International medical graduates: The hurdles to practising in Canada. College replies

British Columbia has a long history of relying on international medical graduates (IMGs) to deliver competent medical care to patients. In fact, 20% of all physicians practising in the province are IMGs. As Dr Rostamkalaee points out, many organizations play a role in ensuring pathways for IMGs to help them establish themselves and set up practice in BC. The College’s role in the recruitment process is to ensure IMGs meet educational competency and general requirements before they are granted registration and licensure. While the College will continue to work toward positive solutions for recruiting IMGs, it is not willing to compromise on the standards for registration and licensure. The College Bylaws ensure that IMGs, like Canadian-trained physicians, meet the required high standards expected of all physicians. The College looks to the College of Family Physicians of Canada (CFPC) and the Royal College of Physicians and Surgeons of Canada (RCPSC) to determine substantial equivalency in training requirements.

Family physicians who have completed their CFPC-recognized postgraduate medical training in family medicine from the United States, United Kingdom, Ireland, and Australia can be eligible for registration and licensure in the provisional class (a registration status under the Health Professions Act) under sponsorship and supervision. Similarly, there are 29 jurisdictions where specialist training is recognized by the RCPSC. To advance to the full unrestricted class of registration, an IMG must satisfy a number of requirements, including completing Canadian qualifying exams—just like Canadian medical graduates.

Family physicians and specialists who have completed their postgraduate training in a jurisdiction not recognized as being equal to Canadian training programs by one of the two national colleges may be eligible to participate in a practice-ready assessment (PRA) program, which involves a competency assessment. British Columbia launched its PRA-BC program for eligible family physicians last year, which requires candidates to complete a rigorous and comprehensive 12-week clinical field assessment following their successful completion of a number of examinations conducted as part of the orientation process.

The UBC family medicine program is one of four postgraduate residency training programs that accepts IMGs in the first iteration of CaRMS. The UBC Faculty of Medicine offers services and evaluations to allow physicians who have trained outside Canada to compete for and obtain medical residency positions that will lead to registration and licensure with the College. These positions and resources are generously funded by the government of BC.

The College is proud of its robust standards and requirements for IMGs to help ensure they can safely enter the practice of medicine. This high level of scrutiny is yet another example of what British Columbians have come to expect from the regulator of the medical profession so that they can receive the best possible care.
—Heidi M. Oetter, MD
Registrar and CEO, College of Physicians and Surgeons of British Columbia