Health Committee on Oct. 30th, 2025

[The Chair, Liberal, Hedy Fry]

I call this meeting to order.

Welcome to meeting number nine of the House of Commons Standing Committee on Health.

We recognize that we meet on the unceded territory of the Algonquin Anishinabe peoples.

Today's meeting is taking place in a hybrid format. I want to remind participants of the following points. You have heard this message before, but I have to read it into the record.

Please wait until I recognize you by name before speaking. For those participating by video conference, click on the microphone icon to activate your mic, and mute yourself when you're not speaking. For interpretation, you can choose English or French or the floor language.

All comments should be addressed through the chair.

For members in the room, if you want to speak, please put your hand up. The clerk and I will try to see your hand and will go in the order of the hands we see first.

Pursuant to the motion adopted on Tuesday, September 23, 2025, the committee will resume the study on the impact of immigration policy on health care and barriers to integrating internationally trained professionals.

I want to welcome our witnesses. Today, as an individual, we have Dr. Pantea Barati, and, from the Canadian Nurses Association, we Valerie Grdisa, chief executive officer.

We will start with Dr. Barati.

I want witnesses to know that you each have five minutes. I will give you a one-minute and then 30-second warning. I would like to ask you to finish your speech by the time the 30 seconds are done. If you didn't get to say everything you wanted to say, sometimes you get an opportunity in the question and answer session to elaborate on things you wanted to put on the table. Thank you.

Dr. Barati, you have five minutes for your opening remarks. Please begin.

[Pantea Barati, Doctor, As an Individual]

Chair and honourable members of the Standing Committee on Health, I appreciate the opportunity to contribute to this important discussion.

I come before you not only as a physician but also as someone who believed deeply in Canada's promise that skill, dedication and compassion would find a home here. My goal is not to criticize but to share what I and many others have lived through, in the hope that our experiences can help shape a fairer, more coherent system that truly serves patients and honours the values this country stands for.

Canada's immigration programs actively recruits physicians and nurses, yet residency training—the gatekeeper to independent practice—is largely inaccessible to international medical graduates, IMGs. A recent analysis shows that just 13.6% of immigrant IMGs in Canada are licensed to practise, even though 84.7% of them held independent licences before immigrating. There were about 1,800 IMGs waiting for residency placements in 2023, but only about 370 residency positions were available. Provinces cap IMG participation at roughly 10% of the positions, meaning that qualified doctors compete for a fraction of the spots while many positions are filled by visa-sponsored trainees who are funded by foreign governments and who often return home. Federal immigration targets have increased, yet provincial licensing bodies offer too few residency slots and impose duplicative testing.

These restrictions contradict the promise of Canada's skilled immigration system. After years of delays, I accepted a psychiatric position in the U.K. to maintain my skills. The professional fulfilment came at great cost. I left my husband and my community behind. Friends have moved to the United Kingdom, Australia and the United States, where integration pathways are clearer and fairer. Their departures represent more than personal choices; they are an exodus of talent that could have alleviated Canada's health care crisis.

Taking the position in Wales was not just a career move; it was a reminder of why I chose medicine in the first place. I love my work there. I am treated as a professional whose education and experience matter, and the system allows me to use the full scope of my training. The result is deeply rewarding. I see patients benefit directly from my skills, and I feel respected by colleagues, who value what I bring to the team. The sense of welcome and belonging contrasts sharply with the uncertainty I faced in Canada and highlights what is possible when policy aligns with need.

My experience and the experiences of thousands of other international medical graduates reveal a glaring contradiction. Canada invites us to fill critical gaps yet bars us from doing so. I am not calling for shortcuts or special treatment; I am asking for fairness, coherence and respect. At what point do we acknowledge that discrimination and poor planning, rather than climate or geography, drive IMGs away?

If Canada wishes to uphold universal health care and remain a destination for skilled immigrants, it must align immigration targets with workforce planning, harmonize licensing pathways and remove arbitrary barriers. Doing nothing is not neutral; it perpetuates a crisis that harms patients, squanders talent and diminishes Canada's standing. Change will require collaboration between federal and provincial governments, medical schools, regulatory bodies and immigrant-serving organizations. It must begin with listening to those whose lives are affected by these policies.

The time for excuses has passed. Canada can choose to be honest about its failures and bold in its reforms, or it can continue to watch both its doctors and its reputation slip away. For the sake of IMGs, patients waiting for care and a health care system that lives up to its ideals, we must choose change.

Behind every policy are lives on hold, families divided and patients waiting. This is not a complaint but a call for coherence, to align Canada's compassion with its practice. Change is not only possible; it is necessary if we are to honour the promise Canada extends to those it invites.

It's been an honour to share my experience. Thank you for listening.

