Canada is grappling with a healthcare human resources crisis. We see it in overcrowded emergency departments, long wait times for surgery and people unable to find primary care providers.
A recent national survey found that more than 6.5 million people in Canada do not have regular access to a family doctor or a nurse practitioner, up from 4.5 million just a few years ago. At the same time, there are thousands of internationally educated healthcare professionals (IEHPs) in Canada — including physicians, nurses, dentists and pharmacists — who face what can seem like insurmountable barriers to working in their professions.
Canada is losing healthcare professionals to stress, burnout, job dissatisfaction and retirement, and fewer medical students are interested in practicing family medicine. With Canada’s population growing and the number of seniors — who often need more care — increasing, the shortage will only get worse if we do not take action to fix it.
Part of that solution must include better supporting IEHPs in returning to practice.
A 2023 Statistics Canada report estimates there are almost 260,000 working-age IEHPs in Canada. While 76 per cent are employed, only 58 per cent of them work in healthcare and most are not in the field in which they trained.
While we face critical nursing shortages, 54 per cent of internationally educated nurses aren’t in nursing. While we expand the scope of practice of pharmacists, 54 per cent of internationally educated pharmacists aren’t helping Canadians understand the complexities of their medications.
While we work to expand access to dental care through the Canada Dental Plan, 75 per cent of internationally educated dentists aren’t helping people develop good dental health habits. And while we face an unprecedented shortage of family physicians that threatens the sustainability of our primary care systems, 72 per cent of internationally educated physicians aren’t practicing medicine.
IEHPs face many challenges: cultural differences, language hurdles, limited professional networks and psycho-social challenges that come along with not being able to practice. Cumbersome regulatory processes require them to navigate complex, lengthy and costly licensing requirements.
Through government-funded programs, non-profit workforce development organizations such as ACCES Employment support these professionals in their licensing and employment efforts with a range of services, but this work is often disconnected from healthcare stakeholders such as health organizations, professional and regulatory bodies and academics.
At the same time, health systems stakeholders implement human resource strategies — that may or may not include engaging with IEHPs — without connecting to workforce development initiatives or the immigrant communities they serve, overlooking the valuable expertise and lived experience that could be brought into their care environments.
This problem has been tackled in silos for far too long, with non-profit workforce development organizations, professional associations and educational institutions working independently to try to improve the rate that IEHPs can contribute to their communities.
Fortunately, recent health workforce development initiatives have tried to overcome barriers to collaboration.
Through an innovative project called Team Primary Care: Training for Transformation, led by the College of Family Physicians of Canada and the Canadian Health Workforce Network, a number of workforce development initiatives serving IEHPs have been integrated to accelerate transformative change in the way primary care practitioners train to work together.
These types of collaboration must be built into the foundations of our efforts to support a return to practice for IEHPs. We need a paradigm shift.
Workforce development non-profits and healthcare stakeholders must recognize each other’s strengths and expertise and work together to solve workforce issues. To do so, they must have structured and clear ways of engaging with each other for this to happen.
To turn this need for widespread, structured collaboration into a reality, both federal and provincial governments need to integrate IEHP workforce development strategies within their health human resource strategies. And, importantly, they must also create funding mechanisms to purposefully engage non-profit workforce development organizations to work closely with healthcare system stakeholders.
Only such collaboration will have the potential to scale to meet the demands of employers and communities.
As a nation, it is incumbent upon us to purposefully address this issue. This is the only way that systems-wide change can be accelerated and scaled. Collaboration will not happen by chance.
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