How to Strengthen Canada's Health Care System with Local Doctors

How to Strengthen Canada’s Healthcare System with Local Doctors

How we can strengthen Canada’s healthcare system with local doctors who were trained outside of Canada. 

The Internationally Trained Physicians of Ontario (ITPO) explain how and why they formed a non-profit organization to support international medical graduates (IMGs) and foreign trained doctors in Canada. Improvements in the integration process, training programs and policies are discussed, as well as solutions to provide immediate assistance to solve some of the health care issues in Canada today.

The Internationally Trained Physicians of Ontario (ITPO): An Introduction

I have been teaching communication skills and coaching internationally trained physicians in Canada since 2015.  The journey to medical licensure in Canada is long, expensive, and complicated. Most Canadians are not aware of the medical licensure process for doctors who are trained outside of Canada. Comments I have seen online about internationally trained physicians (ITPs) also highlight the misconceptions, stereotypes and lack of knowledge Canadians have about who these doctors are, their medical competence, why  they came to Canada and the factual reasons they are not getting their license to practice medicine in Canada. To learn more about what I could do to support ITPs, my curiosity led me to a NEW organization created in 2021 by a group of doctors in Ontario. The members of this group are internationally trained physicians who conduct research and advocate for themselves and their colleagues who live in Canada. They are the first  organization of this kind in Canada. 

The purpose of this blog is to highlight the complexity of the problems, spread awareness and truth about ITPs, and to provide a platform for internationally trained physicians to be heard using their own voices and perspectives about how they can provide assistance to solve some of the health care issues in Canada. 

Introducing, The Internationally Trained Physicians of Ontario (ITPO). 

My Interview with ITPO

The interview is shared below in order to present ITPO as a new non-profit professional organization in Ontario, as well as provide first person experiences with factual information regarding the process internationally trained physicians in Canada must go through to get their licenses. I hope the discussions in this interview help to dissolve some of the misconceptions or assumptions about foreign trained doctors, their medical competence and reasons for choosing Canada as their home. 

Background: Canadian Healthcare and Immigration

Integrating internationally trained physicians in Canada: What's the plan?

The government plans on recruiting even more ITPs to solve the ongoing doctor shortage, without a clear plan about how they will provide the necessary training and integration of these new recruits. Moreover, there is no discussion about utilizing the experienced ITPs already in Canada, who were enticed by the same narrative years prior. There are thousands of internationally trained physicians who are already here and have passed all their exams, waiting on the sidelines, underemployed.  What evidence is there that the new recruits will fare differently in their quest for medical licensure in Canada? According to the Canadian Medical Association, the Canadian healthcare system is on the verge of collapse. This claim suggests that we need to take actions now, swiftly and wisely. We need to invest in the talent that is already here to help Canadians today. 

Is recruiting internationally trained physicians the only option?

Before the pandemic in 2011, experts predicted the doctor shortage would worsen with time. So, Canada recruited more doctors from other countries. In 2020 Statistics Canada reported that in 2019 14.5%  of Canadians aged 12 and older (roughly 4.6 million people), did not have access to a primary care professional to talk to or get advice about their health.  In fact, this practice of foreign doctor recruitment has been continuous for several decades, yet the problem persists. The same narrative about the Canadian doctor shortage is still being broadcast in the news today to entice internationally trained physicians to close their practices in their home countries and choose Canada as a better place to live and practice medicine. No one is addressing the elephant in the room. This strategy isn’t working. The thousands of doctors who believed the same story are now permanent residents or Canadian citizens. They are stuck in the bottleneck of the growing number of internationally trained doctors vying for the limited training spots required to qualify for medical licensure in Canada. The ITPs living in Canada are underemployed in non-clinical roles when they could be working as doctors. It’s time to THINK OUTSIDE THE BOX!

Necessity drives change

Given that Canada had a doctor shortage prior to the SARS-COV-2 pandemic, there is a growing nationwide concern over the stability of the Canadian healthcare system. The effects of the ongoing pandemic highlight the weaknesses in the healthcare system and the significant impact these weaknesses have on the health and well-being of health care professionals, especially physicians and nurses. There is a shift towards systemic and organizational change in Canadian health care. Physician distress is at an all time high, with increased demands and limited human health resources. Canadian doctors are retiring, Family Medicine Clinics are closing, there is a nurse shortage, doctor shortage, and attrition of all types of health care professionals walking away from their careers because of the overwhelming stress affecting their quality of life. 

