Mr. Chair, honourable members of the committee, thank you for giving me the opportunity to present to you this afternoon.
About ten years ago Manitoba embarked on a strategy to increase immigration to Manitoba from the then current 3,000 to 10,000 immigrants annually by 2007, with a deliberate focus on professionals. To assist this endeavour, Manitoba was the first province to introduce the provincial nominee program of Citizenship and Immigration Canada to target and fast-track immigrants who hold qualifications in high demand. The 2007 target of 10,000 new immigrants was achieved with about 70% through the provincial nominee program, and in 2010 nearly 16,000 immigrants came to Manitoba.
As part of this endeavour Manitoba Labour and Immigration alerted professions to the new immigration strategy and encouraged the development of licensing pathways for new Canadians. The engineering profession was singled out as being punitive to internationally educated applicants. Consequently, the University of Manitoba and the Association of Professional Engineers and Geoscientists of Manitoba began to consider ways to encourage applications from internationally educated engineers.
Provincial engineering regulators have always provided a pathway for internationally educated engineers to become registered as professional engineers in Canada through the completion of confirmatory technical exams assigned by the provincial regulator. This pathway often requires three to five years and has a high attrition rate, due to the fact that it tends to be completed in isolation, with little or no support from or contact with other engineers. Given the problems of this process, some internationally educated engineers chose to repeat the entire four-year engineering program at a Canadian university at considerable cost, or leave the profession altogether
Many engineering immigrants to Canada face several challenges. First, many are not familiar with the concept of a regulated profession and the legal requirement for registration to practise the profession, since in many countries the university degree in engineering confers both the right to title and practise. Second, once they understand what the licensing and registration process entails, they often find it punitive and may not have the financial wherewithal to spend three to five years getting their qualifications recognized. Third, without professional recognition, finding an engineering job becomes extremely difficult, but because Canadian engineering experience is required for licensure there's a chicken-and-egg paradox. Fourth, language and communication abilities are frequently insufficient.
The internationally educated engineers qualification program at the University of Manitoba is designed to address these challenges. The objective is to provide an alternative process of equal validity and rigour to the confirmatory exams, but with a higher completion rate in a one- to two-year timeframe. In addition to confirming academic qualifications, additional objectives are to incorporate a labour market component that provides critical assistance in finding that first engineering job, and provide language development and cultural orientation for participants.
The IEEQ program at the University of Manitoba is operated in close collaboration with the Association of Professional Engineers and Geoscientists of Manitoba, the provincial regulator. To enter into the program the engineering background of participants is first assessed by the provincial regulator to identify the engineering disciplines in which confirmatory exams are required. But instead of undertaking these exams, participants take corresponding senior-level undergraduate courses at the University of Manitoba. Successful completion of the normally four to ten courses required is used to confirm their technical background.
In addition to these course requirements, the program contains four additional important elements. First, a co-op work experience term in a local engineering industry gives Canadian engineering experience and helps build a professional network. Second is orientation to the culture of Canada and the culture of professional engineering in Canada. Third is professional networking opportunities within the university and the engineering community. Fourth is development of English language and communication skills. All components of the program are critical to participants gaining professional recognition and success in the Canadian engineering workplace.
The IEEQ program was introduced on a pilot scale in 2003, with up to 12 participants annually and funding from the Province of Manitoba. The program became permanent in 2007. This permanency has allowed enrolment to climb to 35 to 40 participants each year. Concurrently, the University of Manitoba approved an associated post-baccalaureate diploma that provides graduates with an academic credential, in addition to the professional credential.
IEEQ program participants have arrived from 30 countries, the top five being the Philippines, Ukraine, India, China, and Pakistan. Participants are generally between 30 and 45 years old and usually have spouses and children. About 25% are women.
All participants have a previous bachelor-level engineering degree from their country of origin, with three to twenty years of engineering experience prior to arrival in Canada, but rarely do they have any Canadian engineering experience. There are currently 45 participants enrolled in the program. All 86 graduates to date have registered with the provincial regulator as engineers in training. About 90% of the graduates have developed engineering careers, most often facilitated by the co-op work experience component of the program. Through a one- to two-year investment in the program, graduates move from low-paying jobs to engineering positions, resulting in a huge impact on the well-being of the participant and their family. Furthermore, the tax advantage to Manitoba and Canada is significant, with the government investment in funding the program paid back by participants in three or four years as they move from a low to a higher level of income and taxation.
Many immigrant agencies serve and offer support to internationally educated engineers, most often in the form of language and communication development, cultural training, professional job shadowing, or volunteer opportunities. Rarely, though, do these initiatives meet the licensing requirements as does the IEEQ program at the University of Manitoba.
The success of this program at the University of Manitoba has spawned several similar programs elsewhere. Ryerson University in Toronto began a bridging program a few years ago. In 2010 the University of Saskatchewan, University of Regina, and the Association of Professional Engineers and Geoscientists of Saskatchewan began collaborating to provide a similarly structured program that includes cultural orientation and co-op work experience. In Manitoba beginning in 2008, the agrology profession also established the internationally educated agrologists program, a partnership between the University of Manitoba and the Manitoba Institute of Agrologists, which was modelled after the IEEQ program.
