By Vivian Song
It's become a cross-country catchphrase used to illustrate how Canada squanders valuable minds and skills during a growing doctor shortage. While an estimated five million Canadians are without a family physician, foreign-trained doctors are driving cabs - or so the saying goes. Another adage: "Instead of delivering babies, foreign-trained doctors are delivering pizzas." But speak to some key players who help test, certify and license international medical graduates, or IMGs as they're called in the medical industry, and they offer another side of the story that's seldom talked about. "That's a sweeping generalization of the ignorant that they're all driving cabs," said Robert Lee, director of the Medical Council of Canada's evaluation bureau operations. "Some of them are driving cabs because they don't pass the level of standard in Canada ... Just because we need more doctors doesn't mean we should lower our standards."
The Medical Council administers standardized qualifying exams that all Canadian medical students across the country must sit. Foreign-trained doctors must write an additional basic Evaluating Exam before being able to join their Canadian counterparts in writing two final qualifying exams. And the failure rate of foreign-trained doctors is significant, Lee said. "People always talk about the underutilization of IMGs," he said. "Nobody ever talks about them being underqualified ... the problem is not that we're not getting them into the system; the problem is they're flopping out." On average, about 3,000 international medical graduates write the Evaluating Exam every year. Between 2001 and 2006, the failure rate of first-time takers was about 35% and many within that cohort are repeat writers, Lee said. Next, the remaining 65% of successful candidates go on to write Qualifying Exam Part I along with their Canadian competition - an exam set at the level of a graduating MD, ready to enter their residency or supervised internship.
Between 2001 and 2005, 34% of first-time IMG takers failed that exam. Annually, the council tests about 4,000 to 4,500 candidates including Canadian students. A breakdown detailing the number of IMGs in the group is unavailable. Once candidates have completed a minimum one-year residency training, they are able to sit the final MCC exam, Qualifying Part II. The failure rate for first-time IMGs between 2000 and 2005 was another 40%. What does that leave? "Not a lot," Lee said. "The number's not huge." When pressed, Lee refuses to divulge the final number of foreign-trained doctors who actually make it through the funnelling system which weeds out those who can't hack it. "I don't publish that mother of all stats," he said. By contrast, Canadian students pass the exams at about 97%, Lee said. But in a candid conversation with Sun Media, Lee minced no words when discussing the mantra adopted nationwide of doctors driving cabs. "There's a misbelief that any doctor from anywhere in the world should be able to come here and two days later be able to practise in Canada and that's not the case," he said. "And thank God it's not, because the quality of health care would be all over the map." The Medical Council of Canada is one of several different ways international doctors can get licensure and the most standardized. According to the Associaton of International Physicians and Surgeons of Ontario, the province is home to between 2,000 and 4,000 foreign-trained physicians. British Columbia is said to have had at least 400 unlicensed IMGs in 2001, while Alberta was home to 160. "There are so many numbers tossed around. No one knows what the real number is," said Rita Forte, project director of an IMG database at CAPER, the Canadian Post-M.D. Education Registry.
It's become a cross-country catchphrase used to illustrate how Canada squanders valuable minds and skills during a growing doctor shortage. While an estimated five million Canadians are without a family physician, foreign-trained doctors are driving cabs - or so the saying goes. Another adage: "Instead of delivering babies, foreign-trained doctors are delivering pizzas." But speak to some key players who help test, certify and license international medical graduates, or IMGs as they're called in the medical industry, and they offer another side of the story that's seldom talked about. "That's a sweeping generalization of the ignorant that they're all driving cabs," said Robert Lee, director of the Medical Council of Canada's evaluation bureau operations. "Some of them are driving cabs because they don't pass the level of standard in Canada ... Just because we need more doctors doesn't mean we should lower our standards."
The Medical Council administers standardized qualifying exams that all Canadian medical students across the country must sit. Foreign-trained doctors must write an additional basic Evaluating Exam before being able to join their Canadian counterparts in writing two final qualifying exams. And the failure rate of foreign-trained doctors is significant, Lee said. "People always talk about the underutilization of IMGs," he said. "Nobody ever talks about them being underqualified ... the problem is not that we're not getting them into the system; the problem is they're flopping out." On average, about 3,000 international medical graduates write the Evaluating Exam every year. Between 2001 and 2006, the failure rate of first-time takers was about 35% and many within that cohort are repeat writers, Lee said. Next, the remaining 65% of successful candidates go on to write Qualifying Exam Part I along with their Canadian competition - an exam set at the level of a graduating MD, ready to enter their residency or supervised internship.
Between 2001 and 2005, 34% of first-time IMG takers failed that exam. Annually, the council tests about 4,000 to 4,500 candidates including Canadian students. A breakdown detailing the number of IMGs in the group is unavailable. Once candidates have completed a minimum one-year residency training, they are able to sit the final MCC exam, Qualifying Part II. The failure rate for first-time IMGs between 2000 and 2005 was another 40%. What does that leave? "Not a lot," Lee said. "The number's not huge." When pressed, Lee refuses to divulge the final number of foreign-trained doctors who actually make it through the funnelling system which weeds out those who can't hack it. "I don't publish that mother of all stats," he said. By contrast, Canadian students pass the exams at about 97%, Lee said. But in a candid conversation with Sun Media, Lee minced no words when discussing the mantra adopted nationwide of doctors driving cabs. "There's a misbelief that any doctor from anywhere in the world should be able to come here and two days later be able to practise in Canada and that's not the case," he said. "And thank God it's not, because the quality of health care would be all over the map." The Medical Council of Canada is one of several different ways international doctors can get licensure and the most standardized. According to the Associaton of International Physicians and Surgeons of Ontario, the province is home to between 2,000 and 4,000 foreign-trained physicians. British Columbia is said to have had at least 400 unlicensed IMGs in 2001, while Alberta was home to 160. "There are so many numbers tossed around. No one knows what the real number is," said Rita Forte, project director of an IMG database at CAPER, the Canadian Post-M.D. Education Registry.
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