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Canada’s treatment of internationally trained physicians exacerbates the health-care crisis

by Universalwellnesssystems

Canada’s temporary foreign worker program has come under scrutiny recently, with new Reports by UN Special Rapporteurs This is a systematic “A hotbed of modern slavery.”

This report: Temporary Foreign Worker Program It restricts workers’ freedom of movement by tying their status to a single employer.

In contrast, territorial or sectoral contracts offer workers more flexibility in the labour market, potentially reducing existing power imbalances and allowing workers to seek better working conditions without fear of deportation.

Canada’s doctor shortage

The UN report found that similar travel restrictions imposed on International Trainee Physicians (ITPs) It could worsen Canada’s health care crisis, hurt its international standing and exacerbate the doctor shortage..

These travel restrictions are primarily: Actionable evaluation programs Evaluate the clinical competencies of ITPs to ensure they meet the standards necessary to practice independently in a particular state.

Further complicating this issue, return-to-work contracts that are often tied to evaluation programs require ITPs to work in designated, often underserved, areas for a set period of time, further limiting ITPs’ mobility.

While these policies are intended to address local health care shortages, they also create significant mobility barriers for ITPs, making many hesitant to join the workforce through these routes and increasing competition for the limited number of residency positions coveted by Canadian-born medical graduates.

This restrictive environment impedes the effective distribution of medical expertise and exacerbates Canada’s health care crisis. The doctor shortage is acute. 2.5 doctors per 1,000 people by 2021This resulted in dangerously long waiting times for patients. Specialized treatment takes an average of 21.2 weeks.

Residents were notified of the current situation at the emergency room at Eastern Shore Memorial Hospital in Sheet Harbour, Nova Scotia, in August 2018. With no doctors, nurses or paramedics available, the emergency department was temporarily closed.
The Canadian Press/Andrew Vaughan

Integrating ITP into the Workforce No threat to Canadian medical graduates is supported by appropriate labour protections (including enforceable standards); Equal employment opportunities, transparency and standardization of qualification certification processes, and measures to prevent discriminatory practices in employment..

Furthermore, integrating ITP into an actionable assessment program has been shown to provide only a 9-13% return on investment, according to a 2019 Royal Bank of Canada report. The underutilization of foreign-trained immigrant skills is costing the Canadian economy up to $50 billion a year..

Bottlenecks occur

The health crisis and underutilization of ITPs highlights significant barriers to their integration into the Canadian health care system, issues that stem from the travel restrictions imposed on ITPs, as well as the UN’s criticism of the Temporary Foreign Worker Program.

Practice readiness assessment programs require ITPs to practice in the state they completed their assessment in. Additionally, return-to-service contracts tied to these programs mandate practice in designated geographic areas, often limiting ITPs to specific health care facilities or small communities.

As a result, although 72% of ITPs had more than 3 years of clinical experience overseas and 20% had more than 10 years of clinical experience, These restrictive service return agreements will cause many to choose the already overcrowded residential stream to obtain a license.

This will increase competition for residency positions with Canadian medical graduates, creating bottlenecks and forcing ITPs into unnecessary retraining. It has also raised concerns about the potential violation of mobility rights, similar to closed work permits recently condemned by the United Nations and described by one doctor as a form of “freedom of movement.” “Indentured Servant.”

A new path

To address this, Nationwide Evaluation Collaborative Practice Response Evaluationwhich Oversee these programs at the federal levelshould consider offering financial bonuses or loan waivers to attract physicians to underserved areas without restricting ITP mobility.

The doctor, with blonde hair, a white coat and a stethoscope, is photographed from the neck down.
A doctor dons a white coat and stethoscope in an exam room at a clinic in Calgary in July 2023.
The Canadian Press/Jeff McIntosh

Financial bonuses have been proven to immediately reward doctors who choose to practice in underserved areas, while loan forgiveness programs offer longer-term financial relief. In Australia, the Rural General Practice Incentive Program has significantly increased the number of doctors practicing in rural areas. 25 percent increase in rural GP placements between 2015 and 2018.

moreover, In a 2022 survey, 86% of Canadian ITPs With the right support and incentives, they were keen to work in rural Canada.

Promoting economic growth

For both temporary foreign workers and ITPs, the introduction of work permits will promote healthy competition among employers offering better working conditions, wages and benefits to attract and retain both migrant and domestic workers.

By addressing the structural inequalities inherent in closed work permit systems, sectoral work permits can reduce the exploitation of migrant workers, which often has indirect effects by undermining the employment of Canadian workers. Strict labor standards.

A fairer and more transparent labour market will benefit all workers by ensuring that employment standards are maintained across the board, leading to a fairer and more equal working environment across Canada.

Eliminating return-to-work contracts could also free up training places for Canadian medical graduates, as ITPs would no longer need to bypass practice readiness assessment pathways to get around current travel restrictions.



Read more: Why is Canada ignoring internationally trained doctors during a health crisis?


Canada’s systematic mobility restrictions on both low-skilled foreign workers and temporary workers reflect broader patterns of exploitation. The UN Special Rapporteur’s criticism of temporary foreign worker programs has disturbing parallels in the health sector. Casual workers face restrictive reinstatement contracts that, like closed work permits, limit their freedom and perpetuate power imbalances that favor employers over workers.

It is essential to remove these constraints through reform of sectoral work permits and return-to-work agreements. These reforms will protect workers’ dignity and rights and increase the health and productivity of Canada’s labour market. Ultimately, these reforms will foster a more equitable and dynamic economy, benefiting both migrant and domestic workers and contributing to Canadian society.

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