Evidence of meeting #6 for Human Resources, Skills and Social Development and the Status of Persons with Disabilities in the 41st Parliament, 1st session. (The original version is on Parliament’s site, as are the minutes.) The winning word was process.
A recording is available from Parliament.
Vice-President, National Policy, Canadian Manufacturers and Exporters
I know you know.
So we hear a lot of complaints. We haven't done a full analysis of every sector, but we hear the complaints, and they're pretty much universal across the country.
Liberal
Rodger Cuzner Liberal Cape Breton—Canso, NS
So you're not really seeing a best practice or anything.
Vice-President, National Policy, Canadian Manufacturers and Exporters
Unfortunately, no.
Liberal
Rodger Cuzner Liberal Cape Breton—Canso, NS
On the CAs and the mutual recognition credential agreements, with the pilot project that's coming up in 2012, there 14 different countries you are engaged with right now.
Director, Chartered Accountants Qualification, Canadian Institute of Chartered Accountants
Yes.
Liberal
Rodger Cuzner Liberal Cape Breton—Canso, NS
Do you anticipate that once this is complete there will be almost immediate recognition of those credentials? Will Canadians be able to leave to work in the States, and will Americans be able to work in Canada?
Director, Chartered Accountants Qualification, Canadian Institute of Chartered Accountants
We already have that. We have a bilateral agreement with Mexico and the U.S. The only thing we're trying to change is the examination requirement to a course requirement with some testing in it, but not the full examination the way we have it now.
Liberal
Rodger Cuzner Liberal Cape Breton—Canso, NS
That would apply to Canadian students studying in those countries as well, would it?
Director, Chartered Accountants Qualification, Canadian Institute of Chartered Accountants
Yes.
Liberal
Rodger Cuzner Liberal Cape Breton—Canso, NS
Okay.
You mentioned a number of good points, and it's probably off what Carole had asked as well. You identified some of the good points, Ms. Thompson, that you feel in some areas. Hopefully, we're able to forward you some recommendations that will be helpful going forward. Is there one thing that really grinds your gears? Is there something that you think could help expedite the process?
Principal, Education and Communications, Canadian Institute of Chartered Accountants
The actual process?
Liberal
Principal, Education and Communications, Canadian Institute of Chartered Accountants
We're relatively new to this. As I said, we're barely two years into it. The most interesting thing is that the program was very consistent with what we had already identified as our needs, right to the point where our report was actually called “Pathways Report“, as well. Even our terminology was the same.
I know that over time there have been a lot of improvements. I think we're an organization that's really benefited from those improvements.
Liberal
Vice-President, Government and Regulatory Affairs, Certified General Accountants Association of Canada
As I said in my remarks, one thing to expedite the process would be to complete our work in identifying bodies across the world, and achieving more mutual recognition agreements. We have four in place.
Accounting is very different. There's a high degree of harmonization, not only in Canada but internationally, with international reporting standards. There are some very important distinctions with regard to how people are trained, but you have to look at outcomes more than outputs, or the process of those. That is something, for us, that we would pursue aggressively.
What we haven't really talked about is how we can successfully integrate foreign-trained accountants into the Canadian workforce and ensure that they will be successful, and that's through high-quality employment, as I mentioned. That one year of experience has to be at a high level, and there have to be the jobs for those opportunities, so they acquire the Canadian experience.
Conservative
The Chair Conservative Ed Komarnicki
Thank you.
Mr. Wilson, were you going to make a comment? If you do not, then we are ready to conclude. You can make a short comment, if you like.
Vice-President, National Policy, Canadian Manufacturers and Exporters
I would say two things, because there never can be one, I guess.
One is starting to break down the provincial barriers in some of the skilled trades. We talk about it quite a bit in Canada. CME has talked about it. Parliament has talked about it for a long time. We need to find a process to do that. Maybe the model as expressed here today by the accounting groups is a model we can take a look at with a group like CME. Trying to pull together some of these trades from across Canada and working with some of the labour unions would be number one.
The second one is that programs like E-MAP have been really successful in matching. You talked about that first job experience. Programs like that can be hugely successful in getting the right people in the door of Canada and getting them the right jobs to support the industry. Anything we can do to get those types of programs broadened out beyond, say, engineering in B.C. would be probably a huge benefit.
Conservative
The Chair Conservative Ed Komarnicki
Thank you very much. And thank you for your recommendations and your suggestions for improvement. We'll certainly take them into consideration.
With that, we'll suspend for about five minutes for the next panel.
Conservative
The Chair Conservative Ed Komarnicki
We have to get under way. We want to hear from the Canadian Association of Occupational Therapists, the National Association of Pharmacy Regulatory Authorities, and the Canadian Alliance of Physiotherapy Regulators.
I know that each of you will be making a short presentation. And again, if you're going to be reading from notes, try to slow down a bit so that the interpreters are able to keep up for the benefit of the rest of us here. There will be questions after from various members of the committee.
