International medical graduates: The hurdles to practising in Canada

International medical graduates (IMGs) come to Canada with hope for a better life. However, for the majority of them, the life they start in Canada is far from what they’d imagined. For most of them, their professional lives come to an end.

Most IMGs know there will be hoops to jump through in the licensure process, but what surprises them are the unexpected hurdles. In short, we are suffering from the Canadian government’s lack of transparency, consistency, and fair execution of recruitment management plans regarding IMGs.

My current professional situation in Canada exemplifies this mismanagement. I have fulfilled most of the requirements suggested by IMG advisors. Using Canadian resources and supports, I passed the Medical Council of Canada’s exams with honors, scored high in my language exam, finished preceptorship in anesthesiology and family medicine, and was temporarily licensed for almost 3 years. Nonetheless, I could neither enroll in a residency program, due to the huge competition among IMGs, nor be successful in one of the practice-ready assessment programs. As a result, I’ve become a professional nobody, and I’m currently working in retail. After the project that I was licensed for was terminated in 2013, no program existed to bridge my qualifications to the next level. Instead, additional hurdles—a new language exam and a requirement to practise in my home country—were put in front of me.

The enrollment requirements for practice-ready programs in Canada, such as the requirement to be in a current practice as a fully licensed physician, mostly benefit newcomers. New IMGs who were practising in their home countries become superior to the IMGs who have been practising in Canada with a special licence and who have become familiar with electronic medical record systems, patient-centred practice models, and Canadian culture. The government of Canada is hiring physicians from outside Canada who have only obtained working visas, passed the MCCEE, and passed the language exams. This is happening while hundreds of sophisticated IMGs are living in Canada. If they were given the chance to use their expertise beyond bureaucratic work, they would also be able to fill the gaps in Canada’s health care system.

To sum up, there are many qualified IMGs living in Canada who have passed exams such as the MCCEE, MCCQE1, MCCQE2, and NAC-OSCE, fulfilled various levels of training, and built good professional reputations. On top of that, both the IMGs and the government of Canada have spent thousands of dollars on exams and training. Despite this, the regulations and requirements for practice-ready assessment programs like the Saskatchewan International Physician Practice Assessment or the Practice Ready Assessment–British Columbia provide newcomers and foreign doctors a better chance to enroll.

Ultimately, I am left with one question for the authorities: Why don’t you give IMGs a better chance to practise in Canada by recognizing their Canadian experience, and protect your own investment?
—Shirin Rostamkalaee, MD
Whistler