Foreign MDs get lifeline in NDP plan
Aim is to ease doctor shortage; program to offer training, aid
By Dan Lett
FOREIGN-TRAINED doctors will soon find it easier to work in Manitoba, thanks to a new provincial licensing program
in the works.
The program is designed to ease the province's doctor shortage and to meet the humanitarian needs of
international medical graduates. And if it is fully implemented, it will make Manitoba one of the more progressive
jurisdictions in North America for the licensing of foreign-trained doctors.
Sources have confirmed the new initiative, still in its infancy, involves language training and clinical skills
assessment and upgrading. It would also involve some level of income support for participants until they begin to
Dr. Bill Pope, head of the College of Physicians and Surgeons of Manitoba, said the new initiative could dramatically
streamline the process for qualified foreign doctors. The system would also offer the public more than adequate
assurance all doctors met Canadian standards.
"What we're trying to do is provide something to allow individuals with potential to undergo an assessment process
in which we have confidence," said Pope. "I think this could be quite successful for all parties."
Doctors who arrive in Canada as immigrants or refugees are generally discouraged from seeking a medical licence.
Those who still wish to pursue a career in medicine must negotiate a complicated and costly series of evaluating
and licensing examinations, without government assistance for language or academic upgrading.
For those who pass the examinations, there are still barriers. In both Canada and the United States,
foreign-trained doctors are required to perform up to two years in a hospital resident program. However, they have
generally been systemically excluded from the resident programs, creating a maddening Catch-22.
As immigrants with little in the way of financial resources, these doctors are also expected to pay for their
examination fees and other academic costs with no government help.
The Manitoba Human Rights Commission is considering a complaint from a Winnipegger who charges he has been
denied a medical licence because of systemic discrimination.
Health Minister Dave Chomiak would not be interviewed for this story. However, during the last provincial election,
Chomiak said his party has always believed foreign-trained doctors were not given a fair chance to prove they have
the skills and knowledge to practise medicine in Canada.
And with a continent-wide shortage of physicians, Chomiak said he wanted to make it a priority to open up new
opportunities for the foreign-trained.
The Association of Foreign Medical Graduates would not comment on the new initiative until all its members had
been consulted. However, Byron Williams, a lawyer with the Public Interest Law Centre who represents the
association, said most foreign-trained doctors are still somewhat skeptical about the province's plans.
Williams said the province's proposal will do little for those who already live in Manitoba and who may have been
out of practice for many years. There is also concern the province has done nothing to address concerns about the
national resident matching service that is the focal point of complaints of systemic discrimination.
Currently, international medical graduates (IMGs) are not allowed to compete for residency positions with Canadian
graduates in the first round of the national resident matching service. IMGs are allowed to compete in a second
round, but few have found residency positions through that avenue.
"Any step forward is positive," said Williams. "But this is just a modest step forward for a minority of IMGs. The
system still discriminates against IMGs."
Highlights of the new initiative include:
Specialized language training, in conjunction with Red River College, to allow IMGs to study English in a medical
Admission to a three-week preparatory course at the University of Manitoba for medical students about to write
national licensing exams.
For those wishing to practise as family physicians, access to a skill enhancement program, which will allow the
applicant to take up to three rotations in a one-year period.
Access to a conditional medical licence, which gives the applicants up to five years to complete full national
licensing exams while practising medicine.
Income and expense supports to help the doctors support themselves and their families while pursuing a medical
After a provincial skills assessment, doctors will be allowed a period of one year to attend up to three hospital
resident rotations. If, after another assessment, the doctors have still not demonstrated adequate skills, they will
be allowed to repeat one rotation.
Those who meet the requirements of the skills assessment will be allowed to practise medicine under a conditional
licence issued by the College of Physicians and Surgeons of Manitoba. Within five years, the doctor will be expected
to complete the second part of the national licensing examination, which is required for anyone wishing to practise
medicine in Canada.
Farther down the road, the province will attempt to move those doctors who cannot meet the requirements for a
conditional licence into other professions, such as radiation therapy, nursing or laboratory technician.
Sources say it could cost more than $82,000 for each IMG who successfully completes the program. The costs
include $47,000 for evaluating and licensing examinations, skills assessment and language training, and another
$35,000 for income support.
Barbara Hague, director of workforce policy for Manitoba Health, would not discuss specifics of the new system but
noted any IMG licensing system must include measures to ensure applicants meet all professional standards to
practice in Canada.
Doctors will still be expected to complete a national clinical skills evaluating examination, as well as a two-part
licensing examination, said Hague. All are currently required for anyone wishing to practise medicine in Canada,
regardless of where they were trained.