With that, is Ms. von Zweck going to start? Go ahead.
Dr. Claudia von Zweck Executive Director, Canadian Association of Occupational Therapists
Good afternoon, members of the committee.
My name is Claudia von Zweck and I am the executive director of the Canadian Association of Occupational Therapists. I represent over 12,000 occupational therapists from across Canada. I will share some thoughts with you today about ensuring adequate levels of health human resources through sustainable support of internationally educated health professionals.
As you may be aware, Canada is not self-sufficient in producing enough health professionals to meet the growing need, and has long relied upon graduates from international education programs as a partial solution to meet health human resource shortages. However, many professionals who come to Canada become marginalized in their attempts to work in their areas of expertise.
For our profession, this was a major concern. Shortages of occupational therapists currently do exist in Canada and therefore recruitment and retention of our health workforce is of paramount importance. Internationally educated health professionals, or IEHPs, provide a vital resource to address workforce needs yet continue to face challenges in their attempts to work in Canada. Long-term funding is not available to assist IEHPs to access bridging and mentorship programs as well as support networks set up to expedite their transition into the workforce.
One recommendation that I'd like to share with you today is to assist with funding issues so that IEHPs could apply for student loans. We find, however, that participants in most bridging programs do not qualify for existing student loan programs. Many IEHPs cannot afford the cost of participating in valuable bridging programs that would integrate them sooner into the workforce, where they could contribute to the economic well-being of the country.
Before speaking to some of the solutions, I would like to take this opportunity to thank the federal government for initiatives assisting internationally educated occupational therapists to work in Canada that are already in place or are under way. They include, first, an environmental scan we completed in 2006, which indicated that internationally educated occupational therapists who wish to work in Canada must successfully manage an integration process that is complex and involves several steps, including meeting Canadian immigration requirements, fulfilling professional entry-to-practice criteria, finding employment, and then relocating and settling in Canada.
Following the environmental scan, we completed an access and registration framework that outlines the entry-to-practice process for internationally educated occupational therapists. It maps the process among the various and differing jurisdictions and stakeholders of occupational therapy within Canada.
Our next initiative was the internationally educated occupational therapist web portal, which is an online electronic information gateway that centralizes information regarding living and working in Canada as an occupational therapist.
Our current initiative is the national occupational therapy examination and practice preparation project that is developing and implementing a national curriculum to assist internationally educated occupational therapists to work in Canada. Part of this project involved the development of a pilot trial occupational therapy exam and other resources that provide internationally educated occupational therapists with practice to prepare for the national occupational therapy certification exam.
These initiatives have made a difference, but there are still significant issues. We found in our experience that the learning needs of the internationally educated occupational therapists vary greatly and we need to have flexibility in our course offerings. Certainly the availability of time, funding, and commitment to program involvement influences participant success and it may be adversely influenced by the many competing responsibilities they face in their daily lives.
In a study undertaken for five health professions, including occupational therapy, it was found that the average internationally educated health professional requires three to five years to become certified and employed in their profession in Canada. During that time, they frequently work in survival jobs. A properly financed bridging program would cut this period down and would benefit a quicker integration of these valuable resources.
At the Canadian Association of Occupational Therapists we certainly recognize that a sustainable and effective integrated health human resources workforce is essential to respond to the health needs of the Canadian population. All people of Canada should have access to the right professionals at the right time in their communities throughout their lifetime.
To achieve this, CAOT asks the committee to support the following recommendations. First is to increase the availability of profession-specific bridging programs, mentorships, and peer support programs. Secondly, address training programs and support that would address issues such as language and communication and the Canadian culture, Canadian practice standards, certification examination preparation, continuing education to address profession-specific skills and competencies, and how to secure a job in Canada. Lastly, promote and disseminate among health care employers best practices for hiring and integrating internationally educated health professionals.
This completes my presentation. I would like to thank you for the opportunity to share the thoughts and concerns of occupational therapists, and I'm ready to consider your questions.
Conservative
Katya Masnyk Duvalko Chief Executive Officer, Canadian Alliance of Physiotherapy Regulators
Thank you.
Good afternoon. My name is Katya Masnyk Duvalko, and I am the newly minted CEO of the Canadian Alliance of Physiotherapy Regulators. I am just starting my third month with the organization, with still a great deal to learn, but what I have learned I am happy to share with you.
I am very pleased to be here to share my thoughts on the experiences we have had with the Canadian framework for success and with the framework's administering agency, the HRSDC.
The Canadian Alliance of Physiotherapy Regulators, also known as the alliance, is the umbrella organization, a national federation of provincial and territorial physiotherapy regulators committed to the development and improvement of regulatory standards of practice for physiotherapists. The alliance, on behalf of most of the physiotherapy regulators—the one exception is Quebec—administers the physiotherapy competency examination to determine a candidate's readiness for safe, effective, independent physiotherapy practice, and establishes whether the education and qualifications of internationally educated physiotherapists, IEPTs, are substantially equivalent to that of their Canadian counterparts.
