The Society for Canadians Studying Medicine Abroad (SOCASMA) has been fighting since 2010 against the roadblocks that Canadians who are graduates of international medical schools (IMGs) face in becoming licensed to practice medicine throughout Canada. In the early 1990s the provincial Ministries of Health determined that the best way to control healthcare spending was to […]
Depuis 2010 la Société des Canadiens qui étudient la médecine à l’étranger (SOCASMA) lutte contre les obstacles auxquels se heurtent les Canadiens diplômés d’écoles de médecine internationales (DIM) pour obtenir l’autorisation d’exercer la médecine partout au Canada. Au début des années 1990, les ministères provinciaux de la Santé ont déterminé que la meilleure façon de […]
Student Information Meeting for Canadian and American Match. December 28, 2023 at 5:00 p.m. Pacific (6 p.m. Mountain; 8:00 p.m. Eastern time) Via Zoom SOCASMA will be hosting an information/strategy meeting for IMGs looking to get and share information and strategies for the Canadian and American Matches. Canadians studying medicine abroad (CSAs), International Medical Graduates […]
A partner organization of SOCASMA, the Foundation of International Medical Graduates, has launched a Canadian Clinical Competencies Internship for eligible candidates interested in applying to Canadian Residency Training programs. This internship was designed by Dr. Adri-Anna Aloia, current Canadian Family Medicine resident and founder and Executive Director of the Foundation of IMG. This program is […]
Between December 2022 and February 2023 SOCASMA conducted a survey to gather information regarding the experiences of CSAs, IMGs and CMGs with RCPSC examinations. A summary of the results of this Survey are available here: RCPSC EXAM EXPERIENCES SURVEY SUMMARY We welcome comments regarding the Survey which may be posted on our Facebook page or […]
Have a look at SOCASMA’s commentary on the Nazerali-Maitland et al article titled Challenges with international medical graduate selection: finding positive attributes predictive of success in family medicine residency. Socasma’s commentary is now available in the journal BMC Primary Care and is freely available online at the below web page: https://link.springer.com/article/10.1186/s12875-023-02105-6 Here is a link […]
SOCASMA has made a submission in regard to a consultation on the future of competition policy in Canada. Have a look at this very compelling submission: https://ised-isde.canada.ca/site/strategic-policy-sector/en/marketplace-framework-policy/competition-policy/submissions-consultation-future-competition-policy-canada/labour-consumer-or-public-interest-groups SOCASMA a préparé une présentation en réponse aux consultations en rapport avec l’avenir de la politique de la concurrence au Canada. Nous vous invitons à jeter un coup […]
(Le français suit.) PRACTICE READY ONTARIO (PRO) IS NOW OPEN! Practice Ready Ontario application portal is now open to applicants. The Touchstone Institute is the organization running the program. See web site: https://touchstoneinstitute.ca/assessment/practice-ready-ontario/ Phase 1 of Practice Ready Ontario (PRO) is offered for Family Medicine. The deadline for Phase 1 applications is Wednesday, July 19, […]
From the IMGBC Office: To applicants of UBC’s 2022 IMG Clinical Assessment Program: We would like to inform you of an employment opportunity as an Associate Physician in British Columbia, open to international medicine graduates who have specialist and general practitioner postgraduate training. If you have not obtained a residency position and are interested in […]
CPSO REMOVES BARRIERS FOR INTERNATIONALLY EDUCATED PHYSICIANS: CLARIFICATIONS PROVIDED IN RESPONSE TO A REQUEST OF THE SOCIETY FOR CANADIANS STUDYING MEDICINE ABROAD (SOCASMA) SOCASMA met with the College of Physicians and Surgeons of Ontario (CPSO) about the changes the CPSO has made to bring down barriers for certain internationally trained physicians. https://www.cpso.on.ca/News/News-Articles/CPSO-Removes-Barriers-for-Internationally-Educated The following clarifications […]
Comments Off on PARTIAL JUDGMENT RELEASED IN SOCASMA’S CHALLENGE OF ELIGIBILITY RULES FOR RESIDENCY POSITIONS WHICH DISCRIMINATE AGAINST CANADIAN IMGs
The Society for Canadians Studying Medicine Abroad (SOCASMA) has been fighting since 2010 against the roadblocks that Canadians who are graduates of international medical schools (IMGs) face in becoming licensed to practice medicine throughout Canada.
