It's a very good source of income. Millions of dollars are earned every year by the faculty. They can use that money at their discretion.

What they're doing is using taxpayers' resources and our trained doctors to train these foreigners so that they can then have a lot of extra money for the purposes they want, whether it's research or whatever.

I'm not against their making money. What I'm against and what we're struggling with is that Canadians are literally dying. They're not able to get back to work. They're losing their homes because they can't get their problems.... That should be far more important than the faculty being able to make a little bit of extra money.

Literally, thousands.... As Viren said, this year there were a thousand qualified people ready to go to work as resident physicians who were not able to.

A few years ago, the ministry of defence wanted to fund 50 residents. The faculties said no, and they gave them five. They said, “We have the capacity to do five.” The next year they did eight.

11:35 a.m.

Conservative

Dan Mazier Conservative Riding Mountain, MB

Thank you for that explanation. That leads nicely to my next question.

Are foreign-funded visa trainees using medical training capacity that could otherwise be available for Canadians who study medicine abroad?

11:35 a.m.

President, Society for Canadians Studying Medicine Abroad

Rosemary Pawliuk

Absolutely, and the numbers are great.

11:35 a.m.

Conservative

Dan Mazier Conservative Riding Mountain, MB

Dr. Munkley, did you want to add anything to this?

11:35 a.m.

Physician, Society for Canadians Studying Medicine Abroad

Douglas Munkley

Yes.

The teaching hospitals rely on residents. They're a source of good labour and they provide a lot of the care in hospitals. I certainly believe there's capacity to train more.

11:35 a.m.

Conservative

Dan Mazier Conservative Riding Mountain, MB

How many Canadians are currently studying medicine abroad but are unable to obtain a residency position in Canada after graduation?

11:35 a.m.

President, Society for Canadians Studying Medicine Abroad

Rosemary Pawliuk

There are 3,500 who are studying abroad. About 800 graduate every year. In this last year, off the top of my head, there were 181 who applied. That actually is in response to more residency positions. In 2022, because of the barriers, only 119 Canadians out of 800 applied after graduation.

The chances are so slim. In Australia, you're almost guaranteed a place.

The Chair Liberal Hedy Fry

You have one minute.

11:35 a.m.

Conservative

Dan Mazier Conservative Riding Mountain, MB

What country is benefiting the most from the visa trainee program?

11:35 a.m.

President, Society for Canadians Studying Medicine Abroad

Rosemary Pawliuk

It's the United States of America.

I'm sorry; was that which countries benefit from the visa trainees?

11:35 a.m.

Conservative

Dan Mazier Conservative Riding Mountain, MB

It's the visa trainees, yes. I switched back to visa trainees.

Which country is benefiting—

11:35 a.m.

President, Society for Canadians Studying Medicine Abroad

Rosemary Pawliuk

It's Saudi Arabia. There are currently 1,117 Saudi Arabians training in Canada.