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International Medical Graduates: Welcome to Canada?. M. Watanabe ACMC, Calgary AB April 30, 2002. Canadian Physician Workforce: Two Main Policy Levers. Undergraduate Medical Enrolment Immigration Policies of International Medical Graduates (IMGs) Post-MD Trainees – tied to UGME - PowerPoint PPT Presentation
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International Medical Graduates: Welcome to Canada?
M. WatanabeACMC, Calgary AB
April 30, 2002
Canadian Physician Workforce: Two Main Policy Levers
• Undergraduate Medical Enrolment
• Immigration Policies of International Medical Graduates (IMGs)
• Post-MD Trainees – tied to UGME• Practice Communities - distribution
40 45 50 55 60 65 70 75 80 85 90 95 00
Year of MD Degree
0
500
1000
1500
2000
Nu
mb
er
of
Gra
du
ate
s
Total Men Women
MD Graduates of Canadian Medical SschoolsData from Association of Canadian Medical Colleges
8081
8283
8485
8687
8889
9091
9293
9495
9697
9899
00
YEAR COMMENCING
0
500
1000
1500
2000
NU
MB
ER
Canadian/Landed Immigrants Foreign Visa Students
FIRST TIME FIRST YEAR ENROLMENTIn Canadian Medical Schools
Data from Association of Canadian Medical Colleges
8182
8384
8586
8788
8990
9192
9394
9596
9798
9900
Year Commencing
0
100
200
300
400
500
Num
be
of
Stu
den
ts
Other Student Visa Landed Immigrant
Non-Canadian Students, All Years Enrolled in Canadian Faculties of Medicine
Data from Canadian Medical Education Statistics, ACMC
8687
8889
9091
9293
9495
9697
9899
00
Year of MD
0
500
1000
1500
2000
# M
D G
radu
ate
s
Above Quota
Student Visa
LI
CC
MD Degrees AwardedBy Legal Status at time of Entry
Data from Canadian Medical Education Statistics, ACMC
8687
8889
9091
9293
9495
9697
9899
00
Year of MD
0
1
2
3
4
5
6
7
8
% o
f to
tal G
rad
ua
tes
Above QuotaStudent VisaLI
MD Degrees AwardedBy Legal Status at time of Entry
Data from Canadian Medical Education Statistics, ACMC
Canadian Policy Framework
• Immigration Policies– Initially preferential immigration status for
IMG physicians– Preferential status later removed
• 1975 National Committee on Physician Manpower – future needs can be met by domestic supply
69 71 73 75 77 79 81 83 85 87 89 91 93 95 97 99
Year Ending December
0.5
1
1.5
2
2.5
3
Ind
ex
ed
to
19
69
Canadian MD Graduates International MD Graduates
Active Physicians in CanadaData from Southam Medical Database, CIHI
6970
7172
7374
7576
7778
7980
8182
8384
8586
8788
8990
9192
9394
9596
9798
9900
Year ending December
22
23
24
25
26
27
28
29
30
31
32
% I
MG
sActive Physicians in Canada
By Place of GraduationData from SMDB, CIHI
70 75 80 85 90 95 00
-100
0
100
200
300
400
500
600
Nu
mb
er
of
Ph
ysic
ian
s
Unknown Non-Canadian Canadian
International Migration of Canadian PhysiciansNet Loss by Medical School of Graduation 1970-99
Data from CIHI
90 91 92 93 94 95 96 97 98 99 00
Year ending December
0
10
20
30
40
50
IMG
as
% o
f C
oh
ort
s
In Practice Moving Abroad Returning Net Loss
International Migration of Physicianswho are Graduates of International Medical Schools
Data from CIHI
IM DE
NE
PE
PM PS
PH
EM
OM AN
NM DR
RT
MG B
IM
IP
A TO
GS
CV
NS
OG
OP
OT
OR
PS
UR
0
10
20
30
40
50
% I
MG
s
Specialties
Physicians in Active Practice in Canada 2000who are Graduates of International Medical Schools
Data from Southam Medical Database, CIHI
95/96 96/97 97/98 98/99
12
14
16
18
20
22
24
Pe
rce
nt
of
Ph
ysic
ian
s
Canada US Outside NA
Source: NPDB, CIHI
Primary Care Physicians in Rural CanadaBy Place of Graduation
Canadian Workforce Policy: Roadmap and Milestones
