Foreign-trained medical graduates immigrating to Canada face unemployment. [Photo © Sarah Turnbull]
By Sarah Turnbull
OTTAWA — Dr. Sayed Zaki has been tirelessly searching for a job he’s been trained to do since 1999, when he graduated from medical school. Zaki is a 42-year-old immigrant from Bangladesh, now living in Toronto.
He and his wife Dr. Arifa Mitu, also a medical school graduate, immigrated to Canada in May 2005 with the hope of a better life and more employment opportunities in health care. They heard from friends and their visa officer that Canada had a shortage of doctors. The future sounded hopeful.
Reality was much different.
“I needed to feed my family so I started baking Timbits. I was the assistant to the baker.”
“We were in shock,” says Zaki. “After three months, our money was all gone. We were trying to uphold a family with rent and food. Either we had to go to work to pay our bills or apply for social assistance, which lots of our friends had done.”
Zaki spent the first few months in his new city sending out resumés to hospitals and family doctor’s offices. All that was offered to him was a year-long clinical volunteer position with a chance of being paid a minimum-wage salary once completed.
He heard that Tim Hortons was hiring, offering a similar wage. So, Zaki took a job at a downtown location.
“I needed to feed my family so I started baking Timbits. I was the assistant to the baker.”
To be eligible to practice in Ontario, an international medical graduate must have:
- a medical degree recognized by the World Health Organization;
- Canadian citizenship, resident status or authorization to work in Canada;
- passing results on the Medical Council of Canada Evaluating Examination (MCCEE) and part one and two of the Medical Council of Canada Qualifying Examination (MCCQE); and
- one year of mandatory clinical training, otherwise known as a residency, and a passing grade on the mandatory residency exam.
Zaki has successfully passed all necessary exams, yet he’s been denied admission to a Canadian residency.
While his wife continued studying for the MCCQE, Zaki took more evening shifts at Tim Hortons while also working at a call centre selling credit cards in the day.
“I was like a zombie. I was working eight hours in the night and eight hours in the day and I had only eight hours left to feed myself, to sleep and to see my family.”
To make matters worse, every other week Zaki and Mitu drove their son to The Hospital for Sick Children to treat his asthma. This left little time for the couple to focus on their shared goal of becoming family physicians.
In 2008, three years after moving to Canada, Zaki was hired at a sleep clinic through a friend’s recommendation. He was a sleep technician for five years and while it wasn’t a lucrative position, he says he felt relieved to once again work in health care.
Like Zaki, many foreign-trained medical graduates struggle to keep a focus on their medical career given the financial pressures they face to find employment as new immigrants.
Muhammad Raza is an executive board member at the Association of International Physicians and Surgeons of Ontario (AIPSO). Since working with the non-profit organization, Raza has encountered a number of foreign medical professionals facing the same hurdles as Zaki and his wife.
“These people have to put bread on the table,” says Raza. “When they come here, they’re new and they must not only adjust to the system but also help educate and adjust their kids.”
According to a 2014 study in the Journal for Risk Management and Healthcare Policy, out of 462 international medical graduates surveyed, 47 per cent experienced financial hurdles and 49.8 per cent reported working at additional jobs while waiting for admittance to a residency position. Like Zaki, 16.5 per cent of respondents have been trying to obtain a vacant spot for more than five years.
Zaki is in a particularly difficult situation as he received his last medical certificate more than ten years ago. He is competing with young minds, some of whom were born the same year he received his degree. Further, Canadian graduates speak English, often French and because they have trained in the system, they are familiar with the values surrounding it.
“They are competing with Canadian graduates who are fresh and young. People my age are facing more challenges getting into the system,” says Raza.
To add to their struggle, the number of available residency positions in Canada is limited to begin with. For foreign-trained graduates, there are even fewer spots.
Residency spaces limited
Odile Kaufmann is the program co-ordinator for the Internal Medicine Residency Program at the University of Ottawa. She says this year they received about 400 applications from Canadian medical graduates to fill 22 available spots. They received about 800 applications from international medical graduates to fill five spots. Each year, immigrants to Canada will compete with Canadians studying abroad for those few positions.
This rather discouraging outlook on the current system is in stark contrast to the results of the College of Physicians and Surgeons of Ontario’s 2013 report.
It highlighted that in the past year, more international medical graduates than ever before were certified for full practice or residency in the province. Of the 4,441 issued certificates, 40 per cent were given to international medical graduates and 37 per cent were given to Ontario graduates.
However, the College would not comment when asked how many under the label “international medical graduates” were Canadians who studied abroad and how many were, in fact, immigrants to Canada.
Kauffman says enrollment decisions are regulated by strict guidelines and a yearly quota set out by the College and the Ontario Ministry of Health.
“We are mandated by the Ministry of Health for how many positions and the amount of funding we have,” says Kaufmann. “The Ministry promises four or five years of funding. That’s a big commitment. So you’re likely to choose someone who has more chances of success.”
She says Ontario needs to support and educate foreign-trained medical graduates so they are on par with their Canadian colleagues. However, more residency programs require more money, which is ultimately a decision left in the hands of the provincial government.
As for Zaki, he remains hopeful. He’s now working in at the Toronto Western Hospital in the neurology department as an electroencephalogram (EEG) technician. He says he will likely take more college courses to advance his skills but knows more education doesn’t guarantee jobs.
“I have a few friends who came to Canada in 2007 and they passed all three exams. However, when they applied for the clinical training they never got called.”
For Zaki and his colleagues, the current system has failed them, what many in the field refer to as “brain waste”.
Kaufmann says it comes down to supply and demand.
“You can pound out the doctors, but where are the jobs? You can hire a cardiac surgeon but if there are no operating rooms you can’t bankroll these doctors. There is a balance and a logic to it.”
