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 […]
L’ORDRE DES MÉDECINS ET CHIRURGIENS DE L’ONTARIO (OMCO) ÉLIMINE DES OBSTACLES POUR LES MÉDECINS QUI ÉTUDIENT À L’ÉTRANGER : CLARIFICATIONS FOURNIES EN REPONSE A UNE DEMANDE DE LA SOCIÉTÉ DES CANADIENS QUI ÉTUDIENT MÉDECINE À L’ÉTRANGER (SOCASMA) (N.B. En cas de doute, la version anglaise a préséance sur la version française.) La SOCASMA a rencontré l’Ordre […]
Mémoire au Comité permanent de la santé de la Chambre des communes par la Société des Canadiens étudiant la médecine à l’étranger 24 octobre 2022 Au lendemain de la Covid-19, le Canada vit une crise des soins de santé. (1) La COVID-19 a révélé des fissures qui existaient auparavant dans notre fondation de soins de […]
Submission to the House of Commons Standing Committee on Health by the Society for Canadians Studying Medicine Abroad October 24, 2022 In the aftermath of Covid-19, Canada is experiencing a health care crisis. 1 COVID-19 has exposed previously existing cracks in our health care foundation 2 including inadequate planning for future physician needs 3 ; […]
BC Licensing in Associate Physician and USA Certified Class—Some questions answered. Eligibility Requirements See HPA-Bylaws.pdf (cpsbc.ca) for the College eligibility requirements for registration at s. 2-25- Associate Physician Acute Care s. 2-26 Associate Physician Community Primary Care s. 2-27 USA Certified We sought clarifications. The College has advised us: a. that someone registered in this […]
Want to stay informed about the latest and most up-to-date news affecting Canadians studying medicine abroad and Canadian International Medical Graduates who want to practice medicine in Canada? Join our Facebook page and check it out regularly. Public Facebook page: https://www.facebook.com/socasma Private Facebook page (for Canadians studying medicine abroad – includes permanent residents – and […]
NEWS RELEASE SOCIETY FOR CANADIANS STUDYING MEDICINE ABROAD (SOCASMA) (Le français suit.) The Society for Canadians Studying Medicine Abroad is applauding the recent announcements* made by the Government of Ontario and the College of Physicians and Surgeons of Ontario (CPSO) with regards to the funding of additional medical residency positions and the removal of barriers […]
April 1, 2023 The Honourable Sylvia Jones Deputy Premier and Minister of Health of Ontario E-Mail: sylvia.jones@ontario.ca Dear Ms. Jones: More than 2.2 million Ontarians are without a Family Physician and deferred medical care is putting Ontarians at serious risk (Ref: Ontario College of Family Physicians, Feb 2023; Waiting list deaths reach 4 year high, […]
MedsHousing.com, a partner of the Canadian Federation of Medical Students is a global platform founded by a team of medical community members seeking to alleviate the stress of searching for housing during medical training. The service is free for medical learners and caters exclusively to the medical community. It is an important resource dedicated to […]
YOU WANT TO MAKE A DIFFERENCE? THEN GET ENGAGED AND ATTEND SOCASMA’S ANNUAL GENERAL MEETING DECEMBER 17. YOUR INVOLVEMENT IS CRUCIAL TO IMPROVE ACCESS TO RESIDENCY TRAINING AND MEDICAL LICENSING IN CANADA. THE MEETING WILL ALSO BE AN OPPORTUNITY TO SPEAK ABOUT YOUR EXPERIENCES IN GETTING READY FOR THE MATCH. NOTICE of ANNUAL GENERAL MEETING […]
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.
Comments Off on Élimination d’obstacles en Ontario
L’ORDRE DES MÉDECINS ET CHIRURGIENS DE L’ONTARIO (OMCO) ÉLIMINE DES OBSTACLES POUR LES MÉDECINS QUI ÉTUDIENT À L’ÉTRANGER : CLARIFICATIONS FOURNIES EN REPONSE A UNE DEMANDE DE LA SOCIÉTÉ DES CANADIENS QUI ÉTUDIENT MÉDECINE À L’ÉTRANGER (SOCASMA)
(N.B. En cas de doute, la version anglaise a préséance sur la version française.)
Parcours A. Pour les médecins de famille et les médecins spécialisés qui sont certifiés par l’American Board, l’OMCO a modifié un parcours/classe d’autorisation qui élimine l’exigence précédente de supervision et d’évaluation. L’OMCO délivrera un permis restreint pour exercer de manière indépendante dans le champ d’exercice du médecin. Le permis « restreint » dans la pratique n’est pas différent de la possession d’un permis complet pour pratiquer de manière indépendante, ce qui nécessite une certification de l’Odre des médecins de famille du Canada (OMFC) ou du Collège royal des médecins et chirurgiens du Canada (CRMCC), SAUF qu’on ne peut pas prétendre être certifié par le l’OMFC ou le CRMCC. Il n’y a pas de différence de facturation ou de champ d’exercice entre ces deux classes. En d’autres termes, ce permis « restreint » permet à un médecin certifié par l’American Board de faire tout ce qu’un médecin certifié par l’OMFC ou le CRMCC peut faire et de facturer au même tarif. Cette nouvelle approche s’applique à toutes les spécialités, y compris la médecine familiale. Cela signifie également que les médecins formés aux États-Unis n’ont pas besoin de passer les examens de l’OMFC ou du CRMCC.
