MDs trained overseas don't make the cut
Questions asked about calibre of doctors seeking Ontario licence
February 18, 2005
Touted as a solution to the province's physician shortage, nearly half the foreign-trained doctors who apply to eventually practise medicine here don't make the first cut, and the province couldn't reach its limited quota last year, Ontario Health Ministry figures show.
And concern has been raised about the calibre of the latest group of nearly 600 International Medical Graduates, who went through a round of clinical tests two week ago, as the provincial IMG office narrows down the list to this year's quota of 200.
“Just participated in the IMG exam as an examiner along with some of my colleagues. I was utterly dismayed by the calibre of these finalists,” reads, in part, an e-mail sent Feb. 15 to a Windsor doctor by a colleague who helped evaluate finalists earlier this month. The e-mail was obtained by The Windsor Star Thursday. The name of the sender had been deleted.
“These people will be passed through on the wave of political expediency. The government is playing a shell game with this and is likely to create a public health fiasco,” it reads.
The province is hoping that its full quota of 200 IMG candidates will qualify for residencies in Ontario medical schools with their affiliated hospitals this year, with 50 of them allowed to fast-track for a physician's licence after six months. Residencies usually last two to six years, depending on the specialty involved.
That didn't happen last year, when only 165 out of 1,088 original applicants got the spots, and only 14 were fast-tracked, a ministry spokesman said.
Results thus far are trending the same for this year's batch. Last November, 1,041 IMGs wrote exams at McMaster University, the University of Toronto, University of Western Ontario and University of Ottawa.
Only 559 of the foreign doctors — 54 per cent — passed and went on to take the clinical tests two weekends ago at the same locations. The 16 separate tests involved different patient scenarios. Results will be sent to the candidates in April.
This year, 855 residencies will be offered in Ontario medical schools.
“We're looking at the (IMG) candidates to perform at a level equivalent to a fourth-year medical student,” health ministry spokesman David Jensen said, adding they originally came from 155 countries.
“So they're quite spread around.” He had no comment on the e-mail from the examining doctor.
“Why don't we wait and see what the results are of this? We were very curious to know what we're dealing with,” Jensen said.
“Medical schools around the world are not equivalent,” said Dr. Albert Schumacher of Windsor, president of the Canadian Medical Association. He said 10 per cent of Canadian-trained doctors fail their tough final examinations after completing residencies, and you only get three cracks at it.
Kathryn Clarke, spokeswoman for the Royal College of Physicians and Surgeons which licenses Ontario doctors, said the college is committed to licensing only those physicians who can qualify.
“That's why these systems are in place. IMG Ontario is the entry point. Often, IMGs will need to do further training,” she said. “The province is saying only physicians who meet Ontario standards will be licensed.
“The important thing is to build a system. We want to increase the physician resources, but we want to do it responsibly and fairly,” Clarke said.
But Dr. David Bridgeo, a Windsor family doctor, said many physicians in fact fear that political pressure to accommodate more IMGs will result in lower standards.
“In general there is a concern in the profession,” Bridgeo said.
Windsor physician recruiter Joan Mavrinac, a strong supporter of IMGs filling physician shortages, said some parts of the tests are difficult for candidates unfamiliar with how medicine is practised in Ontario. She also said the tests are very tough and it is to be expected that not everyone would pass.
“This should be reassuring,” Mavrinac said. A program has been implemented locally to allow unlicenced IMGs to “job shadow” local doctors to observe and absorb some of the nuances of Ontario medical practices.
The IMG Ontario office was created to simplify the application and testing process for foreign doctors, in a “one-stop shopping” process. Before taking the special IMG tests, the foreign doctors first must pass Medical Council of Canada Qualifying examinations — as do Canadian-trained medical students. They also must demonstrate proficiency in English and prove they have a medical degree.
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A Windsor doctor received this e-mail Feb. 15. The name of the sender was deleted in the copy obtained by The Star.
“Just participated in the IMG exam as an examiner along with some of my colleagues. I was utterly dismayed by the calibre of these finalists. Out of the 30 that went through my … station, only two were practice-ready. Half failed to diagnose the straightforward case presentation and were functioning at a med-school level, the remainder were clerkship level.
“This is the underbelly of this politically correct movement. God forbid you express any clinical and scientific criteria to the process. These people will be passed through on the wave of political expediency. The government is playing a shell game with this and is likely to create a public health fiasco.
“My colleagues reported similar results at their stations as well.
“You get what you pay for.”
The Windsor Star 2005