Human Resources Committee on May 7th, 2012

[Dr. Robert Sutherland]

I wouldn't have information in terms of the numbers applying versus the number of seats. We could try to get that information.

[Rodger Cuzner, Liberal, Cape Breton—Canso, NS]

It's been a theme that has come out through the course of the study that if you're able to allow people in rural communities the opportunity to understand that the training opportunities are there, then they go back and serve those communities. That's really when everybody benefits. They're much more comfortable within the community.

I guess the question comes back to how we are educating first nations communities that those opportunities are there. How are we making sure they're aware that those training opportunities exist?

[The Chair, Conservative, Ed Komarnicki]

We'll conclude with the response to that.

Mr. Swan, did you have a comment?

[Dr. Euan Swan]

It's a very good question, and I don't have that information right now. This weekend the Canadian Dental Association's committee on the dental admission test is meeting here in Ottawa. That's a question I can take to that committee and get back to you with the information.

[Rodger Cuzner, Liberal, Cape Breton—Canso, NS]

Thank you.

[The Chair, Conservative, Ed Komarnicki]

Does anyone else wish to make a comment?

Ms. Fréchette, go ahead.

[Danielle Fréchette]

Thank you.

I think a strategic investment in our aboriginal health workforce would help us go a long way. The cultural sensitization is a very, very large job, but to empower aboriginal peoples to care for themselves in their own settings I think is the winning solution for us. It's investing in mentoring programs, financial assistance, and providing extra resources within our educational infrastructure so that we can really integrate them, because they don't come with the benefits that the likes of me present with.

We're actually developing a program at the Royal College right now for our underserviced populations. If we can think of some of the approaches for aboriginal peoples, we could probably then generalize them for other populations as well. We're hoping to go that way.

It's the medical profession trying to be responsive to societal health needs within its own limited resources. I think partnering with some national resources would help the program go a lot further more quickly. Then we could probably apply some of these strategies to help integrate our international medical graduates as well.

[The Chair, Conservative, Ed Komarnicki]

Thank you.

Mr. Sutherland, did you wish to make a comment?

[Dr. Robert Sutherland]

To come back to an earlier question on the numbers of students, over the past 20 years there's been a consistent 0.6% increase annually in the number of educational positions. It has steadily increased each and every year over the past 20 years, and it has kept pace with the OECD average as well.

[The Chair, Conservative, Ed Komarnicki]

Thank you.

Mr. Shory, go ahead.

[Devinder Shory, Conservative, Calgary Northeast, AB]

Thank you, Mr. Chair, and my thanks to the witnesses for coming here this afternoon.

I want to thank my colleague from across the way, Ms. Charlton, for promoting the story I have been talking about for years and years, about the taxi driver and the doctor. I'm not a doctor by profession, but I have lived through this problem of foreign qualification recognition. It's my passion and one of the reasons I came to politics.

During the study, I found out that the skilled worker point system gives points based upon years of education. Nowhere does it recognize your education as a doctor or an engineer. Basically, it does not qualify you to have the same profession once you come to Canada. That is one fact I found out after doing some study.

When we were having our study on foreign qualification recognition—Ms. Fréchette, this will be for you—the Royal College of Physicians and Surgeons of Canada agreed that there was a shortage of doctors in each province and territory. There was no question about that. They also mentioned that recognizing or training these foreign-qualified doctors would put pressure on provincial and territorial medical regulatory authorities, which would have to register and license these graduates.

We all know there is a shortage. We all know that we do not want to lower our standards. So what do we do? You talked about matching immigration policies with needs. How can we make improvements to foreign qualification recognition without lowering the standard? What is the number one roadblock preventing foreign-trained medical professionals from getting into the system?

[Danielle Fréchette]

Documentation is a huge barrier—to have your qualifications recognized. It comes in variable forms, in different languages, and it's not consistent from one jurisdiction to the other. You're trying to estimate the baseline qualifications of an individual. They could have 15 years of training and all the points that go with it, but what kind of training did they have? Training as a general surgeon is really great, but if you've only observed some appendectomies and you might have tried a couple, does that qualify you as a proper general surgeon?

