Internationally-Educated Health Professionals Seeking Entry into the Canadian Labour Market: Exploring Adjustments of Post-Secondary Institutions Lillie Lum, Ph.D. York University, Ontario, Canada 8 th National Metropolis Conference, March 23-26, 2006

Acknowledgement Research jointly funded by Social Sciences and Humanities Research Council (SSHRC), Human Resources and Skills Development Canada (HRSDC) & Industry Canada Co-Investigator: Sheryl Nestel, OISE/UToronto

Employment Integration Problems for Immigrants Underutilization of highly qualified, skilled new immigrants (Statistics Canada, 2002) Underutilization of highly qualified, skilled new immigrants (Statistics Canada, 2002) Exclusionary regulatory process, ie. gate being narrow (Alboim et al. 2005) Exclusionary regulatory process, ie. gate being narrow (Alboim et al. 2005) Increased numbers of skilled immigrants but downward trend in earnings within last decade (Reitz, 2005) Increased numbers of skilled immigrants but downward trend in earnings within last decade (Reitz, 2005) Solutions are ineffective in addressing health professions skill shortage; supply and demand problems persist (C.N.A., 2005; Hawthorne, 2001) Solutions are ineffective in addressing health professions skill shortage; supply and demand problems persist (C.N.A., 2005; Hawthorne, 2001)

Context: W hat is unique about Western Health Professions ? Governed by profession-specific regulatory colleges, eg. College of Physicians and Surgeons, College of Nurses, College of Teachers…. Governed by profession-specific regulatory colleges, eg. College of Physicians and Surgeons, College of Nurses, College of Teachers…. All members must demonstrate competence in pre- determined profession-specific standards (C.N.A., 2005) All members must demonstrate competence in pre- determined profession-specific standards (C.N.A., 2005) Bridging education programs is often a requirement prior to licensure or registration Bridging education programs is often a requirement prior to licensure or registration Healthcare in North American is highly standardized and technology-based practice Healthcare in North American is highly standardized and technology-based practice

Regulated Professions REGULATORY COLLEGES HAVE delegated authority through legislation REGULATORY COLLEGES HAVE delegated authority through legislation set policies, procedures and practices for admitting new members to the registry set policies, procedures and practices for admitting new members to the registry issues licences or registration issues licences or registration role to protect public and members through ensuring standardized competencies are met. role to protect public and members through ensuring standardized competencies are met.

Success rates of International/Canadian Health and Other Candidates on Registration Exams (Ontario Regulators for Access, 2003)-38 Professions

Professional Bridging Education Bridging Education Programs Bridging Education Programs Post-secondary educational programs offered by either community colleges (diploma granting) and universities (degree granting) to provide additional knowledge/skills based on credential and competency assessments; part or full time status; varies from several months to 2 years.

Bridging Education continued… Success rates of students-No data available! Success rates of students-No data available! In Ontario, 19 of the 30 regulatory bodies can refer applicants to bridging programs In Ontario, 19 of the 30 regulatory bodies can refer applicants to bridging programs 6 of these regulatory bodies serve in advisory capacity to bridging programs 6 of these regulatory bodies serve in advisory capacity to bridging programs Health professions bridging programs include nursing, midwifery, medical technicians, physiotherapy and pharmacy Health professions bridging programs include nursing, midwifery, medical technicians, physiotherapy and pharmacy

Identified Best Practices: Good Bridging Programs (CIITE Report, 2004) Good fit between student learning needs and program Collaboration between key stakeholders, such as regulators and PSE Effective profession-specific language training Comprehensive academic and social support services Stable program funding Financial assistance (student loans, scholarships) and access to additional non-financial resources Faculty development to upgrade expertise Genuine administrative support for continuity of program Alumni follow-up to job entry

Overview of Post-Secondary Institutional Adjustment $$$ many institutions report overall under- funding $$$ many institutions report overall under- funding Bridging education is not a big revenue generator Bridging education is not a big revenue generator Major differences in mandate between colleges (skill development) and universities (scholarship, innovation, research) in educational philosophy and operations (Rae Report, 2005) Major differences in mandate between colleges (skill development) and universities (scholarship, innovation, research) in educational philosophy and operations (Rae Report, 2005) Curriculum tends to be based on Westernized as compared to global view of healthcare/education Specialized programs, such as bridging education are not part of mainstream Operate independently of industry demands, health professions, regulatory and government directives

Why are there so few good programs?…. Operational Issues -limited access for students -lack of sustained program funding -debate regarding integrated or independent programming -lack of best practice standards regarding curriculum design and teaching/learning practices -tend to be marginalized from mainstream Leadership Issues -competition between colleges and university for funding -lack of collaboration between professions, industry -role of government unclear, possibly not desired -role of government unclear, possibly not desired

Proposed Changes to PSE Bridging Education Student Perspectives Student Perspectives Financial support mechanisms, e.g. bursary, loans for part time students Financial support mechanisms, e.g. bursary, loans for part time students Integrated language training courses, with a focus on technical professional concepts Integrated language training courses, with a focus on technical professional concepts Comprehensive technological and academic student services Comprehensive technological and academic student services Opportunities for socialization into profession-specific practices Opportunities for socialization into profession-specific practices

Proposed Changes to PSE Bridging Education PSE Institutional Perspectives PSE Institutional Perspectives Integrated programs with sustainable funding for educational program and other student services Integrated programs with sustainable funding for educational program and other student services Faculty development in curricular and teaching practice Faculty development in curricular and teaching practice Increased role of government in provision of funding; support development of best practice standards Increased role of government in provision of funding; support development of best practice standards Partnerships with regulators, professional associations and employers Partnerships with regulators, professional associations and employers

Bridging Education Certificate of Excellence [Post-secondary Institution] for outstanding performance and lasting contribution on [Post-secondary Institution] for outstanding performance and lasting contribution on Granted: January 31, 2014January 31, 2014January 31, 2014 {name, title}