Welcome and call to order - Dr Muhammad Rafiq, Chair

Part I: Association Update - Elizabeth McIsaac, Project Coordinator

Elizabeth reported that the association membership now totals over 300, from Windsor to Ottawa. Small focus group meetings will be starting next week to document experience, and develop positions and strategies of the association.

From 12 to 15 October, the FTDA was represented at the Qualifications Recognition Conference in Toronto. The conference was the result of a governmental federal-provincial working group on access to professions and trades. Government, universities, regulating and licensing bodies, and non-governmental groups attended, with the objective of identifying best practices and moving forward in removing barriers. There was a panel discussion entitled, "Recognition of Foreign Trained Physicians" with Claire Gerencser (Welland Multicultural Centre), Rudy Masswohl (Employment Help Centre, St Catherines), Dr Tiina Kaigas (CPSO), Dr Muhammad Rafiq (FTDA) and George Zegarac (Ontario Ministry of Health). Dr Rafiq concluded his presentation by inviting Dr Kaigas to meet with the FTDA to discuss ways in which we can work together to improve access for foreign-trained physicians. Dr Kaigas agreed to meet with Dr Rafiq and Elizabeth on 3 November 1999 when she expressed a positive interest in the association and the possibility of working on issues of access. However, she is unable to speak on behalf of the CPSO and advised on how we should proceed with the executive council, president and registrar.

Another outcome of the conference was the formation of the Ontario Network for Access to Trades and Professions. The FTDA is a member of this network which will work on broad based support and advocacy for access to trades and professions.

On 25 November 1999, Tony Ruprecht of the Ontario Liberal Party proposed a Private Members resolution in the Ontario legislature. The resolution follows:

1. That individuals have the opportunity to seek licensure or certification in professions and trades for which they have been trained, in the context of provincial human resource planning, and without additional barriers not faced by Ontario-trained individuals;
2. That full information on the licensing/certification standards and appeal processes of licensing and occupational bodies be available and accessible;
3. That any competency assessment of licensure/certification requirements be based on criteria relevant to performing adequately in the profession or trade;
4. That candidates be provided with written reasons for denial of an application or appeal for certification or licensure in a trade or profession;
5. That individuals have access to training opportunities when upgrade training would allow Ontario competency standards to be reached, based on occupational demand and financial feasibility; and
6. That all self-governing occupational licensing bodies provide internal appeal processes which are sensitive to such matters as timelines and access to information, whereby decisions of licensing bodies can be objectively reviewed by staff other than those conducting initial assessment.

The report from the McKendry Commission has still not been released. The Ontario Ministry of Health is expected to release it within the next couple of weeks. Expected outcomes of the report include an immediate increase in the number of IMG positions, and the appointment of an expert panel to develop long term solutions. The FTDA has made a formal request to be represented on that panel. Postcards to the Minister and the Premier, asking for representation of the FTDA on the panel, an immediate increase in the number of IMG positions, and a commitment on the part of the Ministry to work with the FTDA were distributed to all present.

Regarding communications, the FTDA website is operational at http://home.ica.net/~cassa/FTDA. Members were encouraged to get email addresses to facilitate information dissemination and coordination. A directory will be developed for those members who want their contact information to be made available to other members of the association. For those not present, they can let Elizabeth know if they would like to be included in this directory.

Given the negative connotation of the word "foreign", the absence of professional experience implied in the word "trained" and the formal name of the profession, a motion was put forward by the steering committee to change the name of the association to the Association of International Physicians & Surgeons of Ontario. 

Dr Saddiq Weera (Hamilton) provided background of the group in Hamilton, having formed in 1993. They are looking for ways to work with AIPSO. Dr Weera also presented a two-tiered model of how Hamilton FTDs have approached advocacy work. Dr Weera concluded with encouraging statements of his experience and his current work as a PhD candidate.

Dr Ayman Al-Masri (Kitchener-Waterloo) provided supportive statements on the efforts of FTDs working together and referred to some of the statistical information available on the issue. This information will be posted on the website

Rudy Masswohl (St Catherines) The groups in St Catherines and Welland are making a submission to the Regulated Health Professions Act Review which governs the power of the regulating and licensing bodies in Ontario (i.e. CPSO). There is a need for statistics on examination completion to strengthen arguments around the shortage of physicians in Southwestern Ontario. In St Catherines, they have developed a library for local FTDs studying for exams. Mr Masswohl noted the mentorship programme being developed by the rotary club which provides an introduction for international professionals to the Canadian environment, and increase employment opportunities.

Part II: Panel Discussion

Ratna Omidvar, Maytree Foundation (funder of the FTDA/AIPSO)

Ms Omidvar spoke about the values of the foundation and discussed some of the strategies that the association and individuals should be using to advance their case. Below is a summary of this advice:

1. The work of the AIPSO must be based on facts, solid research and good analysis, moving beyond personal anecdotes to scientific evidence and analysis of the case;
2. We need to understand the complexities of the problem and develop fact based knowledge to give us credibility;
3. Improving access does not mean lowering standards - we need to know that credentials are assessed fairly, and if upgrading is required, how to obtain it;
4. We need to work with other stakeholders, particularly licensing bodies, and introduce to them concepts like Prior Learning Assessment and appeals processes that enhance their institutions;
5. We must make use of timing and context, especially with the current shortage of physicians;
6. We need to work with government - continue to pressure them to deliver on their promises; and,
7. We must work with allies (i.e. licensed international physicians), the media and our own communities.

Ms Acs provided an overview of the problems and barriers existent in professions and trades. The role of the APT Unit is to ensure that there is fair and merit based practices, to develop partnerships with regulatory bodies and community groups like AIPSO, and to try to bring those groups together to develop fair and merit based processes.

Ms Acs reviewed the current projects of the APT unit, including: Information fact sheets on various professions (although physicians are not currently included, this is something government can do);

Website (which should include doctors, although it does not at the moment) Academic Credential Assessment (service should be operational in the next couple of years, yet it is not binding on regulatory bodies); Prior Learning Assessment tools; Alternative testing has been developed with the midwives and physiotherapists; STIC programs.

Below is a summary of the advice Ms Acs provided on how to work effectively with government:

1. We need to be realistic and learn how government works, who the key players are, who the decision makers are, and what their roles are;
2. We need to develop a strategic plan and approach that identifies key decision makers and activities and types of pressure that they will respond to;
3. Present the issue in factual objective terms and present solutions;
4. Understand the economics of the solution, including both the cost of the solution we propose, and the cost of not implementing the solution; and,
5. Identify other stakeholders and build alliances.

The next general meeting will be held in March 2000, and it is hoped to have various political representatives present for a debate on the issues.