The Current - What’s needed for foreign-trained doctors to work in Canada?

Episode Date: October 17, 2024

We received a lot of mail about Nova Scotia’s plan to fast-track licensing for foreign-trained doctors who come to Canada, reducing the time from 18 months to 12 weeks in some cases. Dr. Michelle Morros, a family physician in Alberta, shares her thoughts. 

In 2017, it felt like drugs were everywhere in the news, so I started a podcast called On Drugs. We covered a lot of ground over two seasons, but there are still so many more stories to tell. I'm Jeff Turner, and I'm back with Season 3 of On Drugs. And this time, it's going to get personal. I don't know who Sober Jeff is. I don't even know if I like that guy.

On Drugs is available now wherever you get your podcasts. This is a CBC Podcast. Hello, I'm Matt Galloway, and this is The Current Podcast. This will be able to move qualified physicians more quickly through a competency-based assessment, which is what we really need to have, and that if the door is wide enough, we are going to have lots and lots of physicians be able to come through that door and go relatively quickly into licensure, practicing at the level that all physicians in Canada must meet. The threshold will not change. It will be the Canadian threshold and we will have more doctors. That is Dr. Stan Kutcher, a senator for Nova Scotia, speaking on The Current last week about his proposal to fast-track

licensing for international medical graduates as a way to improve access to care. Nova Scotia is planning to bring in a new dedicated clinic to assess foreign-trained doctors, and the plan is to shrink the assessment time from 18 months to about 12 weeks. Dr. Kutcher thinks it's a model that could be expanded elsewhere. We got quite a bit of a response to this story, including from Dr. Michelle Moros. She is a practicing family physician and the University of Alberta's Family Medicine Residency Program Director. Good morning. Good morning. When you heard about Nova Scotia's plan to have a dedicated clinic to assess and license international medical graduates and sort of speed up that whole process, what concerns did you have?

Well, first of all, my first reaction wasn't to have concerns so much as that it's not necessarily a bad idea. There are obviously lots of different ways we have to think about, you know, getting more docks on the ground. But as far as docks, we often think of family docs as what we need, right? And so one of my concerns was that not all, you know, international medical folks, docs from other places are actually suitable for family medicine, right? And is that assessment, you know, specific to family medicine, because that is the biggest hole that we need to fill right now. Would 12 weeks be enough to turn a neurosurgeon from some foreign trained place

into a family doc here in Canada? No, not at all. But I didn't actually think that they were designing teaching clinics, right? So there's a difference from, am I taking somebody and teaching them and training them to become a family doctor or any other kind of physician? Or are we taking them and assessing

and seeing their readiness for practice, right? So 12 weeks to assess readiness for practice, I think that's not unreasonable for, you know, for those that are ready to fly, it'll be pretty evident quite quickly. And for those who perhaps are not ever going to be ready, it might be evident as well. I think the tricky part comes with that middle, and that'll be a large middle. And it kind of goes to what you say, is 12 weeks enough to train somebody? Well, not at all. And that's actually not the same function as an assessment sort of center, right? Right. So an assessment center in and of itself is fine if you're assessing family doctors from other countries, but your concern is that you're going to have doctors in all kinds of specialties that may be being assessed in the same pipe.

The process would be designed to look for the skills and qualities that would be necessary for a family doctor, if that's what they were looking for. And you train, I think it was mentioned in the segment last week that, you know, the physicians would be trained to do that assessment, which is really great, right? Because it's actually not a simple thing. But then what do you do? Assessing and teaching aren't the same thing. They go together, but they're not the same, right? So you would still maybe end up with lots of folks who have potential, but that who would not be licensed ready. So it just, I guess it just doesn't offer the kind of volume and numbers that perhaps people imagine. Because it's just family medicine is a specialty. It requires certain skills and traits and not everybody can do it.

And yet lots of people could learn it if we can also train them. I understand some of your concern too is that if you get a great family doctor from another country who's ready to fly, you may not be able to keep them where you want them. Well, you know, that's actually exactly right, because there tends to be a big focus on supply of family doctors. As a residency program director, I'm always very interested in, you know, our medical students choosing family medicine. And then what do our residents do once they graduate? And IMGs are no different. They are going to want to practice in a system that supports them. And so while I think it is very important to consider where are we getting a supply of physicians and how are we, you know, growing them and such. It's the

support and the system that they work in that will be key. Return of service does not have a great track record of evidence behind it as far as keeping docs for a long period of time. And IMGs who get licensed will be just like any other physician in Canada. They'll be able to go wherever they want and practice however they want. And an IMG, just so we're clear, is an international medical graduate. You talked about sort of the sustainable, a model that family doctors can get into. And perhaps that's part of the problem that many doctors choose to pursue another path because practicing family medicine comes with an extra burden that perhaps other doctors aren't facing. Yeah, you know, so family doctors, whether it be that they're an international grad or a Canadian grad, we actually do, I think what people maybe don't realize is how much we do.

And because we do so much, we have a lot of choice, right? So if you go to an emergency department, certainly in the small towns, but even sometimes in the city, that might be a family doctor who's taking care of you. It could be that your baby is being delivered by a family doctor. You're being palliated by a family doctor. Your sports medicine person is a family doctor. In a small town, the anesthesia you're receiving might be from a family doctor. And so when we talk about primary care and we talk about how we can improve outcomes for all patients and reduce overall costs with time, what we mean is that we need family

doctors to deliver longitudinal comprehensive care. And what that means is that we form a relationship and deliver that. But if that's not supported and it's not, if it's too hard and not paid well, well, then we're going to do everything else because we can do everything else. Dr. Moros, we're going to have to leave it there. Another story where we could talk for much longer. Thank you so much for this. Thanks. Really appreciate it.

Dr. Michelle Morrows is a practicing family physician and the University of Alberta's Family Medicine Residency Program Director. For more CBC Podcasts, go to cbc.ca slash podcasts.