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International medical grads could help address region's doctor shortage

Under current rules, doctors educated in the U.K., Ireland, the U.S. and Australia face no barriers to practicing in Ontario while those from other countries have a challenging path
Moises Vasquez, front left, Daisy Rivadeneria, and Bryan Blue presented to regional council last week, asking the government to assist in an effort to put doctors from other countries already living in Niagara to work.

A shortage of physicians is an issue being felt across the country, including Niagara.  

During last week’s regional council meeting, a presentation was delivered by three individuals from the International Medical Graduates Support Group, who say they have a potential remedy in Niagara, a place where there are 81 fewer doctors than there should be, according to recent data from the Region.  

Two of the presenters, Moises Vasquez and Daisy Rivadeneria, are both physicians. They are from Colombia and each has about 10 years of experience in their home country. 

Today, they call Niagara home – but are faced with obstacles when it comes to putting their expertise to work.  

Vasquez said the main challenges are not being able to find a residency of practice and a lack of experience in the Canadian healthcare world. Even though he has shadowed other doctors here, it doesn’t count as experience, he told regional councillors last week.  

The purpose of their delegation was to request that the regional government, which oversees Niagara Region Public Health, investigate the possibility of helping them enter the local medical workforce somehow.  

“We strongly believe we can be part of the solution to overcome this challenge,” he said, adding the Region could play a role in an inventory of international doctors available locally and create a systemic review of how their knowledge could be integrated.  

Bryan Blue, a former Niagara Region economic development officer, has helped people like Vasquez and Rivadeneria form the group, and has advocated for their cause.  

“Can we help them help us?” he asked council and staff, hoping they don’t head to the U.S. or are recruited to another province.  

“I don’t want to see these members of our community, healthcare professionals, leave and go somewhere else when we could’ve found a way to retain them,” said Blue.  

During the meeting, Niagara-on-the-Lake Regional Coun. Andrea Kaiser said the struggles explained by the presenters reminded her of her father, also an educated immigrant who was unable to use his education to find employment when he arrived in Canada.  

Her father, Karl J. Kaiser, before he co-founded one of Niagara-on-the-Lake's best-known wineries in 1975, Inniskillin Wines, was a math teacher and professor in Austria, she explained to The Local in an interview after last week’s regional council meeting.  

“His education was not recognized, so he had to return to university,” said Kaiser, explaining that he worked hard to develop his English language skills while also pursuing a chemistry degree at Brock University.  

“I think that was acknowledged by the presenters,” she said.  

“That’s part of the journey – the language barrier,” she added.  

He also pumped gas to feed his family when he wasn’t in school, she explained, adding he “got a little sidetracked” when he decided to start making wine, which ended up being the “leap of faith” he went ahead with.  

He later received an honorary degree from Brock University.  

Asked whether she thinks the Region should move forward with some of the ideas given in last week’s presentation, Kaiser said she knows the Ontario College of Physicians has a “very rigorous process, as it should,” when it comes to allowing people to practice.  

But she did find their presentation intriguing.  

“It’s an interesting perspective for sure – but it’s complicated, too,” she said.  

“Exploring how members of a community can contribute to the betterment of our health is obviously never a bad thing,” said Kaiser.  

Jill Croteau, the Region’s physician recruitment retention coordinator, delivered a presentation to the public health and social services committee on Feb. 6, where it was explained that 69 per cent of Niagara’s population has a family doctor.  

The minutes of that meeting were up for approval on Thursday’s council agenda.  

Two challenges Croteau highlighted in her presentation are that a supply of physicians coming from Canadian programs is just over 400 every year, which is “significantly short.”  

Less Canadian medical students are choosing family medicine and fewer family medicine graduates are choosing family practice, she wrote in her presentation.  

Opportunities that could be taken advantage of, she said, are additional medical school and residency spots, changes to family physician licensing in Ontario, and a quicker immigration process.  

International physicians no longer need to write the Medical Council of Canada Qualifying Exams if they have already written their board certification exams in the United States, United Kingdom, Ireland or Australia to apply for a license in Ontario.  

There were 19 new physicians brought to Niagara in 2023 – 61 percent of them from those countries.  

Croteau explained why those nations are where recruitment has been taking place, and not from other countries as well.  

“Our focus is currently repatriating or attracting doctors from those jurisdictions that are license eligible without having to re-write board exams, as determined by the College of Physicians and Surgeons, including the U.K., Ireland, the U.S. and Australia,” she wrote in a statement.  

Regional staff are considering some of the ideas brought forward in last week’s presentation.  

 “We’re still evaluating some of the proposals made at the meeting, and will be discussing how the Region might be able to contribute,” she said, adding that the responsibility for certifying international healthcare professionals rests with the province, and with the College of Family Physicians of Canada and the College of Physicians and Surgeons of Ontario. 

She also said healthcare professionals outside those jurisdictions may be eligible for Ontario’s Practice Readiness Assessment which would place them in one of Ontario’s rural communities for three years.  

“Unfortunately, none of the communities in Niagara qualify as a rural community for this program based on our Rurality Index,” she explained.  

There are six medical schools in Ireland, more than 25 in the United Kingdom, more than 20 in Australia, and about 175 in the U.S. There are 60 in the Caribbean that are linked to American schools, and 17 schools in Canada where potential doctors can eventually come from under the current model, Croteau said in her presentation earlier this month.  

In an interview Monday, Niagara Falls MPP Wayne Gates said he had a conversation on the weekend with Premier Doug Ford about healthcare issues in Niagara – specifically the pending closure of Fort Erie’s urgent care centre and the Town of Niagara-on-the-Lake's ongoing waiting game related to a nurse practitioner that local officials have been urging the province for.  

Asked about whether he feels the province could step up and find a way to increase its inventory of doctors, such as through what was pitched to regional council, he said a closer look needs to be taken at Ontario’s immigration nominee program, adding he has heard of instances where doctors already practicing in Niagara are being told to shut down by the federal government due to immigration issues.  

But should the province be doing more? 

“Absolutely,” said Gates.  

“There are a lot of things the province can do rather than just say ‘well, we don’t have enough doctors,” Gates told The Local.  

“I think we should be recruiting doctors from anywhere in the world to come here,” said Gates, when asked about local efforts being focused on only four countries.  

“We have a crisis in the number of doctors we have, but there are solutions,” said Gates.  

Referring to the presentation at regional council recently, Gates said the presenters are “obviously frustrated knowing they can provide a service we desperately need.” 

The Region’s recruitment efforts have brought 174 physicians to Niagara since 2019. 

There are 265 family physicians within the 12 lower-tier municipalities, which is 81 short of the 346 recommended based on population, said Croteau’s presentation.