Doctor says he’s coming but you’ve gotta pay in cash

By Julianne Yip

It’s no easy task to become a medical doctor, let alone re-learning your profession in a foreign language and culture. As daunting as it may seem, this is what foreign-trained doctors must accomplish to establish their own practice in Canada. The Medical Communication Assessment Program is helping them to do just that.

The M-CAP is a joint initiative between the University of Calgary’s education and medicine faculties. Currently, there are 40 international medical graduates enrolled in the program from countries such as Chile and Iran. The program’s main goal is to improve the English language proficiency of foreign-trained doctors and, more importantly, to help them develop patient-doctor skills in a new cultural context.

“We’re trying to go from the doctor-centered approach which may be accepted in the countries where [the IMGs] came from, to a patient-centered approach, which is found in North America,” said faculty of education professor David Watt, who is also one of the M-CAP program’s main creators. “It puts language demands on the doctor because they never had to think about these things in their own language.”

Training immigrant doctors isn’t just beneficial for those in the program, but could also help to relieve Canada’s physician shortage. According to Statistics Canada, in 2003, about 1.2 million Canadians were unable to find a regular doctor and the problem will only get worse as Canada’s aging population grows. One proposed solution is to fill the gap with IMGs–an idea that is already in motion.

“Believe it or not, about 25 per cent of practicing doctors are IMGs,” said Alberta International Medical Graduate Program coordinator Howard Wright. “It’s a huge number. Some provinces have even higher numbers. Look at Saskatchewan where almost 50 per cent of doctors are IMGs.”

Some people view the practice of training immigrant doctors to fill the health care system vacuum as irresponsible, as stated in the 2006 Fraser Institute report, written by Nadeem Esmail, Canada’s Physician Shortage: Effects, Projections, and Solutions. Relying on IMGs prevents Canadian-trained medical students from taking advantage of this opportunity. Furthermore, recruiting IMGs from areas like southern Africa, where 34 per cent of global AIDS deaths occur, worsens health care in their native countries.

Wright and Watt both pointed out that neither AIMG or M-CAP poach from overseas.

“All our applicants have to be Albertan, Canadian residents,” said Wright. “All our IMGs are landed immigrants. These individuals have made a choice. They have a right to be employed to use their skills.”

Wright also noted that the program does not eliminate Canadian medical students from obtaining positions. In addition to the number of training positions that it allocates each year to Canadian medical students, the Canadian government also provides seats specifically for international applicants–Canadian and internationally trained medical students do not compete with each other for training spots.

“It’s a very tough situation for these people,” said past U of C professor and Medical Doctor Jean Worms. “Some of these people have been trying for five or six years to get a position and during this time their skills are getting rusty. Even getting into the M-CAP program is an extremely competitive process, with 200 foreign-qualified medical doctors vying for 40 spots.

In the meantime, foreign-trained doctors are driving cabs, working at gas stations, or cutting meat, she said.

“Lakeside Cutters is full of physicians,” said Worms. “But their skills are better than cutting beef.”

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