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Should Canada facilitate more foreign doctors?

Posted on 05/11/2019

While provinces like British Columbia and, more recently, Nova Scotia have opened streams in their provincial nominee programs for foreign doctors, there is an immediate and growing need for doctors across Canada as baby boomers begin to retire and Canada’s populations continues its steady rise.

Unfortunately, getting credentialed by medical organizations in Canada like The Medical Council of Canada, the College of Family Physicians of Canada, and the Royal College of Physicians and Surgeons of Canada is a time-consuming, burdensome process with many foreign-trained physicians having to re-do several years of their medical studies. While the concern for ensuring that foreign-trained physicians are up to Canadian standards is understandable, the process can be so discouraging that hundreds, perhaps thousands, of foreign-trained doctors are living in Canada and having to work at another occupation when many of them could perhaps be helping solve Canada’s shortage of doctors.

Can the process be streamlined without compromising the health and safety of patients in Canada?

Let’s consider Nova Scotia Provincial Nominee (NSPN) Physician stream, which was announced in early 2018. It involves 2 essential stages:

Level 1: Application to the NSPN Physician stream.

  • Applicants must meet the following eligibility criteria:
  • You must have legal status in your country of residence, whether it be Canada or a foreign country. If not, you must first achieve legal status in whatever country you are resident of.
  • You must have what is called a Written Approved Opportunity with either the Nova Scotia Health Authority (NSHA), or the IWK Heath Centre (a provincial health organization known by the initials IWK). The written approved opportunity is essentially a job offer in the following occupations:
  • General practitioner and family physician (NOC 3112)
  • Specialist physician (NOC 3111)
  • The written approved opportunity must:
  • Be on official NSHA or IWK letterhead
  • Be signed and dated by a person authorized to hire physicians
  • Be signed and dated by the applicant
  • Indicate eligibility for licensure with the College of Physicians and Surgeons of Nova Scotia
  • Indicate that the applicant is eligible to apply for privileges and credentials with the NSHA or IWK
  • The applicant must have an Educational Credential Assessment (ECA) of their foreign studies or have proof of education and medical training required for licensure in Nova Scotia.
  • The applicant must have the ability to perform their tasks in either English and/or French. This implies a high level of fluency given the detailed communications involved in a physician’s daily work.
  • Once the applicant has sent in a completed application form with supporting documentation, it will be assessed by Nova Scotia’s Office of Immigration (this is not the IRCC) and if successful, the applicant will receive a letter from Nova Scotia’s Office of Immigration confirming their nomination. A copy of the letter will be sent directly to IRCC as well.

Level 2: Apply for Permanent Residency to IRCC as a provincial nominee.

  • While a provincial nomination is extremely helpful towards getting a PR visa, the province of Nova Scotia cannot guarantee that their nominating an applicant means they will automatically receive a PR visa. The final decision is up to IRCC.
  • If the applicant is successful, they will receive a visa (which will be stamped in your passport when you send it in previous to travelling to Canada) along with a Confirmation of Permanent Residence (COPR). You must send a copy of your COPR to Nova Scotia’s Office of Immigration.
  • You must inform the province’s Office of Immigration within 30 days of arriving.


As can be seen, the credentials assessment is a key part of the process and one which might prove hard for some applicants to overcome. Nova Scotia has been largely hiring doctors from the UK, where language ability and somewhat similar medical systems mean they can transition fairly easily to Canada’s healthcare system.

But for doctors from countries like India, Nigeria, Brazil, and others, the process is often slower and may involve credentialing requirements that the applicants cannot afford the cost and time to undergo. There have been reports that over 1 thousand foreign-trained doctors living legally in Canada have been unable to obtain residency training (which is required to become eligible for licensure) in the province they wish to practice medicine in.

Can a residency training program specially tailored for experienced doctors trained abroad be expanded and improved in provinces like Ontario or Alberta? As well as the other provinces and territories? It’s a question that needs to be asked as doctor shortages are reportedly growing worse around the world. Canada may find itself desperately shopping for doctors anywhere they can find them at some point in the future. Smart choices right now could lessen the impact of such a potential crisis.

This also means expanding the number of physician occupations eligible for a provincial nomination before shortages become too large of a problem. This would involve provincial nominee programs working closely with medical authorities (like those listed above) at the provincial and federal level to open up more physician occupations to qualified foreign-trained and Canadian-credentialed doctors.

Finally, while IRCC is the final arbiter on any given application, perhaps even more weight should be given to provincial nominations in the healthcare field, trusting that the local provincial immigration offices have the best interest of their residents healthcare needs at heart and have taken abundant precautions and done rigorous background checks before issuing a nomination. This is not to suggest that there are conflicts between provincial nomination procedures and IRCC decisions. It is merely to suggest that the reasons for IRCC overturning any nomination must be clear.

It does seem that now is the time to start looking for innovative ways to maintain the quality of healthcare in Canada. Top-quality foreign-trained doctors are certainly part of any solution over the coming years in Canada.

Posted in Tips and tagged foreign doctors coming to Canada, permanent residence Canada, PNP

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