Pourquoi un classement différent pour faire le même travail au même rythme? Ces changements ont été apportés pour remédier à la pénurie de médecins par l’OMCO agissant dans le cadre de son droit légal d’établir des politiques qui répondent à l’intérêt public. Le permis complet d’exercer de façon indépendante, qui exige la certification de l’OMFC ou du CRMCC, est créé par l’Assemblée législative de l’Ontario, qui évolue plus lentement que l’OMCO.
Parcours C. De plus, l’OMCO a établi un nouveau parcours pour les médecins formés aux États-Unis qui ne sont pas certifiés par l’American Board ET qui n’ont pas terminé leur formation depuis plus de 5 ans. Cela peut être particulièrement intéressant pour les médecins formés aux États-Unis qui ont été formés dans des disciplines où la formation américaine est plus courte que la formation canadienne (pédiatrie, anesthésiologie, obstétrique, etc.) ET qui sont admissibles à passer leurs examens de l’American Board. Il s’agit d’un permis à durée limitée permettant d’exercer sous supervision pendant 3 ans. La supervision ne sera plus nécessaire lorsque l’on a terminé un programme de formation accrédité par l’ACGME ET réussi ses examens de l’American Board ET réussi les USMLE ou un examen de qualification acceptable dans les trois ans. Les médecins qui ont réussi ces examens américains ne seront pas tenus de passer les examens de l’OMFC ou du CRMCC.
Ces parcours n’empêchent pas une personne d’obtenir la certification du CRMCC si elle le souhaite. Il n’est tout simplement plus nécessaire pour être en mesure de travailler et de facturer de manière autonome.
OMCO – Inscription des médecins de famille formés aux États-Unis, au Royaume-Uni, en Irlande et en Australie
Les médecins qui ont suivi une formation et qui ont réussi les examens de médecine familiale dans les juridictions susmentionnées pourront obtenir un permis d’exercice en Ontario dans le cadre de la pratique de la médecine familiale. Ces médecins n’auront pas besoin de réussir les examens de l’OMFC.
– Le processus d’identification et d’approbation des juridictions est mené par l’Ordre des médecins de famille du Canada (OMFC). Un appel à manifestation d’intérêt pour devenir une juridiction agréée a été lancé dans un certain nombre de pays. Seules les juridictions susmentionnées ont répondu positivement. La SOCASMA fera le suivi auprès de l’OMFC en ce qui concerne l’opportunité d’augmenter le nombre et le type de juridictions approuvées.
USMLE au lieu de MCCQE
Un autre changement apporté en 2022 : les examens américains USMLE ou un examen de qualification acceptable sont acceptés par l’OMCO à la place de l’Examen d’aptitude du Conseil médical du Canada (EACMC).
ÉVALUATIONS DE LA CAPACITÉ À EXERCER
L’OMCO s’efforce de réduire d’autres obstacles, y compris pour les médecins formés dans d’autres pays. Le nouveau programme d’évaluation de la capacité à exercer est mis en œuvre par le gouvernement de l’Ontario et administré par le Touchstone Institute https://touchstoneinstitute.ca/ Le plan est d’admettre 50 médecins dans la cohorte de médecine familiale. Il est prévu que le processus d’annonce des critères d’admissibilité et de collecte des demandes commencera plus tard ce mois-ci. Le gouvernement n’a pas encore approuvé le plan d’évaluation de la capacité à exercer pour les spécialités.
L’OMCO continue d’examiner les parcours nouveaux et existants dans le cadre de la législation actuelle. Pour suivre les développements, rendez-vous sur cpso.on.ca , cliquez sur À propos, puis Conseil, puis Réunions du Conseil.
