"Welcome mat out for foreign MDs on The Rock"

[Guest Ian Wong]

The Toronto Star is currently putting out a large series of articles regarding the doctors shortage in Ontario and the rest of Canada, and is well worth picking up a copy or two to check these out. I couldn't resist grabbing a copy of yesterday's paper (Oct.12), which had a large section regarding the obstacles faced by foreign doctors trying to find work in Ontario.

 

Anyway, check out the Toronto Star.

www.thestar.com

 

Ian

UBC, Med 4

 

Article URL

 

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By Vanessa Lu

Health Policy Reporter

 

CORNER BROOK, Nfld. — After struggling for several years to get licensed in Ontario, Dr. Foluso Ola is finally living his dream of working as a doctor.

 

Because he studied in Nigeria, it isn't a simple road to practise medicine, especially in Ontario, where doctors are often required to repeat large chunks of their training.

 

"Newfoundland was the most welcoming place for foreign-trained doctors," said Ola. "My advice to others is to leave Ontario. It's not a good place for foreign medical graduates to start."

 

In Newfoundland, graduates of certain universities, notably in certain English-speaking countries like South Africa, Australia or Ireland, can get immediate provisional licences to practice. Others like Ola can complete a clinical skills assessment program, and after demonstrating they meet Canadian medical standards, they can earn a provisional licence to work, on the condition they complete national licensing exams within three years.

 

Ontario has not granted provisional licences. The licensing body has put a priority on protecting the public by ensuring foreign-trained graduates have the same standards and even experience as Canadian graduates.

 

Within days of completing the assessment course, Ola was working overnight stints in the Corner Brook emergency room, and in September he set up a family practice in Twillingate, on the island's northeast shores.

 

His views echo the thousands of foreign-trained graduates who say restrictive licensing rules make it near impossible to practise in Ontario. Health Minister Tony Clement is vowing to introduce rule changes to open up the system for immigrant physicians. Close to a million people are without a family physician, and that number could double by 2010, as retirements loom.

 

Ola, 33, was born in Ottawa to parents who were studying in Canada, but he grew up in Nigeria, where he went to medical school. He practised for a number of years, but decided to immigrate to Canada due to political instability at home.

 

Now, after spending more than $15,000 for the Newfoundland assessment program, plus living costs for himself in Corner Brook and until recently an apartment for his family in Ottawa, he knows he can finally begin his career again.

 

His wife Abiodun, 31, and daughter Tolu, 7, and son Akin, 1 1/2, have joined him in Twillingate and are now settling into life in rural Newfoundland.

 

"I like small places, and I really love family medicine," Ola said. "In family medicine you get to see the whole spectrum of medicine. You have to make sure you're on top of your game."

 

Ola plans to stay here as long as possible, even though there's the pull of family in both Ottawa and Toronto.

 

"The main thing that makes doctors leave Newfoundland is the poor pay. Then, it's the weather," Ola said.

 

While nothing can be done to change the island's weather, the province's 930 doctors have been on strike since Oct. 1 as they press for wage hikes. They have shut their offices and cancelled elective procedures, as they demand pay parity with counterparts in Atlantic Canada.

 

The provincial government — facing a severe budget deficit — is crying poor. Patients have nowhere else to turn but emergency rooms, where waits for minor problems can exceed 12 hours.

 

Without a significant pay hike, doctors are warning the Roger Grimes government that it will begin to see a mass exodus of physicians to other parts of the country.

 

Newfoundland has always depended on foreign-trained graduates to work in the province, especially in the remote outport communities. Estimates suggest as many as half of the island's doctors trained outside Canada.

 

It has traditionally been the entry point for doctors from all over the world, but usually after a few years, they leave for other provinces, creating the revolving door effect.

 

In Baie Verte, an old mining town two hours northeast of Corner Brook, more than 50 doctors — most foreign-trained physicians — have come and gone in the past decade.

 

One of the stalwarts is Dr. Francois deWet, a native of South Africa, who has been there for five years. Unlike some of the foreign-trained doctors who use Newfoundland as a stepping-stone into Canada, deWet says he wants to stay there.

 

"I don't blame them for leaving. If they can go and have a better quality of life, better remuneration, and in some cases better facilities, why not," he said.

 

As soon as deWet hears a doctor is thinking about writing family medicine qualifying exams — not required to practise in Newfoundland, but mandatory for provinces like Ontario — he knows it's time to advertise for a replacement.

 

Three doctors work at the local hospital, which serves a population of 6,500.

 

In his own case, he hasn't bothered to write the qualifying exams, so he wouldn't be allowed to work in Ontario.

 

"It galls me to think that after 10 years of working in rural Newfoundland, I can't work in Ontario," deWet said. But if Ontario were to change its rules, policy makers in provinces like Newfoundland worry that it would lose its edge in recruiting foreign graduates. One doctor said such a move would create "a huge sucking sound" right off the island.

 

"I think there would be a considerable impact on our ability to recruit and retain doctors," said Dr. Robert Young of the Newfoundland and Labrador Medical Board. The mish-mash of licensing rules across the country is prompting a call for national standards. That's in part to ensure physician quality is the same, and also to eliminate the poaching of doctors from poorer provinces.

 

It has always been easier to qualify to practise in places like Saskatchewan and Newfoundland, where it is possible to get provisional or temporary licences, pending exams.

 

While that helps provinces cope with doctor shortages, it also creates high turnover, where doctors stay for a few years, get Canadian experience, pass national certification exams, and then move on to larger provinces like Ontario or British Columbia.

 

A national task force, created by Health Canada, including professional representatives, provinces and territories, met for the first time last month with a mandate of delivering recommendations by next December.

 

The lack of national licensing standards for foreign doctors creates uncertainty for patients.

 

Every time Baie Verte's deWet books a vacation, he'll get a flood of calls from patients checking to make sure he'll be coming home.

 

"I reassure them, it's just a holiday. Then they ask, `Are you interviewing for another job?'," deWet said. "Sometimes I think I should get a T-shirt that says: `No, I'm not leaving.'"

 

Ola said he's planning to stay for a while. He's happy with the pace of life and the welcome he has received.

 

"I find it's about the best place to come in, to get into the system. Elsewhere, no one has time for a new doctor. Over here, they have time for that," Ola said. "Foreign-trained doctors should leave the big cities, and come to the smaller provinces to try and fit into the system.

 

"I'm living testimony that it works."

[Guest McGillGrad]

This is the type of info that is kept a secret for some strange reason. I say this because I have done some research on Canadian IMGs and their difficulties coming back to Canada. If people are willing to sacrifice a few years in NF then they could go back to their home province and practice there.