Pathways to practice: creating new opportunities for internationally trained physicians in New Brunswick

New Brunswick has welcomed 10 new physicians into practice as part of the province’s new Practice Ready Assessment New Brunswick (PRA-NB) program.

The fully bilingual program, which allows candidates to be assessed in English or in French, was launched in October 2023 through the College of Physicians and Surgeons of New Brunswick to attract internationally trained physicians to the province. Dr. Mathias Forgo, from Burkina Faso, and Dr. Wael Zohdy, from Egypt, were among the first PRA-NB cohort and are now practising family medicine in the province. Both say they felt well-equipped for success before completing their clinical field assessments thanks to a program that includes a robust orientation, as well as fully bilingual materials, staff, and assessors.

A unique opportunity for a Francophone physician

Dr. Forgo, who earned his medical degree from the Faculté de Médecine et de Pharmacie de l’Université Hassan II de Casablanca in Morocco before returning to his home country to practise medicine, was thrilled to be able to complete the PRA-NB program in French. “As a Francophone, I thought the only path to medical practice was through a residency in Quebec,” says Dr. Forgo. “It was only after contacting the College that I learned about the upcoming launch of PRA-NB, and I applied right away to be part of the first cohort.”

Dr. Forgo and his spouse first arrived in Canada in 2012, settling in Quebec where he earned a certificate in insurance medicine and health sciences expertise from the Faculty of Medicine at the Université de Montréal. He went back to Burkina Faso with his family in 2020. Returning to Canada three years later, Dr. Forgo successfully applied to PRA-NB. He says that participating in the program was an incredible experience. “I wasn’t treated as a medical student, but rather as a physician with practical experience.”

“PRA-NB is unique as it is the only PRA program offered in both English and French, and it gives internationally trained physicians the opportunity to demonstrate their expertise in their preferred language.”

— Dr. Mathias Forgo

From Cairo to Canada

Dr. Zohdy, who graduated from Egypt’s Cairo University Faculty of Medicine, spent 20 years working as a family physician in Cairo before moving to Canada. He and his family first settled in Ontario, where he obtained a master’s degree in eHealth from McMaster University and went on to work in the field for seven years. When he was unsuccessful in landing a residency training program in the province, he looked to PRA programs. Returning to Egypt in 2019 to resume his practice and obtain recent clinical experience – a key requirement for eligibility to PRA programs – he applied and successfully completed the intake process of PRA-NB, joining the first cohort in 2024. “All the steps were clear, all the timelines and milestones were mentioned and well-explained,” he says of the experience. “PRA-NB offered virtual and in-person orientation sessions that gave us well-thought-out documents that were valuable in our assessment and practise.”

Dr. Zohdy is also grateful for assessors he says were supportive in helping him become a better doctor in the Canadian context.

“The assessors were experts in exposing us to everyday clinical situations that would test our clinical competency. At the same time, they were eager to provide us with the logistics of practice, such as community services utilization, referral process, and running the practice efficiently.”

— Dr. Wael Zohdy

A focus on robust orientation

Candidates identified PRA-NB’s orientation as one of the program’s major strengths, setting them up for success practising in New Brunswick. Participants are provided with everything, from professional standards and training in patient-centered care, to skills for building cultural awareness. As part of the sessions he attended, for example, Dr. Forgo recalls meeting with representatives from First Nations communities. “They came to speak with us to share their realities and guide us on the most appropriate ways to interact with their populations.” 

With New Brunswick being the only officially bilingual province in Canada, launching the PRA-NB program in both official languages has also been an important focus. It has required that the administrative team develop all orientation and assessment materials in both English and French, while also recruiting bilingual assessors and securing assessment sites operating in both languages. Chantal LeBlanc-Maldonado, PRA-NB program manager says the team is particularly proud to have contributed to the creation of tools in French for Francophone candidates. The Therapeutics Decision-Making (TDM) Examination, for example, which is required for selection in most PRA programs and is administered by the Medical Council of Canada (MCC), was initially only available in English. In partnership with the MCC, the exam was translated into French and is now offered in two languages, allowing candidates to take it in their preferred language.

Dr. Mélanie Léger, PRA-NB clinical director, emphasizes the team’s ongoing efforts to raise awareness about the fully French-language PRA stream offered alongside the English stream. She notes that offering both French and English PRA pathways not only improves access to primary care for Francophone and Anglophone communities, but also supports the province’s commitment to providing health care services in both official languages.

The PRA-NB program also benefits from the support of engaged assessors who appreciate the opportunity to guide and evaluate the incoming physicians. “Like much of the country, our province has a chronic physician shortage. Medical education addresses a portion of this need as 75 % of our trainees stay (in New Brunswick) after completion,” says PRA-NB assessor Dr. Christopher Gallant. “Despite this success, a need remains. PRA-NB allows me to work at further addressing this need for the patients we serve.”

Settling into their new communities

Dr. Forgo, who now practises family medicine in the Centre de santé communautaire St. Joseph in the coastal town of Dalhousie, New Brunswick, deeply appreciates being able to provide care in French. “Many Francophone patients have told me how happy they are to receive care from a physician who speaks to them in their mother tongue,” he says.

Now practising in Campbellton, in the northern part of the province, Dr. Zohdy is delighted by the warm welcome from his new community. “People are very kind,” he says. “Even as they face challenges accessing a system with significant wait times, they never lose hope!” He encourages his internationally trained colleagues to consider applying for a PRA program. “It is such a great opportunity for international medical graduates who have trained abroad.”