Pour en savoir plus sur les politiques/classifications de l’OMCO qui sont en cours de révision, allez à https://www.cpso.on.ca/en/Physicians/Registration/Registration-Policies
Comments Off on Mémoire au Comité permanent de la santé de la Chambre des communes, 24 octobre 2022
Mémoire au Comité permanent de la santé de la Chambre des communes
par la Société des Canadiens étudiant la médecine à l’étranger
24 octobre 2022
Au lendemain de la Covid-19, le Canada vit une crise des soins de santé. (1) La COVID-19 a révélé des fissures qui existaient auparavant dans notre fondation de soins de santé (2), y compris une planification inadéquate pour l’avenir des besoins médicaux (3) ; des problèmes de durabilité en rapport avec nos modèles actuels de médecine familiale et de soins primaires (4); des systèmes de soins de longue durée surchargés (5) ; et les problèmes de recrutement et de rétention dans notre secteur des soins infirmiers (6) . La crise est attestée par le fait que 6 millions de Canadiens se trouvent sans médecin de premier recours (7) , et par la fermeture des services d’urgence (8) , des soins intensifs (9) et d’autres services partout au Canada. L’Association médicale canadienne rapporte que plus de 4 000 décès supplémentaires non liés à la COVID-19 en 2021 étaient dus à des procédures retardées et à l’augmentation des temps d’attente (10) . Cette statistique n’est peut-être que la pointe de l’iceberg. Le président de l’Association médicale canadienne est “préoccupé par l’effondrement” et par le fait que “dans certains endroits, l’effondrement s’est déjà produit.” (11)
À son crédit, le gouvernement fédéral s’est efforcé, dans le cadre de ses politiques d’immigration, de remédier aux pénuries de travailleurs de la santé qui constituent une part importante de cette crise. Le Canada a récemment promis 1,5 million de dollars pour éliminer les obstacles pour les immigrants qui souhaitent travailler dans le domaine de la santé. (12) En 2021, le Canada a établi une voie de résidence permanente pour les travailleurs de la santé. (13) Les objectifs d’immigration du Canada se concentrent également sur le recrutement de travailleurs de la santé qualifiés et sur la suppression des obstacles à la résidence permanente
pour les médecins. (14)
Malgré cet investissement fédéral pour attirer des médecins immigrants et d’autres travailleurs de la santé, les médecins formés à l’étranger ont été mis à l’écart pendant une grande partie de la pandémie de Covid-19 en raison des obstacles liés à l’expérience canadienne qui sont sous la gouverne des autorités réglementaires provinciales. (15) Leurs compétences et leur expertise ont été perdues aux Canadiens.
MacFarlane, (16) dans un récent article évalué par des pairs, décrit les obstacles auxquels font face les médecins qui peuvent seulement accéder à des emplois et à un permis d’exercice après avoir suivi une formation en résidence par le biais de CaRMS. Pour les médecins formés à l’étranger, il s’agit d’un processus de diffusion qui enfreint probablement les codes fédéraux et provinciaux des droits de la personne et les droits garantis par la Charte concernant l’égalité, la liberté et la mobilité. Ce processus stipule que les médecins formés à l’étranger qui participent à CARMS, ces médecins étant des citoyens canadiens ou des résidents permanents, sont interdits de concourir pour 90% des places en résidence pour lesquelles ils se sont avérés qualifiés. En 2020, plus de 1400 diplômés internationaux en médecine (DIM) qui ont démontré une compétence au moins au niveau attendu d’un diplômé d’une faculté de médecine canadienne (CMG) n’étaient pas jumelés à une formation en résidence à cause de cette marginalisation. Il s’agit d’un taux de jumelage en résidence de 97,7 % pour les diplômés canadiens en médecine par rapport à un taux de jumelage en résidence de 22,6 % pour les diplômés internationaux en médecine. Ceci représente un écart substantiel et une preuve claire de la marginalisation et de la discrimination des diplômés internationaux en médecine.
Si le Canada veut régler la crise sanitaire actuelle et contrer les répercussions de la COVID-19, il est essentiel que nous utilisions toutes les ressources humaines à notre disposition. Le Canada ne peut pas continuer à gaspiller les compétences médicales, les talents et les ressources humaines en soins de santé que nous avons recrutés à dépense considérable. Des organisations telles que l’Association médicale canadienne, l’Association des infirmières et infirmiers du Canada, le Collège des médecins de famille du Canada et l’Association médicale de l’Ontario ont reconnu le rôle essentiel que les médecins formés à l’étranger doivent jouer pour faire face à la crise actuelle. Ils ont plaidé pour un meilleur accès à la profession pour les diplômés internationaux en médecine. (17, 18)
Il est important que le gouvernement fédéral assume un rôle de chef de file auprès des provinces pour aborder et éliminer les obstacles auxquels sont confrontés les médecins et les professionnels de la santé formés à l’étranger pour accéder à la profession médicale. À cette fin, la Société des Canadiens étudiant la médecine à l’étranger recommande ce qui suit::
1) Le gouvernement fédéral devrait immédiatement ouvrir le dialogue avec ses homologues provinciaux de la santé dans le but d’aborder et d’éliminer les obstacles à la pratique auxquels sont confrontés les professionnels de la santé formés à l’étranger.
2) Le gouvernement fédéral devrait ouvrir immédiatement le dialogue avec les autres parties prenantes dans le but d’identifier et d’éliminer les obstacles à la pratique auxquels sont confrontés les fournisseurs de soins de santé formés à l’étranger. Ces parties prenantes devraient comprendre l’Association médicale canadienne, diverses associations médicales provinciales, et les organismes représentants les Diplômés internationaux en médecine tels que la Société des Canadiens étudiant la médecine à l’étranger, la Canadian on Paper
Society for Immigrants for Physician Equality et la Internationally Trained Physicians of Ontario.
3) Le gouvernement fédéral devrait envisager de lier le financement pour le rétablissement de la COVID-19 et les efforts pour pallier aux pénuries de soins de santé, aux engagements provinciaux et aux progrès visant éliminer les obstacles auxquels sont confrontés les travailleurs de la santé formés à l’étranger.
