To

The Government of Canada

Honourable Government of Canada,

There are many doctors planning to come to Canada as skilled immigrants. According to CIC Canada website, thousands of General practitioners and Specialist Physicians will come to Canada this year with dreams. In Canada they will need to obtain license if they want to practice medicine. They will need to do a residency training to retrain them. A cardiologist, who he has been practicing cardiology in his country for many years, he will need to complete at least 5 years of residency training in internal medicine and cardiology to be eligible to practice cardiology in Canada. This is also true for other specialists.

After a doctor comes to Canada and wants to practice medicine, all his previous experience and training will be ignored and there will be no difference between a GP, a Cardiologist or an obstetrician. They will all have to start like a new graduate from a medical school. They will all need residency training for at least 2-5 years to obtain a license. To become eligible for residency training they will have to qualify in several examinations.

According to residency training website (CARMS) ( http://www.carms.ca/eng/index.shtml )most of the doctors will need to pass in MCCEE, MCCQE1, and NAC-OSCE examinations. On the other hand, a medical graduate from a Canadian medical school will not need to qualify in MCCEE and NAC OSCE examination to be eligible for a residency position. Many of the foreign trained doctors will need to qualify in other examinations, in addition to the three examinations, which may include: MCCQE2, CE1 CE2 etc.

Last year approximately 2000 foreign trained doctors applied for residency positions. They were able to apply for the residency positions only after they got pass standing in the required examinations. Among them approximately 350 doctors got their desired residency positions.

Every year around 2000 Canadian graduates come out of their medical schools. They have got exactly same number of residency positions for them. But there are only approximately 350 residency positions available for the doctors who did not graduate from Canadian medical schools.

So, every year a large number of doctors who did not graduate from Canadian medical schools and who are mainly immigrants are left out of the main system, because there are not enough residency positions for them. There is also evidence of systematic injustice reported by some organizations. http://www.nfb.ca/film/doctors_without_residency">http://www.nfb.ca/film/doctors_without_residency">http://www.nfb.ca/film/doctors_without_residency

At present there are more than 7000 foreign trained doctors residing only in Ontario http://aipso.webs.com/. The total number in Canada will exceed 10,000.

Every year, according to CIC website, more than 2000 doctors (GPs and Specialists) are expected to come to Canada as federal immigrants. There are also doctors coming to Canada as provincial nominees and there are also other immigration programs bringing doctors to Canada. If we consider the existing system and its capacity, only a small number of these doctors (not more than 5-6%) will be able to enter into the system after crossing all the barriers. The question is what will happen to the rest. What will happen to those who are taking all the trouble to come to this country believing that they will be able to serve the people of Canada and help to fill up the shortage of doctors?

There is also an economic problem associated with all these irregularities. I talked to many foreign trained doctors and they told me that they were eager to compete with Canadian graduates in different examinations and they had no objections regarding this. So, foreign trained doctors have appeared in these examinations and most of them have already qualified in the two examinations. Some of the immigrant doctors did better than the local graduates in these examinations. Although most of the immigrant doctors are experienced as specialists and they were graduated long time before coming to Canada, they took all the trouble to study and prepare for these examinations.

Canadian medical graduates have to appear in MCCQE1 and MCCQE2 examinations for licensing. But the foreign trained doctors need to appear in other examinations like MCCEE and NAC-OSCE and CE1, CE2 etc. which the graduates from the medical schools in Canada do not need to appear. There is also a financial tag attached with this examination process.

In the last two years there was a huge raise in the examination fees. Two years ago each of these examinations used to cost a doctor around 800-1000 Canadian dollars. But now the average fee of each examination is around 1500-2000 Canadian dollars. There are also other costs associated with these examinations. These include administration fees, registration fees etc. So, an immigrant doctor needs to spend at least 6000-8000 Canadian dollars for these examinations.

They have to qualify each examination one at a time and then have to wait for six-twelve months for the next examination. So if an immigrant doctor has to pass MCCEE, MCCQE1, NAC OSCE examinations, which are the three examinations one needed to qualify for applying for a residency position, he will have to spend at least 2-3 years in Canada.

Who will take care of his economic needs during this period?

What happens when an immigrant doctor qualifies in all these examinations and still fails to get a residency position only because of limited number of positions?

These are professional examinations and every body knows that one can not be a full time student and a full time worker at the same time. As the number of foreign trained immigrant doctors is rising, the problem is exceeding its limit.

But there is no one to look into this terrible situation.

“Back in January 2008 the Frontier Centre for Public Policy (FCPP) and Europe's Health Consumer Powerhouse (HCP) released the first annual Euro Canada Health Consumer Index http://www.fcpp.org/publication.php/2025">http://www.fcpp.org/publication.php/2025, comparing the user-friendliness of Canada's healthcare system with those of 29 European countries.



The results were startling, especially for Canadians who have been led to believe that our health care system is the best in the world. Canada ranked 23rd out of 30, only outperforming a handful of eastern European states with developing economies, such as Slovakia, Romania, Lithuania, Poland, Bulgaria and Latvia.”

One of the main reasons for this is lack of doctors and other skilled medical professionals.

Still they are invited to come to Canada because every one knows that there is a doctor shortage.

