Canadian Doctors Struggle for Residency as Foreign Nationals Get Preference

Canadian Doctors Struggle for Residency as Foreign Nationals Get Preference
A multidisciplinary team of doctors, residents and nurses meet at the Halifax Infirmary in Halifax on Friday, Feb. 25, 2022. THE CANADIAN PRESS/Andrew Vaughan

Amidst the acute doctor shortage facing Canada, foreign nationals from countries like Oman, Kuwait, and Saudi Arabia are increasingly filling medical residency spots. Simultaneously, many Canadian-trained doctors are facing barriers to returning and practicing in their homeland.

According to a recent review by CBC News, approximately 1,000 Canadian doctors who received their education abroad are turned away annually due to the scarcity of residency spots.

Canadian Doctors Struggle for Residency as Foreign Nationals Get Preference
Saudi doctors work at a hospital in Riyadh. There were 727 foreign trainees in medical residencies in Canada last year, according to healthcare data. (Sultan Al Fahed/Reuters)

A Blessing from Ottawa

In a surprising turn, medical schools that operate these residency programs have been exempted by the federal government from immigration laws that typically prioritize Canadians for job opportunities. This exemption allows them to continue admitting foreign nationals over Canadian doctors seeking residency back home.

Critics argue that this approach to residency allocation exacerbates the physician deficit in the country. According to the Canadian Resident Matching Service (CaRMS), out of 1,810 Canadian international medical graduates (IMGs) who applied for residency during the current academic year, only 370 were successful in securing placements.

This disparity has led to an increasing number of Canadian doctors moving to the U.S., where residency positions are more widely available.

Canadian Doctors Abroad: A Glimpse into Their Struggles

Dr. Joshua Ramjist, originally from Pickering, Ontario, and a graduate of St. George’s University in Grenada, shared his experiences with CBC News, stating that there’s a “tremendous pool of international medical graduates who are talented, who are dedicated, who want to take care of their fellow Canadians.” Dr. Ramjist, having secured a residency himself, currently serves as a pediatric surgeon at the Hospital for Sick Children in Toronto. He emphasizes the importance of reducing barriers to accommodate internationally trained talent.

ICU Dr. Steven Reynold in the intensive care unit at Royal Columbian Hospital in March. Foreign-trained doctors say they could be doing more to help relieve the stress on an overburdened system but there are too many barriers to getting licensed in B.C. (Ben Nelms/CBC)

The Looming Physician Shortage

Federal data has painted a grim picture, predicting a deficit of about 44,000 doctors, which includes over 30,000 family doctors and general practitioners, by 2028.

In stark contrast to these numbers, while Canadian-born or naturalized doctors trained overseas face challenges, foreign trainees are regularly admitted to Canadian residencies. Most notably, Saudi Arabians form the largest national group among these residents. According to data from the Canadian Post-MD Education Registry (CAPER), there has been a staggering 70% increase in foreign trainees over just three years, rising from 87 in 2019 to 148 in 2022.

The Financial Angle

Rosemary Pawliuk, president of the Society for Canadians Studying Medicine Abroad (SOCASMA), suggests that financial incentives play a significant role in the current situation. Foreign nationals, primarily funded by entities such as the Saudi government and state-owned Saudi Aramco, pay significantly more for their medical residencies than Canadian provincial governments allocate for Canadian residents.

Pawliuk points out the monetary advantage these foreign trainees provide to medical schools, emphasizing that not only do these foreign entities pay more for residencies, they also cover salaries for teaching staff.

Canadian Doctors Struggle for Residency as Foreign Nationals Get Preference
Rosemary Pawliuk, the president of the Society for Canadians Studying Medicine Abroad, says it’s unfair that Canada’s limited residency spots are going to foreign nationals who won’t practise here long term. (Martin Diotte/CBC News)

A Need for Systemic Review

Ivy Lynn Bourgeault, a healthcare human resources expert and professor at the University of Ottawa, has expressed concerns regarding the visa trainee system. According to her findings, while a substantial part of the funding for these foreign residents comes from abroad, Canadian taxpayers contribute the rest.

She stresses the need for a systemic review, suggesting that while the existing trainee program requires scrutiny, abrupt changes might lead to further instability.

IRCC’s Stand

When approached for comment, a spokesperson for Immigration, Refugees and Citizenship Canada (IRCC) defended the current system. The federal department highlighted the specialized experience these foreign residents bring to Canadian hospitals and clinics, benefiting the country’s health care system.

However, as Pawliuk counters, many Canadians continue to suffer from limited access to healthcare, leading to severe consequences.