4) La suppression des barrières devrait inclure :
a.. L’ouverture à la concurrence de tous les postes de formation en résidence pour tous les citoyens canadiens et résidents permanents.qui sont diplômés des facultés de médecine canadiennes ou qui ont réussi les examens du Conseil médical du Canada. Ces examens
établissent qu’ils ont les connaissances médicales essentielles, la capacité de prise de décision et les compétences cliniques attendues d’un diplômé d’une faculté de médecine canadienne et, à ce titre, qu’ils sont qualifiés pour travailler comme médecins résidents. Un système conçu pour sélectionner le meilleur candidat déterminé par des comités de sélection composés de médecins praticiens et non universitaires, aura l’avantage supplémentaire d’accroître l’efficacité, de réduire les coûts et d’améliorer la qualité des soins.
b. Augmenter le nombre de postes de résidence.
c. Mettre en œuvre des évaluations de la capacité à exercer (ECE) dans toutes les provinces pour les diplômés internationaux, y compris les spécialistes, comme alternative à la formation en résidence.
d. Mettre fin à l’obligation pour les diplômés des facultés de médecine internationales de signer un contrat de retour de service comme condition de travail en tant que médecins résidents. S’il est jugé nécessaire d’avoir l’engagement des médecins à travailler dans un lieu particulier, ces postes devraient être ouverts à tous les candidats. Ce fardeau ne devrait pas être imposé uniquement aux Diplômés internationaux en médecine.
e. Supprimer la responsabilité exclusive et la discrétion sans entrave du système de sélection des résidents des facultés de médecine en mettant en place une surveillance pour surmonter aux préjugés intégrés dans le système.
F. Mettre en œuvre et/ou renforcer la surveillance et la responsabilité existantes, y compris l’application de la loi (par des institutions telles que les collèges provinciaux de médecins et chirurgiens et les commissaires à l’intégrité) de tous les aspects de l’accès à la profession médicale pour s’assurer que l’admission à la profession est : (i) équitable et exempte de discrimination, c’est-à-dire inclusive et conforme aux principes d’une société libre et démocratique; (ii) impartial ; (iii) objectif ; (iv) flexible et (v) transparent.
g. Exiger la représentation des Diplômés internationaux en médecine dans tous les comités et autres forums qui prennent des décisions qui affectent les diplômés internationaux en médecine et l’accès à la profession médicale.
Merci d’avoir accepté et considéré cette soumission. Si vous désirez plus d’informations
concernant ces questions et recommandations, il nous fera plaisir de répondre aux questions ou de comparaître en personne devant le Comité.
Références (voir les liens html dans la version anglaise):
1. Canada’s health care crisis: What we need now | CMA
2. COVID-19 exposing cracks in our universal healthcare – Healthy Debate
3. Canada’;s doctor shortage will only worsen in the coming decade | Fraser Institute
4. Open letter from the CFPC to our Members | The College of Family Physicians of Canada
5. Long-term care reform in Canada will require a massive, multi-year effort (irpp.org)
6. Canada headed for nursing shortage ‘beyond anything we’ve ever experienced’: experts |
Globalnews.ca
7. Family doctors scarce across Canada amid health-care crisis: report | CTV News
8. Emergency Rooms Across Canada Close Amid Nursing Shortage – The New York Times
(nytimes.com)
9. Significant staff shortage forces ICU closure at Bowmanville Hospital | CBC News
10. Excess deaths, increased mental health disorders and substance use: new CMA report highlights
pandemic’s broader impact | CMA
11. This is a crisis;: Head of medical association warns that the health-care system faces collapse; CBC News
12. Canada to support internationally educated health professionals | Canada Immigration News
(cicnews.com)
13. New pathway to permanent residency for over 90,000 essential temporary workers and
international graduates – Canada.ca
14. Canada removing barriers to permanent residence for physicians | Canada Immigration News
(cicnews.com)
15. Despite health-care ‘crisis,’ internationally-trained doctors, nurses face barriers to work –
National | Globalnews.ca
16. View of When a Canadian is not a Canadian: marginalization of IMGs in the CaRMS match
(ucalgary.ca)
17. Physicians, nurses offer solutions to immediately address health human resource crisis | CMA
18. OMA proposes three immediate solutions for Ontario’s health-care system
Présenté par :
Rosemary Pawliuk
Presidente, Société des Canadiens qui étudient la médecine à l’étranger
22879 29B Avenue
Langley, BC
V2Z 3B1
Comments Off on Submission to the House of Commons Standing Committee on Health, October 24, 2022
Submission to the House of Commons Standing Committee on Health
by the Society for Canadians Studying Medicine Abroad
October 24, 2022
In the aftermath of Covid-19, Canada is experiencing a health care crisis. 1 COVID-19 has exposed
previously existing cracks in our health care foundation 2 including inadequate planning for future
physician needs 3 ; sustainability issues with our current models of family practice 4 and primary care;
overburdened long term care systems 5 ; and recruitment and retention issues in our nursing sector 6 . The
crisis is evidenced by 6 million Canadians being without a primary care doctor 7 , and by closures of
emergency 8 , ICU 9 , and other departments across Canada. The Canadian Medical Association reports over
4,000 excess deaths not related to COVID-19 in 2021 were due to delayed procedures and increased
wait times 10 . This statistic may be just the tip of the iceberg. The President of the Canadian Medical
Association is "concerned about collapse" and "in some places collapse has already happened." 11
To its credit, the federal government has been making efforts through its immigration policies to
address the shortages of health care workers that are a significant part of this crisis. Canada recently
pledged 1.5 million dollars to remove barriers for immigrants who want to work in healthcare. 12 In 2021,
Canada established a permanent residence pathway for health care workers 13 . Canada's immigration
targets also focus on recruiting skilled healthcare workers and removing barriers to permanent
residence for physicians. 14
Despite this federal investment in attracting immigrant physicians and other health care workers,
internationally educated physicians have been sidelined during much of the Covid-19 pandemic by
provincial regulatory authorities’ Canadian experience barriers. 15 Their skills and expertise have been lost
to Canadians.