In the early 1990s the provincial Ministries of Health determined that the best way to control healthcare spending was to ration access to healthcare services by limiting the number of medical graduates who could be licensed to practice medicine. They slashed medical school seats and residency training positions. The provinces also instituted multiple layers of barriers to prevent Canadian citizens and permanent residents (Canadians) who are IMGs from becoming licensed to practice. These barriers are intertwined and found throughout the entire process of licensure. The barriers to access to residency training are framed into a two-stream system and include (i) limiting IMGs to a small number of entry level jobs (called residency positions) which are a pre-requisite to licensing; (ii) preventing IMGs from competing on individual merit against graduates of Canadian and American medical schools for residency positions; (iii) limiting IMGs in most provinces to only a few medical disciplines; and (iv) forcing IMGs to work where the province directs for several years after becoming fully licensed.
These government-imposed barriers harm not only IMGs but also the public. Since this policy was implemented, the gap between need for physician services and the number of physicians that the government bodies allowed to be licensed grew over the years until it reached a critical point where today 6.5 million Canadians are without a primary care practitioner, Canadians are suffering and dying due to delayed access to health care, and Medical Associations are describing the healthcare system as collapsing and in crisis.
SOCASMA has taken the position that this two-stream system of exclusion of Canadians who are IMGs is not authorized by law; contravenes fundamental principles of administrative law (the law which protects individuals from abuse of government powers); and violates the Charter of Rights.
The difficulty that SOCASMA encountered when it determined that it should bring legal action in British Columbia was that those institutions involved in the system refused to release, and/or provided contradictory and conflicted information, as to (i) which institution was the decision-maker which implemented this system of exclusion of IMGs, and (ii) through what legal authority. Answers to these questions are fundamental to holding the responsible parties accountable.
CaRMS initially posted on its website that the regulatory authorities (Colleges of Physicians and Surgeons) set the rules which determined who could apply to work as a resident physician. Then it changed its website to state that the Ministry of Health and UBC made the rules. At the same time, it published that AFMC sets the eligibility criteria for entry into residency training in Canada. Although the College has a statutory obligation to ensure public safety, it claimed that it lacks the jurisdiction to establish the qualifications a medical graduate must have to apply to work as a resident physician. UBC at times said it made these IMG-excluding rules and at other times denied it. At times the Ministry of Health denied any responsibility, stating that AFMC made the rules. At other times the Ministry of Health deflected responsibility claiming that it played a role but that the rules were made by a collaborative process involving CaRMS, UBC, and AFMC.
Because of the institutions’ failure to identify authority and responsibility for making these rules, and because of the finger-pointing they engaged in, it was necessary to name in the Petition all the institutions involved: the College, the Ministry of Health, UBC, AFMC, and CaRMS.
In response to the Petition filed in the Supreme Court of British Columbia, the Ministry of Health pleaded that the eligibility rules of the two-stream system were established by the Ministry together with other parties. All other parties denied they had the authority to create the two-stream system and denied responsibility for the rules inherent in it which had the effect of excluding IMGs from becoming licensed.
The BC Supreme Court on March 13, 2024, on application of CaRMS and AFMC, ruled that CaRMS and AFMC did not have the authority to create or impose the two-stream system. In other words CaRMS and AFMC admitted that they lack the legal authority to make the rules about eligibility criteria to access residency training and the court ruled this to be correct.
This ruling finds that AFMC and CaRMS do not have the authority to make rules determining the qualifications necessary to compete to work as a resident physician. Remaining to be determined in this action is who amongst the College, UBC, and the Ministry of Health has the authority to set the qualifications, and whether the current rules are illegal for contravening administrative law principles and the Charter of Rights.
