Many integration service providers in Canada are intended for all immigrant categories while some target particular ethnic groups or refugees only or some categories of refugees (Quellet & Warmington, 2007). Even though sources of funding vary, majority of the services are provided by non-governmental organizations. There are three types of areas covered by integration services to refugees: 1) reception, orientation, and housing; 2) employment and language; and 3) counselling and social support. Numerous integration services are accessible to Privately Sponsored Refugees (PSRs), Government- Assisted refugees (GARs), protected persons, and Landed-in Canada Refugees (LCRs). Still, as LCRs and protected persons will often have lived in Canada for a while, it is less likely for them to access some of the services pertaining to early settlement phase. The services which tend to target permanent residents are largely inaccessible to refugee claimants, due to their status of temporary residents.

Employment and Language

Federally and provincially funded employment and language services that cater to all permanent resident newcomers are accessible to GARs, PSRs, LCRs, and protected persons (Quellet & Warmington, 2007). Access to employment services may be denied to refugee claimants who are waiting for their status determination, depending on the province of their residence, but they may apply for temporary work permits. Employment services often contain workshops on resume writing, interview skills, and job search tools (Quellet & Warmington, 2007).

In their job search, all immigrant and refugee newcomers are assisted by a number of programs funded by federal and provincial governments. For example, through the Immigrant Settlement and Adaptation Program, settlement services (including employment-related services) are funded by federal government. These services are offered to permanent residents and refugees who have obtained a positive refugee status determination by the IRB. At the provincial level, the Newcomer Settlement Program in Ontario funds the same type of programming. In Ontario, claimants may be eligible for these services regardless of refugee determination. Other employment services cater to those with already high language and professional skills. For example, in the addition to the advanced work-associated language training, Enhanced Language Training program offers a bridge-to-work component for newcomers; the Ontario Internship Program for Internationally Trained Professionals creates job placement opportunities for professional immigrants.

The Job Search Workshop Program that prepares the immigrants for the Canadian labour market is funded by the Department of Citizenship and Immigration Canada. It involves a series of workshops that aim to assist and inform newcomers on the all aspects of job searches in order to aid their integration into the workforce (Multicultural Council of Windsor and Essex County, 2008). In particular, through these workshops, immigrants learn to:

• Understand the Canadian labour Market
• Write an effective resumé with which to present themselves to employers.
• Understand the various types of correspondence and their importance.
• Employ effective techniques for getting into contacts with employers.
• Employ the best Job search strategies
• Be aware of and understand the culture of the Canadian workplace, workers rights and employment standards.
• Employ successful interview techniques.
• Use the internet for research and job searching (Council of Windsor and Essex County, 2008).

In addition to such programs, many integration services offer orientation sessions for newcomers which focus on Canadian Workplace culture. CIC also funds the Enhanced Language Training (ELT) Initiative which it launched in 2003-2004. A total of $20 million per year over four years was allocated to such initiative with aim of expanding to reach 20,000 immigrants annually through partnerships with provinces, territories, employers and non-governmental organizations (Lochhead & MacKenzie, 2007). Permanent residents, refugees and those on temporary resident permits are eligible for training under ELT (Lochhead & MacKenzie, 2007). The initiative aims to provide higher levels of language training to help meet the needs of immigrants who come to the country with basic or intermediate English or French skills (Lochhead & MacKenzie, 2007).

The Case of the Integration of Internationally Educated Health Professionals

It should not come as a surprise that the changes in immigration policy towards a social capital model has resulted in a considerable influx of internationally educated health professionals (IEHPs) into the Canadian labour market. They score highly on the points scale and many hear through friends, relatives and through the news media that there are existing or impending shortages of health professionals in Canada, particularly in the relatively underserviced rural and remote communities. There has also been a longstanding historical policy of Canadian governments at the federal and provincial levels to resolve these shortages with IEHPs (Bourgeault, 2007). Once IEHPs get here, however, they face the difficulty of navigating a complex and highly regulated health care labour market that has until recently created insurmountable barriers to practice. A great deal of government funds have been devoted to addressing what many have labelled a ‘brain waste’ issue (Bourgeault 2008).