MacFarlane, 16 in a recent peer reviewed paper, describes these barriers as they relate to internationally
trained physicians accessing residency training jobs through CaRMS which are a pre-requisite to
licensure. Due to a streaming process that likely violates federal and provincial human rights codes and
Charter rights regarding equality, liberty, and mobility, internationally educated physicians, who are
required to be Canadian citizens or permanent residents to participate in CaRMS, are prohibited from
competing for 90% of residency spaces for which they have proven themselves qualified. In 2020, over
1400 international medical graduates (IMGs) who had demonstrated competence to at least the level
expected of a graduate of a Canadian medical school (CMGs) were unmatched because of this
marginalization. Further, a 97.7% match rate for CMGs vs a 22.6% match rate for IMGs is a significant
and substantial discrepancy and represents clear evidence of marginalization and discrimination of
IMGs.
If Canada is to be successful in addressing the current health crisis and addressing the impact and
aftermath of COVID-19, it is critical we use all the human resources at our disposal. Canada cannot
continue to waste the medical skills, talents, and health care human resources we have recruited at
considerable expense. Organizations such as the Canadian Medical Association, the Canadian Nurses
Association, the College of Family Physicians of Canada and the Ontario Medical Association have
recognized the critical role internationally trained physicians have to play in addressing the current
health care crisis and have advocated for improved access to the profession for IMGs. 17, 18
It is important that the federal government take a leadership role with the provinces in addressing and
removing barriers faced by internationally educated physicians and health professions in accessing the
medical profession. To this end, the Society for Canadians Studying Medicine Abroad recommends the
following:
1) The federal government should immediately open dialogue with their provincial health counterparts
with the aim of addressing and removing barriers to practice faced by internationally trained healthcare
providers.
2) The federal government should immediately open dialogue with other stakeholders with the aim of
identifying and removing barriers to practice faced by internationally trained health care providers. Such
stakeholders should include the Canadian Medical Association, various provincial medical associations,
and IMG stakeholders such as the Society for Canadians Studying Medicine Abroad, Canadian on Paper
Society for Immigrants for Physician Equality, and International Trained Physicians of Ontario.
3) The federal government should consider tying funding for COVID-19 recovery and efforts to address
healthcare shortages contributing to the current crisis to provincial commitments and progress in
removing barriers faced by internationally trained health care providers.
4) Removal of barriers should include:
a. Opening all residency positions to competition by all Canadian citizens and permanent residents
who have graduated from Canadian medical schools or passed the Medical Council of Canada
exams which establish that they have the critical medical knowledge, decision-making ability
and clinical skills expected of a graduate of a Canadian medical school and as such are qualified
to work as resident physicians. A system designed to select for the best candidate as
determined by selection committees comprised of practicing, not academic physicians, will have
the added benefit of adding efficiency, reducing costs, and improving quality of care.
b. Increasing the number of residency positions.
c. Implementing Practice Ready Assessments (PRA) in all provinces for graduates of international
medical schools, including specialists, as an alternative to residency training.
d. Ending the requirement that graduates of international medical schools sign a return of service
contract as a condition of working as resident physicians. If it is considered necessary to have a
commitment for physicians to work in a particular location, such positions should be open to all
candidates. This burden should not be imposed on IMGs alone.
e. Removing exclusive responsibility and unfettered discretion for the system of selection of
residents from Faculties of Medicine and putting in place oversight to overcome the bias
embedded in the system.
f. Implementing and/or increasing existing oversight and accountability including enforcement
powers (by institutions such as provincial Colleges of Physicians and Surgeons and Fairness
Commissioners) of all aspects of the entry to the medical profession to ensure admission to the
profession is: (i) fair and free of discrimination, i.e., inclusive and consistent with the principles
of a free and democratic society; (ii) impartial; (iii) objective; (iv) flexible and (v) transparent.
g. Requiring representation of graduates of international medicals schools on all committees and
other forums which make decisions which affect graduates of international medical schools’
access to the medical profession.
Thank you for accepting and considering this submission. Should you desire further information
regarding these issues and recommendations, we would be pleased to respond to questions or to
appear in person before the Committee.
Comments Off on BC Licensing in Associate Physician and USA Certified Class
BC Licensing in Associate Physician and USA Certified Class—Some questions answered.
