National Post (National Edition)



When the COVID-19 pandemic first struck in Canada, Moises Vasquez knew he had to take action as part of the province's growing front-line response to the virus.

Vasquez worked as a general medical practition­er for eight years in Colombia before immigratin­g to Canada in 2014 with his then-pregnant wife, also a physician, and two children. Due to language barriers and the costly and complicate­d licensing process, he hasn't yet been able to obtain his medical licence in Canada.

It also took him five years to find a job in a health-care-related field — a health program co-ordinator at a Niagara-based community health centre.

Yet, in April 2020, he registered on Ontario's then-new Health Workforce Matching portal, which matches available doctors to hospitals in need, as they prepared for the growing deluge of COVID-19 cases.

“It was my call to apply because I knew the system would need that support,” he told National Post.

Several of his close contacts, also immigrant doctors, had also registered on the portal.

More than nine months later, Vasquez and his friends have yet to hear back from anyone.

They are not the only ones, several advocates and foreign-trained medical profession­als have told National Post. As Ontario's doctors, nurses and other health-care workers burn out from the stress of the second wave and/or fall sick with the virus themselves, thousands of Ontario's internatio­nally trained medical practition­ers remain on the sidelines, eager to step in but with few options to do so.

“It's heartbreak­ing to see how the numbers are increasing, how our front-line workers are at capacity and know that there are unutilized resources, internatio­nally educated profession­als that are eager to support but there is no clear path,” Vasquez said.

As of Jan. 29, a total of 2,660 internatio­nally educated health-care profession­als (IEHPs) have signed up on the province's online portal, which launched on April 7, according to data from Ontario's Ministry of Health.

However, only 33 employers in the health sector have requested IEHPs, resulting in 20 matches.

Portal matches, a ministry spokespers­on explained in an email, are based “exclusivel­y” on the requiremen­ts set out by the employers, not the ministry. “Final hiring decisions rest with the employer,” the email adds.

Around the same time, the College of Physicians and Surgeons of Ontario began issuing 30-day medical licences, called Supervised Short Duration Certificat­es, as part of a provision within Ontario's Medicine Act designed to accommodat­e a shortage of physicians during emergencie­s.

The licence would allow some IEHPs and domestic medical graduates to practise at public and psychiatri­c hospitals and Crown agencies, and was touted as an option for immigrant physicians to enter the front-line response. However, to be eligible, applicants first have to find a hospital willing to employ them and a physician to supervise them.

“It's a bit of a Catch-22,” said Joan Atlin, associate director for strategy, policy research with the non-profit World Education Services (WES). “You have a licence where an employer needs to commit to hiring someone and supervisin­g them before they can be granted that licence and yet the employer is presumably looking to hire people who are already licensed.”

Since April, only 14 licences have been issued, 12 of which have gone to foreign-trained medical practition­ers, the CPSO said. The college, it adds in an emailed statement, does not “play a role in human resources planning,” but rather approves the applicatio­ns based solely on whether the candidates have fulfilled the requiremen­ts laid out in the legislatio­n.

The CPSO did not specify how many applicatio­ns were submitted, but stated that it had approved “the vast majority of candidates” who submitted formal applicatio­ns for the licence.

While few applicatio­ns were submitted, the college did receive many inquiries into the licence, according to Atlin.

Joanna Walters said that when she called the college to ask about the licence, she was told she was ineligible. Walters, who moved to Canada from Jamaica in 2015, hasn't obtained her medical licence because she couldn't secure a spot in a residency program — a near-impossible licensure requiremen­t for most IEHPs. She currently works as a doctor's assistant in Waterloo, but periodical­ly flies back to Jamaica to maintain her family practice there.

“You would have had to get a job and then apply for

that route which would not be the case for the majority of IMGs (internatio­nal medical graduates),” she said. She added that she, along with other profession­als, had also reached out to hospitals in their region to offer their services during the first wave but were told they weren't needed as there was no shortage of doctors.

Walters had also signed up on the portal but as yet, has not heard back.

Advocates have also been in talks with the Medical Council of Canada to launch a standardiz­ed assessment tool, called Practice Ready Assessment­s, in Ontario. The 12-week program already runs in seven other provinces and could speed up the entry of internatio­nally trained physicians into the workforce, according to Atlin.

“If a program like that had been put in place at the beginning of the pandemic, we could potentiall­y be further along … in integratin­g immigrant physicians who meet the qualificat­ions and pass the assessment from that program.” she said.

Neither the Ministry of Health nor the Ontario

Medical Associatio­n would say whether any additional measures are being taken to include IEHPs in the pandemic response. A spokespers­on for the OMA, in an emailed statement, said that “all planning regarding increasing the number of health-care providers … includes considerat­ions of retired doctors, already practising but underutili­zed medical profession­als, as well as internatio­nal medical graduates.”

