This story is part of Situation Critical, a series from CBC British Columbia reporting on the barriers people in this province face in accessing timely and appropriate health care.
As emergency rooms across some rural parts of the province had to close this weekend amid staff shortages, some internationally trained doctors say the barriers to practice in Canada have forced them to seek a different career.
Honieh Barzegari, who earned her degree as a family physician in Iran before immigrating to Canada, says she’s been advocating for international medical graduates (IMGs) and a change in the province’s health-care system to make it easier for foreign-trained doctors to practice in B.C
“The system is set up to fail international medical graduates rather than empowering them to be able to practice here,” Barzegari told CBC’s The Early Edition.
On Sunday, Interior Health announced that the South Okanagan General Hospital in Oliver, BC, would be closed from noon until 6 pm On Friday, emergency departments at Dr. Helmcken Memorial Hospital in Clearwater and the Ashcroft Hospital and Community Health Care Center closed for the weekend.
Barzegari said she moved to Canada knowing there should be opportunities to practice due to the ongoing shortage of doctors in BC but was unaware of all the fees and the time it would take.
“The financial barrier is a lot because exams are so expensive, and also I need to live and pay for bills,” she said. “The emotional barrier of trying and failing and not being able to get the license is all a big issue.”
Barzegari now works as a clinical solutions manager at a medical manufacturing company.
The Institute for Canadian Citizenship, which helps newcomers and people seeking citizenship, estimates there are thousands of foreign-trained doctors whose qualifications have allowed them to be fast-tracked for Canadian citizenship but provincial regulators refuse to recognize their credentials.
Stigma around international training
Valorie Crooks, a professor in the department of geography at Simon Fraser University, says Canadian students who decide to get their medical education in a different country are not aware of what is needed to come back and practice medicine in Canada.
“Many people who are starting to pursue these schools as an option don’t realize that they’ll actually be returning as an international medical graduate (IMG).
“They’ll have to gain entry into practicing in the medical profession in the same way as others who were trained internationally.”
She said in addition to all the qualifying tests and recognized medical degrees, there’s a stigma around students who decide to get a medical education elsewhere.
“One of the points that is being raised is the concern around the quality of education at these institutions, so it does create a layer of stigma that some returning Canadians will have to encounter in addition to other barriers.”
Crooks said many IMGs are “screened out” of the system simply because there isn’t enough capacity in the province’s health-care system to allow them to practice.
“The amount of Canadians who are going abroad for medical school and wanting to come back and practice is actually further constraining the space available for those who are not actually born and raised in Canada.”
Add more residency spots
Rajkumar Vijendra Das, a family physician in Vancouver, BC, said he immigrated to Canada in 2010 from India after working as a doctor in his home country for more than five years.
He said it took him about eight years to pass the qualifying exams and complete his residency before he was able to practice medicine — something that could have taken less time had he been accepted into a residency spot sooner.
“So I passed all the necessary exams, and I applied for residency. I applied all across Canada, and I was willing to go anywhere. I had the experience too, but I didn’t match.”
He said he worked at a call center to save up money to pay for the expensive exams IMGs are required to pass, which are only offered a few times a year.
“The exams can be like $2,000 or more, and you have to take several of them. I had to save up for that.”
Das says he eventually returned to India to gain more clinical experience before coming back to BC and reapplying for residency.
“My employer gave me some time off, and I was able to go back to India, but not everyone can do that because they have families to support,” he said.
That said more residency spots need to be designated for IMGs in BC
“UBC has 52 residency spots for IMGs,” he said. “So it becomes a lottery facility, and it becomes so competitive, but if you had double that number, then it would make sense.”
The Canadian Resident Matching Service’s 2021 report shows that 325 international medical graduates were matched for a residency out of 3,365 matches.
Das said he is one of the lucky ones who was able to continue a career in medicine in Canada when so many others were forced to do something else.
In March, the College of Physicians and Surgeons of BC said a program designed to bring more foreign-trained doctors into the BC medical profession had been delayed due to the impact of the pandemic on surgeries.
The college said the new role of associate physician could help address the province’s health-care needs by allowing doctors who aren’t eligible for a full license to work under a physician’s supervision.
College Registrar Dr. Heidi Oetter said once the program is up and fully operational, it should help bring more physicians into the health-care system in British Columbia.