Eligibility Requirements
See HPA-Bylaws.pdf (cpsbc.ca) for the College eligibility requirements for registration at
s. 2-25- Associate Physician Acute Care
s. 2-26 Associate Physician Community Primary Care
s. 2-27 USA Certified
We sought clarifications. The College has advised us:
a. that someone registered in this class has the same scope of practice as a RCPSC certified physician but cannot hold themselves out to be RCPSC certified.
b. That physicians licensed in this class must bill under the Family Medicine fee schedule, not the specialist fee schedule.
Our additional questions were directed to CPSBC’s lawyer who responded as follows. Response are in italic:
Bylaws 2-25 and 2-26 Associate Physicians
Bylaws 2-25 (Associate Physician – acute care) and 2-26 (Associate Physician- community primary care) At this time, we do not have any further information related to section 2-26. As our website states:
“The Ministry of Health is working with the College and health system partners to develop a structure that enables associate physicians to work in community primary care settings. As this is a new classification, considerable planning is required to ensure appropriate and safe integration of associate physicians into community primary care settings. This includes establishing an employment and compensation model as well as a regulatory framework with supporting policies on clinical supervision. It is vital that policies and processes are in place to protect both the health and safety of patients, and ensure associate physicians are supported in their work to deliver quality medical care to British Columbians.
Interested applicants are encouraged to engage with Health Match (HMBC), the free health professional recruitment service funded by the Government of BC. HMBC supports physicians in navigating the pathway to practise medicine in the province. HMBC also guides physicians through the licensing and registration process and matches physicians’ skills and interests to opportunities throughout BC.
Questions:
1. Could you please send me a precedent sponsorship letter that would be satisfactory to the CPSBC? We will send a template under separate cover.
2. The bylaw provides that the letter must identify the applicant’s sponsor. Is it correct that the physicians seeking to hire, train, and supervise the prospective associate physician should contact the regional Health Authority for sponsorship and approval? This has not yet been determined as 2-26 is still under development with the Ministry.
3. Can you confirm that “sponsorship” is being used in the broad sense where the Health Authority is not paying for the associate physician but sponsoring in the sense of registering and approving the supervising physician and prospective applicant? See template letter.
4. Are there other requirements of sponsorship by the Health Authority? If there are, please specify what they are. It is an employment relationship. See template letter.
5. Does the CPSBC have a list of contact people at each Regional Health Authority for the supervising physicians to contact or do they just contact their local Health office? The College does not have a list of contact people.
6. Out of curiosity, why does the CPSBC require a Health Authority sponsor instead of just a qualified licensed physician sponsor? We are unable to respond as 2-26 is still under development with the Ministry.
Bylaw 2-27 USA Certified
Questions
7. Are we correct that CSAs can now come home and be licensed under 2-27 while they are going through the lengthy certification process, even if they have more than three years of ACGME accredited postgraduate training? Yes. Generally, the College is seeing applications from physicians who have the three years of training.
8. Are we correct that once these physicians licensed under 2-27 have worked their way through the RCPSC certification process, they can apply for full licensure and upon licensure in the full specialty class will no longer be restricted to the family practice fee billing schedule which the CPSBC advises 2-27 registrants are restricted to? Correct – if found to be eligible for the full or provisional – specialty class.
9. As evidenced by the Health Match BC vacancy list, there is substantial need for specialists in other fields. Where there is a difference in length of training, does the CPSBC anticipate expanding this classification beyond pediatrics, internal medicine, and emergency? No.
10. If so, when? See answer above.
11. Of particular interest are psychiatry, anesthesiology, and obstetrics and gynecology where the PGT training is one year shorter. Are these specialties under consideration for a class similar to 2-27? No
Billing
Many of the items in the fee schedule are the same regardless of whether they are billed under the Family Medicine Fee schedule or whether billed under the fee schedule for the specialist. We sought clarification from Health Insurance BC about billing. We were advised:
“Restrictions on certain Specialist fee codes
While fee items within the Payment Schedule may only appear under certain sections (such as under Family Medicine, or Pediatrics, etc.) that does not necessarily mean that the fee items are restricted to those practitioners that are registered with the CPSBC (and thus with MSP) as that particular specialty.
Most procedures listed within the Payment Schedule are not restricted by specialty, regardless of which section the fee may be listed in. The primary exception to this is diagnostic procedures, which are more likely to be restricted to the section specialty in which they are listed. As an example, Electrocardiogram and interpretation codes 00527 (for office) and 00528 (for home) are restricted to Pediatrics. So there will be services that a pediatrician can bill for, that a Family Medicine specialist cannot.
In addition, the specialist consultation and visit codes that appear within a particular section of the Payment Schedule will be restricted to practitioners of that specialty. So 00510 (Pediatric consultation), or 50507 (Pediatric telehealth subsequent office visit) would be restricted to a practitioner that is registered with MSP as a Pediatrician. The same logic applies to all other sections with the exception of Family Medicine. Fee codes such as 00110, or 00100 are billable by any specialist.
