Post on 23-Feb-2016
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IMGs in Canada Project:The Pearson Conference
Toronto, Ontario, CanadaFebruary 22-23, 2011
Welcome!
Why are we talking about IMGs? Many players complex environment Balancing our need for physicians with public safety Standards of Canadian vs. International medical schools
(accreditation, curriculum, graduate preparedness, etc.) Need for standardization of IMG assessment processes Growing domestic and international demand for PGME in Canada Ethical recruitment and treatment of IMGs
I look forward to our discussion…
The IMGs in Canada Project: Where We’ve Been, Where We’re Going • Thank you• IMGs in Canada Project – recent history
– Phase I: 2005-2009• Foundational activities
– Phase II: 2010-2013• Maintain, enhance, create, support• User guided
• Coming up:– Database overview– Scratching the analytical surface
The National IMG Database: ‘Who, What, When and How’ behind the Data
IMG Database – Overview of Data
• Contributing Data Partners• Data Collection and Analysis Process• Current Status - Data Holdings• Data Variables Collected• Type of Analysis
Contributing Data Partners
• Medical Council of Canada (MCC)
• 7 IMG assessment centres
• 17 Faculties of Medicine
• The College of Family Physicians of Canada (CFPC)
• The Royal College of Physicians and Surgeons of Canada (RCPSC)
• Collège des médecins du Québec (CMQ)
• 9 regulatory authorities
7
Data Collection & Analysis Process
Data Providers
MCCFaculties of Medicine
CAPERIntranet
• Datasets are submitted on a calendar year basis by April following the end of the report year.
• Raw data is sent to the IMG Project team through our secure web portal.• All data submissions are verified for missing items and inconsistencies.• Data is processed and stored in a secure relational database.• Analysis is performed and presented as anonymous, aggregate data.• Data providers are consulted prior to the publication of findings derived from
their contribution.
IMGDatabase
CFPCRCPSC
AssessmentCenters
LicensingAuthorities
dBase
dBase
dBase
dBaseTable Verification
Current Status – Data Holdings
CMQ
RCPSC
CFPC
FOM
MCC
2005 2006 2007 2008 2009
2005-2009
2006-2009
2005-2009
2005-2009
2005-2009
Current Status – Data Holdings (Cont’d)Assessment Centres
British Columbia (IMG-BC)
Alberta (AIMGP)
Saskatchewan (CPL)
Manitoba (MLPIMG, CAPE)
Ontario (CEHPEA)
Nova Scotia (CAPP)
NF and Labrador (CSAT)
2005 2006 2007 2008 2009
2005-2009
2005-2009
2005-2009
2005-2009
2007-2009
2005-2009
2005-2009
Current Status – Data Holdings (Cont’d)Assessment Centres
British Columbia (IMG-BC)
Alberta (AIMGP)
Saskatchewan (CPL)
Manitoba (MLPIMG, CAPE)
Ontario (CEHPEA)
Nova Scotia (CAPP)
NF and Labrador (CSAT)
2005 2006 2007 2008 2009
2005-2009
2005-2009
2005-2009
2005-2009
2007-2009
2005-2009
2005-2009
Current Status – Data Holdings (Cont’d)Regulatory Authorities
QuebecBritish Columbia
AlbertaSaskatchewan
ManitobaOntario
New BrunswickNova Scotia
NF and Labrador
2005 2006 2007 2008 2009
2005-2009
2005-2009
2005-2009
2005-2009
2005-2009
2005-2009
2005-2009
2007-2009
2005-2009
Current Status – Data Holdings (Cont’d)Regulatory Authorities
Non-participants:• Prince Edward Island• Health And Social
Services, Government of Northwest Territories
• Health And Social Services, Government of Nunavut
Aggregate Data:• Yukon Medical Council
as of Sept 1, 2010
Sample of Data Variables Collected
Requested Data Variables
Types of Analyses
• Socio-demographic information • Migration analysis • Time and/or Path-specific analyses• Success indicators • Cohort analysis
The Data Behind the Issues: What the National IMG Database is Telling Us About IMGs in Canada
Count of IMGs by first instance of entry into IMG Database, 2005-2009
316; 1% 239; 1% 173; 1%
6097; 27%
11889; 53%
214; 1% 1910; 9%
1445; 6%
Assessement CentreCFPCCMQFaculties of MedicineMCCRCPSCRegulatory AuthorityCombination
N= 22,283
Source: IMG Database, 2010
Distribution of IMGs (Canadian citizens): by country, 2005-2009
