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Nova Scotia’s immigrant medical graduates anticipate a new assessment plan to get them working. Lis van Berkel reports.

Sania Dorey collects breakfast trays, makes beds, stocks supplies and delivers mail at the South Shore Hospital because she’s been told she’s over-qualified to be paid to do anything in a Nova Scotia hospital.

Dorey and Heizer Marval, another physician who volunteers, are from opposite sides of the world—Russia and Venezuela—but both belong to a group of more than 45 immigrant physicians living in Nova Scotia who can’t find work. And both are excited that, in June, the province plans to start assessing international medical graduates. But that doesn’t mean they’re satisfied.

Both Dorey and Marval want to agitate for greater change—specifically, in the cost and amount of time accreditation takes in Nova Scotia—than what the Nova Scotia College of Physicians and Surgeons will offer them when it introduces provincial assessment for IMGs in NS. The two-part assessment will cost each IMG $5,000. Plus, Dorey and Marval speculate, at least one more year without paid medical work.

“My husband doesn’t know about reality—he said Nova Scotia needed doctors,” laments Dorey, who moved with her daughter from Kirov to Bridgewater last June to be with him. “‘Come,’ he said. ‘There is work.’”

In August, the obstetrician-gynecologist with 18-years experience tried to get the ball rolling. But, after six months, the Royal College of Physicians and Surgeons of Canada told Dorey that “ is unable to assess the comparability of the Postgraduate Medical Education system of Russia” with that of Canada, even though her school, the Kazan State Medical Academy, is internationally recognized.

Marval had an easier time with the bureaucracy as a fresh graduate of Central University of Venezuela medical school in Caracas: upon arriving in Canada two years ago, he took the exam Dorey cannot take—travelling to Toronto to do it—and part one of the qualifying exam.

Yet he agrees with Dorey that it is ridiculously difficult to get past this stage: “In Spain, in the UK, I have friends, colleagues, who ask me, ‘What is wrong with you?’ because I am not working in Canada. I moved here, I am a medical graduate, but I am not working. So for them, something is wrong with me.”

Marval, who is living off his savings—”I am eating my car now”—has applied for what he considers his next option: Canadian Resident Matching Service. On March 1, after Canadian medical school graduates were placed in residencies, IMGs became eligible to apply for the leftover positions. Still, Marval was given only a week to apply for one of two resident psychiatry positions in Halifax for which, he estimates, he is competing against 100 other IMGs. Ironically, some of them are Canadians who studied overseas after places in Canadian medical schools were slashed in the early 1990s.

Although IMGs like Marval and Dorey don’t want to take jobs away from Canadians—“We realize that the system is protectionist, and that it has to be that way,” says Marval—they see medicine as a privilege which they have earned through study, experience and, increasingly, a lot of jumping through bureaucratic hoops.

Plus it’s unlikely they would be taking work away from others. Two months ago a national survey of Canadian physicians, conducted in part by the RCPSC, demonstrated the need for doctors. It concluded there is an inadequate number of specialists in Canada, and that more than half of general practitioners are women with children who are working fewer hours.That immigrant doctors who could fill the gap are under-utilized in Canada, and losing their skills each day they are left hanging, is also not really news. In February 2004, a national task force report on licensure of IMGs in Canada made six recommendations, including: ensure there is room for and funding for the assessment and training of IMGs in Canada; and provide financial and educational support for IMGs. Immediately, Health Canada responded to the task force’s findings with $3 million over three years earmarked for the provinces to assist them in assessing IMGs like Dorey and Marval.

Another $1.1 million in federal funding is being used to implement the recommendations. The Halifax Immigrant Learning Centre, where Dorey has spent nine weeks studying medical English for free, received funding from Citizenship and Immigration Canada as well as the Nova Scotia Department of Education.

However, Dorey and Marval believe they should be eligible for more financial assistance like that, or in the form of low-cost loans, which are otherwise unattainable for newcomers with no credit rating in Canada. Marval has already paid at least $2,000 to take his first two exams, not including travel or the cost of the approved study materials.

Bruce Thorne, the director of communications at the NSCPS, declined to discuss the IMG assessment before the College’s mid-April announcement. “We are still putting the final touches on the program,” he explains. “And we don’t want to steal our own thunder.”But that’s exactly what the IMGs will try to do when the province makes its announcement, tempering what should be proudly vaunted by the province and its new immigration ministry.

Despite Marval’s disappointment, he is remarkably upbeat. “People sometimes think we are angry, but we are friendly,” Marval says, shrugging and smiling. “We want to contribute.”


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