Comments Off on JUGEMENT PARTIEL PUBLIÉ EN RÉPONSE À LA CONTESTATION JUDICIAIRE DE LA SOCASMA RELATIVE AUX RÈGLES D’ÉLIGIBILITÉ POUR LES POSTES DE RÉSIDENCE QUI SONT DISCRIMINATOIRES À L’ÉGARD DES DIM CANADIENS
Depuis 2010 la Société des Canadiens qui étudient la médecine à l’étranger (SOCASMA) lutte contre les obstacles auxquels se heurtent les Canadiens diplômés d’écoles de médecine internationales (DIM) pour obtenir l’autorisation d’exercer la médecine partout au Canada.
Au début des années 1990, les ministères provinciaux de la Santé ont déterminé que la meilleure façon de contrôler les dépenses de santé était de rationner l’accès aux services de santé en limitant le nombre de diplômés en médecine pouvant être autorisés à exercer la médecine. Ils ont supprimé les places dans les facultés de médecine et les postes de résidence. Les provinces ont également institué plusieurs niveaux d’obstacles pour empêcher l’obtention d’un permis d’exercice par les citoyens canadiens et les résidents permanents (Canadiens) qui sont des diplômés hors du Canada et des États-Unis (DHCEU). Ces obstacles sont encadrés et se retrouvent tout au long du processus d’obtention d’un permis. Les obstacles à l’accès à la formation en résidence sont regroupés dans un système à deux volets et comprennent (i) la limitation des DHCEU à un petit nombre d’emplois de premier échelon (appelés postes de résidence) qui sont une condition préalable à l’obtention d’un permis ; (ii) sur la base de leur mérite individuel, empêcher les DHCEU de concurrencer avec les diplômés des facultés de médecine canadiennes et américaines pour les postes de résidence ; (iii) limiter les DHCEU dans la plupart des provinces à seulement quelques disciplines médicales; et (iv) obliger les DHCEU à travailler là où la province les ordonne pendant plusieurs années après avoir obtenu leur permis complet.
Ces barrières imposées par le gouvernement nuisent non seulement aux DHCEU mais aussi au public. Depuis la mise en œuvre de cette politique et au fil des années, l’écart entre les besoins de services médicaux et le nombre de médecins autorisés par les organismes gouvernementaux à obtenir un permis s’est creusé jusqu’à atteindre un point critique où aujourd’hui 6,5 millions de Canadiens se retrouvent sans praticien de soins primaires. Des Canadiens souffrent et meurent en raison des délais reliés à l’accès aux soins de santé et les associations médicales décrivent le système de santé comme étant effondré et en crise.
La SOCASMA a adopté la position selon laquelle ce système d’exclusion à deux volets des Canadiens qui sont des DHCEU n’est pas autorisé par la loi; qu’il contrevient aux principes fondamentaux du droit administratif (la loi qui protège les individus contre les abus de pouvoirs gouvernementaux) ; et qu’il viole la Charte des droits.
Lorsqu’elle a déterminé qu’elle devait intenter une action en justice en Colombie-Britannique, la SOCASMA a rencontré une difficulté importante, à savoir que les institutions impliquées dans le système refusaient de divulguer et/ou fournissaient des informations contradictoires et conflictuelles quant à (i) quelle institution était le décideur qui a mis en œuvre ce système d’exclusion des DHCEU, et (ii) par quelle autorité légale ce système a été établi. Les réponses à ces questions sont fondamentales pour responsabiliser les parties responsables.
CaRMS a initialement publié sur son site Web que les autorités de réglementation (Collèges des médecins et chirurgiens) établissaient les règles qui déterminaient qui pouvait postuler pour travailler comme médecin résident. Ensuite, il a modifié son site Web pour indiquer que c’était le ministère de la Santé et l’UBC (University of British Columbia) qui établissaient les règles. En même temps, il a publié que l’Association des facultés de médecine du Canada (AFMC) fixe les critères d’éligibilité pour l’entrée à la formation en résidence au Canada. Même si le Collège a l’obligation légale d’assurer la sécurité publique, il prétend qu’il n’a pas le pouvoir d’établir les qualifications qu’un diplômé en médecine doit posséder pour postuler à l’exercice du métier de médecin résident. L’UBC a parfois déclaré qu’elle avait établi ces règles d’exclusion des DIM et, à d’autres moments, elle l’a nié. Le ministère de la Santé a parfois nié toute responsabilité, affirmant que l’AFMC fixait les règles. À d’autres moments, le ministère de la Santé a contourné la question de la responsabilité en prétendant qu’il avait joué un rôle, mais que les règles avaient été établies dans le cadre d’un processus collaboratif impliquant CaRMS, l’UBC et l’AFMC.
