SfC In The News
June 2000
Right skills, wrong country
Canada is desperately short of skilled professionals in medicine,
engineering and other disciplines.
So why are we making it next to impossible for talented
newcomers to practise in their fields of expertise?
 
By Dawn Calleja
©Canadian Business News, June 26, 2000
 
 Benilda Silkowska-Masior,
SfC program coordinator, comments
 
Two years ago, Kanwal and Tarvinder Kukreja had it all. Both were successful young doctors: Kanwal was a pediatrician in private practice; Tarvinder, a pathologist, was chief resident at Chandigarh Medical College Hospital in India’s Punjab state. In their free time, they worked with an international group of doctors developing standard guidelines for the treatment of asthma. They had a comfortable four-bedroom home and a somewhat pampered three-year-old daughter, Gazal, who had her parents’ undivided attention when they were able. "But we both felt we had to do something more in life so that we could be at the cutting edge of our professions," says Kanwal, 35. "We chose Canada."
 
Tarvinder completed the requisite immigration forms as the primary family applicant because her specialty, pathology, was on a list of occupations in demand published by Citizenship and Immigration Canada (CIC). Just before they got their papers–after a wait of almost two years–an immigration officer made them sign waivers saying they understood they might never practise medicine in Canada. Just a formality, they assumed, seeing as the only reason they’d been accepted in the first place was because they were both physicians.
 
Today, they live in a cramped basement apartment in Brampton, Ont., a half-hour’s drive northwest of Toronto. And since arriving in October 1998, they’ve been struggling to have their credentials recognized by the College of Physicians and Surgeons of Ontario (CPSO). Their graduate and postgraduate degrees–from renowned Indian medical schools where they studied in English with doctors from North America, the UK and Australia–so far mean absolutely nothing in Canada. They’ve spent their entire life’s savings on expensive credential assessments (which equated their education to postgraduate work at the University of Toronto) and exams. They’re now $9,000 in debt–and still no closer to getting licensed than they were when they first arrived.
 
But they still have to pay the bills. Between them, they applied for more than 300 jobs, from sofa-maker to home-care worker, in the three months after they first stepped off the plane. Either they were too qualified or not qualified enough. Kanwal initially took a job as a security guard for $8 an hour, but quit after only four days. "I put on the uniform, but I kept thinking to myself, ‘What am I doing here?’" he sighs. Money was so tight that the couple considered applying for welfare. Both finally landed jobs at a medical lab a year ago. Kanwal is a sorting clerk, opening boxes of samples and sending them to the appropriate departments for analysis for $9.52 an hour. Tarvinder, 32, works part-time as a lab assistant, packing slides for pathologists and earning the same wage as her husband. "I used to have people doing this for me," she says. "I used to train lab assistants."
 
The Kukrejas aren’t alone. Far from it. Of the 174,000 people who immigrated to Canada in 1998, 81,000 were skilled workers; of those, 72% had university degrees (compared with just 13% of all Canadians). In Ontario–the destination of choice for more than half the immigrants who come to Canada each year–the unemployment rate for foreign-trained professionals is more than three times the provincial average; only 24% have jobs in their exact professions. Nobody knows for sure just how many highly skilled people each year suffer the humiliation of working in menial jobs just so they can feed their families. And it’s not even because their qualifications are worthless; they’re simply not understood.
 
The problem is so widespread, it’s become cliché. Tap any cabbie on the shoulder and you’re bound to find a neurosurgeon or nuclear engineer. Ever wonder why? Most, like the Kukrejas, had no idea before they applied to immigrate what they would face in Canada. Some can’t produce the necessary transcripts and documents required by regulatory bodies–or the thousands of dollars for assessments, as well as national and provincial exams. It takes an immigrant at least a year, for example, to become a licensed veterinarian in most provinces. Applicants have to pass a three-part national exam costing $5,000–and then pass provincial tests.
But with such a tight labor market–and the world’s biggest talent magnet right next door–it’s a colossal waste Canada can no longer afford.
 
But with such a tight labor market–and the world’s biggest talent magnet right next door–it’s a colossal waste Canada can no longer afford. A case in point: it’s estimated that Ontario is short about 1,000 physicians. Northern communities–and even mid-sized Ontario towns like Sault Ste. Marie and Waterloo–can’t lure doctors their way. At the same time, hundreds of international physicians and surgeons immigrate to Ontario every year–and an overwhelming majority are willing to go where the jobs are, says Elizabeth McIsaac, project coordinator of the Association of International Physicians and Surgeons of Ontario (AIPSO). Yet there are only 36 residencies–which can last up to six years for specialists–available to foreign-trained doctors each year. AIPSO alone has 500 members across Ontario, most of them still trying to qualify to practise. "These barriers were put up when there were too many physicians in the country," says McIsaac. "There’s a clear need for a national policy to clear up the jurisdictional gap."
 
