Alberta Accelerated Licensing for International Trained Doctors- A Gimmick or Game Changer?
Politics and decision-making are just like sports. They have hidden agendas at times. As a soccer fan, I understand that coaches or managers may make decisions to substitute players or fire coaches, not to win the matches but to control the fans and regain support. Sometimes in soccer, they may restructure and regain the support they want and still lose the games. Here is the question to ask was the motive for the changes to win the matches, or was it just to appease the fans?
Like any soccer match, Alberta Health Services (AHS) has faced major challenges in the health system, particularly in the medical side. Since 2019, in the pandemic and post-pandemic era, Alberta has experienced high family doctor shortages, a shortage of specialized doctors, and long wait times in walk-in clinics and emergency rooms. Amid this crisis, AHS and the Alberta government responded by reshuffling the Board of Directors in 2022 (to promote the health sectors as expressed by premier Danielle Smith in her speech). The College of Physicians and Surgeons of Alberta (CPSA), in partnership with the Ministry of Health, introduced a new project to increase the number of doctors and to manage the crisis.
The CPSA recently introduced a five-year pilot project to increase the number of Internationally Trained Doctors from approved countries. The approved countries are: Australia, Ireland, United Kingdom, the United States, New Zealand, Hong Kong, Singapore, South Africa, and Switzerland. The project requires several steps for the professional assessment to make sure that doctors moving to Canada are competent. These assessments may take up to 6 years. The fees to be paid to attain these credentials cost on average $15,000 inclusive of competency assessment fees. This policy was introduced after an outcry by Albertans as they felt that their health needs were not met in accordance with their expectations.
AHS and CPSA policy intentions are of the greater course as it benefits the Albertans. However, the structured program does not meet the intended policy objectives. An assessment of the following issues must be considered for better results.
The reshuffling of the Board of Directors timing was in tangent to the premier assuming the position. This could be a way to bring new perspectives, expertise, and leadership to an organization, leading to positive changes. However, this can be regarded as a gimmick if the changes are purely symbolic and do not lead to any substantive improvements in the performance of the organization or the quality of care provided to patients.
If the new board members have conflicts of interest that undermine their ability to make effective decisions, then the reshuffle may be seen as a superficial gesture designed to create the appearance of action without addressing the root causes of the crisis.
If the reshuffle is not accompanied by other meaningful changes, such as increased funding, policy reforms, or better support for frontline workers, then it may be seen as a cosmetic solution that does not address the underlying issues facing the health sector.
It would make sense to broaden or change the approved countries and consider having more people coming from those countries that have a high rate of immigration to Canada. They can explore a regional strategy: Asia (including the Middle East) (62%), Africa (15%), Central, and South America, Europe, and USA (23%) (according to 2022 Statistics Canada data). Alberta will have more doctors willing to migrate from those countries since most of them are seeking ways to move out of their countries for different reasons.
Alberta can utilize the available international Doctors who are not practicing by shortening their programs to 2-3 years. Most of these doctors are permanent residents and citizens, and if those barriers are removed and they start to incentivize the immigrant doctors to practice the province will have more family and specialized doctors.
One suggestion for Alberta to consider in streamlining the assessment process is to establish assessment centers in different source countries. For example, the UK's General Medical Council has set up several centers in countries such as South Africa and Nigeria to administer exams, which can expedite the process before visa processing even begins.
Just like in soccer, a game plan is critical in bringing out results. Broadening approved countries will give better results and improve the diversity of doctors. It may also improve medical care for newly landed Canadian immigrants who can assess care in their first language. Alberta urgently needs to address its doctor shortage and considering some of those recommendations will make the policy successful.
William Ngezi is a Master’s student at the University of Calgary’s School of Public Policy.