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  1. #1
    azskeptic's Avatar
    azskeptic is offline Moderator 666 points
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    Foreign Physicians--filling the gap or falling short?



    Over the years, the shortage of physicians in Ontario has
    become increasingly apparent and well publicized.
    Recently, the government of Ontario has responded by
    facilitating international medical graduates (IMGs) in
    gaining licensure to practice in Canada. This move
    includes expansion of the current Ontario IMG program,
    as well as the implementation of a new program to expedite
    the licensing of practicing foreign physicians. While
    this is intended to address the issues of physician supply
    and the distribution of specialties in under serviced areas,
    it is questionable whether these policies will meet their
    intended goals in the long term. Potential problems with
    these programs include lack of fulfillment of needed specialties,
    difficulties retaining IMGs in rural, remote and
    under serviced areas, and the exploitation of these opportunities
    by Canadian students unable to gain admission to
    domestic medical schools.
    In the fall of 2001, the Ontario government increased the annual
    number of positions in the existing program to train international
    medical graduates (IMGs) and initiated a program to
    quickly license recently practicing foreign physicians.1 The goal
    of this move is to ensure “an appropriate supply, mix and distribution
    of doctors throughout the province to meet the health
    needs of all Ontarians”, as addressed in The George Report:
    “Shaping Ontario’s Physician Workforce”.2 Increasing the number
    of IMGs will produce more physicians in Ontario, but
    sheer numbers are not enough. Based on current trends, it is
    questionable whether foreign-trained doctors will effectively fill
    the gaps in physician mix and distribution in Ontario and be
    able to provide the quality of care expected of Canadian-trained
    As shown by recent years’ residency match results, the mix of
    specialties required in under serviced areas has not been met.
    As described by The George Report, the most critically needed
    services in smaller communities are family physicians who
    can provide comprehensive care in obstetrics, emergency services
    or anaesthesiology.2 Although the IMG program was
    designed to target the most-needed disciplines, only 12 of 70
    (17%) graduates of foreign medical schools entering practice in
    the year 2000 were trained in family medicine in Ontario. In
    comparison, 210 of 582 (36%) Canadian graduates entered
    practice in family medicine that year.3 Furthermore, in the 2001
    Canadian Residency Match, 60 out of 387 IMGs were matched
    to a residency position while, across Canada, 38 family medicine
    and 2 psychiatry residency positions remained unfilled.4 In
    Ontario alone, there were 22 unmatched positions, 21 in family
    medicine and 1 in psychiatry. It may be beneficial to explore
    why such a large number of IMGs are unmatched each year
    despite the large number of residency positions in the targeted
    disciplines remaining unfilled. Reasons for this discrepancy
    may include IMGs entering the match but not applying to these
    much-needed disciplines or being found to be unsuitable candidates.
    Given this predicament, educational resources might
    be put to more effective use by increasing enrollment in
    Ontario medical schools. This may be a viable solution since
    domestic graduates seem to be more inclined to enter fields in
    need and would have received an education tailored to the
    needs of Ontarians.4
    Historically, the use of IMGs has not been effective in addressing
    problems of physician distribution, as noted in The George
    Report. The difficulties associated with retaining physicians in
    rural areas, including lack of support, resources and inadequate
    compensation, have been well described.2 Foreign medical graduates
    would certainly be expected to face the same challenges
    but may also encounter difficulties communicating effectively
    with patients. Despite passing TOEFL (Test of English as a
    Foreign Language), IMGs have themselves raised the issue of
    language barrier in the past to account for poor performance
    on subsequent testing such as MCCQE Part II.5 These same
    language problems would invariably compromise patient-physician
    interaction, which is an essential part of family practice.6
    This is particularly true in rural communities where English and
    French are often the only functional languages, and patients’
    choices of physicians are limited. Moreover, IMGs from forvolume
    79, number 2, March 2002 169
    Foreign Physicians: Filling the Gaps or Falling Short?
    Luke Drzymala (0T3)
    Joyce So, PGY1, Medical Genetics, University of Toronto
    Medical Education
    Moderator - State Licensing Forum

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  2. #2
    sofya is offline Newbie
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    Mar 2004
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    doubts...maybe you can hel me???

    Hi! I´m an international medical student graduating in December and I´m interested in doing my postgraduate residency in Canada but I´m not sure about the best way to prepare for the exams I have to take. If you know of anyone who has taken them or have any suggestions as to how to best study for the examinations...I would greatly appreciate any info...

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