Thank you, Mr. Chairman.
Honourable members of the committee, it's a special privilege to be here to give this presentation, because sitting before you is a true product of today's topic. I'm a physician currently working in the Foothills Hospital in Calgary, Alberta, the Peter Lougheed Centre, as well as the Rockyview General Hospital under a special licence, a “supervised licence”, despite the fact that I was trained as a family physician and have between 14 and 16 years of experience as a family physician in South Africa.
The Alberta International Medical Graduates Association that I represent is a manifestation of what exactly is going on today. We consist of doctors trained or educated in countries other than Canada. It includes individuals and organizations interested in the various challenges facing international medical graduates in Alberta. The most challenging obstacle is having our members' foreign qualifications recognized by the College of Physicians and Surgeons of Alberta. It's a similar situation across Canada.
It is well publicized that within Canada there is a huge shortage of family physicians. Approximately five million Canadians do not have access to family physicians, which is very sad. International medical graduates account for only approximately 25% of physicians in Canada. Despite the growing physician shortages, IMGs continue to be an underutilized resource by the strained Canadian medical system.
Addressing this perennial dilemma has been an uphill battle. The sole reason is due to the provincial regulatory bureaucracy constantly devising various means, in a selective and biased manner, to limit recognition of the foreign qualifications of several immigrants who have settled in Canada.
The general misperception and misinformation in the public is that these IMGs have inferior knowledge and skills compared to graduates of Canadian medical schools. However, a direct comparison study done by Andrew Moran compared 24 IMGs with 21 Canadian medical graduates in a family practice residency program in 2006 and 2008 at St. Paul's Hospital in Vancouver. It showed that IMGs and Canadian graduates had similar results in evaluation reports. The results of these in-hospital training evaluation reports indicated that IMGs are seen by their teachers as competent physicians. Consequently, in clinical practice there are no valid statistics at the moment to show that IMGs are not proficient in patient care.
The Canadian government's pan-Canadian framework for the assessment and recognition of foreign qualifications shows that within one year an individual will know whether their qualifications will be recognized, be informed of the additional requirements necessary for registration, or be directed toward related occupations that are commensurate with their skills and experience.
For IMGs, the assessment and recognition process can take many years--sometimes from 10 to 15 years. There may be cases where it is not appropriate or practical to come to a licensing decision within one year. However, exceptions should exist, such as where an IMG, as a newcomer, requires an extended practice-based or workplace-based component to their registration process to continue. The foreign qualification recognition process may seem fair, transparent, and timely, but it is inconsistent across Canada, and marred by bureaucratic bottlenecks.
My first recommendation is to have a simplified system of assessment. It should be realized that cases involving well-known qualifications should be treated in a simpler way. If the recognition authority reaches the conclusion that recognition cannot be granted in accordance with the applicant's request, alternative or partial recognition should be considered to facilitate integration of IMGs into the Canadian medical system. Recognition bodies should take an active role in specifying the steps needed to be taken by IMGs through clear, coherent, objective, and unambiguous pathways, to enable them to get their qualifications recognized.
My second recommendation is standardization. The ruling medical authorities, as well as the provincial bodies, should consider forming a partnership with the Alliance of Credential Evaluation Services of Canada, national information centres, and other assessment agencies. These centres should publicize standardized information on the processes, procedures, and criteria of the assessments used for foreign qualifications for specific professions, especially foreign-trained physicians. This information should automatically be given to all, as well as any persons making preliminary inquiries about the assessment of their foreign qualifications. This currently does not exist.
Third is timelines. The untimely process in the evaluation of qualifications causes a delay in IMGs entering the medical system. In addition, this slow process causes IMGs to have further distance from their medical skills. A specified timeline should be given to applicants and adhered to by all regulatory bodies. Applications should be processed as promptly as possible, and the processing time should not exceed three months.
Fourth is educational credits. Each academic year of study, as recognized by the official designated authority in the country of origin, should be granted as at least one academic year of recognition within Canada. That doesn't exist now.
Fifth is the availability of recognized funding for clinical transition programs. The current limited opportunities for foreign-trained doctors to obtain clinical experience through recognized externship, hands-on hospital experience, and continuing medical education programs for IMGs to complete any theoretical or clinical skills deficits have to be addressed. These CME programs will help IMGs become familiar with the Canadian medical system and gain educational credits, while maintaining their certification. This could be achieved through more funding, either as grants or loans directly to IMGs. Most of these IMGs are either permanent residents or citizens at the moment.
Seven, a one-stop shop for foreign qualification recognition is highly advocated. It would be helpful to deal with one regulatory body, and for applicants to understand the full menu of options from the onset. The application procedures should be expedited. There should be a single enhanced written test, and one practical clinical examination instead of the current myriad of multiple tests that are so varied and confusing. At the end of the day, they do not guarantee a licence or recognition of qualifications.
Increasing the residency training positions, or having well-defined practice assessment programs to avoid backlog, with the aid of clarity of direction from this one-stop centre would be most helpful.
Finally, a pre-qualified pool system, whereby applicants are pre-screened and pre-qualified by the regulatory authority before immigrating to Canada, would be an added advantage. We recommend advancing the timing of foreign qualification recognition in the immigration process.
With this and the many other recommendations I've handed in, I want to thank you for your time for listening. I look forward to a very fruitful deliberation today.
Thank you.