International health professionals face slow accreditation in Canada

Canada's healthcare system increasingly relies on internationally trained professionals but many immigrants complain that becoming licensed to practice here takes months, if not years, even as different levels of government recognize the need to accelerate the accreditation process. 

Some new arrivals say they're falling through the cracks.

One of them is Palwasha Anwari, a doctor who — despite her 15 years experience in public health in Afghanistan — found it easier to get a job in Egypt than remain in Canada.

Anwari arrived in Thunder Bay, Ont., in February, 2022, months after the Taliban seized Kabul and returned to power. Seeking opportunities that matched her experience, the 44-year-old later moved to Ottawa.

But a fruitless job search has left her "tired, frustrated [and] disappointed," she said. 

Expertise overlooked?

Anwari worked as a pediatrician in Afghanistan and specialized in public health, gaining advanced degrees in the United States and United Kingdom. She's worked with the World Health Organization, UNICEF and Global Affairs Canada.

Having her degrees recognized in Canada was no issue, she said, but the complex process of obtaining a medical licence — including exams and a residency — was discouraging.  

In December, Anwari defended her doctoral thesis in the hope that she could bring her experience in humanitarian crisis zones to Canadian academia.

But her attempts to leverage her experience — sending out resumes, giving university guest lectures and tapping her contacts in Canada's foreign service — yielded nothing. This despite attending job search training and career fairs facilitated by Immigration, Refugees and Citizenship Canada. 

"At some point, I felt that I have no skills, no experience, no knowledge to contribute to Canada," she said.

Her job search wasn't completely fruitless however. This week, Anwari is leaving Ottawa for Cairo to take a job as a health economist with the World Health Organization's Eastern Mediterranean Regional Office.

She said the job aligns with her passion. But she's concerned that others — including her sisters — are still struggling to have their credentials and their experience recognized. 

"It's a waste of resources while they are here ... they end up in Amazon as a packing person or an Uber driver," Anwari said.

"Canada's healthcare system needs to be open to … internationally [trained] medical professionals."

Sebastian Martin, senior director of employment services at YMCA Ottawa, has seen similar situations play out among other professionals who are new to Canada.

"We see clients who are well-educated, who have lots of experience they could offer, but sadly, with our systems, it's a little more complicated," Martin said in a French interview.

From Cameroon to Gatineau

Across the Ottawa River, Laurelle Temtching Maffo strikes a more optimistic note than Anwari, though she's not yet practicing as a nurse. 

While still in Cameroon, Temtching Maffo applied to certify her credentials before moving to Gatineau, Que., in April 2024.

"I already knew that once I got here I wouldn't be able to practice as a nurse so I started the process there," she told Radio-Canada in a French-language interview. 

The 40-year-old applied for admission by equivalence to Quebec's college of nurses.

The evaluation of foreign credentials takes about four months according to Quebec's Ministry of Immigration, Francisation and Integration (MIFI), almost double the wait in 2023.

A rising number of applications over the past three years has increased wait times, MIFI told Radio-Canada.

The Quebec college of nurses process for foreign-trained candidates takes up to three months before the start of a professional integration program and a professional exam.

Into the hospital

Temtching Maffo received help from a local resettlement services agency that identified a path to get her working.

The Service Intégration Travail Outaouais (SITO) enrolled her in a professional immersion program with the regional  health authority and she's now working as an orderly at the Hull Hospital. 

The regional health authority (Centre integré de santé et services sociaux de l'Outaouais) says this partnership with SITO — which requires the recognition of foreign credentials — lets applicants gain Canadian work experience while being evaluated for permanent positions. 

The program has integrated 296 foreign-trained workers into the Outaouais health system since its launch in September 2022. 

While Temtching Maffo says she is grateful, she's impatient to qualify to work as a nurse.

"While today I'm working in healthcare, I'm still not in the role that I chose," she said. 

Accelerating accreditation

The federal government committed $50 million over two years in the 2024 budget to simplifying recognition of foreign credentials in the medical and residential construction fields. 

The federal immigration department said the credentialing process also involves provinces and territories, which have their own professional bodies. 

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Ontario's professional colleges of physicians and surgeons have both called for a faster path to licensing foreign-trained doctors. The province launched the Practice Ready Ontario program in 2023 with the goal of licensing 50 internationally trained doctors by the end end of 2024.

Though the program fell short, licensing 28 doctors, it has set a new target of licensing 100 primary care doctors. 

The College of Nurses of Ontario says the province will update the criteria for the education and work requirements of nurses by April.

The college says a new "transition to practice" program will help nurses with validated international education get up to speed with their responsibilities and patient safety requirements so they can practise in Ontario.