Canada’s Healthcare Labour Shortage Fuelled By Lack Of Residencies For Foreign-Trained Doctors

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Canada’s Healthcare Labour Shortage Fuelled By Lack Of Residencies For Foreign-Trained Doctors
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A lack of residency spots means Canadians who studied medicine outside the country and international medical graduates are being deterred from practicing medicine here. 

“The messaging for so long has been that it’s nearly impossible to get a bloody residency in Canada if you’re an international graduate,” Peter Nealon, chief executive officer of the Atlantic Bridge Program, reportedly told The Globe and Mail national daily newspaper.

“These people are the cream of the crop and they’re simply going elsewhere because they’re in demand. You tell people to go away long enough, and eventually, they go away.”


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Atlantic Bridge Program is an admissions organization for North Americans who want to attend medical school in Ireland.

Thousands of Canadians unable to get into the limited space in medical schools here opt to study medicine in other countries, including the United Kingdom, Australia, Israel, the United States and the Caribbeans. 

But, there’s a snag. 

When those Canadians want to come back to Canada and practice medicine here, they often find it almost impossible to get into a residency program because residency spots for foreign-educated grads are even more limited than for those who studied medicine in Canada.

And the number of those spots has been dwindling since the late 1980s despite the growing shortage of healthcare professionals in Canada and Immigration, Refugees and Citizenship Canada’s (IRCC) efforts to open up immigration programs to healthcare workers, including physicians and nurses.

This year, only 13 per cent of the spots in residency programs in Canada, or 439 of the total 3,295, are filled by those who graduated from medical schools outside of the country, reports The Globe and Mail.

That’s down from 499 a decade ago and 700 residency spots for foreign-trained doctors in the late 1980s, reports the national newspaper. 

Many Canadian, foreign-educated physicians wind up never coming back, choosing to practice instead in the United States, Australia or Britain which have lower barriers for those who studied medicine outside their countries than Canada.

And yet, foreign-educated doctors are widely-regarded as a possible fix for at least part of Canada’s healthcare labour shortage.


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Across Canada, just under one in three doctors is already foreign-educated, and nowhere is that truer than among family physicians.

But fewer and fewer internationally-educated doctors are now even bothering to apply for Canada’s dwindling number of residency spots.

The Canadian Resident Matching Service (CaRMS), the national organization that matches medical school students with postgraduate training residencies, has reportedly said international applications for entry-level positions fell by 40 per cent, from 2,219 in 2013 to 1,322 in 2022.

Experts increasingly agree that creating more residencies for international medical school graduates could help Canada resolve its physician labour shortage.

Foreign-Trained Doctors Have Lots Of Opportunities In Canada – If They Can Get Here

Those foreign nationals aspiring to practice medicine in Canada first have to complete a bachelor’s degree and then get a medical degree from a school accredited by Canada. That entire educational process usually takes seven years.

The newly-graduated applicants must then pass the Medical Council of Canada Qualifying Examination (MCCQE) Part 1 exam and the National Assessment Collaboration (NAC) Examination, the latter of which accesses their readiness for a Canadian residency program.

Once that’s done, the foreign national has to apply for a Canadian work permit with the IRCC and apply for a post-graduate residency spot through CaRMS.

Physicians can also apply for permanent residence through the Federal Skilled Worker Program or the Canadian Experience Class.

Under the Provincial Nominee Program, provinces and territories can also nominate physicians for permanent residence if they meet particular regional labour market needs and intend to settle in that province or territory. Provinces can recruit candidates from the Express Entry pool or they can nominate individuals under their non-Express Entry paper-based streams.

Before a physician can practice in Canada, he or she needs to have his or her qualifications recognized.

The national organization that sets standards for physicians, including immigrating physicians, is the Ottawa-based Medical Council of Canada (MCC). It does not confer or issue licences to physicians. That responsibility belongs to the provincial and territorial medical regulatory authorities.

Those who are successful in obtaining one of the few residency spots for international grads will then be supervised by a Canadian medical school for at least two years before taking their certification exam in family medicine and getting their certification to join the College of Family Physicians of Canada (CFPC).

World Directory Of Medical Schools Notes Schools Acceptable To Canadian Regulatory Bodies

The last step is to apply for a license from a provincial or territorial medical regulator to practice family medicine there.

International medical graduates can see if their medical college will be readily acceptable to the licensing body, the medical college, in each province. It is the physician’s responsibility to check whether his or her medical school is listed in the World Directory of Medical Schools, something that can be done by visiting WDOMS.org.

Once a physician finds his or her college in that online directory, the next step is to check the “Sponsor Note” tab and see if it states “Canada Note”. This means medical degrees obtained from this medical school are acceptable to the provincial and territorial medical regulatory authorities in Canada and therefore acceptable to all medical organizations in Canada.

With a population of about 38 million people spread over 10 provinces and three territories, Canada offers many opportunities for physicians – but not all areas are equally as profitable or offer the same quality of life.

Typically, the more remote an area is, the better the income opportunities for physicians.

That can be important for a young doctor with a lot of student debt who might choose to work in a remote northern community and get paid not only for seeing patients but also simply for working in that remote location.

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