Waseem Sharieff, David Zakus.
Resource utilization and costs borne by International Medical Graduates in their pursuit for practice license in Ontario, Canada.
Pak J Med Sci Jan ;22(2):110-5.

Background: Many physicians immigrate to Canada to pursue postgraduate training. However, these International Medical Graduates (IMGs) face difficulties in achieving their goal. For licensing IMGs who meet `Canadian` practice standards, the Ontario Ministry of Health and Long Term Care (MOHLTC) provided funding for establishing a program, the Ontario IMG Clearinghouse (OIMGC). Announced in January 2004, the program replaces the former programs: Ontario IMG program (OIMGP) and the Assessment Program for IMGs (APIMG). However, during this process IMGs are required to write and re-write several exams and bear the associated costs of the needed resources such as study time, exam fees, books and commuting. The main objective of this study was to estimate the resource utilization in the process of entry into OIMGP and the associated costs in relation to IMGs` annual income. Methods: We identified a subgroup of IMGs (n = 21), who were fluent in English and had written Medical Council of Canada Evaluating Exam (MCCEE). Using a semi-structured questionnaire, we collected information on IMGs` demographic characteristics, resource utilization and associated costs in the process of entry into OIMGP and then estimated the percentage of IMGs` annual income spent on the utilized resources. Results: The study time, books and commuting were the main resources utilized in the process of entering OIMGP. Most IMGs had very limited financial resources and required more than one attempt and 6 months of full time study to pass MCCEE and the like; the median percentage of annual income spent was 42% (IQR = 21%, 74%). Conclusion: IMGs` limited financial resources in relation to the current process appear to negatively impact their pursuit for practice license in Ontario. On the other hand the process of re-testing their already `tested` medical knowledge is counterproductive from a broad societal perspective.

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