Practice Ready Ontario steps up to welcome internationally trained physicians

Last year, Ontario became the eighth province to offer an expedited route to licensure for internationally trained physicians. Building on the experiences of seven other jurisdictions in Canada who already offer Practice-Ready Assessment (PRA) programs, the province launched Practice Ready Ontario (PRO) in June 2023 — followed closely by New Brunswick that launched a PRA program a few months later. Considered as one of the ways to ease the critical shortage of physicians, the PRA route streamlines the entry into practice of qualified internationally trained physicians, who are assessed through these programs for readiness to work in the Canadian health care system.

A major undertaking

With funding from the Government of Ontario, three organizations, namely Ontario Health, the College of Physicians and Surgeons of Ontario and program’s overall facilitator Touchstone Institute, joined forces to bring PRO to life. These main partners worked collaboratively to design and develop the program, from assembling the various planning and implementation components and establishing processes and criteria, to assessors’ recruitment and initial participants’ selection.

Several other provincial organizations representing physicians and other health professionals, including the Ontario Medical Association, Ontario College of Family Physicians and Association of Family Health Teams of Ontario, are helping to promote PRO within the medical community, including for the recruitment of clinical assessors who play a vital role in the process. Support also continues from the Medical Council of Canada (MCC) and experienced PRA programs who assisted with PRO’s implementation efforts. Ms. Nicole Beben, CEO of Touchstone Institute, notes those shared efforts are “the kind of partnership that is necessary for meaningful and lasting change”.

Giving back to the community

The launch of the PRA program in Ontario spurred a lot of enthusiasm within our medical community. Dr. Eric Wong, PRO clinical director, says that rolling out “this important government initiative” is timely, as it “will help to alleviate the current family physician shortage and to diversify the physician population in Ontario”. He recalls the very positive response from family physicians when the call for PRO assessors went out, explaining that despite their already busy schedules and heavy workloads, many expressed their interest to participate as assessors: “Across the board, almost all of them said they wanted to get involved because they wanted to give back to their community and profession.”
Dr. Wong also stresses the high level of commitment of eligible candidates, who are grateful that “the system is listening to the fact that they have a high skill set and could contribute directly to the health care system”.

“A major lesson for us is how candidates experience the program, and we have a real responsibility and obligation to build the best practice ready assessment pathway.”

Dr. Eric Wong,
PRO clinical director

Supporting the delivery of safe and quality care

Dr. Wong emphasizes that PRA programs and their efficient but rigorous processes have a dual mandate in that they facilitate the entry of internationally trained physicians in the workforce, while ensuring that family physicians who are coming through the program provide safe, quality care. He points out that “the program’s selection and assessment processes allow us to balance those two responsibilities appropriately.”

For Ms. Beben, following these physicians as they continue their practice is another important aspect of rolling out a PRA program in Ontario. She explains that their feedback will help the program partners understand what these family physicians in rural and remote areas need in order to be successful in the longer term. “There are important, ongoing lessons being learned from our participants, and there might be additional support and resources required for this community of physicians who may be new to practising in rural areas”, she adds. In coming years, Ms. Beben sees this program will “help address the large number of people without access to family physicians in these parts of our province.”

Looking ahead

From PRO’s inaugural administration, Dr. Wong’s hope is “to have positive experiences for assessors and candidates of the first cohort”, adding that the program “carries a deep meaning for many participants on a personal level”. Almost one year into the launch of PRO, the 30 participants are moving through the 12-week clinical assessment; after successfully completing the assessment, they are expected to start their return of service in early fall, delivering care in communities across rural and northern areas of Ontario. The applicant intake for the second cohort is already underway, and the program is planning for at least 50 candidates in practice this fiscal year while it continues to actively recruit clinical assessors. As the word about PRO continues to spread and people learn that this is now a reality in Ontario, the team is seeing an increase in the number of eligible applicants for the second cohort.

Moving forward, Ms. Beben is confident that the PRO model will continue to expand to ensure more people in Ontario are getting the health care they need and more internationally educated physicians with experience can get into practice. Building on the PRA success story, she strongly believes the model can be applied beyond family medicine to other specialties, as it is in some other provinces.

“We’re making sure skilled physicians get into practice to support people in Ontario in accessing the health care they need.”

Ms. Nicole Beben,
Touchstone Institute CEO

PRA programs: a strong support network

Currently, nine provincial PRA programs work together to develop and maintain common guidelines, and representatives of all the programs meet periodically through the National Assessment Collaboration Practice-Ready Assessment (NAC PRA) Working Group led by the MCC. This partnership is greatly valued by the PRO team, as they appreciate the opportunity to share updates and information and to learn from the long-established programs: “It has been very rewarding to see programs at different phases of maturity at the MCC partnership table, and to be able to share lessons learned”, says Ms. Beben. And the contribution goes both ways, as the programs who recently joined bring new perspectives and a renewed dynamic within the group.

The participants of PRO’s inaugural cohort will be graduating within months and embarking on the next chapter of their journey; with many more cohorts to follow in the future, the roll-out of a PRA program is a positive development and a step in the right direction, among others, to give patients in Ontario access to much needed family doctors.