[The Chair, Liberal, Hedy Fry]

Thank you very much.

I now go to the next presenter..

Valerie Grdisa, go ahead, please. You have five minutes.

[Valerie Grdisa, Chief Executive Officer, Canadian Nurses Association]

Good afternoon and thank you, Madam Chair and members of the committee, for the opportunity to appear before you today.

My name is Dr. Valerie Grdisa, and I'm the CEO of the Canadian Nurses Association. I have practised as a registered nurse and nurse practitioner for more than 34 years in two provinces in Canada, and I've had the privilege of serving as the CEO of a community-based health care organization during the global pandemic and integrating internationally educated health professionals into the workforce. We look forward to bringing forward proven solutions.

Before going further, I wanted to share that I'm joining you today from Toronto, situated on Treaty 13, which was signed with the Mississaugas of the Credit and is the traditional territory of the Anishinabe, the Chippewa, the Haudenosaunee and the Wendat peoples and is now home to many diverse first nations, Inuit and Métis peoples.

As nurses and nurse practitioners, we have a duty to respond to the calls to action of the Truth and Reconciliation Commission of Canada.

CNA is the national professional voice of approximately half a million nurses across Canada, representing all categories of regulated nurses. For over a century, CNA has worked to advance nursing practice, shape health policy and improve the health and well-being of people in Canada and around the world. The nursing profession is deeply committed to ensuring that every person in Canada has timely and equitable access to care. This includes access to nurse practitioners, who already provide comprehensive primary care to many Canadians and must be part of the solution to closing the access gaps.

CNA’s vision for federal health policy is outlined in our policy road map for 2025 and beyond, entitled “Building a Healthier Canada, Powered by Nurses”. This road map provides practical, evidence-based solutions to strengthen Canada’s health system, including optimizing the nursing workforce so every nurse, including internationally educated nurses, IENs, can work to the full extent of their legislated scope of practice; expanding team-based models of primary care to increase access; strengthening retention and well-being supports for nurses, including IENs; and advancing a pan-Canadian framework for harmonized nursing regulation to improve labour mobility across jurisdictions.

Today’s discussion on the impact of immigration policy on health care is timely and vital. IENs have long enriched Canada’s health system. In the 1960s, nurses from the Philippines were recruited via direct employment programs and were able to start working the day after their arrival. Nowadays, too many nurses face unnecessary barriers that delay or prevent their full participation in the workforce. Credential recognition can remain slow, inconsistent and costly. CNA has called for a streamlined, transparent and competency-based approach that maintains rigour while removing duplication.

IENs come to Canada through multiple pathways, including express entry, provincial nominee programs, temporary foreign worker programs and refugee settlement routes. These pathways, however, are complex, resource-intensive and sometimes difficult to navigate. Many nurses take alternative routes, such as live-in caregiver programs, which further delay their entry into the health workforce.

Credential recognition is equally challenging. Multiple assessment services and inconsistent equivalency lists across jurisdictions create inequities and delays, yet there are strong examples of innovation and advancements within the nursing regulators. Nova Scotia’s Office of Healthcare Professionals Recruitment provides a centralized one-door model, while nurse-led initiatives like the CARE Centre for IENs and University Health Network’s IEN pathway help nurses integrate successfully.

Despite this, many IENs remain underemployed or lose skills with significant delays to entering the workforce. Solutions exist, but national coordination is needed.

A pan-Canadian strategy should align ethical international recruitment with streamlined integration, bringing together governments, regulators, educators and employers to ensure every qualified nurse can contribute fully to Canada’s health system. That’s why CNA recommends the federal government convene a national IEN task force as part of the broader health human resource strategy. This task force should align immigration policy, ethical international recruitment and workforce planning with a national nursing dataset to understand our supply and ensure accountability from pre-arrival through employment.

In short, CNA envisions a future where every qualified nurse and nurse practitioner in Canada, educated here and elsewhere, can contribute fully to the health of our population.

Thank you again, Madam Chair and members of the committee. I look forward to your questions and to working together on practical solutions that strengthen the nursing workforce and improve access to care for all.

[The Chair, Liberal, Hedy Fry]

Thank you very much.

We'll now go to the question and answer segment. The first segment is six minutes and that includes questions and answers. Thank you.

I will begin with the Conservatives.

Ms. Konanz, you have six minutes, please.

[Helena Konanz, Conservative, Similkameen—South Okanagan—West Kootenay, BC]

Thank you, Chair.

Dr. Barati, I have a couple of questions for you.

Thank you so much for coming today. Your story is extremely concerning, and it's why we're here today, really.