Exemption of specialty restrictions
There may be circumstances where a practitioner wishes to bill for specialty restricted fees. To be able to do so, the practitioner would first need to obtain the approval of the section of medicine that is responsible for the fee item in question. To start this process, the practitioner needs to contact the responsible section through the Doctors of BC. They will be able to provide further guidance on how to apply for an exemption to a specialty restriction.
Rate difference between conceptually similar Specialty fee codes
There will be circumstances where the rate of compensation between different specialties for the same conceptual service differs (ex: 12100 GP office visit age 0-1 @ $34.90 vs 00507 Pediatric subsequent office visit @ $91.04 vs 00307 General Internal Medicine subsequent office visit @ $53.73). The rate at which a fee item is set is done external to MSP and would be handled by the Medical Services Commission at the recommendation of the Doctors of BC and/or the Government of British Columbia. Section C. 2. “Setting and Modification of Fees” (page 1-8) in the MSC Payment Schedule has more information about this.
Ministry of Health – Medical Services Commission Payment Schedule – 01 May 2022.pdf
Associate Physician Classification Payment Schedule and Billing
MSP does not have any information at this time as to whether or not any fee codes, or a broader Payment Schedule, is being developed for associate physicians. Such development would be handled by the Medical Service Commission with the Doctors of BC and the Government of British Columbia.
So long as the associate physician is registered with MSP, they would submit claims for services to MSP using eligible fee codes. This may be done through the Teleplan system, or if eligible, via form HLTH 1915 (details of which may be found here: HLTH 1915 Pay Practitioner Claim (gov.bc.ca))
I hope this has provided the information you were looking for. If there are other questions, please do not hesitate to contact us.
MSP Billing Support can be reached at:
Phone 1-866-456-6950 press option 1, then option 1 again
Fax 250-405-3593
Doctors of BC can be reached at:
Phone 1-800-665-2262
https://www.doctorsofbc.ca/
Want to stay informed about the latest and most up-to-date news affecting Canadians studying medicine abroad and Canadian International Medical Graduates who want to practice medicine in Canada? Join our Facebook page and check it out regularly.
Comments Off on NEWS RELEASE: PROGRESS IN ONTARIO / COMMUNIQUÉ DE PRESSE: PROGRÈS EN ONTARIO
NEWS RELEASE
SOCIETY FOR CANADIANS STUDYING
MEDICINE ABROAD (SOCASMA)
(Le français suit.)
The Society for Canadians Studying Medicine Abroad is applauding the recent announcements* made by the Government of Ontario and the College of Physicians and Surgeons of Ontario (CPSO) with regards to the funding of additional medical residency positions and the removal of barriers for internationally educated physicians.
“These are first, but important steps aimed at improving the provision of medical care for all Ontarians. We applaud Ontario’s leadership and urge other provinces to follow suit and consider going even further in providing Canadians the health care they deserve. Our health care system will recover when an adequately sized workforce is qualified and treated equitably, whether trained in Canada or abroad” says Rosemary Pawliuk, Executive Director, SOCASMA.
To build upon the partial progress made as a result of these recent announcements, SOCASMA urges the Government of Ontario, as well as other provincial and territorial governments to also:
Establish a residency recruitment system that permits all Canadians and permanent residents to compete equally for all residency positions on the same level playing field and that is free from systemic discrimination, whether they are graduates of Canadian Medical Programs or Internationally Recognized Medical Programs.
Support the development Practice Ready Assessment for physicians trained in non-approved jurisdictions.
For the College of Family Physicians of Canada to expand the list of approved jurisdictions. For example, to better serve the needs of the francophone community of Ontario, and in line with the French Language Act of Ontario, for the CPSO to consider adding France, Belgium and Switzerland as part of those countries that will be able to obtain Registration from the College of Physicians and Surgeons of Ontario without supervision, assessments and further examination. (U.S., U.K., Ireland and Australia are newly eligible.)
For all provinces to implement transition programs and alternate medical profession pathways for unmatched medical graduates.
Rosemary Pawliuk
Executive Director
SOCASMA
E-mail: socasma@outlook.com
Tel: 604-541-4747
SOCIÉTÉ POUR LES CANADIENS QUI ÉTUDIENT
LA MÉDECINE À L’ÉTRANGER (SOCASMA)
La Société pour les Canadiens étudiant en médecine à l’étranger applaudit les récentes annonces* faites par le gouvernement de l’Ontario et l’Ordre des médecins et chirurgiens de l’Ontario (OMCO) concernant le financement de postes de résidence en médecine supplémentaires et la suppression des obstacles pour les médecins formés à l’étranger .
« Il s’agit de premières étapes, mais importantes, visant à améliorer la prestation de soins médicaux à tous les Ontariens. Nous applaudissons le leadership de l’Ontario et exhortons les autres provinces à emboîter le pas et à envisager d’aller encore plus loin pour fournir aux Canadiens les soins de santé qu’ils méritent. Notre système de santé se rétablira lorsqu’une main-d’œuvre de taille adéquate sera qualifiée et traitée équitablement, qu’elle soit formée au Canada ou à l’étranger », a déclaré Rosemary Pawliuk, directrice générale, SOCASMA.
