‘I feel the world has collapsed’
Ethiopian refugee’s ambition to become a neurosurgeon faces bureaucratic hurdle
Ever since he was a kid and saw the film “Gifted Hands,” about how a Black American man overcame all odds to become a neurosurgeon, Yonas Fetle was inspired to follow the same path.
The medical graduate was determined to pursue that dream even after he fled persecution in Ethiopia and arrived in Canada as a refugee two years ago.
In March, after working hard to meet all the registration requirements, Fetle could finally see the light at the end of the tunnel when he was offered a residency position in the U.S. to restart his stalled career.
“I cried out of joy and happiness,” said Fetle, a member of the Tigrayan minority who was granted asylum in Canada last May and is now awaiting his permanent residence. The process can take up to a couple years.
“I studied neurosurgery, trying to become a neurosurgeon in my home country. I lost everything to come here, struggling to find work. And now I’ve got a chance to become a doctor and go back to the profession that I really loved.”
But now the Toronto man is seeing that dream slipping away. He has been given a May 7 deadline to update the university hospital of his visa application or the opportunity will go to someone else.
Last month, Health Canada informed Fetle it would not issue him what’s called the Statement of Need letter, required for his American visa application for the training position. That’s despite an earlier agreement that the Health Ministry would accept the Immigration Department’s verification as a proof of Canadian permanent residence.
“Our hands are tied, we cannot process a Statement of Need without confirmation that your (sic) either a Canadian Citizen or a Permanent Resident, without confirmation that your PR has been approved,” Health Canada said in an email.
(The Statement of Need letter is required by the U.S. government of foreign medical graduates to confirm there is a need for the medical skills where they live and that the person intends to return after training in the U.S.)
Fetle was devastated, especially since a former colleague from Ethiopia in similar circumstances had gone through the same process in 2021 and successfully obtained the Health Canada document, and is now training in the U.S.
“I feel the world has collapsed,” he said, sobbing.
Born and raised in Addis Ababa, the 31-year-old said he studied hard to get into Ethiopia’s best medical school. After graduation, he did three years of mandatory community service before starting a fiveyear residency program there.
But he was unable to finish due to the escalating violence against the Tigrayan minority and joined his younger brother in Toronto in May 2022.
Soon after his arrival, he was advised that it’s really hard for international medical graduates to get a residency position in Canada and he’s better off focusing on competing for a match in the U.S., a route that some Canadian graduates also pursue.
“Everyone was telling me how difficult it was to get into residency here even passing all the exams and many foreign doctors are driving cabs or Uber to survive,” recalled Fetle, who passed two American qualifying exams and a language test by last August to enter the pool to be matched with a university or hospital.
For each medical exam, he said he needed six months to prepare and refresh because the curriculum in North America, for instance, focuses more on issues such as metabolic and genetic diseases rather than malaria, cholera and infectious diseases common in Africa.
Since he had to concentrate on his studies, he was supported by the meagre income of his younger brother, who has worked as a supermarket stocker, server at catering and driver for a food delivery service. A good friend in the U.S. also helped pay residency application fees to each institution.
Like others who knock on as many doors as possible, Fetle applied to 219 universities and hospitals, paying in total about $6,000 (U.S.) in fees. On March 10, he learned he was matched with Marshall University in West Virginia in their internal medicine residency program.
Fetle and his younger brother hugged and couldn’t help crying, thinking their lives could turn around. He immediately contacted Health Canada to initiate his J1 visa application.
“Concerning about your question about proof of residency documents, following consultation with Immigration, Refugees and Citizenship Canada, Health Canada determined that it would accept either a Verification of Status (VoS) document or valid permanent resident card as proof of permanent residency for SON,” Health Canada said in an email March 19, referring to the Statement of Need.
With help from the office of Deputy Prime Minister Chrystia Freeland, his local MP, Fetle got his immigration verification application expedited and received the document on April 10. That same day, he forwarded it to Health Canada so it could work on the letter for his visa application.
But Health Canada told him the immigration paper only indicated he’s a protected person in Canada and didn’t state he’s a permanent resident — so he’d need a permanent resident card to process the Statement of Need letter.
“I feel like all my hopes are shattered,” said Fetle. “I’m back to a dead end and there’s no way out for me to reclaim my profession.”
Still, he didn’t give up. He tried to appeal for reconsideration. He and his brother drove to Ottawa two weeks ago and showed up unannounced to try to speak to the Health Canada manager responsible for the letter. Fetle said the manager, over the phone at the security desk, told him she understood his “precarious” situation and would look into it.
He started an online petition pleading with the Health Ministry to urgently review his case. Fetle has also been calling and emailing Health Canada and the manager for updates. On April 26, he got a response.
“We ask that you please stop emailing and calling Health Canada staff and direct your questions to this email address only,” said the email from Health Canada’s J1 Visa Statement of Need Program. “We are in the process of examining your application and we will communicate with you as soon as we can.”
But time is running out for Fetle, who has until Tuesday to report to Marshall University on whether his Statement of Need letter will come through. The school will need to find out as soon as possible if he will be able to start his job on June 17, given it takes time to process the visa. And if he can’t get into this year’s residency program, it will be hard to qualify again because his current Ethiopian medical license will expire next year and he can’t go back to renew it.
“Canada has provided me with peace, safety and the promise of a brighter future,” said Fetle. “Please give me this opportunity to further my training and apply my knowledge and expertise to give back to the community that has so generously provided me with refuge and safety.”
Health Canada said in an email that recognized proof for permanent residence includes a permanent residence card, a confirmation of permanent residence document or a Verification of Status document indicating permanent residency status. Since October, Canadian officials have processed 1,062 applications for a Statement of Need.
Health Canada did not explain the discrepancy in what Fetle had been told, but said there hasn’t been a change in eligibility requirements or documentation required as proof for permanent residence since 2021.