Just recently, there was a headline in Global News. It was disturbing. It said, “Health care systems 'dismantling' in B.C.'s Interior amid physician resignations”. Seven obstetricians/gynecologists and four psychiatrists have recently left Interior Health. Regions like where my riding is located are short of doctors. Also, to add to that, Kelowna General Hospital's pediatric unit was forced to close last summer for a while due to a shortage of doctors, yet someone like you—who immigrated to Canada because of your medical training and who was told that you would be able to practise here and that Canada needed doctors—is not permitted to practise in any of our hospitals or clinics.

When you found out that the residency training you needed to practise wasn't truly open to doctors like you, as you were told, did you feel that the rug was being pulled out from under you, as another witness has mentioned?

[Pantea Barati]

Absolutely. That's the same feeling that everyone is feeling. We came to Canada. We chose Canada because of what we believed about it. There were other countries that were offering the same position, the same opportunities, but we chose Canada for a lot of reasons. One was the openness and the truth behind everything, and we believed it, but when we came here, the reality was very different from what we had heard.

Unfortunately, I'm still hearing news from my colleagues in the U.K. that they've been offered to come to B.C. to practise, yet in Canada, Canadian citizens are waiting to be chosen to practise.

[Helena Konanz, Conservative, Similkameen—South Okanagan—West Kootenay, BC]

Thank you for that.

Just to be clear, you were told you that you would most likely be able to practise in Canada, and that's why you came to Canada.

[Pantea Barati]

That's correct, yes.

[Helena Konanz, Conservative, Similkameen—South Okanagan—West Kootenay, BC]

Do you feel that you were invited under false pretenses? What do you think is going on here?

[Pantea Barati]

Absolutely, that's the feeling I have, and that's the reality that I've faced along with many other IMGs. The reality is very different from the policy or what media is saying.

[Helena Konanz, Conservative, Similkameen—South Okanagan—West Kootenay, BC]

I know that you mentioned this in your opening remarks, but is Canada getting a bad reputation in the world by attracting medically trained doctors like you and not allowing them to get residency spots or to practise? We continue to encourage them to come to Canada.

[Pantea Barati]

Absolutely, that's a fact. In the IMG community, if someone wants to move to Canada, they are highly encouraged not to do that because of that reality. We are telling our friends and colleagues that it's better to choose another country if you are looking to practise as a physician.

[Helena Konanz, Conservative, Similkameen—South Okanagan—West Kootenay, BC]

That's extremely concerning, I'm sure, to everyone in this room today.

Do you think that more training opportunities should be reserved for international medical graduates who intend to practise in Canada or reserved for people who might not be intending to practise in Canada? For example, there's the visa trainee program signed off by our federal government offering short-term training for internationally trained doctors who are not planning on staying in Canada or are not allowed to even stay in Canada.

[Pantea Barati]

I'm not asking for more seats dedicated to IMGs. What we are suggesting is that, if some seats are not filled, there wouldn't be any harm offering them to an IMG. What is the reason and logic behind offering a lot of seats to different visa-sponsored positions while we have permanent residents and Canadian citizens waiting for those seats? We all know that those doctors are going to leave Canada. There is no way they are going to stay here.

[Helena Konanz, Conservative, Similkameen—South Okanagan—West Kootenay, BC]

On that note, how many doctors do you know personally who we've lost to the U.K., Australia or the United States? Is it too many to count?

[Pantea Barati]

From my close circle of friends, I could say that at least 50 of us have left Canada.

[Helena Konanz, Conservative, Similkameen—South Okanagan—West Kootenay, BC]

That's a lot, considering that we're so short on doctors.

[The Chair, Liberal, Hedy Fry]

You have 30 seconds.

[Helena Konanz, Conservative, Similkameen—South Okanagan—West Kootenay, BC]

Are there best practices in other countries that you would say Canada should look to adopt to help get more international graduates into our health care system?

[Pantea Barati]

If you look into the U.K., Australia and the United States, they offer fair chances to IMGs and domestic doctors. If I registered with the General Medical Council, GMC, in the U.K., I would have the same opportunity as a medical graduate from the U.K. I could practise in the same position, and I could earn the same salary. There is no difference between me and them so, if we want to improve Canada's health care system, we need to look into those policies.

[The Chair, Liberal, Hedy Fry]

Thank you very much. We went over time on that.

I now go to the second questioner, who is from the Liberals, Mr. Eyolfson.

[Doug Eyolfson, Liberal, Winnipeg West, MB]

Thank you, Chair.

I would like to thank both the witnesses for coming here today and for their powerful testimony.

Dr. Barati, I'd like to clarify something you said on the number of positions. You said that it is the provinces that are capping the number of these positions. Is that right?

[Pantea Barati]

That's correct.

[Doug Eyolfson, Liberal, Winnipeg West, MB]

Is there any policy in our federal immigration system that serves as a barrier to your practice, or is it these provincial policies?