Canada is grappling with a severe shortage of family doctors — but Canadian-born family physicians working abroad are fighting to get the paperwork they need to practice here.

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This situation is so much more complex than the media makes it clear, and as a doc it’s frustrating to read about. There very much is a problem getting internationally trained doctors into practice in Canada, and there’s a ton of corruption in the system. Our system is much too restrictive on who we allow in, and our immigration policies give incoming physicians a lot of straight up misinformation and false hope about how they’ll get to practice when they get here. The examination systems are an absolute racket, as described in the article. The colleges are abominably useless, both slow and uninformative to those who need help.

On the other hand, I train international graduates that have jumped through those hoops, and it’s not nearly as simple as I’ve ever seen it represented in the news. This is a case where, probably, this person could just dive into practice - but it’s rarely so clear cut as this. A lot of IMGs, even from pretty credible-appearing backgrounds, have knowledge gaps that can’t easily be tested out. Every one I’ve worked with hasn’t needed much guidance to get past it, but it takes time and effort to find those differences. How do we approach this? Do we declare certain countries or universities “good enough” to not need further vetting, but discriminate against others (and believe me when I say this would almost certainly wind up quite racist)? Do we drum up the massive human resources necessary for one on one shadowing to assess each incoming grad? As someone involved in the training process, I don’t have a great answer.

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