Doctors With Borders
The Walrus|June 2021
Physicians trained abroad have long struggled to find work in Canada. COVID-19 was supposed to change that
JAGDEESH MANN

AT THE START of 2020, Suvash Pokhrel was in danger of becoming a cliché. The thirty-eight-year-old had worked as an internal medicine specialist in Nepal, but since becoming a Canadian permanent resident, in 2018, he hadn’t been able to practise medicine. Instead, the physician spent his days taking online courses, so he could stay abreast of developments in his field, and caring for his kids.

The difficulty of practising medicine in Canada as a doctor trained outside the country is well known. Pokhrel was luckier than many others in his position: he was eligible for a loan to cover the thousands of dollars needed to take his two recertification exams. But that’s just one step. The relicensing process for international medical graduates (or IMGs) involves verifying one’s medical degree and previous practical experience, passing a language- proficiency test, and completing a Canadian medical residency or practicum. According to one researcher, all this can take up to a decade to complete and, accounting for factors like textbooks, commuting, and the study time that could have been spent earning income can cost as much as $28,000.

In Canada, there are thousands of IMGs who will never practise here. Worse still, some international graduates have had their immigration applications expedited precisely because, as doctors, they qualify for Canadian immigration streams designed for skilled workers — but now find their careers stalled. Often, the biggest barrier is securing the required residency because few spots are allocated to IMGs. Vahid Nilforushan, for example, an anesthesiologist who trained in Iran but now lives in Vancouver, said his application for a residency was denied several times between 2010 and 2016, and he eventually gave up trying to get re-licensed. Around half of the roughly 1,000 doctors who immigrate to Canada every year eventually abandon their medical careers.

Last spring, it seemed like these inveterate difficulties faced by IMGs would finally ease. The pandemic brought with it the fear that hospitals might become short-staffed, and provincial governments realized they needed more hands-on deck. Both BC and Ontario announced they would be issuing temporary licences for IMGs to practise under the supervision of other physicians. IMGs would no longer need to have completed a Canadian residency but only to have passed their Canadian medical exams or graduated from medical school in the past two years to participate.

Pokhrel looked forward to working in medicine again. “I have the skills to help, so I just want to do something,” he said. It took a pandemic to offer a glimmer of hope that professionals like him might finally be able to practise again — and fill the widening gaps in Canada’s health

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