It’s not just because Canada desperately needs skilled human resources–or even because it’s the fair thing to do. Something has to give because it’s costing Canadian businesses and taxpayers cold, hard cash–and plenty of it. A study in Australia (with demographics similar to those of Ontario) estimates the foreign credentials problem costs the country between US$100 million and US$350 million annually due to the loss of potential income and taxes, welfare and employment insurance and unnecessary retraining. The Kukrejas estimate that they’d have raked in about $400,000 between them had they been allowed to practise as soon as they arrived–and paid at least half that in income taxes. "And Canada didn’t pay any money to educate and train us," Tarvinder points out.
 
The now-defunct Canadian Labour Force Development Board, a national advocacy group, estimated that the cost to Canada of raising and educating the immigrants who arrived here between 1992 and 1997 would have been more than $1 billion. Ratna Omidvar, executive director of the refugee and immigrant program at the Toronto-based Maytree Foundation, can’t believe employers and governments have allowed this situation to go on for so long. "It makes good business sense to recognize these professionals," she says.
 
It’s obvious something has to change–and fast. But in the jurisdictional muck that is Canada, there’s no quick fix. "It’s going to be slow," says Omidvar, who was a teacher in Iran before she immigrated to Canada in 1981. "The decentralized system makes progress very difficult."
 
Immigration falls under federal jurisdiction. But once immigrants get to Canada, they become the responsibility of whichever province they settle in. And if they’re in a regulated profession, the province then puts them at the mercy of professional regulatory associations like the CPSO and the Professional Engineers of Ontario (PEO). These bodies are comprised solely of members of the profession and have more or less free rein; their only mandate is to protect the public. How each association chooses to interpret that mandate is entirely up to them. As a result, criteria vary from province to province and from occupation to occupation. Some recognize credentials from certain countries; others don’t. It’s all a big hodgepodge.
 
But the problems start well before skilled immigrants even set foot on Canadian soil, something that can entail a wait of up to three years. Currently, immigration applicants are awarded points based on whether their occupation appears on a list of occupations in demand. The list is usually outdated; the current one–last changed in 1997–includes barbers, bakers and potters, but not physicians. And it’s left to immigration officers, many of whom are locals facing enormous backlogs and a shortage of resources, to assess an applicant’s credentials or ask for an independent assessment of how they measure up against Canadian standards. If they’re accepted, they naturally assume they’ll have no trouble finding work. "There’s a lack of information that helps immigrants make up their mind whether they can practise," says Omidvar. "They’re painted a certain picture by visa officers, but only people working in a regulated profession can know who will qualify and who won’t."
While CIC’s intentions are good, critics say the new act has some fundamental flaws.
 
A new immigration act unveiled by federal Citizenship and Immigration Minister Elinor Caplan in April aims to address part of the problem. "The new system won’t select immigrants based on occupation," says Mark Davidson, acting director of economic policy and programs with CIC. "But if someone has experience in a highly skilled occupation with transferable skills, they will qualify." While CIC’s intentions are good, critics say the new act has some fundamental flaws. The ultimate decision on who has the right skills and who doesn’t is still up to often unqualified and harried immigration officers. It also leaves it entirely up to them to ensure prospective immigrants understand what they will face when they arrive in Canada–something Davidson insists immigration officers do already. "But the message often goes in one ear and out the other," he says.
 
Omidvar disputes this assertion. And a recent survey of foreign-trained professionals conducted by the Ontario government found that only 20% of respondents said they’d been briefed on occupational requirements before they immigrated–and half of them received that information from family or friends. Often it was inaccurate.
 
Shamira Madhany is manager of the Ontario government’s Access to Professions and Trades Unit, part of the provincial Ministry of Training, Colleges and Universities. Its mandate is to address many of the concerns identified in a report on the problem published back in 1989. Madhany agrees that a lack of information overseas is a huge barrier. The ministry has worked with occupational bodies to come up with fact sheets detailing occupational requirements to be handed out at immigration offices abroad. But there’s still no guarantee that those who need them will get them. "Systemic change is a very long process," says Madhany.
 
