A new study suggests that about half of international medical graduates living in Canada are currently working as doctors due to intense competition for residency positions, which has some foreign-trained doctors working as taxi drivers and in gas stations.
Researchers from St. Michael's Hospital in Toronto found that in 2011, 1,800 applicants competed for 191 residency spots designated for foreign-trained physicians in Ontario. The study found that 55 per cent of these graduates end up working as physicians.
The Ontario study, published in the Journal of Risk Management and Healthcare, looked at the "brain waste" foreign-trained physicians experience when they immigrate to higher-income countries.
The success rate that year was about 20 per cent for Canadians who had gone abroad for their medical training, compared to six per cent for immigrant international medical graduates (IMGs).
"There are doctors who are working as cab drivers, working in gas stations right now," study co-author Dr. Nishit Fumakia told CTV News Channel.
"They find it very difficult to find a training position despite finishing their medical exams."
Fumakia, a Canadian who attended medical school abroad, said the report pointed to a need to increase residency positions – which provide medical grads with a period of practical training in a teaching hospital.
The study found that the top five reasons for choosing to immigrate to Canada were: socioeconomic or political situations in their home country, better education for their children, concerns about where to raise children, quality of facilities and equipment and lack of opportunities for professional advancement.
The study found a "substantial number of respondents" felt they were misinformed about their chances of securing a residency position in Canada.
Because these doctors migrated to Canada as skilled workers, many said they assumed it would be easy to find relevant employment.
Many of those surveyed said they regretted their decision to move to Canada.
The study also showed that a number of foreign-trained doctors feel shame for taking on "survival jobs," such as delivering pizza.
The numbers are similar in the United States, the study found, where almost half of international medical graduates are unsuccessful in their first attempt at securing a residency position.
In 2013, 47.6 per cent of non-American citizen applicants secured a residency position compared to 53.1 per cent of U.S. citizens trained in international schools. IMGs that are originally from the U.S. ultimately have a 91 per cent success rate, while only 73 per cent of IMGs born outside of the U.S. are eventually successful.
"Our findings suggest that brain waste is pervasive for physicians who migrate to Ontario and that both brain drain and brain waste have no easy, quick solutions,” Dr. Aisha Lofters, a family physician and researcher in the St. Michael's Centre for Research on Inner City Health, said in a statement. "Restricting emigration and immigration for health care workers would be very difficult from an ethical and moral standpoint."
Lofters said Canada should take greater steps to ensure that the low number of residency positions for IMGs and the relatively low likelihood of securing a job in medicine is made clear to those looking to immigrate to the country.
She said many spoke of the shame they felt in taking what they viewed as "survival jobs," delivering pizzas or driving a cab instead of practicing medicine. Many said they regretted their decision to move to Canada.
"Our findings suggest that brain waste is pervasive for physicians who migrate to Ontario and that both brain drain and brain waste have no easy of quick solutions," Dr. Lofters said. "Restricting emigration and immigration for health care workers would be very difficult from an ethical and moral standpoint."
She said that where feasible, low- and middle-income countries should implement incentives to encourage their physicians and other health care workers to stay in their home countries, such as improved working conditions, financial incentives for working in rural or underserved regions. At the same time, she said, countries like Canada need to ensure that the immigration process clearly outlines the relatively low likelihood of obtaining a career in medicine after immigration, the low number of post-graduate training positions available for non-Canadian IMGs and the average time and financial commitment required.