Canada needs more doctors. Now. Millions of people living in Canada have no family physicians. Others are languishing on waitlists for specialist care.
Internationally trained physicians (ITPs) and international medical graduates (IMGs) are already helping to close these gaps. Sadly, thousands more remain stuck on the sidelines of health care, eager but unable to contribute. Why?
The answer is that immigration pathways were not designed in consultation with medical education, assessment, or regulatory partners – and while there have been updates and innovations, they’re not equally accessible across the country. The result is a fragmented, confusing route to practice that is discouraging newcomers to either change careers or move elsewhere.
This is a loss of medical expertise that we cannot – and need not – accept. There are ways to bring highly qualified IMGs and ITPs into the health system safely and fairly – faster.
The Canadian Medical Forum brings together leaders from major national medical organizations. Together, several members have developed seven recommendations for change.
1. Expand and standardize Practice-Ready Assessment (PRA) programs
Before they can obtain licensure, many physicians must go through a PRA. This is one of Canada’s most effective mechanisms for integrating experienced doctors safely into practice. Yet capacity is limited.
To fix that, Canada needs coordinated federal and provincial funding for national assessment frameworks; more training, support and compensation for assessors and supervisors; more options for specialists, especially those in high-need disciplines; and standardized fairness, transparency and quality monitoring.
2. Mandate integrated Indigenous health and cultural safety training as part of PRAs.
Cultural safety in health care is not optional. To serve First Nations, Métis and Inuit communities appropriately, PRAs should require training in cultural competency, safety and humility, Indigenous history and the social determinants of health in Canada, as well as education on the Truth and Reconciliation Commission’s health-related calls to action, the In Plain Sight report, Joyce’s Principle and missing and murdered Indigenous women, girls and 2SLGBTQI+ people.
3. Increase residency capacity for IMGs
Canada trains fewer physicians per capita than peer OECD countries – a threat to the long-term sustainability of our health system.
Funding is needed for more residency positions, particularly in high-need regions and specialities (including but not limited to family medicine); dedicated IMG training streams; preceptor capacity, learner accommodation and community-embedded training; and “top-up” training to address targeted competency gaps.
4. Align immigration policy with health workforce planning
Immigration pathways currently operate separately from the systems responsible for evaluating, licensing, and deploying physicians. This misalignment creates unrealistic expectations and delays entry into practice.
A coordinated, national approach would prioritize physicians in disciplines with severe shortages; allow for a concierge-style intake pathway to help newcomer medical graduates and physicians navigate different processes; remove outdated administrative hurdles (for example, Labour Market Impact Assessment requirements); support predictable transitions from temporary to permanent residency; and ensure medical regulators and health authorities receive early notification of incoming candidates.
5. Simplified, centralized, digitally integrated support for newcomer physicians
Many ITPs struggle to identify which requirements apply to them, how long processes will take and have no automatic triggers between licensing milestones, visa processing or community onboarding. Solutions include pre-arrival credential verification linked to immigration streams; a single navigation portal with milestone tracking and clear timelines; and interoperable digital systems that reduce administrative burden and increase transparency.
6. Establish a national data system for ITPs and IMGs
Canada lacks comprehensive information on ITPs and IMGs: their training, the status of their licensure and certification efforts, the outcomes of PRAs, where they end up practising – even whether or not they leave Canada. We also don’t have solid data on how many Canadians are studying medicine abroad or how many physicians are here on work visas, but are not permanent residents.
A national data system would identify bottlenecks and inefficiencies, improve mobility and deployment across jurisdictions, support evidence-based workforce planning, and enhance transparency and accountability. A unified national data observatory, ideally integrated with the Medical Council of Canada’s National Registry of Physicians and immigration tracking systems, to provide comprehensive insights into the presence and career trajectories of internationally trained physicians in Canada is critical.
7. Strengthen coordination across governments and medical organizations
Canada lacks a pan-Canadian forum for dialogue on policy, standards, innovation, and processes affecting IMGs and ITPs. This could be achieved via regular touchpoints with federal, provincial and territorial deputy ministers, the Committee on Health Workforce and the Canadian Medical Forum. With unified action, Canada can create a streamlined, patient-centred, fair and predictable pathway that fully leverages global medical talent — while maintaining high standards of care.
In leveraging this global talent, we remain firmly committed to the World Health Organization’s principles on ethical international recruitment. The reality, though, is that Canada is a desirable country in which to live and practise medicine, and many physicians and medical graduates choose to come here for a range of personal, professional and family reasons. Our focus should be helping them realize their potential.
Along with federal leadership on integrated health workforce planning – a national approach that connects how we train, recruit and support health care professionals with the care Canadians need – we can attract and retain the professionals we need to support both patients and providers.
Signatories listed in alphabetical order:
Black Physicians of Canada
College of Family Physicians of Canada
Canadian Federation of Medical Students
Canadian Medical Association
Fédération médicale étudiante du Québec
HealthCareCAN
Indigenous Physicians of Canada
Medical Council of Canada
Royal College of Physicians and Surgeons of Canada
Society of Rural Physicians of Canada
