international medical graduates: welcome to canada?
DESCRIPTION
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 PresentationTRANSCRIPT
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International Medical Graduates: Welcome to Canada?
M. WatanabeACMC, Calgary AB
April 30, 2002
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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Thank you!