International Medical Graduates (IMGs): During 1970s’, about one third of Canadian physicians were internationally trained. According to the statistics of Canadian Medical Association, the number of IMGs rose substantially from 388 in 1993 to 790 in 1997 (as cited in Bourgeault, 1997). In the past, most immigrant physicians came from English, Irish and Scottish medical schools. Today 22% of Canada’s physicians are internationally trained and the greatest percentage of new international registrants come from South Africa (Health Canada, 2007). Despite the fact that Canada has relied on IMGs to fill labour shortages in a medical field, many of them still face the obstacles which prevent them from realizing their full labour market potential. In order to be able to practice in their field, IMGs often have to go through an extensive licensing process (Bourgeault, 2007). This means that they first have to pass several standardized tests and often to take two to six more years of medical training (Bourgeault, 2007). Other barriers that have been identified in the literature include: 1) lack of specific information available to prospective and new immigrants on Canada’s foreign credential system; 2) navigating through the policies, practices and procedures for registration; 3) the needs for higher levels of occupation-specific language skills; 4) the time and costs of being assessed; 5) lack of capacity that some Canadian institutions have to analyze qualifications of immigrants; and 6)inconsistent processes of assessment and recognition of foreign credentials between different jurisdictions (Ikura, 2007, Lochhead & MacKenzie, 2007). In rare instances exceptions are made to these rules. For instance, it had been the case that needed specialists are employed from abroad for urban hospital placements as well as family physicians in underserviced areas and licenses are fast tracked to meet these needs (Bourgeault, 2007).

As one of the ways to remove such barriers, in 2003 the Government of Canada established Federal Credential Recognition (FCR) Program as a part of the Governments’ broader Internationally Trained Workers Initiative Program whose goal is to “facilitate the recognition of international qualifications so that internationally trained workers may better contribute to Canada’s economic and social development” (HRSDC, 2007). The FCR Program has specifically allocated $68 million over the six year period between 2004 and 2010 to implement the program and to “engage organizations in activities that will achieve systematic improvements in the way in which their professions assess or recognize foreign credentials” (Ikura, 2007, p.19). In 2004 and 2005, following the footsteps of FCR Program, key federal government agencies, including Human Resources and Social Development Canada (HRSDC), CIC and Health Canada proclaimed a set of programs and projects that focus on IMGs and on internationally educated nurses (IENs) discussed below (Bourgeault, 2007).

In March 2004, HRDSC provided $341,050 in funding to Medical Council of Canada for the Self-Assessment Tool Project (HRSDC, 2004). Such a project aimed to “create self-assessment examination and associated delivery system to be made available to foreign-trained medical graduates wishing to come to Canada to train or practice in the field of medicine” (HRDSC, 2004). In addition, in 2005, Health Canada, announced an investment of $75 million over five years for Internationally Educated Health Professional Initiative, through which it has attempted to “work with provinces, territories and stakeholders to enable more priority IEHPs to put their skills to work in Canada’s health system”(Health Canada, 2007, p.11). An Internet Portal was also established by the Association of International Physicians and Surgeons of Ontario (Bourgeault, 2007).

Internationally Educated Nurses (IENs): The reliance on IENs is less so than for IMGs but some Provinces, namely British Columbia, Ontario, Saskatchewan have slightly increased the recruitment of IENs in response to the shortages encountered in these areas (Bourgeault, 2007). According to the study done by Little (2007), the majority of IENs come from Philippines (27.9%), followed by UK (23.3%), United States (6.9%) and Hong-Kong (5.6%). The flow of IENs in Canada is characterized by three dimensions: application, the eligibility to write a national licensing exam and success on that exam that guarantees registration (Little, 2007). In order to be eligible to write a licensing exam, the applicant must have fulfilled the following requirements: a graduation from an approved school of nursing, demonstrated competencies in delivering nursing care and satisfactory knowledge of language (Little, 2007).

IENs face similar barriers to that which IMGs faced, discussed above. Hence, also in March 2004, HRSDC provided $545,145 of funding to Canadian Nurses Association to launch the Diagnostic for the National Assessment of International Nurse Applicants Project (HRSDC, 2004). The goal of this project was to identify and assess the “current practices and policies with respect to the licensing of international applicants for each of the three regulated nursing groups and providing draft recommendations for further action” (HRSDC, 2004). The report emanating from such project was issued in 2005 and recommended: 1) the establishment of a national assessment service to create an evidence based standardized approach to the assessment of IENs; 2) the establishment of nationally standardized, flexible bridging programs to ensure that IENs are competent to meet Canadian nursing standards and; 3) all stakeholders reach consensus on a principled, comprehensive and collaborative approach to assessment and recruitment within an ethical framework (as cited in Little, 2005).