Health Committee on Oct. 28th, 2025

[Doug Eyolfson, Liberal, Winnipeg West, MB]

This is driven by the faculties of medicine.

[Rosemary Pawliuk]

That's correct.

[Doug Eyolfson, Liberal, Winnipeg West, MB]

Thank you very much.

Dr. Alexander, I am sorry for what's happened. I do understand the concept of the rug being pulled out from under you. I graduated from medical school in 1993. There were a lot of changes to medical training at that time that affected many people who had certain plans for residencies, and because of the changes, that was pulled out from under them. Others who had gone on to a formal internship with the intention of working and then going into a residency no longer had that option. I do feel that this was not a change that a lot of people thought was positive at the time.

I just want to clarify. To your knowledge, were these changes a federal government decision, or was this done at the provincial level?

[Scott Alexander]

I don't know the official answer to that, but I would assume, based on the fact that it was a CaRMS application issue, it was done more at the federal level than in any of the individual programs.

[Doug Eyolfson, Liberal, Winnipeg West, MB]

Thank you.

Dr. Naik, you were talking about how we need to achieve this cross-country coordination of increasing the proper training slots and making sure that any medical graduate, a Canadian who's trained abroad, is able to get a position. How does the federal government do that if we try to make such a pronouncement and the provinces push back and say this is a provincial responsibility and we should stay in our lane?

[Viren Naik]

Thank you for the question.

First and foremost, we need the data. The provinces and territories decide what training spots we need through CaRMS, but I think the missed opportunity is around internationally trained physicians. They are the ones who have actually finished their graduate training in another country and have potentially even practised.

In such cases, the practice-ready assessment programs can rapidly bring someone to licensure in as little as eight to 12 weeks. The federal government could have transfer payments to the provinces and territories directed to the establishment and expansion of these practice-ready programs.

Regional hubs, like the Physician Assessment Centre of Excellence in Nova Scotia, are examples of how you can address the bottlenecks in assessor and assessment capacity that could be stood up across the country.

[Doug Eyolfson, Liberal, Winnipeg West, MB]

Thank you.

I actually agree with you.

[The Chair, Liberal, Hedy Fry]

You have five seconds, Doug.

[Doug Eyolfson, Liberal, Winnipeg West, MB]

Thank you.

I would say that we've tried targeted funding before, and the provinces have basically torpedoed that.

I think that's my time. Thank you.

[The Chair, Liberal, Hedy Fry]

Thank you.

I will now go to Monsieur Thériault for two and a half minutes, please.

[Luc Thériault, Bloc, Montcalm, QC]

Thank you, Madam Chair.

Dr. Naik, you talked about the global shortage of health care workers. As we know, the World Health Organization predicts that there will be a shortage of approximately 11 million workers by 2030. You also said that recruitment must be ethical.

According to the Organisation for Economic Co-operation and Development, in 2021, the proportion of foreign-trained health professionals recruited in Canada was 24%, which was above the global average of 19%.

What should we be doing? Does our need to bring in people trained abroad conflict with ethical recruitment?

[Viren Naik]

The issue of migration is a complex one. We have obviously signed onto the World Health Organization's ethical recruitment objective, and Health Canada has also produced a paper on it.

Having said that, people will migrate, and while we shouldn't actively recruit, we should certainly accept potential paths of migration. There are countries in the world that aren't on the red list that are actually overproducing doctors, and we should actively recruit from them. India, for example, has between 850 and 900 medical schools. Part of the purpose of the overproduction of doctors is for migration. We need to seize this opportunity, because in a global competition, other countries are going to the countries that aren't red-listed and doing some active recruitment, and we too could benefit from that.

[Luc Thériault, Bloc, Montcalm, QC]

You talked about countries that train more people than they need. Those could be resources available for recruitment in Canada.

Other than India, what are those countries?

[Viren Naik]

Absolutely. The one thing we have to do is recognize that the training is heterogeneous and do the appropriate assessments, as well as look at countries where training might be substantially equivalent to that in Canada. Those trainees or those doctors could walk on without any assessment or with minimal assessment.

[The Chair, Liberal, Hedy Fry]

Thank you very much.

I will now go to Mr. Strauss for five minutes, please.

We will finish this bang on time, guys, with the full one hour.

[Matt Strauss, Conservative, Kitchener South—Hespeler, ON]

Thank you, Chair.

Dr. Naik, thanks for coming.

For everyone's information, what exams in total does the MCC administer?

[Viren Naik]

The MCC administers three examinations.

One is the qualifying examination, which is a written multiple-choice examination that is issued in countries around the world. It is issued over 100 days of the year, in four different sessions, so there's no barrier to taking that exam. That exam is usually done at the end of medical school, prior to supervised practice in residency.

We also have an OSCE examination, which is used for the purpose of selection into residency programs.

We have a selection exam as well, which is used with variable uptake for our practice-ready programs.

[Matt Strauss, Conservative, Kitchener South—Hespeler, ON]

How do the success rates or the pass rates of Canadian medical school graduates, Canadians studying abroad and other IMGs differ?

[Viren Naik]

Our Canadian medical graduates are highly successful on our examinations at the end of medical school. Their grades range between 80% and 98% on their first attempt, and they go up with second and third attempts.

International medical graduates—again with a different curriculum and a recognition that we do ask about Canadian-specific competencies, like indigenous health and other cultural competencies—usually have a success rate of 50% on the first attempt.

Canadians studying abroad are somewhat in between. Part of that reflects the fact that they come to their training with some of the Canadian context and that some Canadians studying abroad are at schools whose purpose is to ready those graduates for return to Canada, so the curriculum and the exam preparation are geared to that. Their pass rates tend to be closer to those of Canadian medical graduates.

[Matt Strauss, Conservative, Kitchener South—Hespeler, ON]

You mentioned that the MCCQE part I exam is administered internationally.

[Viren Naik]

That's correct.

[Matt Strauss, Conservative, Kitchener South—Hespeler, ON]

Are you aware if success on that exam prior to immigrating to Canada affects someone's chances of immigration? Is the immigration industry aware of that, and do they take that into account?

[Viren Naik]

It does not impact immigration per se, but it is an examination that we are trying our best to advise and inform candidates that they should do before submitting their application for immigration.

[Matt Strauss, Conservative, Kitchener South—Hespeler, ON]

As I recall from my own time writing these exams, they're good exams and they're pretty difficult exams.

They are administered in English or French. I would have a really hard time passing those exams if I didn't speak English or French. Do you think that these exams effectively prove language fluency?

[Viren Naik]

Yes, and we also have worry about language being a confounder. For that reason we do, again, advise candidates to take their English equivalency or their OET or their other exams before they do these exams.