Unrecognized Health Human
Resource Impact of Canadians
Studying Abroad
Sandra Banner
Ian Bowmer, MD
Sara 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
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Survey Respondents
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.
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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
Motivation to Study Abroad
Unable to obtain a place in a Canadian
medical school
Allowed me to enter medical school
directly from secondary school
Wanted to live in another country
Tuition costs were lower than Canadian
medical schools
My family was living in this foreign
country currently
Other
77.6%
7.8%
6.6%
1.8%
0.5%
5.8%
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Sample Size
1,030 respondents as of June, 2010
CSA and CMG Comparison
Highest Level of Education Prior to Attending Medical School
80%
70%
60%
50%
40%
30%
20%
10%
0%
High School
College
2 years or less 3 years+
in university university (no
(no degree)
degree)
CSA
Bachelor's
Degree
Master's
Degree
Ph.D. or
equivalent
Other
CMG
8
CSA and CMG Comparison
Average Number of Applications to Canadian
Medical Schools
2.95
1.76
CSA
CMG
Average Number of Applications
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CSAs Going Abroad Compared to Population
Baseline by Province
70%
60%
50%
40%
Province of Residence (%)
Population Baseline (%)
30%
(Statistics Canada , 2009)
20%
10%
0%
NL
PE
NS
NB
QC
ON
MB
SK
AB
BC
Planning to Return to Canada to Pursue
Postgraduate Medical Training
Yes, all of my postgraduate training
Yes, a portion of my postgraduate training
No
n = 1030
73.8%
24.5%
9.8%
Number of IMGs who passed MCC Examinations, by
Birth Country, 2005-2009
12000
10000
1183
8000
584
6000
366
4000
2000
0
9789
5452
3829
EE
QEI
QEII
Not Canada
Source: IMG Database, 2010
Canada
Applications to MCCEE
1800
# Applications by Canadians Studying Abroad
1600
1400
1200
1000
800
# applications
600
400
200
0
216
2009
Source: Medical Council of Canada 2011
1262
1557
2010
2011
Countries / Regions educating students born in Canada
According to MCC 2009-2011 EE registrations
Region / Country Selected
Count
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