Foreign-trained physicians frustrated by roadblocks to working on P.E.I.

Dr. Khaled Salar can't help but shake his head, as he reads through news stories on his laptop about the challenges facing P.E.I.'s health-care system — from Western Hospital's emergency department closing due to a staffing shortage, to the growing list of Islanders waiting for a family physician. 

"Why I get disappointed is that I am a doctor sitting at home, not being able to do anything," said Salar, who currently works for a software development company in Charlottetown. 

Salar is from Afghanistan, and is among the thousands of physicians in Canada, trained in other countries, held back from working here by what he calls a "time-consuming, resource-exhausting" process to get licensed. 

'Regulatory barriers' 

With P.E.I. and the whole country facing a health staffing crisis, the Canadian Medical Association says it's a problem that needs to be addressed. 

"The reality is there many regulatory barriers that are preventing both physicians and nurses from being credentialed and brought into the system, where they could be serving Canadians," said CMA president Dr. Katharine Smart.

Salar thought he was well positioned to work as a doctor on P.E.I. 

He graduated from medical school in Afghanistan in 2017, after completing a seven-year program, including a one-year residency at a hospital. 

He then spent a few years working with a non-governmental organization, trying to improve access to health care in under-serviced areas of the country. 

A year ago, after the Taliban started gaining control of Afghanistan, he and his wife made the difficult decision to leave their home, moving to Canada through a special settlement program. Salar knew people living on P.E.I., and chose to settle in Charlottetown. 

"When I was thinking about moving to P.E.I., my friends and people I knew here said there was a shortage of doctors," he said. "And I was like, 'well this is perfect for me. I can go and start off my career as a doctor here."'

But Salar hit a roadblock. As a foreign-trained physician, he needs to complete a major qualifying exam issued by the Medical Council of Canada. He estimates all the fees associated with writing the exam would cost him $20,000.

With little savings in the bank and he and his wife expecting their first baby, he said he can't afford the exam fees, or to take months off work to properly prepare.  

"There should be a process to make sure I have the necessary knowledge and qualifications to be able to practise as a doctor," said Salar. "But I believe it shouldn't be very expensive for me. This way, I can't afford it ... and P.E.I. loses that opportunity to get a doctor."

Assessment program a possibility 

Salar thinks P.E.I. should have a mentorship program in place that allows him to work for some time under a Canadian-trained physician, who can assess his abilities, and expedite the process of getting him licensed and working on his own. 

Programs like that, typically called Practice Ready Assessments, do exist to some degree in most other provinces. 

According to P.E.I.'s College of Physicians and Surgeons, the Island is one of only three provinces that doesn't offer the assessments. 

"The P.E.I College has been in discussions with Newfoundland and Nova Scotia regarding how their programs work and what it would look like here," Dr. George Carruthers, the college's registrar, said in an email to CBC. "Further discussions are being planned and will be brought to government for discussion."

The CMA president said the assessment programs have been somewhat effective in getting foreign-trained physicians working, but they have their limitations. 

"There's not a lot of [training] positions available," said Smart. "And when you look at a health workforce that's burned out and stressed and overworked, it can be challenging to find people that are able to support other physicians in that. So that's another program that needs to be scaled, and funded, and resourced adequately, so it can be more successful."

Smart said a streamlined licensing process and consistent regulations across the country would help as well. As it stands, there are different rules from province to province, which she said physicians moving to Canada can find difficult to navigate. 

"We need to get everyone on the same page — the colleges, which are the regulatory bodies, the provincial governments, and the federal government, who could be providing some of that leadership and support to get us all in the same direction," said Smart. 

Just days ago, Ontario's government directed that province's regulatory colleges to find ways to get foreign-trained doctors and nurses working faster. 

But here on P.E.I., the provincial government has had little to say on the issue. When asked by CBC whether efforts are underway here — beyond the college exploring an assessment program —  a spokesperson for the health department issued a statement, that offered no specifics. 

"Foreign trained professionals are important members of our medical and nursing teams ... We continue to work with the colleges to make sure the recognition process is as quick and efficient as possible while still upholding our standards for care and training in P.E.I.'s health system."