In 2009 there were 155 applications to the Association of Professional Engineers and Geoscientists of Manitoba from internationally educated engineers. There were nearly 2,000 such applications to Professional Engineers Ontario. Nationally 36% of applicants for professional engineering licensure in 2009 were immigrant engineers. For these immigrant engineers to realize their full potential and fully contribute their skills to the well-being of the Canadian industry and society there must be an expeditious, efficient, and effective process so they can become professional engineers in Canada. However, the program at the University of Manitoba accepts about 30 new participants each year, only a fraction of the 155 applicants. Likewise, the capacity at Ryerson is only a small fraction of the nearly 2,000 applicants.
It is clear that the success of the Internationally Educated Engineers Qualification Program at the University of Manitoba provides real benefits to the individual, the engineering profession, the province of Manitoba, and Canada. It more than halves the time for internationally educated engineers to enter the Canadian engineering profession. Accordingly, governments at all levels should endeavour to make resources available to allow this and analogous programs to expand to meet the existing and growing demand.
Mr. Chair, thank you very much for the opportunity to present this program to the committee this afternoon.
Thank you, Mr. Chairman.
Honourable members of the committee, it's a special privilege to be here to give this presentation, because sitting before you is a true product of today's topic. I'm a physician currently working in the Foothills Hospital in Calgary, Alberta, the Peter Lougheed Centre, as well as the Rockyview General Hospital under a special licence, a “supervised licence”, despite the fact that I was trained as a family physician and have between 14 and 16 years of experience as a family physician in South Africa.
The Alberta International Medical Graduates Association that I represent is a manifestation of what exactly is going on today. We consist of doctors trained or educated in countries other than Canada. It includes individuals and organizations interested in the various challenges facing international medical graduates in Alberta. The most challenging obstacle is having our members' foreign qualifications recognized by the College of Physicians and Surgeons of Alberta. It's a similar situation across Canada.
It is well publicized that within Canada there is a huge shortage of family physicians. Approximately five million Canadians do not have access to family physicians, which is very sad. International medical graduates account for only approximately 25% of physicians in Canada. Despite the growing physician shortages, IMGs continue to be an underutilized resource by the strained Canadian medical system.
Addressing this perennial dilemma has been an uphill battle. The sole reason is due to the provincial regulatory bureaucracy constantly devising various means, in a selective and biased manner, to limit recognition of the foreign qualifications of several immigrants who have settled in Canada.
The general misperception and misinformation in the public is that these IMGs have inferior knowledge and skills compared to graduates of Canadian medical schools. However, a direct comparison study done by Andrew Moran compared 24 IMGs with 21 Canadian medical graduates in a family practice residency program in 2006 and 2008 at St. Paul's Hospital in Vancouver. It showed that IMGs and Canadian graduates had similar results in evaluation reports. The results of these in-hospital training evaluation reports indicated that IMGs are seen by their teachers as competent physicians. Consequently, in clinical practice there are no valid statistics at the moment to show that IMGs are not proficient in patient care.
The Canadian government's pan-Canadian framework for the assessment and recognition of foreign qualifications shows that within one year an individual will know whether their qualifications will be recognized, be informed of the additional requirements necessary for registration, or be directed toward related occupations that are commensurate with their skills and experience.
For IMGs, the assessment and recognition process can take many years--sometimes from 10 to 15 years. There may be cases where it is not appropriate or practical to come to a licensing decision within one year. However, exceptions should exist, such as where an IMG, as a newcomer, requires an extended practice-based or workplace-based component to their registration process to continue. The foreign qualification recognition process may seem fair, transparent, and timely, but it is inconsistent across Canada, and marred by bureaucratic bottlenecks.
My first recommendation is to have a simplified system of assessment. It should be realized that cases involving well-known qualifications should be treated in a simpler way. If the recognition authority reaches the conclusion that recognition cannot be granted in accordance with the applicant's request, alternative or partial recognition should be considered to facilitate integration of IMGs into the Canadian medical system. Recognition bodies should take an active role in specifying the steps needed to be taken by IMGs through clear, coherent, objective, and unambiguous pathways, to enable them to get their qualifications recognized.
My second recommendation is standardization. The ruling medical authorities, as well as the provincial bodies, should consider forming a partnership with the Alliance of Credential Evaluation Services of Canada, national information centres, and other assessment agencies. These centres should publicize standardized information on the processes, procedures, and criteria of the assessments used for foreign qualifications for specific professions, especially foreign-trained physicians. This information should automatically be given to all, as well as any persons making preliminary inquiries about the assessment of their foreign qualifications. This currently does not exist.
Third is timelines. The untimely process in the evaluation of qualifications causes a delay in IMGs entering the medical system. In addition, this slow process causes IMGs to have further distance from their medical skills. A specified timeline should be given to applicants and adhered to by all regulatory bodies. Applications should be processed as promptly as possible, and the processing time should not exceed three months.