• 1992 Conference of Provincial/ Territorial Ministers of Health and NCCPMT– Reduce UGME by 10%, starting 1993– Maintain 50:50 specialist:FP/GP ratio– Maintain or reduce physician:population ratio– Reduce PGME by 10%; reduce visa trainees– Reduce Canada’s reliance on IMGs
• Implement two pathways to licensure– MCC, ACMC, FMLAC
71 73 75 77 79 81 83 85 87 89 91 93 95 97 99
Year
60
70
80
90
100
110
Ph
ysic
ian
s/1
00
,00
0 p
op
ula
tion
Primary Care Specialists
Physicians in CanadaPhysicians per 100,000 population, 1971 - 2000
Data from Health Personnel in Canda and CIHI, SMDB
69 71 73 75 77 79 81 83 85 87 89 91 93 95 97 99
Year
49
50
51
52
53
54
Pe
rce
nt
in P
rima
ry C
are
Physicians in CanadaPercent Primary Care 1969 to 2000
Data from Health Personnel in Canda and CIHI, SMDB
8081
8283
8485
8687
8889
9091
9293
9495
9697
9899
0001
Years, November
0
2
4
6
8
10
Thou
sand
s
Nu
mb
er o
f p
hys
icia
ns
Non-Ministry Ministry
Funding of Postgraduate Trainees in CanadaResidents and Fellows, all years
Data from ACMC, CAPER
8081
8283
8485
8687
8889
9091
9293
9495
9697
9899
0001
Years, November
0123456789
10
Thou
sand
s
Nu
mb
er
of
ph
ys
icia
ns
Fellows Other years Year 1
Post-MD Trainees in CanadaResidents by Level of Training and Fellows
Data from ACMC, CAPER
90 91 92 93 94 95 96 97 98 99 00 01
Years, November
0
200
400
600
800
1000
1200
1400
Nu
mb
er
Non-Canadian MD Canadian MD
Post-MD Fellowship Trainees in CanadaBy Place of MD Degree
Data from CAPER
8081
8283
8485
8687
8889
9091
9293
9495
9697
9899
00
Year Commencing
0
1
2
3
4
5
6
7
8
9
Thou
sand
s
Num
ber
Visa LI, IMG CC, IMG CC, MD Canada
Post-MD Trainees by School of Graduation and Legal StatusData from Canadian Medical Education Statistics, ACMC
8081
8283
8485
8687
8889
9091
9293
9495
9697
9899
00
Year Commencing
0
500
1000
1500
2000
Nu
mb
er
Visa LI, IMG CC, IMG
Post-MD Trainees by Legal StatusGraduates of non-Canadian Medical Schools
Data from Canadian Medical Education Statistics, ACMC
1697 1725 1718 17001770
1998 1999 2000 2001 20020
500
1000
1500
2000
Num
ber
of P
hysi
cian
s
IMG, Visa
CMG, Visa
IMG, CC/PR
CMG,CC/PR
First Time, First Year Post-MD Trainees in Canada1997-98 to 2001-02
Data from CAPER
CC-CMG CC-IMG LI-IMG Visa
Legal Status
0
20
40
60
80
100
120
% o
f C
oh
ort FM
Lab
Surg
Med
Post-MD Trainees from 1996-2000In All Years by Legal Status and Field of Training
Data from Canadian Medical Education Statistics, ACMC
93-9494-95
95-9696-97
97-9898-99
99-0000-01
Year
0
500
1000
1500
2000
2500
Num
ber Visa
IMGs (CC+PR)
Can Reentry
Can MD First
Practice Entry Cohorts Exiting All ProgramsBetween November to November of Each Year
Data from CAPER
93-9494-95
95-9696-97
97-9898-99
99-0000-01
Year
0
100
200
300
400
500
600
700
800
900
Num
ber Visa
IMGs (CC+PR)
Can Reentry
Can MD First
Practice Entry Cohorts Exiting Family Medicine ProgramsBetween November to November of Each Year
Data from CAPER
93-9494-95
95-9696-97
97-9898-99
99-0000-01
Year
0
10
20
30
40
50
60
70
80
90
Num
ber Visa
IMGs (CC+PR)
Can Reentry
Can MD First
Practice Entry Cohorts Exiting Laboratory Medicine ProgramsBetween November to November of Each Year
Data from CAPER
IM
GIM
Res
p
Car
d GI
Rh
eu
Ped
G P
ed
Car
d
Neo
Cri
t
Su
rg
G S
urg
Ped
Th
or
Car
d
Specialty/Subspecialty
0
20
40
60
80
100
120
% o
f tot
al VisaLICC
Post-MD Trainees in 2000-2001In all Years by Legal Status
Data from Canadian Education Statistics, ACMC
Questions about IMGs
• Whom do they serve? – Canada’s professional care needs – their own professional needs
• Are the post-MD training programs serving their needs– Rural practice, specialties – choice of specialty needs in their own country
Thank you!
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