En raison de l’incapacité des établissements à identifier l’autorité et la responsabilité dans l’élaboration de ces règles, et comme toutes les institutions se pointaient du doigt, il a fallu nommer dans la contestation judiciaire toutes les institutions concernées: le Collège, le ministère de la Santé, l’UBC, AFMC et CaRMS.
En réponse à la requête déposée auprès de la Cour suprême de la Colombie-Britannique, le ministère de la Santé a plaidé que les règles d’éligibilité du système à deux volets avaient été établies par le ministère en collaboration avec d’autres parties. Tous les autres partis ont nié avoir le pouvoir de créer le système à deux volets et ont nié toute responsabilité quant aux règles inhérentes à celui-ci, qui avaient pour effet d’empêcher les DHCEU d’obtenir une licence.
Le 13 mars 2024, à la demande de CaRMS et de l’AFMC, la Cour suprême de la Colombie-Britannique a statué que CaRMS et l’AFMC n’avaient pas le pouvoir de créer ou d’imposer le système à deux volets. En d’autres termes, CaRMS et l’AFMC ont admis qu’elles n’avaient pas le pouvoir légal d’établir des règles sur les critères d’éligibilité pour accéder à la formation en résidence et le tribunal a jugé que c’était exact.
Cette décision conclut que l’AFMC et CaRMS n’ont pas le pouvoir d’établir des règles déterminant les qualifications nécessaires pour postuler au poste de médecin résident. Il reste à déterminer dans cette action qui, parmi le Collège, l’UBC et le ministère de la Santé, a le pouvoir d’établir les qualifications et si les règles actuelles sont illégales car elles contreviennent aux principes du droit administratif et à la Charte des droits.
Comments Off on Student Information Meeting for Canadian and American Residency Match.
Student Information Meeting for Canadian and American Match.
December 28, 2023 at 5:00 p.m. Pacific (6 p.m. Mountain; 8:00 p.m. Eastern time)
Via Zoom
SOCASMA will be hosting an information/strategy meeting for IMGs looking to get and share
information and strategies for the Canadian and American Matches. Canadians studying medicine abroad (CSAs), International Medical Graduates (IMGs), parents, spouses and friends are welcome.
Before the meeting we will send you information which you will likely find helpful to the match
processes. This meeting is relevant to students at all levels in the process.
We will have CSAs who have negotiated the Canadian and American Match provide advice and answer
questions, but hope that everyone present will share their concerns, experiences, and advice.
We invite those who have navigated the match to join us as well to pass on your wisdom. Supporters of
IMGs are also welcome.
TO ATTEND, please message us on Facebook or email us at socasma@outlook.com. We need your
name and email address to send you the resource material and Zoom link prior to the meeting.
Your year of medical school or PGT would also be helpful in our planning. Please send any issues you
would like us to focus on or questions you wish addressed.
Comments Off on Foundation of International Medical Graduates Canadian Clinical Competencies Internship
A partner organization of SOCASMA, the Foundation of International Medical Graduates, has launched a Canadian Clinical Competencies Internship for eligible candidates interested in applying to Canadian Residency Training programs.
This internship was designed by Dr. Adri-Anna Aloia, current Canadian
Family Medicine resident and founder and Executive Director of the Foundation of IMG.
This program is a 3 month certification which orientates candidates to the Canadian
Healthcare System, its operational function as well as future expectations of resident level
learners. Following the College of Physician and Surgeons of Ontario’s limitations and
restrictions for Internationally Trained Physicians to participate in current medical practices, this program offers guided and supervised clinic exposure as well as skill development, etiquette
and EMR training.
