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REF NO.: 20

SUBJECT: International medical graduates provide essential service for Newfoundland and Labrador

DATE: Sept. 21

Doctors who received their medical degrees from countries outside of Canada play an essential role in the health of Newfoundlanders and Labradorians especially in rural and under-serviced areas.

Researchers from the Faculty of Medicine and the Leslie Harris Centre of Regional Policy and Development have collaborated on a report that sheds light on a valuable yet understudied component of the Canadian physician workforce. Titled: The Role of International Medical Graduates in the Provision of Physician Services in Atlantic Canada, the report examined a wide range of issues surrounding international medical graduates (IMGs) and included an Atlantic Canadian perspective.

The paper presents a thorough background on how IMGs become licensed to practice and eligible to work in Canada, as well as a discussion of issues with recruitment, deployment, and retention. It described how in each province, a special type of medical licence allows some IMGs to become licensed only with conditions or provisions attached. These “provisionally-licensed IMGs” (PLIMGs) are often restricted to practice in rural or remote areas, and sometimes receive supervision from a physician who holds a full licence. A survey of the medical regulatory authorities in each province determined that Newfoundlandand Labrador has one of the highest proportions of PLIMGs, more than twice the ratio in all provinces except Saskatchewan and PEI. The report also showed that Newfoundlandand Labrador has in the past and continues to rely on Commonwealth nations as a supply of doctors. In fact, among provisionally-licensed IMGs in 2003, over 60 per cent were from South Africa, Pakistan, and India.

The report described the out-migration of these physicians to larger urban centres from rural areas once they gained the needed experience and credentials.

Nowhere is this more pronounced than in Newfoundlandand Labrador, where turnover in rural areas is a big concern. In addition, provisionally-licensed doctors are a component of the workforce that is severely understudied in formalized health policy research.

The report provided information about the labour issues facing IMGs, and a basis from which health policy decision-makers can address these issues. The report also commented on the need for improved retention mechanisms to be put in place for the IMGs who take up practice in Newfoundlandand Labrador, particularly in rural areas. Commenting on the paper, David Vardy, associate director of the Harris Centre stated that “in light of the importance of immigration to the continued growth and economic stability of Newfoundlandand Labrador, retention of IMGs in this province is of paramount importance”.

The report was prepared by Dr. Rick Audas, assistant professor of Health Statistics and Economics in the Division of Community Health, Faculty of Medicine; Amanda Ross, research assistant and David Vardy, associate director of the Leslie Harris Centre of Regional Policy and Development. Work started in the Fall 2004 and wrapped up in the early Spring of 2005. Funding for the work came from a number of local physician workforce stakeholders, demonstrating that the IMGworkforce in Newfoundlandand Labrador is receiving increased attention and awareness.

The complete report can be found at:

The Faculty of Medicine/Harris Centre research team has begun putting together a new full-scale labour market study which will focus on the IMGs and identify factors associated with the decision to stay or leave Newfoundland and Labrador to practice medicine elsewhere. The new study is scheduled to begin in the Fall of 2005.

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For more information, contact, Deborah Inkpen, communications co-ordinator (research), Memorial University, at 737-4073or


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