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.
Conservative
Dan Mazier Conservative Riding Mountain, MB
Before the federal government brings in more foreign doctors through immigration, should it first make sure that qualified Canadians who studied medicine abroad can return home to practise here?
October 28th, 2025 / 11:35 a.m.
Liberal
The Chair Liberal Hedy Fry
Thank you.
I will now go to the Liberals.
Ms. Chi, you have six minutes, please.
Liberal
Maggie Chi Liberal Don Valley North, ON
Thank you, Chair. Through you, I want to thank all the witnesses for appearing today. Thank you for making the time to come to Ottawa on a chilly morning. It's getting colder and colder.
My first question is for Dr. Naik.
You mentioned that the system in Canada in terms of assessment or workforce planning remains somewhat fragmented.
From your vantage point, where do you see the biggest misalignments today, and what practical steps would you say we can take to better link these systems so that physicians who arrive ready to contribute can be practising sooner?
Chief Executive Officer, Medical Council of Canada
For a migrating physician, we have to be very clear about what the requirements are and what the expectations are.
Assessment and meeting a national standard do need to occur. That's not necessarily an examination, but rather a program of assessment. We need to make all of that more clear up front or upstream so that a person can make an educated decision before they come.
The realities are that all provinces and territories are looking to serve their constituents. We see nuances and heterogeneity in the requirements in different provinces. If we could be more consistent and have a national approach to this, it would bring clarity to those coming and to those who are already here.
By definition, we are a federated model, but when you look at countries that have more of a national approach to this in this global competition, you see that they provide more clarity to the international medical graduate and internationally trained physician.
Liberal
Maggie Chi Liberal Don Valley North, ON
On the idea of that federal coordination piece, could you expand on that? Is it more digital infrastructure and more data sharing? Is it more in program design?
You mentioned the centre of excellence in Nova Scotia. Does it play a role? How does it play a role?
Chief Executive Officer, Medical Council of Canada
To be similar to our residency match, which is nationally based, and be similar to our practice-ready assessments, we can move to more nationally consistent requirement and application models. Both could be made more consistent.
The advantage there is that while repeating residency is an option and is certainly something we see people apply to, we know that a mid-career physician coming from abroad may be better served by a workplace-based assessment through practice-ready programs.
If we could become more consistent in those practice-ready programs across all of our provinces and territories, both for primary care and for specialties, it would bring clarity and a more national approach to those programs in general.
Liberal
Maggie Chi Liberal Don Valley North, ON
Thank you, Dr. Naik.
My next question is for Dr. Alexander.
Thank you so much for sharing your story of what you went through personally in transitioning from Australia back to Canada. You shared your story about why you wanted to practise. I deeply appreciate it, because I think there are many folks right now who are going through what you went through.
Dr. Naik touched upon some of the coordination piece. Could you expand on what the most confusing part was when you were going through that process?
As the second part to that question, from your perspective, what would have helped you navigate the process? What would improve that process?
Medical Advisor, As an Individual
Thank you very much. I appreciate the sentiment.
In all honesty, I think the CaRMS process is fairly straightforward. I think the biggest thing is just the limited access for any international doctor, as Rosemary alluded to. Being from Vancouver, I was trying to apply to the University of British Columbia residency programs, and there were only four options that I could have chosen from. If I had wanted to go into anything as a subspecialty, such as cardiology or endocrinology, that was completely off the table. I was not able to do that, and any kind of surgical positions...there was nothing available for me. I was very grateful that I was trying to get into family medicine and psychiatry, but beyond that there is limited capacity, and the competition was just incredibly steep.
I think that a way to make it more transparent is just understanding why that might be the case, why you might be able to go somewhere and have the want or desire to practise in a certain speciality, but then, in trying to come home, understand why that's not available to you. That's one of the major reasons a lot of Canadians I studied with abroad wanted to stay abroad. It was just the option and the availability of the training for them to go into the program that they were committed to, because coming back home was not an option.
Liberal
Maggie Chi Liberal Don Valley North, ON
I'm not too sure to whom I should direct this question, but I'll throw it out there.
In terms of other jurisdictions, like Australia or the U.K., is there anything you're seeing that works really well, that we could seize as a model and also emulate, in that sense?
Who wants to start?
President, Society for Canadians Studying Medicine Abroad
From my perspective, it seems like a waste of time and energy to be forcing immigrant physicians, who have been practising in their country—there's nothing special about us; I mean, doctors are excellent all over the world—to go through residency training. For instance, a neurosurgeon will have to do seven years. At any rate, in that way, if they were trained, as Dr. Naik talked about, then residency positions could be used for new graduates. They are the ones who really need that period of time of experience in order to ensure public safety.
Liberal
Bloc
Luc Thériault Bloc Montcalm, QC
Thank you very much, Madam Chair.
My questions are for Mr. Munkley and Ms. Pawliuk.
You said that the practice instituted by bulletin 230 should be revoked. My understanding, and this was also found by researchers in Quebec and Ottawa, is that international students who come here make a significant financial contribution to medical schools. They're kind of cash cows. Meanwhile, internationally trained Canadian students are having a hard time coming back to work in this country.
Isn't that indicative of something that we haven't talked about since the beginning of our study, which is that the federal government is investing less and less in health, particularly in health transfers? We could train more people here and bring our people home if we put the money in, but the reason we use international students is that they essentially become cash cows.
President, Society for Canadians Studying Medicine Abroad
My French is not good enough to understand it, and our translation isn't working.
Bloc
Luc Thériault Bloc Montcalm, QC
Madam Chair, should I start from the beginning, since the witnesses didn't understand my question?
Liberal
The Chair Liberal Hedy Fry
We stopped the clock. It's all right.
You can go ahead. You have three minutes, Monsieur Thériault.
Bloc
Luc Thériault Bloc Montcalm, QC
Madam Chair, I would like all of my time back. It took me two minutes to ask my question, but the witnesses weren't able to answer it because they didn't hear it.
Liberal
The Chair Liberal Hedy Fry
I know, but we went back to when the problem occurred. The clock is giving you three minutes and nine seconds.
Bloc
Luc Thériault Bloc Montcalm, QC
I want my five full minutes of speaking time to make up for lost time. It took me two minutes to ask my question, but the witnesses couldn't hear it because of a technical glitch. If I use another two minutes to ask my question again, they will have only one minute to answer it and I won't be able to ask any more questions.