Posted on November 18, 2010 by rkhan
Authors: A. Baumann & J. Blythe

Executive Summary

Introduction

A shortage of health care professionals is forecast for Ontario. An aging workforce and insufficient recruitment and production in the past decades mean that the province must make full use of all health human resources. The purpose of this report is to provide background information to support the development of guidelines for the integration of internationally educated health professionals (IEHPs) into the workplace. Challenges and barriers to hiring IEHPs and mechanisms for addressing them are outlined. The report also focuses on the extent to which the recruitment and retention of IEHPs is a priority. It identifies professions that are encouraging the recruitment of IEHPs and the strategies and resources required to reduce barriers and improve IEHP recruitment and retention. Multiple methods were used to gather information on IEHP integration into the Ontario health care system, including a review of published literature, an investigation of relevant web sites and interviews with various stakeholders. Individuals from government, education and health care organizations were interviewed. The community sector, acute care hospitals and rural, urban and mid-sized communities were represented.

Identifying Internationally Educated Health Professionals

It is impossible to determine accurately how many IEHPs reside in Canada or individual provinces (Torgerson, Wortsman, & McIntosh, 2006). Most health professionals enter the country before passing registration examinations or contacting regulatory bodies, and many remain unregistered for several years or indefinitely (Baumann, Blythe, Rheaume, & McIntosh, 2006). Data is available for IEHPs who have completed registration, but it varies in quality among professions. The Ministry of Health and Long-Term Care (MOHLTC) is currently working with health regulatory colleges in Ontario to create an Allied Health Human Resources Database (HealthForceOntario [HFO], 2009e). This will improve our knowledge of IEHPs in the workforce.

Migration and Settlement

Internationally educated health professionals encounter challenges in obtaining complete and timely information about re-entering their profession after migration. Early acquisition of this information facilitates their professional transition. Citizenship and Immigration Canada is becoming more proactive in supplying potential immigrants to Canada with relevant information and referral services.

Information dissemination and support for IEHPs who have settled or plan to settle in Ontario have improved. This includes government and professional organization web sites such as the Ontario Ministry of Citizenship and Immigration and Global Experience Ontario (Ontario Immigration, 2005a). A major investment by HealthForceOntario (HFO) is the Access Centre for Internationally Educated Health Professionals, which provides information, advice, support and Integrating Internationally Educated Health Professionals Into the Ontario Workforce 9 programs to IEHPs pursuing registration in regulated health professions (HFO, 2009a). One organization that serves a specific region of Ontario is the Access Centre for Regulated Employment, which provides information and assistance to IEHPs seeking licensure and employment in Southwest Ontario.

Registration: Processes and Challenges

Challenges for IEHPs in meeting registration criteria include supplying and validating credentials, satisfying educational/practice requirements, achieving language fluency, gaining clinical experience and passing the professional examination.

In 2008, the Canadian government signed labour market agreements with the provinces and territories. On January 16, 2009, an agreement was made to develop a common pan-Canadian Qualification Recognition Framework and Implementation Plan for better integration of immigrants into the Canadian labour force (White, 2009). Proposed legislation (i.e., the Labour Mobility Act) would ensure that a worker certified to practice in one province or territory would be entitled to certification in that occupation in Ontario, without having to complete additional material training, experience, examinations or assessments (Province of Ontario, 2009).

Human Resources and Skills Development Canada funds the Foreign Credentials Recognition Program, which supports projects initiated by provincial and territorial governments and other stakeholders.

In Ontario, the Centre for the Evaluation of Health Professionals Educated Abroad is part of an MOHLTC strategy to enhance services to IEHPs. Bridging programs help IEHPs satisfy registration criteria, and ways of recognizing prior learning experience are being developed. Regulatory bodies and the Centre for Canadian Language Benchmarks have undertaken projects to improve language testing and acquisition. Bridging and adaptation programs find clinical placements and job shadowing opportunities for IEHPs. Regulatory bodies and educational institutions have developed courses and tools to help IEHPs prepare for registration examinations.

Entering the Workforce

Given the current shortages, unemployment rates are low for IEHPs. Nevertheless, they face challenges due to uninformed employers, bias and their potential need for extended orientation. HealthForceOntario was created to oversee a number of health human resources strategies “designed to make the province ‘the employer of choice’ in health care” (HFO, 2008a). Marketing and recruitment activities include maintenance of a job posting web site, working with employers and communities to satisfy health human resource needs, acting as a clearing house of information about marketing and promoting Ontario though various media (e.g., career fairs). Integrating Internationally Educated Health Professionals Into the Ontario Workforce 10 Integration Into the Workforce Although the retention rate of IEHPs is reported to be high, they may face adaptation problems. Ultimately, the success of IEHPs in re-establishing themselves in their profession and contributing fully to their workplace depends on their efforts to integrate and on whether their practice environment is welcoming and adaptive. The literature makes it clear that diversity must be accepted into corporate culture (Kukushkin, 2009). It would be beneficial to identify exemplars or establish a gold standard to encourage successful diversity management. Among individual organizations, St. Michael’s Hospital, University Health Network, the Ottawa Hospital and Hamilton Health Sciences have all initiated programs to assist IEHP integration.

Source: NHSRU