Time to trade in that taxi license

Ontario eases the strictures on foreign medics getting licensed

By Janet Baine

Flipping burgers in some fast-food joint, or putting in hours of hard, manual labour is not where any med student would want to end up after years of gruelling studies. Unfortunately, this is what the future holds for the thousands of international medical graduates (IMGs) in Ontario. The cold reality is that they can't get a license to practice medicine in Ontario.

To help solve this problem, the province has opened the Ontario International Medical Graduate (OIMG) clearinghouse and they're also making twice as many spots available to foreign-trained doctors to go into practice. This is good news for Dr Louis Monterrosa, who worked for 15 years as a pediatrician in Columbia until civil war brought him and his family to Guelph, Ontario as refugees in 1999.

He is currently working as a volunteer doing pediatric research at McMaster Medical Centre in the mornings and supports his family as a labourer in a factory in the afternoons and evenings. Dr Monterrosa doesn't know when, but he's certain that one day he'll end up practicing medicine somewhere in Canada, preferably in Ontario. It's been a long and frustrating road and each time he climbs over one wall he faces another. "Now at least there is some hope," he says. "Four years ago [when I came to Canada] there was nothing but a dark tunnel. Now there's a little door at the end." He expects to be eligible to apply for the new specialist residency program but has no illusion about how difficult it will be to claim one of those coveted spots for himself. He says there could be as many as 1,500 applicants, all of them as well qualified and experienced as him.

SERVICING THE PROVINCE
This year the provincial government is opening up 200 places for IMGs to enter residencies or practice, compared to 100 last year. This will help bring medical services to the one million Ontario residents who don't have a family doctor. "It is a major positive step forward to double the size, which makes it a very, very large program," says Brad Sinclair, executive director of the OIMG clearinghouse. "The University of Toronto Medical School has about 200 entry positions each year, the same number that the clearinghouse will be responsible to fill," he says. He has no idea of the number of applicants, but says medical schools tend to have five people applying for each position, and he anticipates a large number of applicants to come through the clearinghouse.

The OIMG clearinghouse replaces the Ontario IMG program and the Assessment program for IMGs. The clearinghouse means IMGs will only need to complete one application for medical licensure in Ontario, which will greatly simplify the application process. IMGs bring with them a variety of educational and professional backgrounds. The new system will take into account this diversity to ensure they meet Ontario's standards for medical doctors, whether they have come as medical students with no experience or specialists with several years experience, according to Mr Sinclair.

IMGs may be eligible to start in a pre-residency program (50 places), go directly into the first year of residency (25 places), and enter into second year residency (75 places) with the possibility of being fast tracked into a more senior year or enter a six month assessment (50 places) that could result in a provisional license to enter practice.

"The clearinghouse is a way of simplifying the application process, but it is also a more sensitive way of ensuring IMGs enter the system at a point more appropriate to their background and experience," says Mr Sinclair. He anticipates the clearinghouse will have a staff of 15 to 18 people, but it will depend on the demand for service. The staff will first ensure that the basic requirements of applicants have been met, such as language ability and immigration status. They will then make sure that that the IMGs take the required exam and apply for a spot that is suitable to their medical background.

Joan Atlin, executive director of the Association of International Physicians and Surgeons of Ontario (AIPSO) says her organization has 1,300 members, all doctors from other countries living in Ontario who want to find their way through the red tape and into medical practice. "What we have is not a doctor shortage but a licensing bottleneck," says Ms Atlin. The clearinghouse and additional opportunities for AIPSO members are a big step in the right direction.

"There is a significant increase in the number of positions and an increase in flexibility for people to enter the system," she says. "People can enter at a more appropriate level and not be sent back to the beginning."

But there's still a long way to go to ensure there are enough residency training and assessment positions. Her organization is advocating that qualified Canadians and residents of this province have every opportunity under the new system to become doctors here before doctors are recruited directly from overseas. "We don't want to create a system that disadvantages the people that are already living here," Ms Atlin says.

For more information please visit http://www.oimgc.utoronto.ca/