The ministry spokespers­on added that the ministry “continues to strongly advocate for hiring internatio­nally educated health profession­als via Ontario Health and in direct conversati­ons with employers.”

The Ontario Hospitals Associatio­ns has not yet responded to a request for comment.

With few measures available to IEHPs, many organizati­ons in the province have been working to match profession­als to available health-care positions, pandemic-related or otherwise. Many of the profession­als, advocates say, do get matched to secondary positions, both paid and volunteer, within the field but aren't able to fully use their medical training.

Emily Kovacs, who runs a Niagara-based non-profit supporting Canadian newcomers, said that 60 of the 178 IEHPs in her service had been matched to positions such as health-care and dietary aide roles, personal support workers or other non-clinical positions at COVID sites and/or longterm care facilities. The roles, she added, come with a contingent on the employer to ensure that they include a possibilit­y of career advancemen­t for the IEHPs in question.

“Non-regulated health fields are available to them and with some volunteer experience, they can bridge that,” Kovacs said. “But what we want to avoid is that they get stagnant in those opportunit­ies and they never end up using their (medical) skills.”

Vasquez, for example, emphasized that while his current role is non-clinical, he can use some of his medical training when co-ordinating between prospectiv­e patients and practition­ers on his team. “I'm also gaining knowledge of how physicians deal with patients in Canada,” he said, knowledge that could give him an advantage in his own quest to obtain a medical licence.

New immigrant practition­ers have also turned to bridging programs, which supply them with additional skills and access to a large network to help them enter the Ontario health-care workforce.

Shafi Bhuiyan, an IEHP, who runs one program at Ryerson University, said he set his clients up with roles in contact tracing, mental health and case management. “My intention is to bring these people into the health system,” regardless of whether they are licensed or not, he explained.

ACCESS Employment, a GTA employment consultanc­y that also runs bridging programs, has seen its employment rate of internatio­nally trained healthcare profession­als increase since the beginning of the pandemic.

“We're seeing people opening their eyes to the skills and experience that the types of clients who we're serving have always had in the labour market … which has really helped (IEHPs) that we serve get into very strong roles,” said Cameron Moser, the organizati­on's director of services and program developmen­t.

Many of their clients, he added, have found jobs in COVID-19 research and in pharmaceut­ical supply chains, aiding the vaccine rollout.

Abby Akintade, who found her current role as a clinical coordinato­r at Inner City Health Associates through ACCESS Employment, described her job as a “great opportunit­y” to get to know the public health issues in Canada. “(But) I feel underutili­zed,” she said.

She said that her experience dealing with communicab­le diseases in Nigeria should have made her a “go-to resource” when the pandemic struck in Canada. “I definitely believe I have a lot to contribute to the table when it comes to coming up with disease prevention programs, health promotion, health education,” she said.

Since the beginning of the pandemic, politician­s, advocates and medical profession­als have called on the province to allow more foreign-trained medical profession­als to help with the COVID-19 crisis.

On March 27, 2020, the Ontario Council of Agencies Serving Immigrants (OCASI), Toronto Region Immigrant Employment Council, and World Education Services issued a public plea to the province to mobilize its more than 20,000 IEHPs in its front-line response. The letter cited numbers from the Healthforc­e Ontario, stating that there are 13,000 foreign-educated doctors, 6,000 foreign-educated nurses who aren't working in their fields.

“And there are hundreds, if not thousands more, who have not currently registered with Healthforc­e Ontario but are anxious to do their part,” the letter adds.

Similar statements have been issued by Brampton Coun. Charmaine Williams and Ontario Liberal Leader Steven Del Duca to the government in March and April. However their pleas, according to Del Duca, have resulted in little from the province.

“It was a lot of fluff, as opposed to any tangible plan,” Del Duca said. Including internatio­nally trained profession­als in the response, he said, could have alleviated some of the pandemic burden felt by other health-care workers, nursing homes and other affected regions across the province.

“It's deeply disappoint­ing that Doug Ford did not take this possibilit­y more seriously,” he said. “If we're really going to create an economic recovery … I think we can no longer permit to have this talent sitting on the sidelines, being undervalue­d and not being brought into the general workforce.”

 ?? NATHAN DENETTE / THE CANADIAN PRESS FILES ?? Only 14 special 30-day medical licences have been issued since April, 12 of which have gone to foreign-trained
medical practition­ers, the CPSO said.
NATHAN DENETTE / THE CANADIAN PRESS FILES Only 14 special 30-day medical licences have been issued since April, 12 of which have gone to foreign-trained medical practition­ers, the CPSO said.
 ?? CARLOS OSORIO / REUTERS FILES ?? Health-care workers prepare to test passengers at Toronto's Pearson airport last week.
CARLOS OSORIO / REUTERS FILES Health-care workers prepare to test passengers at Toronto's Pearson airport last week.

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