Fourth is educational credits. Each academic year of study, as recognized by the official designated authority in the country of origin, should be granted as at least one academic year of recognition within Canada. That doesn't exist now.
Fifth is the availability of recognized funding for clinical transition programs. The current limited opportunities for foreign-trained doctors to obtain clinical experience through recognized externship, hands-on hospital experience, and continuing medical education programs for IMGs to complete any theoretical or clinical skills deficits have to be addressed. These CME programs will help IMGs become familiar with the Canadian medical system and gain educational credits, while maintaining their certification. This could be achieved through more funding, either as grants or loans directly to IMGs. Most of these IMGs are either permanent residents or citizens at the moment.
Seven, a one-stop shop for foreign qualification recognition is highly advocated. It would be helpful to deal with one regulatory body, and for applicants to understand the full menu of options from the onset. The application procedures should be expedited. There should be a single enhanced written test, and one practical clinical examination instead of the current myriad of multiple tests that are so varied and confusing. At the end of the day, they do not guarantee a licence or recognition of qualifications.
Increasing the residency training positions, or having well-defined practice assessment programs to avoid backlog, with the aid of clarity of direction from this one-stop centre would be most helpful.
Finally, a pre-qualified pool system, whereby applicants are pre-screened and pre-qualified by the regulatory authority before immigrating to Canada, would be an added advantage. We recommend advancing the timing of foreign qualification recognition in the immigration process.
With this and the many other recommendations I've handed in, I want to thank you for your time for listening. I look forward to a very fruitful deliberation today.
Mr. Chair and honourable members of the committee, thank you for the opportunity to tell you what we've observed regarding assessments of internationally educated nurses.
I'm here as director of the School of Nursing at Mount Royal University in Calgary. One of my responsibilities is to work with internationally educated nurses. I do want to clarify, though, that I'm not here representing the Alberta nursing regulators.
Over the past six years we've taken some good directions based on the recommendations that were described in a document called “Navigating to Become a Nurse in Canada”. However, we're clearly experiencing a nursing shortage, and our successful initiatives are being taxed by the number of people accessing our services.
Although our initiatives have been very successful in where we've come from in the last six years, we are unable to track and to speak to outcomes.
I'm going to provide you with my recommendations first and then proceed to explain why I've identified these points and how they link to the funnel that's on top of that slide.
We need to support data-sharing to improve understanding of IEN recruitment and retention patterns; we need policies to support stakeholder collaboration to improve flow through the funnel, which I'm about to explain; we need sustainable recruitment plans of international nurses; we need to build databanks of assessment tools and incorporate intelligent technologies; and we need to measure outcomes along the funnel.
Mount Royal has had considerable experience in pioneering initiatives for internationally educated nurses over the past decade. I won't take time to describe each of our studies, but I've presented the ones we've received funding for under the slide “IEN initiatives at MRU”. Our learnings from these initiatives are the basis for my comments and recommendations.
What have we learned?
We've chosen to use a funnel to describe the recruitment and retention flow, at least from our perspective. The reason we want to use a funnel was that it showed that a much larger number of IENs start the process than actually end up working. However, the shape of the funnel isn't perfect, in that it doesn't show proportions, if we used the analogy “leaks”, of where the leaks might be in our funnel.
The different stages in the funnel are essentially sequential. IENs, who either refer themselves or are brought through the recruitment process through a formal agency recruitment, contact the professional regulator, and if the professional regulator is unable to determine, by paper documentation, that they have the competencies to enter practice in Canada as a nurse, they'll refer them to Mount Royal, where we do an assessment of their skills and competencies. I'll speak to that in just a moment.
A report on their assessment is referred to the regulator, who then determines if they need a bridging program. And once they've completed the bridging program they move on to write the national exam and then move into the workplace.
At each phase of that funnel, IENs may choose to continue or they may to choose to step out and come back later. And certainly the push and pull factors in the context they live in are at play in terms of immigration or family needs, but we haven't identified those in the funnel specifically.
Our experience over the past five years certainly indicates that the countries of origin impact the number of people who are coming through that funnel. Currently, 75% of all internationally educated nurses who apply to our regulator, the College and Association of Registered Nurses of Alberta, are referred to us for further assessment. Just over half of those who are asked to contact us actually do. And once they've contacted us, just over half of those proceed.
Approximately 200 IENs come through each year, and we've assessed over 1,200 IENs in the past five years. Of those who are required to go through the assessment process, 70% are required to do remediation. That may sound high, but remember, the IENs who are good to go, so to speak, who have met the requirements, don't come to our assessment centre.
We've also learned that our assessment strategies must be comprehensive to reflect the complex nature of our practice. So we have a series of tests. Certainly language and communication are a challenge, and the regulator requires that all English language requirements be done prior to their assessments. Partnerships with regulators, government, and employers are essential for this process to work.
