1. Unrecognized Health Human Resource Impact of Canadians Studying Abroad Sandra Banner Ian Bowmer, MD Sara Rattanasithy

2. 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. 2

3. 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 3

4. Survey Respondents 4 Medical School RegionSurvey Respondents Ireland272 Poland79 Caribbean501 Australia206 Middle East23 Totals1081 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.

5. 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 training.

6. Motivation to Study Abroad 6

7. Sample Size 1,030 respondents as of June, 2010

8. CSA and CMG Comparison 8

9. 9

10. CSAs Going Abroad Compared to Population Baseline by Province

11. Planning to Return to Canada to Pursue Postgraduate Medical Training n = 1030

12. Number of IMGs who passed MCC Examinations, by Birth Country, 2005-2009 Source: IMG Database, 2010

13. Applications to MCCEE Source: Medical Council of Canada 2011

14. 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

16. 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. 16

17. 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

18. Questions and comments