By Shafi Bhuiyan and team of ITMDs
Toronto, Canada, Sep 3 2021 – Access to quality healthcare is a basic human right, but for many, especially those in vulnerable communities, the right is not fully realized.
While surgical backlogs and delayed appointments may be prominent features of the healthcare crisis, the indirect impacts of Covid-19 must be considered. These include a halt in preventive programs, such as cancer screenings, declining health among Indigenous and aging people and for those with chronic illnesses, as well as worsening mental health among health care workers, to name just a few.
Canada already possesses a significant number of educated, qualified, and experienced Internationally Trained Medical Doctors (ITMDs) who can help fill gaps in the healthcare system. For example, Immigration Refugee Citizenship has reported that over 5,000 physicians came to Canada between 2015 and 2021, and this number does not include ITMDs who immigrated via a different method.
Many ITMDs possess much-needed cultural diversity, linguistic skills, and cross-cultural patient care talents. These can be utilized in the long-term care sector, for chronic disease prevention, and with Indigenous peoples and ethnic-racial groups, especially those residing in remote and rural areas across the country. Although 20% of the Canadian population lives in rural areas, only 8 percent of physicians work cfin these areas. Many ITMDs are well suited to provide quality healthcare for some of these communities.
Canada’s annual immigration intake plan is to welcome more than 400 000 immigrants per year in 2021-23, in keeping with the national plan for population growth. Based on data trends from Immigration, Refugee, Citizenship Canada (IRCC), this will likely include at least 900-1000 physicians each year. The need for diversity among physicians will continue to rise to provide culturally sensitive and quality care for all Canadians. ITMDs can provide culturally sensitive care and in-demand language skills to Canada’s increasingly diverse population.
Although the Truth and Reconciliation Commission of Canada (TRCC) Calls to Action were created in 2014, most healthcare calls have yet to be addressed. ITMDs can help address the long-standing shortcomings for this communities’ access to equitable healthcare and could contribute to rebuilding trust in the healthcare system.
The underutilization of immigrants’ education and qualifications has been reported to cost Canada $3 billion per year. Supporting the incorporation of internationally educated health professionals into the healthcare system would benefit Canada’s healthcare system and positively impact the economy.
Integration of internationally educated health professionals / ITMDs into the healthcare system requires a national strategy with a multi-stakeholder approach that focuses on scalable solutions. This strategy needs the engagement of governmental policymakers, regulatory bodies, employers, educational and training entities, service delivery agencies, and ITMDs themselves.
Once ITMDs have proven their expertise, they still require a bridging program to integrate their skills and expertise into the healthcare labor force. A recent survey of selected ITMDs who had participated in a career bridging program showed one-third had passed their licensing exams. These exams assess candidate’s clinical knowledge and skills to ensure they are comparable to Canadian medical graduates. Despite this achievement, another hurdle remains, to secure licensure. This is the residency program, which ranges from 3 to 5 years depending on the field of specialty.
The residency application process is complicated, but to describe it simply, medical students apply – via the Canadian Resident Matching Service, or CaRMS – for residency positions at universities across the country in one or more specialties of their choice. Not only are the total number of residency slots limited, but there are caps on the number of slots reserved for internationally trained versus Canadian medical graduates. The available slots for ITMDs are considerably smaller.
With the 2021 residency match results, data clearly illustrates the inequity i.e. a total of 2,852 Canadian medical graduates were matched. On the other hand, 410 internationally trained medical doctors were matched to residency positions. Over 90% of ITMD’s who have passed their qualifying exams cannot secure a residency due to their limited number and inequitable distribution of the residency slots.
An immediate solution is developing and delivering bridging programs, including in-class training and practicum placements, to support ITMDs’ employment in work commensurate with their skills, training, and experience, such as clinical assistant, research associate, and healthcare manager. Incorporating ITMDs into the healthcare system as licensed physicians can be further achieved via Practice Ready Assessments, increased residency opportunities, and increased post-graduate public health education and training.
Developing a clear roadmap will facilitate ITMDs’ integration into the Canadian healthcare system and foster diversity and equity in health research, management, and patient care.
There is a worldwide health crisis. If we cannot save a life despite having a huge pool of foreign-trained physicians ready to serve any time, we are neglecting untapped human resources to the detriment of our health.
The inclusion of ITMDs in the health system will benefit the healthcare system, patients, and the community and have a positive impact on society by reducing wait times and ensuring a better quality of life.
ITMDs are here, ready, willing, and qualified to serve Canadians as we work together to strengthen our healthcare system. There is no better time than NOW! Let’s work together to make healthcare more available and accessible to all Canadians so that no one is left behind.
- The authors are from Asia, the Middle East, Africa, and South American countries.
- The co-authors are Drs Bhuiyan S, Orin M, Krivova A, Fathima S, Walters J, Uzonwanne G, McGuire M, Mohammad A, Alamgir AKM, Radwan E, Tasnim N, Tazrin T, Parungao J, Saad W, Shalaby Y.