Bridging the gap for internationally trained medical doctors

The challenges medical doctors face when moving to Canada

When Dr. Shafi Bhuiyan immigrated to Canada a decade ago, he found that internationally trained medical doctors had difficulty practising medicine without obtaining a licence.

According to Bhuiyan, about 6,000 medical doctors around the world immigrated to Canada in the last four years and only two to three per cent received a licence. 

“If 100 people try, the 98 get out from the system,” he said. “My role is to take care of the 98 per cent.”

In 2015, the Internationally Trained Medical Doctors (ITMD) bridging program at the G. Raymond Chang School of Continuing Education at Ryerson was launched. The program  integrates international medical graduates into non-licensed jobs in Canada’s health-care sector. 

Bhuiyan, co-founder and program manager of the ITMD program, developed the one-semester program as an alternative for those who can’t be practising physicians in Canada. 

“My mandate is non-licensed health-care jobs, because they’re left out,” he said. The program trains immigrants for careers related to, but not limited to, health research, health-care management or other non-licensed positions. 

After operating the program as a pre-pilot for three years, Bhuiyan said it was deemed successful. In winter 2018, the program received funding from the Ontario government and will continue. According to the ITMD progress report, as of December 2019, a total of 98 ITMD participants graduated with an 85 per cent success rate, meaning they went on to secure placements in the health-care sector.

The program consists of 13 weeks of in-class training followed by six to eight weeks of practicum placement in a hospital or in health-care management. Bhuiyan said that they’re currently working with 24 health-care partners, including St. Michael’s Hospital, Sunnybrook Hospital and the Hospital for Sick Children.

He added that students who come into the program are already educated about the medical field and its research, but they often struggle presenting that information during job interviews.

“We train them how to talk,” Bhuiyan said. “They understand how to prescribe, not to talk…It’s about selling yourself.”  

He added that the biggest difference is the importance of making job connections in Canada. “Back home they know all the medicine and diseases…but they don’t know how to do the research and present it.” 

Abha Sharma came to Canada in July 2018 in hopes for a better life.

After working as an epidemiologist in India for three years — where she researched diseases like malaria, hepatitis C, seasonal influenza and dengue fever under the state government — she was hoping her move to Canada would expose her to more opportunities in public health. 

But when she first got here, Sharma worked as a shuttle bus driver at Toronto Pearson Airport in addition to enrolling in some courses.

Her husband told her about the ITMD program. However, she was unsure that a program would help her get back into the health-care field. “I didn’t think a bridging program would help me,” Sharma said. “I thought you would have to do a master’s.” She enrolled in the program in March 2019 as part of the ninth cohort. 

“It was overall a wholesome package — you would get a brief introduction of every single sector and you can choose your interest, like project management. Students could go on to pursue project management and eventually work in that field.”

For her practicum, Sharma was interested in getting a position where she could apply her previous skills as a medical doctor along with what she learned in the IMTD program. She was linked for a post-doctoral fellowship at St. Michael’s Hospital global health department, where she is a Research intern in the Centre for Global Health Research (CHGR) for the Million Death Study in India. “I learned a lot and I’m still learning,” she says. 

Nour Amiri, a medical graduate from the Royal College of Surgeons in Bahrain, immigrated to Canada in late 2015. She said that she felt alone and was trying to manage the cultural changes of a new country, while also trying to handle the challenges of making it in the medical field.

“You’re kind of hesitant in the sense that you always question, ‘Am I good enough?’” She added that little to no clinical exposure makes it frustrating because of all the training and schooling one has to go through to get to this point.

“If you want to have clinical training you need a licence, but you can’t get a licence without actually training,” Amiri added. “It’s this cycle you can’t get around.” 

Bhuiyan said that Canadian research and experience are two major factors that people look at in the health-care field.

“You’re waiting and nobody calls you because they see your resumé and you don’t have Canadian education (and) if you don’t have any standard of research, they don’t call you,” he said.

Amiri was interested in finding research opportunities relating to her love for pediatrics, when she stumbled upon the ITMD program through the Access Alliance website — an organization that promotes health-care learning opportunities for immigrants, refugees and their surrounding communities. 

“The diversity factor and new learning opportunities are fantastic here,” she said. 

She added that the program taught her basic communication skills, like how to properly write an email, and that it helped her build confidence by working with like-minded people. 

”People going through the same struggles — it’s a shared experience,” Amiri said.

Since graduating from the ITMD program as part of the third cohort, Amiri did her post-year internship at the Hospital for Sick Children, where she was a research associate. She was also part of the University of Toronto’s medical pilot program in 2018, which allowed 10 internationally trained doctors to apply for a master’s degree without a medical licence. Since then, she has secured a permanent job and is now working toward being able to clinically practise in pediatrics.

Bhuiyan says his personal history makes him appreciate his work in the bridging program.

At a young age, Bhuiyan said he was granted a “second life” which inspired him to dedicate his life to people. In 1971, Bhuiyan was affected by the Pakistan and Bangladesh war.

“I was a war affected child, I got gun shot by the Pakistan army when Bangladesh and Pakistan divided,” he said. “That’s my real inspiration. I thought, ‘what is my life meaning for the people?’” 

After receiving his medical degree from the University of Dhaka in Bangladesh, he did a PhD in global human sciences at Osaka University in Japan.

“I made an oath that I would work for the people.” Bhuiyan added that in Bangladesh, many mothers delivered their babies at home because there is no respect or care in hospitals. At the age of 26, he built a maternity hospital in 14 months.  It opened in August 2000. “I built a hospital with more than $5 million — I was project director of the first medical doctor,” he said. “I love to help people.”

Like many others, Bhuiyan moved to Canada in 2010 for a better life for his two kids. “I came here with a huge risk,” he said. 

He is now running a global project with the Netherlands, looking at how Ryerson’s bridging program could be adapted to work there. 

According to a study, Ontario currently has the highest number of internationally trained medical doctors, totalling 6,000. Approximately 1,500 applicants compete for the maximum 200 residency positions at several medical schools annually.