BY BILL BRADLEY
It seems like a contradiction. There are estimated to be 4,000 foreign-trained doctors in Ontario who can’t work in their field because of seemingly insurmountable regulatory hurdles.
Yet many communities in the province, including Greater Sudbury, have severe doctor shortages.
The city lacks 20 family doctors, who would normally care for 30,000 to 40,000 people. Five emergency room physicians are also needed.
This is in spite of doctor recruitment efforts that have attracted 75 physicians since 2001.
Sudbury psychiatrist Dr. Rayudu Koka knows the obstacles foreign doctors face when they come to Canada.
He received his initial medical training in India and did post-graduate work in England.
“When I came to Canada, and that was some time ago in the 1980s, I still did have to write my exams to be licensed as a specialist, though I came with British post-graduate qualifications,” he said.
“That took me three years, but I was allowed to work as an academic appointee.”
Koka, who represents Northern Ontario on the College of Physicians and Surgeons of Ontario, said he and his colleagues are working to reduce the doctor shortage in the north.
This includes making sure more foreign-trained doctors can work here.
“We have the medical school underway, and that I strongly supported, but it takes time to train a doctor. My colleagues and I are doing everything we can to turn around the problem of doctor shortages.”
Dr. Vijay Kumar, who works as a pediatrician in the city, said although he trained in India, when he came to England he had to retrain there for four years. He eventually moved to Manitoba, where he had to take three more years of training.
“I hope what I went through is going to change because I know many specialists are going to retire soon. We have to have a better assessment process.”
Last month, the province passed Bill 124, which will reduce the barriers for foreign doctors who hope to become licensed to work in their field in Ontario.
John Letherby, a spokesperson for the Ministry of Health and Long-Term Care, said, “We will even work with the Ontario Ministry of Citizenship and Immigration to create a Foreign Trained Professionals Loans program of up to $5,000 per person to cover assessment, training and exam costs.”
The legislation requires that 34 regulated professions in Ontario, including physicians, have a licensing process that has fair, open and timely assessment of credentials of foreign trained professionals.
One regulatory body that is affected by the legislation’s closer scrutiny of their tough licensing process, especially with regards to foreign-trained physicians, is the College of Physicians and Surgeons of Ontario.
They argue they already have internationally trained medical graduates making up 25 percent of their membership, and that in 2005, 1,082 international graduates were licensed out of a total number of 2,747.
The college does not agree with some of the language in Bill 124 because it insinuates their licensing system is not open and fair, says Jill Hefley, associate director of communications for the college.
“Some of the provisions in Bill 124 such as requiring audits of the licensing process could actually hinder the efficiency and speed of the accreditation of foreign trained doctors because of bringing in third parties who are not part of the college’s experience,” she said.
“Currently the college relies on assessors from the Royal College of Physicians, a national body. We are afraid the government may slow down the process with more bureaucracy, defeating their original purpose.”
Koka said international graduates are being accredited.
“I do know who is being licensed recently: 44 from India, 39 from Egypt, 32 from the UK, 37 from South Africa, 17 from Nigeria, 14 from Iraq. This shows the 25 percent of our membership are medical graduates from outside North America.”
Koka said the reason why doctors educated in foreign medical schools need to be reassessed is because standards may differ, even between the United States and Canada.
“Take the requirements to practise internal medicine. In the United States the training is three years.
“Here in Canada, we require four years. I am sure the public feels more confident in physicians who are properly accredited when they go to see them.”
The college is changing its rules to make it easier for foreign doctors to get accreditation, said Koka.
“I know the college has put in place programs that help foreign doctors get their credentials and experience assessed while they are overseas in their workplaces.”
“If they check out…then they can apply to have a restricted license to practise under supervision by another physician called a preceptor, in an under-serviced area like the north for a year.
“They are paid full salary, and after a year, they are reassessed and allowed to practice wherever.”
The Ontario College of Family Physicians (OCFP) said this kind of action is needed because doctor shortages are already severe.
Things could get worse in the future because doctors who are part of the baby-boom generation will start to retire soon, said Jan Kasperski, executive director of the OCFP.
It takes a long time to train a doctor – up to 10 additional years in the case of specialists, she said.
“If we can access physicians who already are trained properly from credible medical schools in Europe or Asia and get them through an accreditation process efficiently, then that is a positive step forward.”
