Foreign Doctors Willing To Help Are “Outcast” By Regulation, Expert Says | The Canadian News

More than 21 months after the COVID-19 pandemic, Canada’s public health systems are shrinking as thousands of overseas trained physicians living in Canada remain marginalized due to accreditation and licensing policies.

Experts say existing barriers include failing to recognize international experience and asking foreign doctors to start off as newly graduated medical students. It is limiting them from working in Canada as doctors and contributing to the effort to fight COVID.

“This is the time to make a change,” said Shafi Bhuiyan, an associate professor at the University of Toronto, who was a practicing physician in Bangladesh but had to work through the Canadian accreditation process.

Dr. Saida Azam spent almost four years working as a doctor in India and Oman, but was unable to work during the pandemic. His years of training, his experience dealing with thousands of patients and his desire to help have not been enough for him to work in the Canadian healthcare system.

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“I want to get involved as much as possible. It has been very difficult for me to be on the sidelines, because this is the moment to give my most complete experience to the population where I live ”, said Azam.

There are currently more than 13,000 internationally trained physicians in Canada who do not work as physicians, according to the Coalition for Access of Internationally Trained Physicians. Of those doctors, 47 percent are not in the health field at all.

Meanwhile, Canada is ranked 26th globally in doctor-to-patient ratio, with 2.8 doctors per 1,000 people, according to the Organization for Economic Cooperation and Development (OECD). That’s about half the number in Norway (5.3) and other developed countries. The Canadian Medical Association estimates that five million Canadians do not have a primary care physician.

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In Ontario and BC, foreign physicians seeking to practice must obtain a certificate of registration with a government medical school, verify their degree to ensure that they were educated by an institution in the World Directory of Medical Schools, obtain a license from the Council Doctor of Canada and complete one year of postgraduate training or active medical practice, as well as obtain Canadian citizenship or permanent residency.

The Ontario College of Physicians and Surgeons states on its website that it is “committed to finding new ways to evaluate people who want to practice medicine in Ontario” regardless of the country of origin of their medical degree.

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Azam, 30, has been in Canada since 2018. To become a practicing physician, Azam must take a required written and practical exam, each costing between $ 1,500 and $ 2,500. In addition, he plans to write another optional exam to try to increase his chances when he applies for residency.

So far, Azam hasn’t written any of the exams yet. Instead, he has focused on taking advanced English classes to prepare for the exams.

After the exams, Azam must apply to a residency program, which will last between three and five years.

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Medical school graduates who attended school in North America or who have practical experience in the US are statistically favored for residency programs. Less than a third of recent international medical graduates who applied for residency were accepted, according to the Canada Resident Matching Service (CaRMS). Meanwhile, 95 percent of Canadian-trained medical graduates who applied were paired for residencies.

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“The unwritten rule is that we should have recent practice within the last three years of application and preferably the practice is in North America with referral letters from North American physicians,” Azam said.

CaRMS decides where to match Canadian and foreign medical graduates with a residency program. A spokesperson for CaRMS told Global News that the matching process is objective and does not discriminate based on where someone studied.

“The role of CaRMS in the residency assignment process is to provide a fair, objective, reliable, and transparent application and matching service to enter postgraduate medical training across Canada, for all participants,” wrote a spokesperson for CaRMS in an email to Global News.

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For Bhuiyan, the current method of re-licensing and having foreign doctors go through the same process as new medical graduates is discriminatory and discredits international medical care.

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“The expertise of foreign doctors coming to Canada is extremely underutilized. It perpetuates the bias, ”he said.

Dr. Hassan Moustafa was a supervising physician in one of the largest refugee camps in Kurdistan, where he supervised the medical operations of 60,000 people. The Syrian-born doctor spent more than a decade working as a surgeon in Iraq and Syria with the United Nations and Doctors Without Borders, but now he can only get a job with a medical equipment manufacturer in Canada.

Moustafa has tried to be regulated and even accelerated in Canada in order to continue practicing, but he would have to go through the typical five years of residency to be a surgeon in Canada. At age 45, the clock is ticking, and while he eventually wants to work as a surgeon, Moustafa is willing to take a less-skilled job just to get into the system.

“Respect my experience. I have worked a lot. I have a lot of experience. So let me come into this system as an assistant surgeon, ”he said.

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There are two obvious needs for policy change around foreign doctors, Bhuiyan said: Canada’s aging population and the continuing shortage of doctors.

Canada is not graduating enough doctors to meet the country’s needs, Bhuiyan said, especially in family medicine where there is a national shortage. Investing in foreign doctors is a simple solution and can happen immediately, he said.

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“We have all the resources. We need to make a plan, ”he said.

Katharine Smart, president of the Canadian Medical Association, agreed that the staffing shortage in healthcare settings across the country is glaring and has dragged on for decades.

“We have a long-standing staff shortage, particularly in primary care,” he said.

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According to Smart, nearly a quarter of all doctors working in Canada at this time were trained abroad, but challenges remain regarding how to obtain credentials for doctors entering the country. Each province and territory has a medical regulatory authority responsible for establishing licensing criteria.

“The training and experience of people is highly variable, depending on what part of the world they are from. We definitely have systems that allow people to access our system, but it’s complicated, ”Smart said, adding that the concern warrants an exploration.

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“It is not something that will probably be solved overnight.”

—With files from Jamie Mauracher

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