DEADLINE DATE FOR THE WINTER INTERNSHIP: 20 NOVEMBER
This internship is not a paid role. Enrollment to this program is sponsored by the Fort
York Medical Clinic. Number of positions sponsored: 2 per cycle detailed below:
Winter Internship: December 1 2023 – February 29 2024
Spring Internship: March 1 2024 – May 31 2024
Comments Off on Results of survey regarding RCPSC examinations
Between December 2022 and February 2023 SOCASMA conducted a survey to gather information regarding the experiences of CSAs, IMGs and CMGs with RCPSC examinations. A summary of the results of this Survey are available here: RCPSC EXAM EXPERIENCES SURVEY SUMMARY
We welcome comments regarding the Survey which may be posted on our Facebook page or emailed to SOCASMA@OUTLOOK.COM.
Comments Off on SOCASMA’s commentary to the report titled Challenges with IMG selection: finding positive attributes predictive of success in family medicine residency
Have a look at SOCASMA’s commentary on the Nazerali-Maitland et al article titled Challenges with international medical graduate selection: finding positive attributes predictive of success in family medicine residency. Socasma’s commentary is now available in the journal BMC Primary Care and is freely available online at the below web page:
Comments Off on Submission in response to a consultation on the future of competition policy in Canada. Présentation en réponse à une consultation en rapport avec l’avenir de la politique de la concurrence au Canada.
Comments Off on PRACTICE READY ASSESSMENT IS NOW OPEN IN ONTARIO!
(Le français suit.)
PRACTICE READY ONTARIO (PRO) IS NOW OPEN!
Practice Ready Ontario application portal is now open to applicants. The Touchstone Institute is the organization running the program. See web site: https://touchstoneinstitute.ca/assessment/practice-ready-ontario/ Phase 1 of Practice Ready Ontario (PRO) is offered for Family Medicine. The deadline for Phase 1 applications is Wednesday, July 19, 2023.
We encourage you to sign up on the Touchstone Institute website so that you can receive updates. You can do so via this link to their website. https://us11.list-manage.com/subscribe?u=0c1d6f52cca4a685392109af2&id=dbed7cd9b1
UN PROGRAMME D’ÉVALUATION DE LA PRATIQUE À EXERCER EST MAINTENANT OUVERT EN ONTARIO !
le Programme d’évaluation de pratique à exercer en Ontario reçoit maintenant les demandes des applicants. L’Institut Touchstone Institute est l’organisme qui est responsable dece programme. Voir le site web suivant (seulement disponible en anglais): https://touchstoneinstitute.ca/assessment/practice-ready-ontario/
La Phase 1 du Programme d’évaluation de la pratique à exercer en Ontario est offerte pour la médecine de famille. L’échéancier des demandes d’application pour la Phase 1 est le mercredi 19 juillet, 2023.
Nous vous encourageons à vous inscrire sur le site Web du Touchstone Institute afin d’être averti dès qu’il y a des mises à jour. Vous pouvez le faire via le lien suivant: https://us11.list-manage.com/subscribe?u=0c1d6f52cca4a685392109af2&id=dbed7cd9b1
En Ontario, des médecins francophones ou bilingues sont recherchés pour desservir la population francophone qui se trouve surtout dans l’Est de l’Ontario, à Ottawa et dans le Nord de l’Ontario. Mais, à notre connaissance, il se peut que l’évaluation à la pratique soit seulement disponible en anglais. Nous vous fournirons de plus amples renseignements à ce sujet dans un avenir rapproché
Comments Off on Associate Physician Opportunities in British Columbia
From the IMGBC Office:
To applicants of UBC’s 2022 IMG Clinical Assessment Program:
We would like to inform you of an employment opportunity as an Associate Physician in British Columbia, open to international medicine graduates who have specialist and general practitioner postgraduate training. If you have not obtained a residency position and are interested in the opportunity, you can find more information, including a description and the eligibility requirements of the Associate Physician role, vacancies and the application process, on the Health Match BC website: https://www.healthmatchbc.org/Health-Professionals/Associate-Physicians.