The purpose of an IEN assessment is twofold: to assess IEN competencies that aren't evident in their paper documentation to the regulator, and to provide IENs an opportunity to demonstrate their capacity for practice as a Canadian nurse. We use a constellation of tools and it takes one to four days depending on the nature of the assessments required. We've benefited greatly from our provincial government grants that fund centres in Edmonton and Calgary. The average cost, based on our studies, is about $1,000 per assessment. IENs need anywhere from one to four assessments, so it's an average of $4,500 per IEN. But the candidate does not have to bear those costs. It's important to know that we report to the regulator what our assessments are and the regulator makes a decision on what bridging is needed.
We have a program called “Bridge to Canadian nursing”. Once the assessments have been done and the IEN is needed or requires some bridging, she can apply to the program. We have eight courses they can take, but they take only what they need, and they bear the cost of this tuition. We've noticed that the average course-taking has gone up over the past couple of years, but that also reflects the countries of origin from which recruitment's been occurring. Of IENs who engage in this part of the process, 95% complete their studies.
We are seeing many IENs, but because of the limited information that flows through the funnel, we can't speak definitively about the yield to the workforce or outcomes. We know there are leaks and losses within that funnel. We don't know the scope and magnitude of those losses, because of the limitations on information-sharing across the system of stakeholders, so we're unable to measure our flow-through in concrete outcomes and costs. We know IENs sometimes get lost in that funnel, and we don't know the reasons for this, although we have many anecdotal pieces of information.
In summary, I go back to the recommendations I presented at the beginning. Assessment and bridging courses are critical tools for access to the RN profession. But we need the ability to track so we can use a unique identifier that started with IENs at the beginning of the funnel and followed them all the way through. This would help us to get accurate information and a strong sense of outcomes. It would help us to understand why the IENs are leaving the system.
We need coordinated, regular engagement by all stakeholders and at all levels of the government to coordinate policy development that makes sense to those who are implementing it and actually improves the situation for IENs. We need sustainable recruitment plans so that stakeholders and resources are aligned and sufficiently nimble to be able to manage the expansion and compressions of recruitment.
The processes we've developed for assessment, at least in the western provinces and in collaboration with Nova Scotia, are serving IENs and regulators well, at least better than they were when the “Navigating to Become a Nurse in Canada” document was written in 2005. But we need to invest in databases of assessment tools and use intelligent technologies that make these tools accessible to IENs and the assessors while still maintaining security.
I think the reason the decrease has been like that is because right across the border, in the U.S.... When I discussed it with a number of colleagues, most of the provincial regulatory bodies impose all these barriers and difficulty. Why do you want to sit in a place? You come to Canada. This is a home. You've got this feeling, and it's a nice place.
But do you sit, for five, ten years, trying to get a licence as a physician. You were at home working as a physician, and you come to Canada and you're driving a taxi cab or you're working at Walmart. You could go across to the U.S. and write the U.S. MLE exam, and in under a year, two years, you'd become a certified physician working in a hospital—a defined pathway.
Because of the discouragement, a lot of people have moved out. Some of them have lost dreams, fallen by the wayside and decided to do something else. I know some physicians who have given up because of what's going in. It has been very frustrating.
That is the reason the trend is falling. A lot of people are losing hope.
The real problem is that most of the members are eager, are wanting to go to the rural areas to work. But what happens when you pick up.... It's typically unlike what happens with nursing, where you have at least a website after you put in your credentials. Just talking with respect to the college of physicians in Alberta, when you put in your credentials, and they just give you “ineligible” or “eligible”. Being ineligible, the door is slammed on you. Nobody tells you, “Okay, Peter, you have to do one, two, three steps and we'll give you a licence.” You have to go through a bridging program. You now have to figure it out yourself.
As a newcomer to Canada, it's extremely difficult. Sometimes what they do, they're going to have to go to the rural areas, which I did also. I called some of the rural hospitals and asked if they could sponsor me, and talk to the college. I asked them to contact the hospitals I worked at in South Africa, and let them assess me, if they can't talk to me, because it's always online and you can't ever reach anybody. They don't bother to send you if they like....
Some of them contacted me, and the first thing they said is that it's extremely difficult. There is a brick wall. The college has set to make it extremely difficult for foreign-trained doctors to come in, especially if you are here in Canada. I'm not saying we have kind of a different pathway, because they go over, which they do, to get doctors from southern countries, and recruits. But we've got a huge pool of doctors already on the ground in Canada. Most of us are Canadian citizens, but we can't access the pathway because our credentials are not recognized by the college, and they don't give you the reason why.
They tell you you're ineligible. So you now have to figure out what you need to do. If you're lucky enough, you become a clinical associate or a clinical assistant in a hospital, and you work as a physician, but you are not recognized as a doctor.
Thank you very much, all of you, for your presentations.
I want to say just one thing from a standpoint of correcting the record. I am a member of the Royal College of Physicians and Surgeons. Just so that we are clear, in this country there are provincially based colleges, which provide the regulatory regime for people to become physicians, to practise, and to receive a licence.
That is different from the Royal College of Physicians and Surgeons, in which the examinations take place. There are regulatory bodies by province, just like there are in the United States. You have to take a licence state by state. You do write a national exam, the USMLE, just like we do here in Canada. The process is the same state by state as it is here province by province. Just so we're clear on the process there.
