Looking Forward: Integrating Immigrant Medical Doctors to Support Equitable Healthcare.


Amir Salamat, University of Toronto, Temerty Faculty of Medicine; Cindy Sinclair, University of Toronto

Year after year, “immigrant” medical doctors submit applications to the Canadian Resident Matching Services (CaRMS) for a family medicine residency training to continue their medical career as family doctors. Very few are selected due to lack of retraining spots while millions of patients suffer from lack of access to a regular family doctor or timely and critical services. As per the Government of Canada’s website, 6.5 million people do not have a family physician or nurse practitioner they see regularly. That is a dramatic increase from the 4.5 million in 2019 (Duong, D, and Vogel, L.). In the Province of Ontario, one of Canada’s most highly multicultural and diverse provinces, almost three million people do not have access to a family doctor as determined by the College of Family Physician of Ontario. This doctor-shortage escalation leads to longer wait time for primary care services, reduced access to preventative care that eventually will cause lead to increasing rate of mortality and morbidity from chronic illnesses such as diabetes and high blood pressure, as well as delay in diagnosis critical illnesses such as cancer in the early stages of disease, and finally an increased burden on health care system, specially emergency services and diagnostic facilities such as medical imaging as eluded in the literature. There are many factors that contribute to this shortage, including but not limited to the aging physician population, generational retirement, (in general older generation of doctors work longer hours compare to new regeneration), heavy physician workload that leads to burnout and even early retirement or reduced working hours. Physician financial problems and other geographic /provincial disparities also cause dissatisfaction among practicing physicians while many communities and rural areas in the country face immense challenges as they try to absorb and retain health care professionals in their communities. For decades medical schools and governments have been developing programs to entice new physician graduates to work and practice medicine in areas of country where the needs are high but the doctor shortage gap keeps widening. With Canada’s commitment to accepting nearly 1.5 million new immigrants by 2026, the crisis will become greater, not only in rural and underserviced communities but also in urban cities. More patients will suffer, and the injustices to humanity will become more acute. Argument: Patients and families are suffering from shortage of physicians while It is extremely difficult for immigrant doctors to be recognized as a physician and enter into health care system in Canada. Looking forward, we believe a plan as highlighted below would be a feasible way to integrate more immigrant doctors to help provide the serious humanitarian health care needs of patients. Plan: Based on the above, there are benefits of facilitating integration of immigrant doctors into the Canadian health care system. It could be done by 1) Facilitating of evaluation and recognition of international medical credentials; 2) Designing and implementing transitional programs, that train and help immigrant doctors fill the knowledge and other gaps and get culturally ready, which are required and essential to meet the Canadian standards of medical practice. This can be done by mentorship and academic training and continuous evaluation programs. Similar programs in other provinces such as Nova Scotia, Alberta, Manitoba, and Saskatchewan are already in place to handle doctor-shortage problem in these provinces. It could be worthy to think and consider a federal and universal approach to train and absorb newcomer immigrant doctors in Canada. We are exploring the possible ways to use and adapt other provinces experiences and approaches in the Ontario setting; 3) Alternative career in medical fields. Immigrant doctors can be trained to work in other healthcare fields based on their experiences, such as training and working as physician assistant, registered nurse, operating room assistant, respirologist technician, psychologist, lab technician, etc. Moreover, it is expected their training will be shorter compared to new students. Therefore, they can start providing services to the healthcare system faster. Raise awareness of the range of medical and healthcare skills immigrant doctors bring to Canada. Explore licensure and other professional pathways to effectively utilize immigrant doctors’ skills as a method to address the doctor-shortage crisis while ensuring equitable healthcare access for all.

This paper will be presented at the following session: