1. The National IMG Database: An Emerging Picture of International Medical Graduates in Canada 2012 Physician Workforce Research Conference Washington, D.C. Tamara Brown, Project Manager Steve Slade, VP Research and Analysis Canadian Post-MD Education Registry Association of Faculties of Medicine of Canada

3. The History Behind the IMG Database

4. Why the focus on IMGs? Increased immigration of medical graduates to Canada Balancing our need for physicians with public safety Growing emphasis on foreign credential recognition and standardization Ethical recruitment and treatment of IMGs

5. History of the National IMG Database 2004 Canadian Task Force on the Licensure of International Medical Graduates 2005-2009 Phase 1: Foundational Activities 2010-2013 Phase 2: Development of an Analytical Agenda and Increasing Project Visibility

6. Partnerships 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. Key Findings

8. Cumulative Number of Distinct IMGs in the National IMG Database Source: National IMG Database, 2011

9. Number of IMGs who passed MCC Examinations, 2005-2010

10. MCC Exams: Early Signs of Incoming IMGs

11. Data in an Evolving Context Increased Number of First Year Post-MD Trainees Source: CAPER, AFMC, 2010. Note: Excludes visa trainees.

12. MCCEE MCCQEI & MCCQEII PGME CFPC/RCPSC/CMQ LICENSURE Following a Cohort of Canadian Citizen IMGs ASSESSEMENT 114 1491 461 322 144 41

13. CERTIFICATION WITH RCPSC/CFPC/CMQ 2271 EE 519 QEI 820 QEII 1158 Licensed 660 PGME 1447 IMG Certification, 2008-2010 203

14. LICENSED 2852 EE 950 QEI 835 QEII 784 Certified 622 PGME 437 IMG Licensure, 2008-2010 1152

15. IMG Statement of Need Applicants

16. What is a Statement of Need? IMGs wishing to pursue postgraduate medical training in the United States need to obtain a J1 Visa – a “Statement of Need” is one necessary component in the J1 Visa Application. Applicants must be Canadian Citizens or Permanent Residents of Canada. A Statement of Need signifies two things: o It serves as confirmation to those issuing the Visa that qualified physicians are required in Canada; o Confirms the applicant has the full intention to return to Canada following residency training. Candidates are expected to train in medical specialties identified by provincial and territorial physician resource planning. Source: Health Canada

17. Applicant Categories Category A (Final Year Medical Student) Final year medical students wishing to pursue medical specialty training in the United States. Medical graduates wishing to pursue either a fellowship, or a short-term rotation or elective training program in the United States. Category B (Non-Licensed, Non-Student/Resident) Medical graduate not currently enrolled in Canadian postgraduate training and not a licensed specialist in Canada who wishes to pursue medical specialty training in the United States. Category C (Licensed Physician) Licensed physician wishing to pursue a fellowship in the United States that is either within or different from their current field of practice.

18. Country of MD Graduation - Distribution across Statement of Need Categories

19. An Increase in IMG Applicants

20. MCC Examinations

21. IMG Statement of Need Applicant by Highest Level of MCC Exam Passed

22. Number of IMG Statement of Need Applicants Having Reached Key Milestones

23. Conclusions

24. IMGs comprise 66.1% of all Statement of Need applications. Of IMG applicants who have completed one or more MCC exams, 82% of these individuals are CSAs. Large numbers of IMG applicants have reached the point of having written an MCC exam, however very few have reached PGME, certification, or licensure. The data suggests that Immigrant IMGs are less likely to apply for a statement of need, likely as a result of their planned immigration to Canada.

25. 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-ORIS Tamara Brown, Project Manager, tbrown@afmc.ca Linda Bourgeois, Research Associate, lbourgeois@afmc.ca