Despite an urgent need for doctors in Canada, thousands of internationally trained physicians (ITPs) already residing in the country face significant barriers to practicing medicine. Advocacy groups estimate that more than 5,000 ITPs in provinces like Ontario, Quebec, and Alberta are unable to work in their field, even as millions of Canadians lack access to a family doctor.
Complex Licensing Process
Navigating Canada’s licensing system is a significant challenge for ITPs, as each province and territory has its own requirements. The process often involves multiple exams, some costing thousands of dollars, and can take years to complete. For many, the difficulty is compounded by the need to secure residency placements, which are essential for hands-on training.
Residency opportunities are scarce, with most spots reserved for graduates of Canadian medical schools. In 2024, only 671 ITPs secured residencies compared to 2,936 Canadian-trained graduates. Competition is further heightened as Canadians who study medicine abroad also vie for the same limited slots.
Practice-Ready Assessments and Alternatives
To address the shortage, provinces have introduced programs like Practice Ready Assessments (PRA), which provide an alternative pathway to licensing. These 12-week clinical evaluations allow ITPs to demonstrate their competence under supervision. However, PRA eligibility often requires recent experience as a practicing doctor, forcing some ITPs to return to their home countries—often under challenging circumstances—to gain the necessary qualifications.
Financial and Emotional Strain
Many ITPs take on unrelated jobs to support themselves while pursuing licensing. For instance, family doctor Ismelda Ramirez worked at McDonald’s after moving to Quebec from the Dominican Republic. Others, like Nigerian-trained physician Oghenefego Akpomi, have returned to their home countries to meet eligibility requirements, despite personal and safety concerns. The financial strain of the process has left many feeling disillusioned and considering leaving Canada altogether.
Efforts to Address the Shortage
Canada has taken steps to improve the situation, including increasing residency slots and introducing associate physician programs in provinces like British Columbia and Alberta. These programs allow ITPs to perform certain medical tasks under supervision. However, the experience gained in these roles currently does not count toward licensing requirements, though discussions to change this are underway.
A recent Senate report recommended federal funding for 750 additional residency spots annually, a move that could help provide care for over a million Canadians. Advocacy groups continue to call for a more streamlined, transparent process to integrate ITPs into the healthcare system efficiently.
A System in Need of Reform
Canada’s fragmented licensing system and limited opportunities for ITPs highlight inefficiencies in addressing the country’s healthcare crisis. As more than 6.5 million Canadians remain without a family doctor, the untapped potential of foreign-trained physicians could play a crucial role in bridging the gap—if systemic barriers are addressed.
