Dr. Aida Elnagar from Sudan has passed all her qualifying exams for medical practice in Canada and volunteers at Refuge: Hamilton Centre for Newcomer Health while she seeks a residency position, which is required for employment.
Nearly 1.9 million Canadians are unsuccessful in their attempts to find a family doctor, according to Statistics Canada (2009). Yet, the line-up of Internationally Trained Medical Doctors (IMDs) seeking employment in Canada is shockingly long. In Ontario alone, there are over 7,500 IMDs. Over half of these have completed their exams, but have been unable to successfully secure a residency position, according to the Association of International Physicians and Surgeons of Ontario, a non-profit advocacy group.
How is it possible that this disconnect exists?
Dr. Maysoon Alhiali is asking the same question. She was accepted into Canada as an Internationally Trained Professional and in 2009 made Ontario her home. But there is one thing that has troubled Alhiali – the large gap between what she was told before coming to Canada and what is actually being offered in terms of available positions and support for IMDs.
“All we would have wanted is the facts, from the beginning,” she explained. Now she is finding that in her fight for employment, “the odds are against us.”
Dr Syed Affaq, a Radiologist Physician from Pakistan faces struggles of his own. “Being new immigrants in Canada, we have to face a number of stresses and difficulties. First are financial problems: unemployment and not having a job related to our skills.”
“I was aware that there would be certain hurdles including examination and certification. I was not aware that some of my colleagues who have passed the exam have not been able to get residency. This is the thing that is disappointing.”
He mentioned that two or three examinations can amount to fees of around $5,000. In addition to the number of years spent studying, applying, and seeking residency without paid employment, many physicians (often facing unemployment after gaining qualification) are left in financial despair.
Affaq’s experience has “led to depression sometimes” – but he and his family are facing their struggle bravely.
He continued, “My family and I are thankful to the Canadian Government for letting doctors immigrate to Canada. But the system is very difficult. We are facing culture shock and financial problems now. We left very good jobs and practices.”
“The system is very difficult. We are facing culture shock and financial problems now.”
“It is discriminatory, I’m afraid,” said Sara Cymbalisty, founder of the Bridge Program for IMDs in Hamilton.
“A lot of physicians end up on social assistance and the government could put that funding into helping them get residency…We need that funding for established physicians to get paid to mentor Internationally Trained Doctors.”
“I wish there were such a program in Canada where professionals would get programs and guides to help with going through the system,” continued Alhiali. ”We have people who are skilled; we have positions which are not filled. They need to put funding toward programs which will create bridging programs for residencies.”
She continued, “It’s not easy to bring people and let them sit without jobs. We are used to work and we cannot live without work. All internationally trained immigrants have this story – but each of us have our own difficulties,” she explained.
Alhiali is still waiting for documentation in order to qualify for certification, proving her work experience in wartorn Iraq. Some of the hospitals she worked in are now ashes and rubble.
Coordinated by Sara Cymbalisty, International Medical Doctors gather for a course at The Bridge Program for IMDs in Hamilton with guest Dr. Elise Hall.
Four times a year Cymbalisty offers a six-week long course in Hamilton that teaches exam principles and Canadian cultural competency to IMDs. Doctors pay for the course, and come from across Canada to take it.
In her work, Cymbalisty has seen her fair share of success stories, of doctors getting jobs across the country. But she has also seen the other side of the story, including families broken up because physician couples find residencies in different provinces, or they return home bankrupt without any employment. The decisions and stresses these doctors face can be traumatic.
Despite the challenges, she remains hopeful: “For people who don’t give up, they have a strong chance of getting in.”
“For people who don’t give up, they have a strong chance of getting in.”
That is the attitude of Dr. Aida Elnagar, who came to Canada as an IMD from Sudan. She has passed her qualifying exams and has been volunteering at the Refuge: Hamilton Centre for Newcomer Health to use her skills for the betterment of the community while she seeks residency.
“I was a refugee too,” she explained. “I’m using my experience to help others.”
While her search for residency hasn’t yet been successful, she is applying again this year with high hopes. “It’s been hard but not impossible,” she said. She agrees Canada should have more residency spots for IMDs so qualifying applicants don’t lose years to uncertainty.
Article and Photos by Michelle Drew