It’s already too late for some. Steve Thomson immigrated to Canada from England in 1988. He had 17 years’ experience as an engineer building submersible drilling rigs in Norway and oil platforms in the North Sea. But when he got here, he was told by employers that although engineers don’t necessarily need a licence to practise, they wouldn’t consider hiring him without one. And to get a licence from the PEO, he’d have to write anywhere from two to 20 exams–and get at least one year of Canadian experience. "It’s a catch-22," says Thomson. "Does it not occur to people’s common sense that if someone has been practising engineering in an overseas refinery for 17 years, they might have got the hang of it by now?"
 
Thomson now runs an engineering recruitment agency in Sarnia, Ont. He has a pile of letters on his desk from foreign-trained engineers–the largest category of skilled workers coming to Canada–trying to set up jobs before they arrive or to land something better. Thomson pulls out one résumé from a 40-year-old Russian man with a doctorate in engineering. Since he arrived in Canada in 1996, he’s been working on an assembly line at a plastics factory. He had no idea before he came that he’d have to get licensed before he could find professional work. "These people write to me and ask for help," says Thomson. "I’m the one who has to tell them."
"No matter what area you work in–except software and computers–you have to start again, no matter what your education and achievements."
 
Morgan Gao came to Vancouver from China this past August with a master’s degree in engineering and 10 years’ experience in mineral processing. "I wanted a new life, adventure," says Gao. "And Canada is more advanced than China." He got a rude awakening when he arrived: he faced a year of studying and exams before he’d be able to work as an engineer. Right now he’s working part-time at SUCCESS, a BC immigrant services network, doing administration and interpreting. While he hopes to practise as an engineer again, he’s not optimistic. "I know lots and lots of people with the same problem," says Gao. "No matter what area you work in–except software and computers–you have to start again, no matter what your education and achievements."
 
It’s the same story in most of the more than 40 regulated occupations across Canada. Chris Baerwinkel, a native of Lörrach, Germany, graduated from the Technical University of Berlin with a degree in architecture a couple of years ago. He worked for two years as an architect in Berlin before moving to Toronto with his Canadian wife, Sarah, last year. He contacted the Ontario Association of Architects to find out what credentials he’d need. He was told that he could work as an architect without a formal Ontario licence, but he’d never be able to sign off on architectural plans. For that he’d have to pay $700, write extensive exams and possibly go back to school. In Germany, architects automatically earn the right to sign plans after two years in the business. "Eventually, I want to start my own company," says Baerwinkel, 33. "It’s going to be a problem." So far, he hasn’t even been able to find a job; most local firms won’t hire someone who’s not familiar with local building codes. "It’s protection of the local business," says Baerwinkel.
 
Nowhere is that more true than in the case of medical licensing. No one wants quacks operating on unsuspecting patients. But because of complicated requirements for foreign-trained doctors and other medical personnel, patients are facing mind-numbingly long waits at emergency rooms across Canada. Others wait even longer to see specialists. "They’re protecting themselves, not the public," says Ontario Liberal citizenship critic Tony Ruprecht, who’s been trying to get Mike Harris’s Tories to deal with the problem for the past two years. "Up north they’re crying for doctors, and we have hundreds just sitting here."
 
The system is beyond confusing–at least three federal and provincial bodies are involved in the licensing process–and the short-term prognosis is not promising. Qualifying exams are expensive and plain unfair: even pathologists, who analyze lab samples rather than treat patients on the front lines, have to write exams in psychiatry, surgery and obstetrics before they’re allowed to practise.
 
And before anyone can qualify for a licence, they have to complete a residency period. At least 1,000 residency positions are reserved each year for Canadian-educated medical graduates, and just about all are guaranteed a placement. Tarvinder came in the top 90 or so out of almost 300 foreign-trained physicians vying for spots in Ontario, but she didn’t make the top 36. Now if she wants to try again she’ll have to rewrite the exams next year. And as with many other regulated professions, there’s no appeals process. The Foreign Medical Graduates Association in Manitoba has even launched a human rights complaint because the process is so obviously biased.
 
With the move toward a global economy and more open borders, leaders around the world have realized they’re losing out by not recognizing international qualifications. In 1997, more than 50 countries–including European Union members, Canada, the US and Israel–signed an agreement that would see them recognize the educational credentials of immigrants from signatory countries. Twenty nations have ratified the agreement so far, including Russia, Australia, France and Switzerland. No word yet on when the US or Canada plan to put it into effect. It seems the federal government isn’t willing to step on provincial toes just yet. As for the provinces, they’ve included a chapter in the 1995 Agreement on Internal Trade that should clear up some jurisdictional wrangling by making regulatory bodies recognize their counterparts across the country. But most of the provisions apply to Canadian-trained professionals or those already licensed in one of the provinces.
In Ontario, Premier Mike Harris has been promising to address the problem since he first ran for office in 1995, and he’s finally making a move.
 