I do have a question, though, for all three members of the panel.
You may be able to answer specifics now, or you may want to submit something to us. Obviously there are concerns about shortages in these areas, and we'd like to ask you first what you believe those shortages are, and what the specific numbers of those shortages are. Also, explain how and through what foreign credentialling programs we could address these shortages.
Second, I would also like to ask you what you think those specific financial challenges are for your profession. I would ask you to be specific as to what that might be. We've heard different reasons for financial challenges from different organizations.
Third, what are your specific recommendations for addressing the shortages, and addressing the financial needs based on foreign credentialling?
As I said, I would like all three of you to answer, and if you are not able to give us a fulsome answer based on the time, I'm respectful of that. Maybe you could submit something to us.
You've asked a number of very good questions, none of which have simple answers, unfortunately.
Let me try to touch on each of them individually, and remember I'm speaking from the Manitoba perspective, and from the perspective of the engineering profession.
It's relatively clear—at least to me—that there is a shortage of engineering skill in Manitoba. Senior business people and owners of companies have told me directly that they would expand in Winnipeg if they could get engineers. One of the unique things about Winnipeg, of course, is that it's not really on anyone's top ten list of places to live, despite the fact that it's a great place to live. So it's very difficult to recruit people from elsewhere in the country to come to Winnipeg.
There is a shortage of engineers in Manitoba, and that's why the province adopted the provincial nominee program, and targeted foreign-trained engineers to come to Manitoba to help with this shortage.
As for the specific financial challenges some people face when they're recent immigrants, oftentimes their financial wherewithal is very limited. Prior to going to Manitoba, I had extensive experience here in Ottawa at Carleton University, and I was continuously appalled at the number of foreign-trained engineers with very good credentials who, without access to an internationally educated engineers qualification program as we have in Manitoba, would end up taking the entire four-year undergraduate program over again. During that time, they're full-time students, they're not working, they've got a spouse, and they've got children. It's incredibly difficult.
When I speak to these students and ask them why they are doing that, the typical response I get is that they don't want to give up on engineering; either they do this or they're a taxi driver. They don't want to be taxi drivers. But to put them through four years of engineering education where an awful lot of what they're learning is exactly the same as what they have already learned elsewhere overseas—and it is just too difficult for us to recognize it—is incredibly frustrating to me, and I'm sure it's incredibly frustrating to the individuals as well.
It's because of that previous experience here in Ontario that I am convinced that programs like the internationally educated engineers qualification program that we have at the University of Manitoba, which we operate in close collaboration with the provincial regulator for engineering, is such a good idea. It allows the students to get through the program. We aim for one year to 18 months, depending on the individual's background, and that includes a six-month co-op placement with a local employer in an engineering position, for which they are paid by that employer. Frequently they're hired on for a full-time basis by that same person. That reduces the financial challenge quite considerably.
I agree with your comment that we let people in based on the training they've had elsewhere, and then when they get here we don't allow them to undertake the occupation for which they've been trained. That is very frustrating. I think one recommendation, which was alluded to earlier, is that Canadian immigration authorities overseas be well aware of the requirements to become registered as a professional in whatever occupation you are in once you get to Canada.
How does our language and training component work? As I said, we have a mandatory co-op program, which is part of the IEEQ program at the university. We work in very close collaboration with local industry to place each student with a local industry that's associated with the training they've had. That's a paid assignment for that person. So financially it's very good for them, but it's also primarily important from the “getting experience” point of view.
With regard to the language and cultural part, almost all the immigrant students who come to us in this program have some English-language abilities, some more than others, but their language abilities specifically with respect to engineering technology may be weaker. So we have worked with each individual student and the various applied-language experts at the university to try to raise their language skills up to the level required for entry into the profession.
We also have a mandatory course as part of the program, which is called “Practicing Professional Engineering in Canada”, so that they understand the regulatory framework within which engineering works in Canada, which is oftentimes very different from what they might be used to in their country of origin.
So we focus not only on the technical skills, which are clearly important, but on all of the other skills you need to be successful in the workforce.
And thank you, witnesses, for coming this afternoon. I have to admire your passion and I can also feel your frustration in this process.
I won't waste too much time speaking of other things and I will come to the question directly.
Mr. Idahosa, I'll start with you because you also have lived through this problem. I want you to quickly go through what you had to go through and how long it took. And when we talk about the medical profession specifically.... I'm from Calgary, and in Alberta there is a shortage of almost 2,500 doctors, whereas we have almost 1,100 foreign-qualified doctors. And when we talk about foreign qualifications, we are not only talking about the individuals who came from overseas. Canadians also go out of the country to get their education.
So coming back to your profession--and talking about taxi drivers--there are some people who say that the best place to have a heart attack might be in the back seat of a taxi because the chances are a doctor is driving the taxi. It sounds funny, but it is true that the professionals have to go through all this.