While Associate Physician registration is not a pathway to full independent practice, it is a dynamic new career option where international medical graduates can apply their medical training in the BC health care system.
Please note that Health Match BC is a free health professional recruitment service funded by the Government of British Columbia; it is not affiliated with IMGBC. If you have any questions about Associate Physicians in BC, please contact physicians@healthmatchbc.org.
Kind regards,
IMGBC Office
Faculty of Medicine | Postgraduate Medical Education The University of British Columbia
Comments Off on Ontario Removes Barriers for Internationally Educated Physicians
CPSO REMOVES BARRIERS FOR INTERNATIONALLY EDUCATED PHYSICIANS: CLARIFICATIONS PROVIDED IN RESPONSE TO A REQUEST OF THE SOCIETY FOR CANADIANS STUDYING MEDICINE ABROAD (SOCASMA)
The following clarifications were provided in response to our questions:
CPSO – Alternative Pathways to Registration for Physicians Trained in the United States
Pathway A. For family and specialty physicians who are American Board certified, the CPSO has modified a pathway/class of licensure which eliminates the previous requirement of supervision and assessment. The CPSO will issue a restricted license to practice independently within one’s scope of practice. The “restricted” license in practice is no different than having a full license to practice independently which classification requires CFPC or RCPSC certification EXCEPT that one cannot hold themselves out to be CFPC or RCPSC certified. There is no difference in billing or scope of practice between these two classes. In other words, this “restricted” license allows an American Board-certified physician to do everything a CFPC or RCPSC certified physician can do and bill at the same rate. This new approach applies to all specialties, including family medicine. It also means that U.S. trained physicians do not need to do the CFPC or RCPSC exams.
Why a different classification to do the same work at the same rate? These changes were made to address the physician shortage by the CPSO acting within its legal right to establish policies which address the public interest. The full license to practice independently which requires CFPC or RCPSC certification is created by the Ontario Legislature which moves more slowly than CPSO.
Pathway C. In addition, the CPSO has established a new pathway for US trained physicians who are not American Board certified AND are not more than 5 years out of training. This may be of particular interest to American trained physicians who trained in disciplines where American training is shorter than Canadian training (pediatrics, anesthesiology, obstetrics, etc.) AND are eligible to take their American Board exams. This is a time-restricted license to practice under supervision for 3 years. Supervision will no longer be required when one has completed a training program accredited by the ACGME AND passed their American Board Exams AND successfully complete the USMLEs or an acceptable qualifying exam within the three years. Physicians who have successfully completed these U.S. exams will not be required to do the CFPC or the RCPSC exams.
These pathways do not impede a person from obtaining RCPSC certification should they want to. It is simply no longer necessary to be able to work and bill independently.
CPSO – Registration of family physicians trained in the United States, the United Kingdom, Ireland and Australia
Physicians who have trained and have successfully passed the family medicine exams in the above noted jurisdiction will be able to get a licence to practice in Ontario within the scope of practice of family medicine. These physicians will not need to pass the exams of the CFPC.
The process for identifying and approving jurisdictions is conducted by the College of Family Physicians of Canada (CFPC). A call for interest in becoming an approved jurisdiction was sent out to a number of countries, to which the above-mentioned jurisdictions responded positively. SOCASMA will be following up with the CFPC with regards to the opportunity of expanding the number and type of approved jurisdictions.
USMLE in lieu of MCCQE
Another change made in 2022 is that USMLEs or an acceptable qualifying exam are accepted by the CPSO in lieu of the MCCQE.
Practice Ready Assessments
The CPSO is also working to bring down more barriers, including for physicians who trained in other countries. The new Practice Ready Assessment Program (PRA) is being implemented by the Ontario government and administered by the Touchstone Institute https://touchstoneinstitute.ca/ The plan is to admit 50 physicians into the family medicine cohort. It is anticipated that the process of announcing eligibility criteria and collecting applications will begin later this month. The government has not yet approved PRA for specialties.
The CPSO continues to look at new and existing routes within the constructs of the current legislation. To follow developments go to cpso.on.ca, click on About, then Council, then Council meetings.