Foreign Trained Doctors Association
(FTDA)
c/o Council of Agencies
Serving South Asians (CASSA)
2 Carlton Street, Suite
1302, Toronto, Ontario; M5B 1J3;
Tel (416) 979-8611;
Fax (416) 979-9853
Email: cassa@ica.net
Website: http://home.ica.net/~cassa/
Dr Robert McKendry
c/o Maureen McEwen
8th Floor, Hepburn Block
Queens Park,
Toronto ON; M7A 1R3
By fax: (416) 327-0167
Pages: 4 including this cover
page
31 August 1999
Dear Dr McKendry:
On behalf of the Foreign
Trained Doctors Associations of Ontario that were represented by our submission
on 20 August 1999, I would like to thank you for taking the time to meet
with us, and to listen to the concerns and viewpoints of our membership.
It was our understanding
that you were interested in and receptive to further and more tangible
recommendations on the integration of foreign trained doctors into the
Ontario health care system. As such, we undertook a brief consultation
with some of our members and have prepared some initial proposals which
follow.
In light of your role in
making recommendations to the Minister of Health for a subsequent expert
panel, we strongly encourage you to recommend that;
-
foreign trained doctors be represented
on the expert panel,
-
foreign trained doctors be fairly
included as part of the short and long term solutions to physician resource
management in Ontario,
-
the Ministry of Health engage
the College of Physicians and Surgeons of Ontario, and the Foreign Trained
Doctors Associations of Ontario in an open consultation on integrating
foreign trained doctors.
It is part of the mandate of
the FTDA (Toronto) to undertake ongoing research on the profile of FTDs
in Ontario and issues of access. As broad-based consultation and surveying
of our membership continues, we welcome future opportunities to share this
information with yourself and/or other parties commissioned by the Ontario
Ministry of Health.
Once again, thank you for
the opportunity to meet with you. We look forward to hearing the outcome
of your current commission.
Sincerely,
Elizabeth McIsaac
Project Coordinator
Proposals for Integrating
Foreign Trained Physicians into the Ontario Health Care System
There is a need to look at
a programme specifically designed for expediting the process and opening
access to the educated and trained foreign trained doctors (FTDs) who are
landed immigrants or Canadian citizens currently living in Ontario. Ontario
has a resource of already educated and trained physicians who can be mobilized
quickly.
While the desired long term
objective of various levels and bodies of health care practitioners and
policy makers is to reach a strong level of national self-sufficiency,
integrating FTDs makes sense when qualitative aspects of health care delivery
and Canadian cultural diversity are considered. With specific reference
to Ontario, over 50% of newly arrived immigrants settle in Ontario. Given
the national economic and demographic needs, levels of immigration are
expected to continue to increase. As such, it is important to factor FTDs
in the future management of physician resources.
In the development of options
for integrating FTDs, there is need to establish a partnership among the
College of Physicians and Surgeons of Ontario, universities, hospitals
and foreign trained doctors in developing a programme that meets the needs
of both the Ontario health care system and the foreign trained doctors.
The following is a proposal,
with various options, for more effectively integrating FTDs into the health
care system:
1. Medical Council of
Canada evaluates documentation
2. MCC Evaluating Exam
3. Observation Programme
(5 month rotation, 1 month in each area)
Once candidates have had
their documents evaluated by the MCC and have registered for the MCCEE,
they would become eligible to participate in the health care system as
observers. Ideally, the MCC could provide referrals. This would be voluntary
in the sense that it would not be required as part of the licensing process,
as well as being unpaid. The primary objective of the programme is a self-directed
professional orientation that facilitates the FTDs adaptation. As well,
it offers the FTD an opportunity to ground her/himself in the realities
of the Canadian health care system while preparing for the MCCEE. The role
of the FTD would be as an unobtrusive observer with no direct patient care
or evaluation demands on the part of the staff.
OR
Professional Orientation to the Health System: (3 month course)
-
Canadian Health Care System:
Structure, roles, training requirements for each staff, how everyone works
together, pharmaceutical
drugs, technology used,
statistics/trends in health, billing, current research and the place of
research in the system.
-
Communication: Teamwork,
written procedures/report writing, technical language, self-confidence/self-esteem,
conflict resolution,
management styles, information
management, and portfolio development.
-
Legislation: Health laws
and ethics.
-
Human Rights: Sexism,
racism, homophobia, ableism, ageism, etc.
-
Self-Directed Learning:
Continuing medical education requirements, self- assessment, ways to continue
learning.
4. Limited License
Upon successful completion
of the MCCEE, candidates would be granted a limited license allowing them
to work under the supervision of a fully licensed physician.
5. In-service Preparatory
Programme (IPP)
A six-month rotation with
limited license, oriented to assisting candidates in their preparation
for the Qualifying Exam Part I and Part II. Remuneration would be comparable
to that provided to Canadian interns.
OR
Supervised Practice
A six month placement in
a particular area of a hospital or with a physician in practice.
6. Qualifying Exam Part
I and Part II
7. License as General
Practitioner/Family Physician
Doctors with a minimum
of 2 years experience as family physicians would be immediately eligible
to write the Family Medicine exam and practice independently. Otherwise,
they would enter the Canadian system with equal access to Family Physician
residency opportunities.
8. Residency Review Board
A board to review specialists’
experience and make recommendations for the length of residency required
(operating on a continuum from no residency required, to advanced standing,
to full residency). The board would have representation of at least one
fully licensed foreign trained specialist from the same region who would
be competent to evaluate the experience of candidates. The Residency Review
Board would also have an appeal process.
9. Application to CaRMS with
Equal Access on First Iteration
This requires an increase
in the number of residency positions available and, in turn, financial
commitment from the Ministry of Health. Over the past five years, the percentage
of International Medical Graduates placed in the CaRMS has averaged less
than 10% as they are not allowed to apply to the first iteration.
10. Residency (if required)
11. College Exam