According to a recent publication by Fraser Institute:

“Canada is in the midst of a physician shortage. Because of insufficient training in Canada, Canada’s physician shortage will grow more acute in the coming years without an influx of foreign trained physicians”. -Canada's doctor shortage will only worsen in the coming decade. Fraser Institute. March 20, 2011. Retrieved from: http://www.fraserinstitute.org/research-news/news/display.aspx?id=

The department of Immigration is busy defining the nature of skill shortage. Every year there are initiatives taken by the Government, Immigration ministry and other relevant authorities to tackle the problem of skill shortage. Honourable Immigration Minister himself most of the year remains busy talking to different groups trying to solve this problem and trying to find its solutions. There are many Canadians who believe that nobody is giving any time to think or plan how to utilize the skilled people after they come to Canada.

Jeffrey G. Reitz , the R.F. Harney Professor of Ethnic, Immigration and Pluralism Studies at the University of Toronto, in his essay titled: “Taxi Driver Syndrome. Behind-the-scenes immigration changes are creating new problems on top of old ones”, wrote:

“Are immigrant professionals still driving taxis?



The answer is yes. They are also mopping floors, bagging groceries, guarding office buildings, delivering pizzas, waiting tables and working at call centres. Once in Canada, many skilled immigrants, particularly those with Indian, Caribbean, Chinese or Arab backgrounds, wind up in occupations far below their educational levels—despite having been selected for high levels of training and experience in professions such as health care, engineering and education. The problem is known as “brain waste” and some economists estimate its cost to Canada as totalling at least $3 billion a year, not to mention the ruined dreams suffered by the immigrants themselves. “

http://reviewcanada.ca/essays/2011/02/01/taxi-driver-syndrome/

After coming to Canada I have attended many workshops and programs organized by different immigrant serving organizations which were funded by the Government of Canada and the Ministry of Immigration. Though the programs were organized to help the doctors and other skilled health professionals to allow them to enter into their own profession, I was surprised to observe that one of the main motives behind these activities were to let the doctors know that they will never be able to get a license as a doctor in Canada and so it will be better for them if they leave their dream behind and try to join the health care system as personal support workers or nursing assistants. I have heard doctors saying that when they told the organizers that they had enough experience and skills and they wanted to apply there skills for the service of the people of Canada and that was the reason why they came to Canada, they were totally discouraged and every body made fun of them.

There are many people in Canada who think that immigration has become a very profitable business for many people. New immigrants are weak and vulnerable and they want to believe everything they are told. They also have great respect for everything that is Canadian and is in Canada. There are self serving groups who are busy trying to utilize this opportunity to exploit them. People are frustrated to see how these hard working skilled people are systematically betrayed and how there skills are gradually destroyed and wasted due to complete apathy and inertia and total lack of planning from the establishment.

There were many news stories about foreign trained doctors and their struggle for survival. Many news stories and editorials were published showing concerns regarding failure to integrate foreign trained doctors in Canada’s medical system. http://www.theglobeandmail.com/news/national/canadian-pediatrician-helps-deliver-baby-in-plane-flying-over-kazakhstan/article2212130/

Political leaders also make promises before elections and then forget.

Ontario Premier Dalton McGuinty recently made comments regarding foreign trained doctors. Honourable Premier commented they “are actually what we call practice ready, so instead of going into the lengthy residency for which they are overqualified, they’re going to go into the practice under the direct supervision of the other doctors who will help them fill in any gaps between 6 to 12 month period before they can practice independently.”

Honourable Ontario Premier also expressed his concerns: “In certain communities like the South Asian communities doctors driving cabs has become a common phenomenon to the aggravation of many. Ontario and Canada needs to send a strong message to the world that people are welcome here in Ontario and Canada.” Retrieved from: http://www.sagennext.com/2011/08/03/mcguinty-you%E2%80%99re-welcome-here/

Andrew Padmos, the chief executive officer of Royal College of Physicians and Surgeons, recently commented “between 6,000 and 10,000 doctors can’t practise in Canada because there aren’t enough spots in residency programs”. Dr. Padmos also told the Commons standing committee on human resources: “If they require residency, there are severe constraints, that’s because there are only slightly more residency spots in Canada than there are medical school graduates each year. He further commented: “It’s insufficient to deal with several thousand foreign-trained grads”. Dr. Padmos also gave his solution: “qualifying doctors can sometimes get around the residency backlog by working under the temporary supervision of a Canadian-trained physician – but that option has its own price tag”. Retrieved from: http://www.theglobeandmail.com/news/national/ottawa-urged-to-help-expedite-licences-for-foreign-trained-doctors/article2222079/

There are many clinical and research fellowship positions in every hospital and academic institution in Canada. These fellowships are now offered to foreign trained doctors who are neither citizens nor permanent residents of Canada. Among the foreign trained immigrant doctors there are many specialist physicians and academics with long experience of working in specialized hospitals. These fellowship positions can be utilized to give them Canadian experience.

Highly skilled and experienced doctors have come to Canada to fulfill their dream and also for a better life. They came to Canada because they promised to utilize their skills when they were invited to contribute to the growth of Canada and also to serve the people of Canada. .

As these skilled doctors are now struggling to find any means to survive and also to find a meaningful life, they are praying to God and waiting for any hope.

Thank you very much.

Sincerely,

Immigrant Doctors of Canada