In Ontario, Premier Mike Harris has been promising to address the problem since he first ran for office in 1995, and he’s finally making a move. The Tories are set to roll out a provincially endorsed foreign credential assessment service–contracted out to a company in New York–in October. Quebec has had a similar service since 1971, and BC and Alberta have both had one for the past few years. In theory, the service will be used by occupational bodies to assess a person’s credentials and experience, and compare them to Ontario standards. The problem is that no one can force regulators to recognize the assessments. "I don’t think the government has thought this through," says Omidvar. "Immigrants will pay $250 for an assessment by a body that has no authority. Therein lies the stupidity of all this."
 
José Pereira, manager of employment services at the PEO, agrees. "The assessment service is a waste of time as far as we’re concerned," he says. "We have our own admission process. That’s the nature of a self-regulatory body." Pereira speaks regularly to groups of international engineers to make them more aware of how the process works and to give them an idea of their chances of becoming licensed–and, more importantly, employed. The PEO is also considering the creation of an associate member designation for foreign engineers who have all the required qualifications except the ever-important Canadian experience.
 
The College of Nurses of Ontario (CNO) is another association that’s working to make its licensing process more fair. In conjunction with the provincial Access to Professions and Trades Unit, the CNO has developed a detailed booklet explaining licensing requirements and procedures, as well as some of the cultural differences involved in practising nursing in Ontario. The CNO plans to make the booklets available at immigration offices and Canadian embassies overseas. The college will also grant temporary licences to foreign nurses and place them in long-term care facilities to gain some Canadian experience. "We’re hoping this will help foreign-trained nurses be better equipped," says Brenda Lewis, the Toronto-based director of the CNO. Madhany hopes the program can be tested in other professions as well. "Although we’re working with individual occupational bodies, it’s always with a view to developing a ‘best practice’ solution for all professions," she says.
 
Benilda Silkowska-MasiorBut until the attitudes of the professional bodies change en masse, it’s up to social services agencies like the Maytree Foundation to do what they can. Omidvar’s refugee and immigrant program works with professional organizations to develop initiatives like those of the CNO. "Canadian standards are not negotiable–as long as they’re relevant," she says. "But differences need to be accommodated." Skills for Change (SfC) is another active agency. The Toronto-based community centre offers international professionals courses in résumé-writing, ESL, occupation-specific language and interview skills. It also offers programs on cultural differences, becoming licensed and how to network to find jobs. Even if they get licensed, many newcomers still can’t find jobs because they don’t have contacts in the industry. "Networking is like a post-graduate degree," says Benilda Silkowska-Masior, SfC program coordinator. "We try to help our clients build corporate contacts through various means."
 
SfC hosts regular employer breakfasts and brings in speakers from different professions. And Silkowska-Masior developed a mentoring program that matches foreign-trained professionals with people working in the field. Ontario Power Generation and the City of Toronto are just two of the companies involved, and Silkowska-Masior hopes to recruit more companies and individuals in various occupations. She’s also helped other organizations in Ontario set up similar programs. "More than 75% of participants in the program find jobs in their field as a result," she says proudly.
 
But there’s still a long way to go. "The system has to change," says Omidvar. "Regulators need to work together, and the provincial government has to call for greater accountability. If we’re bringing immigrants to Canada to meet skill shortages, doesn’t it fall to us to do it better?"
 
In the meantime, Kanwal and Tarvinder Kukreja are still fighting for their professional lives. They’ve finally scraped together enough money for Kanwal to start writing his exams, and he spends between six and eight hours a day studying before starting his 6 p.m. shift at the lab. Tarvinder just finished writing medical exams in the US – where foreign-trained physicians have just as good an opportunity to land residencies as US graduates. If they don’t get to practise in Canada soon, and Tarvinder gets a residency south of border, the family will move. Meanwhile, Kanwal gets to spend only 15 minutes with his daughter in the morning before he takes her to day care at the local YMCA–where her spot is subsidized–and drops Tarvinder off at the lab. Sometimes she spends hours on the bus after work to pick up Gazal before heading home to make a quick dinner and settling in to study. "It’s been very depressing, and there’s no light at the end of the tunnel," says Kanwal. "We like this country, but we came here for a specific purpose." Tarvinder shakes her head in frustration. "We came here to be useful citizens, to pay back society," she says. "It’s just such a waste."
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