The documentation is probably top of my list, and it has been identified in other research as well. Providing some resources to the physicians abroad so that they could provide standardized documentation would help speed up the process of having credentials recognized.

[Devinder Shory, Conservative, Calgary Northeast, AB]

If we had targeted immigration, say, pre-certification of medical professionals, would that help us?

[Danielle Fréchette]

It's a stage process. If the Medical Council of Canada qualifying examination was offered offshore in a number of languages, you could establish certain baselines. You could adjust the expectations of the physicians wishing to immigrate, so they'd know if they were close to being able to practise or if they should be looking at a longer path of training. It could also help the jurisdictions better understand what kind of individual is coming into their community, so that they could provide the proper resources. At the end of the day, the objective is to integrate our internationally educated physicians into meaningful work. Ontario's program for physician assistants allows for the reintegration of physicians who really don't have the appetite for all of the required training but who want to continue to work in medicine.

[Devinder Shory, Conservative, Calgary Northeast, AB]

I understand, but the frustration is that I don't see a clear pathway for so many professionals, and that's where we are seeking some help.

I understand clearly as well that there are jurisdictional issues. Provinces and territories have the jurisdiction on all these things. At the federal level, our government has taken the leadership role by establishing this pan-Canadian framework, which hopefully will help, and it has been helping to an extent.

I'm looking for some suggestions on how we can help with foreign qualification recognition or in addressing the issue of this shortage of skilled workers.

[The Chair, Conservative, Ed Komarnicki]

Thank you, Mr. Shory. That is your time, but we will allow a response.

Go ahead, Ms. Fréchette.

[Danielle Fréchette]

Again, I wouldn't say that we have a shortage of physicians. We have shortages in different locales, so it is a distribution issue. If we could match qualified workers with available positions, I think we would be ahead of the curve ball. This is also predicated on having a longer-term understanding of what the needs are, and we are not there. We are not sophisticated there.

[The Chair, Conservative, Ed Komarnicki]

Thank you very much for that.

I'm not sure if anyone has any concluding remarks, either from the dental association or from the college. You're welcome to make them now before we conclude.

Mr. Sutherland, I see you do. Go ahead.

[Dr. Robert Sutherland]

I will just comment from the dental point of view on the same question, if I may.

The profession has taken a number of steps to improve and streamline this sort of processing to get foreign-trained, non-accredited dentists into Canada to practise their skills.

We have a program that has three parts to it that can be completed in a year's time, and at the end of that, on successful completion, they can sit the same examination that a graduate from any dental school in Canada would sit. When they pass that, they can practise in any province in Canada. There is freedom of movement across the country.

If for some reason they're not successful there, there is access to gap training programs and upgrading programs that are offered in essentially all the universities in Canada.

Dentistry is very proud of its track record in this area.

[The Chair, Conservative, Ed Komarnicki]

Thank you.

Mr. Swan, do you have a comment to make?

[Dr. Euan Swan]

No, thank you.

[The Chair, Conservative, Ed Komarnicki]

Ms. Fréchette.

[Danielle Fréchette]

Thank you.

It would be encouraging to see the certifying bodies working together, with some federal resources to ramp up our assessment capabilities and technology. We know that simulation is huge, and to really capitalize on the potential of simulation, to give our foreign-trained physicians a quicker diagnostic of where they're at, would help pave the way for their integration as well.

Thank you.

[The Chair, Conservative, Ed Komarnicki]

Thank you very much for that presentation.

We will suspend now for our next panel.

Thank you very much for coming before this committee.

[The Chair, Conservative, Ed Komarnicki]

I call the meeting to order.

We have a good group of witnesses here with us today, and we're waiting to hear each of your presentations, and there'll be some questions and answers.

We'll start with the dieticians, I understand. Please go ahead.