You are also very actively involved in the organization, I know that. I also want you to tell us if any improvement has been made from the earlier days when we talked about coordination between different provincial bodies. Does the pan-Canadian framework help, and what more can be done? And considering the shortage of doctors, is there any appetite or is there any capacity to speed it up? What exactly should we be doing when we talk about shortening the processing time? And would this pre-certification, which you also touched on, help the professionals when they come to Canada?
Thank you, Mr. Devinder Shory.
Just briefly, my life is a two-page book. It's very easy, it's not a long one. I graduated in 1996 in Nigeria. I wrote exams and I passed the exams and moved to South Africa because I wanted to be a very good doctor.
During that process I applied to immigrate to Canada. And luckily in 2007 my immigration came through, and I moved here. But prior to that I already took the Canadian evaluation exams, the QE1 and then the QE2.
But right off the bat most people told me that Canada is a dead end for a physician; it's extremely difficult to get licensed. But it's a country I've always loved, I've looked for, and it's something I've dreamed about and I want to settle. I look at obstacles as stepping stones. You don't need to shut the door, no matter what people say. So I said I'd put in my head and I would come in. But I wasn't told that by immigration; it was a personal decision and I am ready to face the consequences, and that's what is happening.
So back to the other question with regard to the pan-Canadian framework, we were extremely happy when we saw that the Canadian government decided to address it. It's very welcome.
Our members are a bit disillusioned, because I think it's the Canadian government, the political leaders, who have to make the decisions. We're a little disillusioned with the college, because we've lost faith in them. I come in.... Give me a licence and let me address the physician shortage. I want to contribute. This is my home. My kids will be born here. Where am I going to go? I can't go to the U.S. This is Canada. I love being in this country, but you're shutting the doors on us. You don't want to give us a pathway. Show us a pathway so we can go through. So the pan-Canadian framework is good.
Let it be an all-encompassing body that will bring together the college as well as the people whose lives are affected--that is us, the IMGs--and discuss a pathway. You cannot sit in the college in Edmonton and make a decision about people's lives without sitting with them, and that's what's happening.
We want the government to play an active role, because they are more neutral. And I believe, for this gathering today, they are not happy about what's going on. But the college has not deemed it fit to call the association and ask if they could sit and let's pool on that. We are close to 2,500 unlicensed physicians in Alberta, and that is a disaster. And 80% of us are family physicians.
Thank you for the question. I'll approach that in two different ways.
The challenge right now is that we don't have a unique identifier to know if you've been recruited by an employer and if you've contacted the regulator. Those pieces of information aren't necessarily shared. The regulator would send them to us, but that piece isn't shared. We know who comes to see us, but we don't know how many don't come to see us. We have a hunch from the regulator. They're keeping some track. An employer doesn't necessarily hire them and tag them, so to speak, as internationally educated, because as employees, they're all employees of their institutions. It's not that there isn't interest. It is that we haven't developed mechanisms or been willing to share because of privacy of information about different people. Each of us interprets our obligations for protecting privacy, and it's just not being shared.
One of our current research activities is some retrospective work on what we have. We are contacting each of those IENs who have been to us for assessment or for the bridging program. We are asking them to speak to what their integration into the workplace has been like. Have they pursued it? Our numbers are based on what we know. I think it would be much richer data if we could pool together the data from the recruiters, the regulators, us, and employers so that we could understand it a little bit better.
What do I know about the applicants who might not come to us? Part of it is that they are recruited internationally. To come to Canada they need immigration papers, and if they're unable to produce those, we lose them early on. They need to understand that nursing work in Canada is a little bit different from nursing work in other countries, so we provide the website to give them an idea of RN practice in Canada and perhaps other options they might pursue as well.
Thank you, Mr. Chairman and honourable members. My name is Joan Atlin and I'm the director of programs for the Toronto Region Immigrant Employment Council, or TRIEC.
TRIEC is a multi-stakerholder council that brings together employers, community organizations, colleges, universities, occupational regulatory bodies, and all three orders of government to seek practical solutions to connect skilled immigrants with appropriate employment.
At TRIEC our understanding of foreign credential recognition is cast broadly. In an effort to maximize our reach and impact, we have focused on those highly skilled immigrants who are seeking employment in non-regulated professions, which actually represents the majority of immigrants to Canada. They are people like sales managers, financial analysts, software developers, project managers, HR professionals, etc. Whether and how their credentials, experience, and qualifications are recognized is up to the employer. So our work with regard to foreign credential recognition has been focused largely on reaching out to employers to build their capacity to recognize immigrants' skills, experience, and qualifications.
For many employers, concerns about hiring skilled immigrants include not understanding their experience, not being familiar with their credentials or previous employers, and concerns about communication skills. Often the requirement for Canadian experience, which we hear so much about, is in fact a kind of euphemism for not knowing how to interpret the immigrant's qualifications.
This lack of familiarity, and the perceived risk that goes along with it, leads to widespread non-recognition of qualifications by employers in non-regulated professions. This has been our focus since TRIEC was established in 2003. We think it's important to recognize that some programs, initiatives, and practices have met with success and that future directions should build on this success. So the remainder of my comments will focus on the opportunities we think the federal government should consider in order to facilitate immigrant attachment to the workforce and opportunities delivered by third-party organizations.