1001-1250 751-1000 201-750
71-200 1-70
1001-1250
1-70
1001-1250
71-200
1001-1250
Source: IMG Database, 2010
Number of IMGs who passed MCC Examinations, 2005-2009
EE QEI QEII0
2000
4000
6000
8000
10000
1200010972
6036
4195
Source: IMG Database, 2010
Number of IMG Assessments in Canada, 2005-2009
CSAT-NL
CAPP-NS
CEHPEA-ON
MLPIMG-M
B
CPL-SK
AIMGP-AB
IMG-B
C0
200
400
600
800
1000
1200
14001600
74189
1549
557
132
791
385
Source: IMG Database, 2010
Number of IMGs Certified and seen in PG training in Canada, 2006-2009
2006 2007 2008 20090
50
100
150
200
250
171160
192185
109 110
136
155
24 25 26 32
CFPCRCPSCCMQ
Source: IMG Database, 2010* Excludes visa trainees
Distribution of IMG practice locations
Full Licenses All Other Licenses
Source: IMG Database, 2010
Distribution of Licensed IMGs in Urban/ Rural Canada
Large Urban Centres
Small Cities Towns Rural Places and Territories
0%
10%
20%
30%
40%
50%
60%
70%62.5%
4.8%
16.8% 15.9%
44.0%
5.4%
25.0% 25.6%
Full licenses All other licenses
License Status by Field of Practice
Full Licenses Other Licenses0%
10%20%30%40%50%60%70%80%90%
100%
Family Medicine Specialty
IMGs migrating between jurisdictions, 2005-2007
AB
BC ON
MB
NL
3
2
254
3
4
1510
2
1 0
Note: includes all types of licenses
Practice location at 2 and 5 years after PGME graduation, 2000-2004
2 years 5 years 2 years 5 years0%
20%
40%
60%
80%
100%
77.1 78.191.7 91.6
22.9 21.98.3 8.4
Outside CanadaIn Canada
IMG CMG
Source: CAPER Database, 2010
Practice location at 2 and 5 years after PGME graduation, 2000-2004
Source: CAPER Database, 2010
IMG CMG
IMG CMG2 years 5 years 2 years 5 years
0%
20%
40%
60%
80%
100%
78.5 81 82.3 82
15.4 14 10.7 11.1
6.1 5 7 6.9
Rural places + Terri-toriesSmall cities + TownsLarge urban centres
First Year Post-M.D. Trainees by Place of MD Graduation, 2000-2009
'00-'01'01-'02
'02-'03'03-'04
'04-'05'05-'06
'06-'07'07-'08
'08-'09'09-'10
0
400
800
1200
1600
2000
2400
2800
1548 1574 16441764
19292058
22532379
2504
2740
95% 91% 88% 90% 85% 87% 84% 83% 83% 83%
5% 9% 12% 10% 15% 13% 16% 17% 17% 17%
Total 1st Year Trainees CMG IMG
46677
Source: CAPER, AFMC, 2010.
2005-2009
2005-2007
Post MD training
411
Assessment Centre
218
Certifying Body
97
Regulatory Authority
77
MCC EE1491
How many Canadian IMGs make it through the system?
62
Source: IMG Database, 2010
2 35
Relative success of Canadian citizens into PG training–by country of M.D. graduation
Source: IMG Database, 2010
Irelan
d
United Kingdom
Australi
a
Czech
Republic
Poland
South Africa
Trinidad
and Tobag
o
Saint K
itts an
d Nevis
Netherl
ands A
ntilles
Ukraine
Romania
Dominican Rep
ublic
IndiaIsr
ael
Algeria
Dominica
Grenad
a
Pakist
an
Cayman
Islan
dsIra
n
Russia
China (PRC)
Bosnia-
Herzeg
ovina
Hungary
Philippines
Egypt
Banglad
esh
0%
10%
20%
30%
40%
50%
60%
70%
Relative success of Canadian citizens into PG training–by school of M.D. graduation
0%
20%
40%
60%
80%
100%
Source: IMG Database, 2010
Relationship between M.D. University and field of PG training
Source: IMG Database, 2010
0%
20%
40%
60%
80%
100%
SpecialtyFamily Medicine
Initiatives that involve IMGs
Agreement on Internal Trade- Chapter 7- Labour Mobility
Framework for Foreign Credential Recognition
National Registration Process
National Assessment Collaboration
Contradicting news
Number of IMGs in the Active Physician Workforce, Canada, 1994-2008
1994
1996
1998
2000
2002
2004
2006
2008
5000
5500
6000
6500
7000
7500
8000
8500
9000
9500
IMGs from countries with higher doc:pop ratio than CanadaIMGs from countries with lower doc:pop ratio than Canada
Source: Physician counts : Canadian Medical Association Masterfile as of January 1 of each year. Doc:Pop ratios : Organization for Economic Cooperation and Development and WHO
We look forward to our discussions …
Thank you
This project is funded by the Government of Canada's Foreign Credential Recognition Program.
The IMGs in Canada Project Team:Steve Slade, VP, Research and Analysis CAPER-ORISParomita Deb-Rinker, Project Manager, pdeb-rinker@afmc.caLinda Bourgeois, Research Associate