A major stumbling block to licensing cited by many IEHPs, is the cost of the process. Indeed, while expected to pay thousands of dollars to complete the examination process, many, and IMGs in particular, do not ultimately get to practice in their profession. This in turn, limits their ability to pay back these costs. As mentioned above, there are some who decide not to embark upon the process, for they feel that they will only be wasting time and money.

Where IEHPs are reluctant to attend bridging programs and other integration initiatives, their reasoning is often related to the lack of financial support they face while being enrolled in the program:

But in our case our future is, you know, it can be very bright and it can be very dark. So we have no guarantees there so nobody will give us any kind of OSAP [Ontario Student Assistance Program] or any kind of student loan because they don't know where we will end up. So we have to take regular loans with high interest rates, 18.5 and things like those. So that's why we had to pay $3,300 in a month. [Manitoba IMG #2, practicing]

Many IEHPs raised the issue of lack of access to student loans. Many IEHPs are not eligible for student loans in the provinces that we studied and among those that are, many may not realize their eligibility. A promising practice implemented through funds from the Maytree Foundation in 2006, was the Immigrant Education Loan Program (IELP). This was kick-started with funds from the provincial government through its Foreign Trained Professionals Loans program, which provided loans of up to $5,000 per person to cover assessment, training and exam costs. None of our participants had availed themselves of these loans. Since we conducted the interviews, however, the IELP has ceased. The Maytree Foundation now redirects those interested to the Royal Bank's Skilled Immigrant Education Loan Program which provides short-term financial support for training programs through a credit line of up to $10,000. This, unfortunately, does not allow for an interest free period during training which is a critical component of a student loan program. Hence, exploring the possibility of establishing student loan eligibility for at least some IEHPs (who meet particular criteria – good language, near practice ready) would be a promising approach to address the financial barriers that face IEHPs.

Another promising route to help address financial difficulties is to help improve the interim labour market positions of IEHPs, either while they are in the process of gaining professional integration, or as an end in and of itself. A promising model for IEHPs is employed by the Ontario Ministry of Health funded Access Centre. The Access Centre provides comprehensive information about the requirements for integration into one of the over 20 regulated health professions in Ontario, including standards of professional qualifications and the licensing and registration processes. The Centre provides on-site reference materials and resources, including an on-site library, links to education and assessment programs, self-assessment tools, and information sessions focused on various aspects of the registration process for internationally educated health professionals (IEHPs). Its truly value-added components include ongoing counseling and support, alternative career options, referrals to relevant organizations and community resources, information and referrals for retraining, and bridge-training programs.