Canada’s treatment of internationally trained physicians exacerbates the health-care crisis

Canada’s Temporary Foreign Worker Program has recently come under intense scrutiny, with a new United Nations report by a Special Rapporteur characterizing it as a systemic “breeding ground for contemporary slavery.”
The report criticizes the Temporary Foreign Worker Program for limiting workers’ freedom of movement by tying their immigration status to a single employer.
In contrast, regional or sectoral contracts could offer workers more flexibility in the labour market, reduce existing power imbalances, and enable them to push for better working conditions without fearing deportation.
Canada’s doctor shortage
The UN report overlooked how similar mobility restrictions imposed on internationally trained physicians (ITPs) could be aggravating Canada’s health-care crisis, tarnishing our international standing and intensifying our ongoing doctor shortage.
These mobility restrictions largely stem from what are known as practice-ready assessment programs that evaluate the clinical competence of ITPs to ensure they meet the standards required to practice independently in a specific province.
Compounding this issue, return-of-service contracts — often tied to the assessment programs — further limit ITPs’ mobility by mandating that they work in designated, often under-served, areas for a set period of time. These policies aim to address regional health-care shortages but create significant mobility barriers for ITPs. This deters many from entering the workforce through these pathways. It also intensifies competition for limited residency positions, which Canadian-born medical graduates clamour for.
This restrictive environment worsens Canada’s health-care crisis by preventing the effective distribution of medical expertise. The physician shortage is severe, with only 2.5 doctors per 1,000 people in 2021. As a result, patient wait times are dangerously long, averaging 21.2 weeks for specialized treatment. Integrating ITPs into the workforce poses no threat to Canadian medical graduates when supported by appropriate labour protections, including enforceable standards for equal opportunity in hiring, transparent and standardized credential recognition processes and measures to prevent discriminatory practices in job placements.
Additionally, integrating ITPs through practice-ready assessment programs has been demonstrated to yield only a nine to 13 per cent return on investment, and a 2019 report by the Royal Bank of Canada estimates that the under-utilization of skills among foreign-trained immigrants costs the Canadian economy up to $50 billion annually.
Creating bottlenecks
The health-care crisis and under-utilization of ITPs highlight a significant barrier to their integration into Canada’s health-care system. This issue, similar to the UN’s critique of the Temporary Foreign Worker Program, stems from mobility restrictions imposed on ITPs. Practice-ready assessment programs require ITPs to practise in the province where they completed their assessment. Additionally, return-of-service contracts tied to these programs mandate practice in designated areas, often restricting ITPs to specific health-care facilities or small communities.
Source:theconversation.com