Unrecognized Health Human Resource Impact of Canadians Studying Abroad

Sandra BannerIan Bowmer, MDSara Rattanasithy

Canadian Students Studying Medicine Abroad (CSAs)

• Since 2003, there has been a significant increase in the number of Canadian students studying medicine abroad as seen through applications at CaRMS.

• Canadians who choose this path are termed Canadians studying abroad (CSAs) but are considered international medical graduates (IMGs).

Definition of IMG:• An IMG is a physician who received their medical degree outside of

a North American medical school accredited by the CACMS/LCME.

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2010 CSA Study• Fill a knowledge gap by providing information on CSAs

• Career plans

• Factors influencing their career decisions

• Motivation to return or not to return to Canada

• Location of International Medical Schools Ireland Czech Republic

Poland United Kingdom

Israel Caribbean

Bahrain Australia

3

Survey Respondents

4

Medical School Region Survey Respondents

Ireland 272

Poland 79

Caribbean 501

Australia 206

Middle East 23

Totals 1081

• Based on enrolment data received by participating medical schools and Canadian medical student organizations abroad, we have estimated over 3000 CSAs studying medicine around the world.

CSAs Graduating per Year Based on our estimate of more than 3000 CSAs around the world:

Approximately 600 CSAs will be graduating per year*

CSA are studying in more than 30 countries and 60 different medical schools

This number of graduating CSAs add an additional 25% over and above the graduates of Canadian medical all competing for Canadian postgraduate training.

*Calculations based on CSAs in a 4 yr program and that are planning to return to Canada for postgraduate training.

Motivation to Study Abroad

6

Other

My family was living in this foreign country currently

Tuition costs were lower than Canadian medical schools

Wanted to live in another country

Allowed me to enter medical school directly from secondary school

Unable to obtain a place in a Canadian medical school

5.8%

0.5%

1.8%

6.6%

7.8%

77.6%

Sample Size1,030 respondents as of June, 2010

CSA and CMG Comparison

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High

Schoo

l

Colle

ge

2 ye

ars o

r les

s in

unive

rsity

(no

degr

ee)

3 ye

ars+

uni

vers

ity (n

o de

gree

)

Bache

lor's

Deg

ree

Mas

ter's

Deg

ree

Ph.D. o

r equ

ivale

nt

Other

0%

20%

40%

60%

80%

Highest Level of Education Prior to Attending Medical School

CSA CMG

CSA and CMG Comparison

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CSA CMG

1.76

2.95

Average Number of Applications to Canadian Medical Schools

Average Number of Applications

CSAs Going Abroad Compared to Population Baseline by Province

NL PE NS NB QC ON MB SK AB BC0%

10%

20%

30%

40%

50%

60%

70%

Province of Residence (%)Population Baseline (%)

(Statistics Canada , 2009)

Planning to Return to Canada to Pursue Postgraduate Medical Training

Yes, all of my postgraduate training

Yes, a portion of my postgraduate training

No

73.8%

24.5%

9.8%

n = 1030

Number of IMGs who passed MCC Examinations, by Birth Country, 2005-2009

EE QEI QEII0

2000

4000

6000

8000

10000

12000

9789 5452 3829

1183

584

366

Source: IMG Database, 2010

Applications to MCCEE

2009 2010 20110

200

400

600

800

1000

1200

1400

1600

1800 # Applications by Canadians Studying Abroad

# applications

2161262 1557

Source: Medical Council of Canada 2011

Countries / Regions educating students born in CanadaAccording to MCC 2009-2011 EE registrations

Region / Country SelectedCount

AUSTRALIA 152

CARIBBEAN 893

EGYPT 931

INDIA 991

IRELAND 361

POLAND 171

UNITED KINGDOM 284

Source: Medical Council of Canada 2011

Conclusions Increasing number of Canadian students studying medicine

abroad According to our survey 90% are planning to return to

Canada for postgraduate training.

No restrictions or limits on how many international students medical schools abroad can recruit. International medical schools are not responsible for

providing CSAs with the next step of their medical training.

A large portion of trained physicians may have no opportunity to enter postgraduate their training either abroad or at home.

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• CSA have not been included in any physician resource planning

• Because of family status are becoming a significant political force

• Canada has had a 77% increase in enrolment over the last decade leading to increased requirements for elective experiences and postgraduate education

• Capacity for integrating IMGs into postgraduate training is limited

• Lack of planning for CSA has the potential to undermine current efforts to integrate immigrant IMGs into the Canadian health care system

Questions and comments