EDITORIAL: Are we treating international medical graduates fairly?
May 05, 2009 | Colin Leslie

         

Our nation offers a rather patchwork welcome mat to doctors trained overseas. Rules and programs for international medical graduates (IMGs) vary widely from province to province, so for simplicity today we’ll just look at Ontario.

Doctors who have immigrated to this country and want to get licensed in Ontario must, of course, complete a series of tests starting with the Licentiate of the Medical Council of Canada.

These written and clinical exams, however, are not a bottleneck in the system, according to Dr. Joshua Thambiraj, president of the Association of International Physicians and Surgeons of Ontario (AIPSO). He says the 1,800 IMG members of AIPSO generally complete these exams.

“There is just one thing wrong (with how Canada processes IMGs). And it is so simple it is surprising,” Dr. Thambiraj said.

It is getting through the residency match. In 2008, only 353 IMGs secured resident positions and 946 went unmatched, according to Canadian Resident Matching Service data.

So, the problem is a shortage of residency positions—a capacity shortage—at Canada’s teaching hospitals?

Well, not exactly. In 2008/09 Canadian hospitals had 2,153 foreign visa trainees, according to the Canadian Post-MD Education Registry. Foreign visa trainee residency spots are generally paid for by foreign governments (Saudi Arabians make up the largest group in Canada).

So, in fact, the capacity to train more overseas-educated doctors who have chosen Canada as their new home exists—if we only reduced the spots reserved for foreign visa trainees. And yes, that means the provinces would likely have to pay a bit more instead of us collecting money from the Kingdom of Saudi Arabia and other nations.

But don’t we as a country with a doctor shortage owe that to our fellow new-Canadian colleagues? Physicians who were educated in other lands but have chosen Canada as their home?

Find the right balance

We’re inclined to agree with Dr. Nick Busing, president and CEO of the Association of Faculties of Medicine of Canada, in a letter he wrote to the Ottawa Citizen about the allocation of resident spots on May 5, 2008: “We may not have struck the right balance between Canadian medical graduates, IMGs and (foreign visa trainees) within the current demographic context.