The first is internships, or work-experience programs. They have been successful employment interventions because they directly connect employers and skilled immigrants. Internships can provide immigrants with their flrst job in Canada as well as professional references, both of which reassure risk-averse employers. On average, about 80% of participants find full-time work in their field upon completion of a work-experience program—a highly successful outcome, both for the individual and for the economy.
However, the demand for internships from immigrants far exceeds the number of participating employers and positions. There are also employers and communities across the country that would welcome an internship program but lack the capacity to establish one. There is a need for a national internship program that could leverage the participation of employers across the country.
The federal government has the opportunity to set an example as an employer by taking the lead in offering targeted internships for skilled immigrants. In 2010, the federal internship for newcomers program was established. The program was initially piloted by CIC and HRSDC and has now expanded to a number of other departments. According to the government's 2010 annual report on foreign credential recognition, there were 65 internships offered through the program in 2010.
There's considerable scope to expand this program across the federal government. The Ontario Public Service has a similar internship program that has placed nearly 600 newcomers in internships between 2006 and 2011 in Ontario alone.
The second intervention I want to talk about is mentoring programs. They have been successful because they connect skilled immigrants with a mentor who is an established colleague in their occupation. The mentor shares professional networks and helps navigate the job search. The mentee, a skilled immigrant job-seeker, gains a greater understanding of the occupational context and expectations in Canada.
In 2004, TRIEC launched our mentoring partnership. To date, more than 6,000 immigrants in the greater Toronto area have been matched through this program and 70% of them are employed in their field or a related one within six months after the end of their mentoring relationship. While many smaller-scale mentoring programs are currently offered across the country, they often have difficulty recruiting mentors and they lack the marketing resources they need to build a profile for their programs.
CIC is currently supporting ALLIES, which is a national project of the Maytree and McConnell foundations, to share this mentoring model nationally. ALLIES is building on the experience of TRIEC to support other immigrant employment councils across the country. Together, we have provided advice and supported the start-up of similar mentoring initiatives in Halifax, Montreal, Calgary, and Edmonton. There's a strong role for the federal government to play as an employer-partner in these local mentoring initiatives.
TRIEC is currently working with the Foreign Credentials Referral Office, the FCRO, to launch a mentoring pilot in the Ontario region of CIC. Pilots will also be launched with our sister employment councils in Calgary and Ottawa. This pilot should pave the way to national involvement of the federal public service in mentoring programs for skilled immigrants. However, beyond the role of supporting the dissemination of the model and participating as an employer, there is a need for a funded national mentoring program to ensure the ongoing delivery of this successful intervention. Creating a national mentoring program would allow for enhanced program quality and coordination, increased employer participation, and reliable and sustained funding for these programs.
Third, I will talk about bridging programs, which you heard quite a bit about with the previous panels. They were initially piloted in regulated professions. They bring together key stakeholders—employers, occupational regulatory bodies, and educational institutions—to assess immigrant skills and competencies, deliver training to fill gaps, and provide mentoring and workplace or required clinical experience. The objective of these programs is to fill gaps that may exist in knowledge or skills while avoiding duplication in the immigrants' education and training so that they can be bridged quickly to licensure and/or employment in their fields. To date, there are many successful examples of bridging programs in various sectors, both regulated and non-regulated sectors. Most bridging programs have been funded by provincial ministries and while the outcomes of the bridging programs have been very promising, they are only accessible to a limited number of participants and are difficult to sustain. The FCRO is currently developing a website called the International Qualifications Network as a vehicle to disseminate best practices on bridging programs and other initiatives. Beyond this promising initiative, there may be an opportunity for the federal government to invest in a nationally-coordinated bridge-training strategy as well as to create a loan program for participants to cover their living costs. You heard about that from the previous panel as well.
The fourth element I want to talk about is employer engagement, which is key to immigrant employment success. While there has been a significant investment in the development of labour market programs for immigrants, there has not yet been a parallel investment in programs targeted directly at employers. Ultimately, it's employers who either recognize or reject the credentials of skilled immigrants. We and our immigrant employment council partners across the country have seen a strong and growing demand from employers for support in recruiting, assessing, integrating, and promoting skilled immigrants, and we need a national strategy to respond to this demand. Of the three key elements of employer engagement needing support, the first is awareness.
There is still a need to increase employer awareness of the value of immigrant skills, and of how including this talent pool can make Canada more productive and competitive in the global marketplace. Despite an uncertain economic outlook, the evidence is unequivocal that immigrant skills will play a key role in the Canadian labour force in the upcoming years. With support from CIC and HRSDC's FCR program, TRIEC has been successful in running awareness campaigns to engage employers, and an employer awards program to recognize innovative and leading employer practices.
Second, employers need tools and resources to support organizational change. There's a wide array of assessment tools for language, for credentials, for competencies, and HR practices that employers need to learn about and be able to implement. Hireimmigrants.ca, a website originally developed by TRIEC and now managed by the national ALLIES project, is a key national resource for employers. It houses a wealth of resources for employers, including best practices and case studies from around the country. There is an opportunity for the federal government to fully endorse hireimmigrants.ca as the go-to place for employers and to support extensive marketing for this resource.