Pour tirer parti des progrès partiels réalisés à la suite de ces récentes annonces, la SOCASMA exhorte le gouvernement de l’Ontario, ainsi que les autres gouvernements provinciaux et territoriaux à également :
– Établir un système de recrutement en résidence qui permet à tous les Canadiens et résidents permanents de concourir de manière égale pour tous les postes de résidence sur un pied d’égalité et qui est exempt de discrimination systémique, qu’ils soient diplômés de programmes médicaux canadiens ou de programmes médicaux reconnus à l’échelle internationale.
– Appuyer le développement d’évaluation de la préparation à la pratique pour les médecins qui ont été formés dans des juridictions non approuvées.
– Pour que le Collège des médecins de famille du Canada élargisse la liste des juridictions approuvées. Par exemple, pour mieux répondre aux besoins de la communauté francophone de l’Ontario, et conformément à la Loi sur les services en français de l’Ontario, que l’OMCO envisage d’ajouter la France, la Belgique et la Suisse parmi les pays qui pourront obtenir l’inscription auprès de l’Ordre des médecins et chirurgiens de l’Ontario sans supervision, évaluation et examen supplémentaire. (Les États-Unis, le Royaume-Uni, l’Irlande et l’Australie sont nouvellement éligibles.)
Que toutes les provinces mettent en œuvre des programmes de transition et des cheminements alternatifs vers la profession médicale pour les diplômés en médecine non jumelés.
On March 9, 2023, the College of Physicians and Surgeons of Ontario (CPSO) released proposed changes to registration and licensing policies that seek to expand access and reduce barriers for U.S. board-certified physicians and U.S. physicians deemed eligible to sit U.S. Specialty Board examination to practise independently in Ontario. https://dialogue.cpso.on.ca/2023/03/proposals-reduce-barriers-for-u-s-trained-physicians/
If implemented, this proposal could substantially increase the number of physicians in Ontario. Physicians recruited to Canada from the United States would primarily be Canadians who studied medicine abroad (CSAs) and then completed training in the United States. We urge you and the College of Physicians and Surgeons of Ontario to approve this proposal to bring Canadian physicians back home so that they can serve Ontarians in need of health care.
Sincerely,
Carole Lafrenière
Director
Society for Canadians Studying Medicine Abroad
Ottawa, Ontario
Cc. College of Physicians and Surgeons of Ontario feedback@cpso.on.ca
MedsHousing.com, a partner of the Canadian Federation of Medical Students is a global platform founded by a team of medical community members seeking to alleviate the stress of searching for housing during medical training. The service is free for medical learners and caters exclusively to the medical community. It is an important resource dedicated to helping the medical trainees find reliable housing across Canada and abroad during their undergraduate and postgraduate training.
MedsHousing.com is a website dedicated to posting short and long-term housing that is:
● Offered exclusively to the medical community
● Suitable for international placements, such as clinical rotations and electives
● Close to hospitals, clinics, medical school & satellite campuses
● Furnished and unfurnished
● Ideal for rural placements
Web site: https://www.medshousing.com/
Comments Off on YOU WANT TO MAKE A DIFFERENCE? ATTEND OUR ANNUAL GENERAL MEETING!
YOU WANT TO MAKE A DIFFERENCE? THEN GET ENGAGED AND ATTEND SOCASMA’S ANNUAL GENERAL MEETING DECEMBER 17. YOUR INVOLVEMENT IS CRUCIAL TO IMPROVE ACCESS TO RESIDENCY TRAINING AND MEDICAL LICENSING IN CANADA. THE MEETING WILL ALSO BE AN OPPORTUNITY TO SPEAK ABOUT YOUR EXPERIENCES IN GETTING READY FOR THE MATCH.
NOTICE of ANNUAL GENERAL MEETING for CANADIANS STUDYING MEDICINE ABROAD and THEIR FAMILIES AND FRIENDS.
Date: Saturday, December 17, 2022
Time: 9:00 a.m. PACIFIC TIME
Place: Zoom
It is time for our annual meeting. Participation will be by Zoom. The meeting invitation link is below.
At this meeting we will be discussing:
Our annual report
Our work and achievements including progress in court challenge to the discrimination we face in access to licensing.
Obstacles we are facing and supports we need,
Planning an information meeting for students in late December so they can strategize to match
and
We will be electing the directors of SOCASMA.
We have invited some CSAs who have matched recently to speak and field questions.
MEDICAL STUDENTS- PLEASE SHARE THE MEETING INVITATION AT YOUR SCHOOL AND OTHER SCHOOLS AND FORWARD IT TO YOUR CANADIAN CLASSMATES. ENCOURAGE YOUR FAMILY AND FRIENDS TO ATTEND THE MEETING.
Please RSVP socasma@outlook.com or message us on Facebook the number that will be attending the meeting, together with any questions or requests that you would like discussed at the meeting.
SOCASMA is inviting you to a scheduled Zoom meeting.
Topic: SOCASMA Annual General Meeting
Time: Dec 17, 2022 09:00 AM Vancouver
Meeting ID: 840 5514 6270
Passcode: 107250
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