By David Chilton
Special to The Sun
Ontario's Ministry of Health and Long Term Care says there are 140 or so communities in the province considered medically underserved. And despite popular opinion, not all of them are fly-in native communities on James Bay or small northern resource towns. Some, such as Kitchener and Cambridge, are in far less remote parts of the province, an hour or two drive from Toronto.
One of the ways Queen's Park is tackling the problem is International Medical Graduates Ontario, which marked its first anniversary at the end of June. The program is a collaborative assessment and training initiative by the Ministry of Health, the College of Physicians and Surgeons of Ontario and the province's five medical schools to integrate doctors trained abroad into the medical system here.
Anne Marie Crescenzi, executive director of IMG Ontario, says last year the government put up the funding to assess and train 200 doctors a year from overseas who are already living in the province. In the first selection cycle 154 physicians were chosen.
"A hundred and fifty four were considered the best candidates available," Crescenzi says. "You have to maintain the standards in Ontario. We certainly had many more applications, but the selection process is undertaken by all five medical schools in the province and we're dependent on the expertise of educators."
There were about 950 applicants to the IMG Ontario program last year, Crescenzi says.
How much time a foreign-trained doctor needs to spend being brought up to Canadian medical standards depends on the individual and where he trained, she continues. A general surgeon from New Zealand might only need six months preparation before being practice ready, Crescenzi says. A family physician from Sri Lanka would have to spend another two years studying before being allowed to practice here.
Many applicant doctors come in at the "entry level," Crescenzi says, so if they want to become orthopedic surgeons they would need five years training, just as a Canadian would.
American doctors who want to practice in Ontario are exempt from the assessment and training process since their skills are considered the equal of Canadian physicians'.
IMG Ontario offers 200 assessment and training places a year to foreign-trained physicians.
Successful IMG Ontario applicants are trained along side Canadians in one of five medical schools in the province.
Applicants must pass a written exam, a clinical exam and be interviewed by the medical school's program directors before being accepted.
Proof of competency in English is required.
Last year out of 950 applicants 154 doctors trained abroad were selected for the program.
Doctors who apply to the program must of course supply the necessary documentation to support their application. "The (doctor's) actual portfolio is assessed, but then everybody must write a written exam and they must all do a clinical exam. You are scored on that and then invited for an interview or not invited for an interview depending on those scores," Crescenzi says.
Medical school program directors conduct the interviews. Naturally, there is an English competency requirement for all applicants.
As attractive as IMG Ontario is, it doesn't come without strings attached. Crescenzi says in return for the foreign physician's assessment and training, the province demands a five-year "return of service" agreement from them. That means they have to spend five years practicing in an underserved community. That could be Kitchener or Cambridge, or it could be in other towns that people don't realize need doctors, says Ministry of Health spokesperson Dan Strasbourg.
Guelph needs doctors, Strasbourg says, and so do St. Catharines, Cornwall, Sarnia, Brockville and elsewhere. In Barrie alone, he says, there are 14 vacancies for general practitioners.
But as well as the IMG Ontario program doing its part to address the shortage of physicians, Strasbourg says there are also financial incentives to encourage doctors -- trained here or requalified here -- to practice in designated areas. Any physician who goes to a designated northern community is eligible for a $40,000 grant over four years, and even in designated areas in southern Ontario there's a $15,000 grant for them spread over four years.
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