Meeting the moment: advancing solutions to integrate international medical talent and improve patient care

Last year, the Medical Council of Canada (MCC) answered Health Canada’s call to gather objective information with a view to informing additional pathways to licensure and mitigating physician shortages, particularly in underserved areas. The primary focus was to explore opportunities to expand the Practice-Ready Assessment (PRA) program, and to identify potential new roles and pathways for internationally trained physicians (ITPs). The project and its outcome, a research-based report entitled The integration of internationally trained physicians (ITPs) to improve access to care for patients in Canada, are informing ongoing discussion and next steps for the MCC and its partners.  

ITPs continue to play a strategically important role as we address the critical health care challenges that persist in Canada, particularly as we identify new pathways to build workforce capacity and increase access to patient care.

Understanding the role of ITPs in the health care system

Through this recent work, conducted by a consulting team led by Queen’s University, the MCC sought to offer a shared understanding of the current and crucial roles filled by ITPs, including options for better achieving their potential, as well as barriers to their successful integration. In addition, the team set out to identify effective strategies for considering the complexities of Canada’s health care system.

The research methodology comprised a combined approach, integrating a literature review, insights-gathering interviews, focus groups and surveys. Data analysis identified patterns, themes, insights, and evidence to better understand the current ITP roles within our health care workforce, also noting regional considerations, integration barriers, and any pathway-enhancing resources.

A high-level summary of key findings confirms that ITPs continue to be a key contributor to health care services in Canada, accounting for about one quarter of the national health care workforce. Their presence and participation in the health care system enhances cultural competency and brings valued multilingual skills for serving diverse patient communities.

Barriers impacting ITP integration in Canada remain, however. These include everything from the prohibitive costs for obtaining licensure, to complex certification and licensing processes. Further, the application and eligibility for PRA and associate physician programs, challenges of adapting to Canadian-specific terminology, disease profiles and medical practice, discrimination affecting job satisfaction and career advancement, and employability that recognizes their qualifications and experience all negatively impact ITP integration.

Workable strategies and recommendations

The MCC remains committed to the principles of collaboration and inclusion, and, following this research, is now engaged in sharing the findings at national and provincial levels, including with medical regulatory authorities, the National Assessment Collaboration (NAC) PRA Working Group and others. A series of recommendations, validated by evidence, draw the research findings into practical strategies for action. These include how to improve and scale PRA programs, the considerations for developing an associate physician pathway, how to improve both orientation and training for ITPs and their families, and the need to create a national hub to simplify and expediate immigration, licensure and certification requirements. Embedded in these recommendations are more wide-ranging ways to support ITPs, including educational support and learning resources, mentorships, and onboarding and peer support, along with guidance related to resources and funding.

Standardizing and centralizing resources in a multi-jurisdiction health care environment is challenging. Respect, consistency and fairness will continue to guide how the MCC proceeds, with the focus squarely on achieving our shared objectives—to significantly enhance the integration of ITPs into the Canadian health care system, increase workforce capacity, and improve critical access to patient care.

Time is of the essence. With so many people in Canada experiencing difficulties in accessing timely health care, we must make Canada the country of choice for more ITPs. The MCC, with its demonstrated expertise and national reach, will continue its engagement with key partners to synthesize discussion outcomes and to shape the next steps that will help ITPs navigate this complex system, ensuring their effective integration to benefit the health care needs of patients in Canada.