Honourable members of the standing committee, my name is Thomas Tam. I'm the CEO of SUCCESS, which is a multicultural organization serving new Canadians in British Columbia. We serve over 180,000 people a year through our offices in greater Vancouver, northern B.C., and three overseas offices in China, Korea, and Taiwan.
Today my focus will be on the foreign credentials recognition process. As an immigrant-serving agency, we have been working with internationally educated skilled workers, or IEPs, since 2001. Of course, we have a lot of partners. We partner with employers, sector councils, regulatory bodies, and government departments. Details of our involvement and services are attached for your reference.
Today I will focus on our recommendations to overcome the systematic challenges faced by internationally trained professionals. They face four major challenges, but recently we identified an additional fifth one.
The first four challenges are lack of Canadian work experience, lack of Canadian cultural exposure, lack of language proficiency, and lack of a Canadian network. The recent fifth challenge we have identified is the financial barriers. I think in the previous session, there was also some discussion on the financial barriers facing foreign-trained professionals.
In terms of recommendations, we recommend a six-point strategy. There are six areas that we would like the committee, as well as the federal government, to consider. We suggest a specialized foreign credential recognition case management service. At this time, most new immigrants can only get employment services at a provincial level in a very piecemeal manner. It's short term and when the funding contract is finished, there's no continuity of service for the internationally educated professionals. As you know, the whole process is very lengthy, costly, and sometimes insulting, so a lot of immigrants end up just getting survival-type jobs. They may not be able to afford the long battle without a very supportive case management system.
Second, we recommend a new and separate language and communication proficiency to replace cultural competency training. Language and workplace culture are always very big hurdles for foreign-trained professionals entering the different professions. This is what we call a soft skill. We have a lot of experience working with sector councils and employers, and this proved to be a very effective way to speed up the whole foreign credentials recognition process.
Third, we recommend an effective bridging mechanism between the internationally educated professionals and the regulatory bodies. This bridging program would be different from what we just discussed; it's not a technical bridging program. We find that many internationally trained professionals group together, but they don't have very good communication with the regulatory bodies. We tried a couple of projects. One was working with foreign-trained nurses in B.C., in partnership with the nurses' union of the province, to develop some support groups among the nurses. Then the nurses grouped together to support each other, and we also organized activities between the support groups, the nurses' union, and some regulatory bodies. People can sustain the struggle with the support of their peers on the same journey toward the foreign credentials recognition process. We would like to see more support for these support groups so that they can sustain the whole journey.
Fourth, we recommend extensive work placement services for IEPs. I think Joan also mentioned that. Mentoring and placement opportunities are very important. In B.C. we've been working closely with both the local organizations as well as some sector councils. We work with ICTC, the Information Communication and Technology Council, to run some pilot projects in Vancouver to help to recruit foreign-trained professionals to get into some placement and mentoring services.
The fifth one is the service support to employers. In the last ten years we never overlooked the importance of employers accepting and understanding the challenges and the benefits of hiring foreign-trained professionals. So the support to employers is very important. We have a website providing the tools for the HR departments of the business owners in terms of hiring and retaining immigrant workers. We also provide training for employers in understanding the challenges of internationally trained professionals.
Finally, we would like this document to support regionalization initiatives. What I mean here is to connect the immigrants to areas of more opportunities, especially in some smaller communities that are industry-based, like our project now at Fort St. John, which is the oil- and gas-based small town in northern B.C. We need more resources and support to encourage internationally trained professionals to go there and to help resolve the skill and labour shortage over there. We've been working very well with the community, with the energy companies, and also with people in Vancouver encouraging immigrants to relocate to the smaller communities.
Honourable members of the standing committee, I respectfully submit my report for your deliberation.
The mentoring program that TRIEC runs is a structured program for skilled immigrants who haven't yet had significant work experience in their field in Canada. The mentees are recruited by employment services organizations funded by Ontario's employment services program.
The unique thing about the mentoring partnership is that there were a number of small mentoring programs around Toronto that a number of different organizations were running. We brought all of those programs together so that we could go to large employers and recruit qualified mentors directly in the workplace from among their workforces.
For instance, TD, in financial services, have recruited over 800 mentors for us over the last five years--Deloitte, RBC, AMEX, CGI...-- across those services, so we've now, as I said, matched over 6,000 skilled immigrants. It's a mentoring relationship that provides 24 hours of professional mentoring over a four-month period. It's not a work experience program, and yet even with that intervention, our outcome statistics show that it's leading to a 70% success rate of people getting employed directly in their field, or related field, within six months of completing that mentoring relationship.
A large part of the need for this is that people lose their professional networks when they come to Canada. We all know that a large part of a successful job search is knowing who to talk to, having those networks, and knowing where the opportunities are. A big part of the success of those mentoring relationships is helping people to rebuild a professional network here.