Currently there are approximately 18,000 registered physiotherapists practising in Canada, the majority of them in Ontario and Quebec, followed by British Columbia and Alberta. The most recent statistics reported by CIHI, which include 2009 data, indicate that 12% to 15% of registered physiotherapists are educated outside of Canada. The top five countries for training in order of frequency are the U.K., India, the United States, Australia, and Poland. There have been a few changes in that rank ordering in the current report, but it's more or less the same.
The highest proportion, by province, of registered physiotherapists who were internationally trained are found in Ontario, where almost one-fifth of the registered physiotherapists were trained internationally; British Columbia, where 16% were internationally trained; and Alberta, where 15.5% were internationally trained.
As mentioned, the two main lines of business of the alliance within its evaluation services mandate are administering the physiotherapy competency exam and credentialling internationally trained applicants.
First I will provide a few words about our exam process. The physiotherapy competency exam is a national exam that includes both a written component and a clinical component. The written component is administered six times a year and it can be taken during the last term of education, while the clinical component is administered twice a year and must be taken after the completion of all physiotherapy training. Furthermore, a candidate cannot challenge the clinical component until they have passed the written component.
Each year, approximately 1,000 physiotherapy candidates challenge the exam. Of those taking the exam, 60% are Canadian educated and 40% are educated internationally. Overall, 85% of the candidates pass. However, the pass rates vary significantly between Canadian and internationally educated candidates. In recent years Canadian-educated candidates have passed the clinical component of the exam, on average, 96% of the time—so almost all of them—compared to only two-thirds, 68% of the internationally educated candidates. The disparity is even greater for the written component of the exam, where on average 94% of Canadian-educated candidates passed compared to only 53% of the internationally educated. There is quite a big difference.
The other main line of business of the alliance is the credentialling of all internationally educated physiotherapists to determine if their education and qualifications are substantially equivalent to their Canadian-educated counterparts and whether the candidate has the necessary knowledge and skills to challenge the exam. The physiotherapy profession is one of only a few health professions that has a coordinated pan-Canadian credentialling program. Pharmacy is another health profession that has a pan-Canadian approach, although others are moving in this direction.
Each year the alliance receives approximately 600 applications for credentialling from internationally educated physiotherapists, half of them from India. Other common source countries are the Philippines, Australia, the U.K., the U.S., Egypt, Iran, and Brazil.
Of all the credentialing applicants seen and completed in recent years, about 40% are eligible to move directly to challenging the competency exam. An additional 40% are eligible for what's called the prior learning assessment review, which takes a look at their work experience learned outside of education. They will eventually take the exam. Further research is needed to assess what percentage of candidates, and with which training and education characteristics, are successful in the exam and are successful in integrating into successful physiotherapy practice in Canada.
The alliance has been working diligently to research opportunities for improvements in its evaluation services processes, and HRSDC has been a valuable partner in this process. We have been able to count on their financial support for many years, starting with the first mutual recognition agreements process in 1999, designed to support compliance with labour mobility, and continuing to our current proposal for support, which is to develop an updated rubric for the assessment of credentials, a data analytics capacity, and a variable-pathway approach to credentialing.
The alliance is a small organization with only 12 staff and a member-funded budget of around $3 million. We could not have done nearly as much as we have without your support.
As a result of our initiatives, the alliance has seen improvements in its processes and in its communication with IEPTs. For example, with HRSDC funding, we've been able to revise our website and to review and update all of our documents to follow profession-specific and plain-language guidelines. We've been able to train our staff in cultural sensitivity and improved communication. This has led to increased effectiveness of our candidate support and increased satisfaction among our applicants.
In addition, the alliance completed an HRSDC-funded comprehensive review of the full spectrum of credentialing activities, resulting in numerous recommendations for updating policies, procedures, and strategies in credentialing. We are currently in the process of implementing these recommendations.
The alliance's experience with the granting and financing process administered by the HRSDC has been a positive one. Staff have been accessible and responsive, providing support in a timely fashion. This support and guidance allowed for the efficient and effective completion of funded projects, and efficient tracking of project progress, without undue administrative burden on our very small staff.
A few key challenges remain, especially as we move from addressing the structural and process challenges that have been our focus to date and we turn to dealing with challenges with outcomes. The alliance is mindful of the ever-changing national and international educational landscape for physiotherapists, and the need to update our credentialing framework to keep up with these changes.
Our biggest priority at this time is the development of an analytical plan that would link credentialing information with exam results, and then in turn with practice outcomes. We really need a clearer understanding of what barriers remain to the successful integration of IEPTs into the Canadian workforce, and we need to identify variables that predict success. This will allow us to develop further training and apprenticeship programs and continue to build on appropriate bridging programs to support those internationally educated candidates most at risk.
Chief Executive Officer, Canadian Alliance of Physiotherapy Regulators
I'm on my last paragraph.