There are many experienced doctors capable and willing to help

The good news is that there are already qualified physicians living and working in Canada…but not as physicians. The Canadian Medical Association (CMA) and the Canadian Nurses Association (CNA) are calling on the government to implement strategies to prevent health systems from collapsing. By working together, changing perspectives and building relationships within our borders, I believe the solution is possible. It is time we reframe how we look at the issues and reinvent the way we “do normal” again in Canada.

Collaboration is critical among immigration authorities, medical organizations, politicians, educational institutions, the public and other stakeholders in decision-making involved in Canadian health care to address the issues and conditions that limit access to health services. The quality of life for all Canadians could be improved if we open the lines of communication between the decision makers nationwide, who have the power to enact large-scale change. Uniting strengths rather than fighting change is necessary for progress.

THE INTERVIEW: Meet the Internationally Trained Physicians of Ontario (ITPO)

To understand more about ITPO and their mission, I decided to set up an interview with co-founders, Dr. Joanna Walters, Director of Operations  and Dr. Ahmad Alkhatib, Vice-Chair of the Board. This interview took place on February 11, 2022. 

Meet the Players

In this segment, you will meet Dr. Walters and Dr. Alkhatib. We discuss how the leaders of ITPO, (Dr. Ayesha Badiuzzaman, Co-Founder and Former Chair; Dr. Makini McGuire-Brown, Chair of the Board; Dr. Ahmad Alkhatib, Vice Chair of the Board and Co-Founder; Dr. Joanna Walters, Director of Operations and Co-Founder; Dr. Rami Al-Ani, Treasurer), collaborated and took the initiative to start a professional organization to advocate for themselves and their colleagues across Canada. The definition and differences between terms such as IMG vs. ITP, the reasons Canada is the country of choice for these medical professionals, and international medical training are explained. 

What Drives Internationally Trained Physicians of Ontario (ITPO)

Mission and Vision

In this segment of the interview Dr. Alkhatib and Dr. Walters explain ITPO’s mission and vision. Communications with political leaders  through innovative campaigns using letters, interviews and social media are discussed. Dr. Walters highlights the importance of shared ITP experiences and having a community of peers for support in Canada.

Topics discussed in this segment include:

  • ITPO’s Mission and Vision
  • Research and projects of ITPO 
  • How ITPO supports ITPs 
  • Benefits of ITPO membership 
  • Peer support 

The Barriers Internationally Trained Doctors Face

Problems and Solutions

Before discussing the problems and solutions for ITPs, it is important to understand the pathways that are currently available because some of the problems are rooted in these pathways. There are currently two pathways that ITPs can use to get licensed to practice in Canada: CaRMS and the Practice Ready Assessment (PRA). This two-pathway process is the same for newcomers to Canada and Canadian citizens who studied medicine abroad.  

The Canadian Resident Matching Service (CaRMS) can be described as a digital portfolio/database of a medical candidate’s required documents for their medical school applications. In this pathway, applicants fill out the application and submit corresponding documents in order to get matched to a medical residency program for training. A computerized system collects information from applicants and medical schools, then matches candidates to the programs that are the closest match to their profile. If a candidate is selected and is successful in the interview process, they would have to complete a 1-3 year residency training program through a medical school.

The PRA includes a practical assessment program where eligible candidates work under supervision and are evaluated over a period of 12 weeks with an aim of obtaining an independent licence to practise in Canada. This is only available in some provinces. 

Topics discussed in this segment include:

  • Current issues and barriers to licensure
  • Proposed solutions for ITPs and Canadian health care
  • Bill 27 and ITPO’s media statement
  • Ways to bring attention to these barriers
  • Types of support that can help ITPs
  • Ideas that could improve the Canadian healthcare system
  • Number of ITPs in Canada

Become an Ally for Internationally Trained Physicians of Ontario in Canada

How to get involved

The Internationally Trained Physicians of Ontario is a professional organization led by a strong team of health advocates and change-agents. Become familiar with ITPO by going to their website ( to learn more about the issues, research, CaRMS process, FREE resources and ITPO campaigns.

If you would like to support the movement, you can become a member, donate, volunteer, or participate in the campaigns. (Details of the #mppchats campaign,   and how to contact your local representatives across Canada are at the end of this blog). 

Becoming a member and advocate are discussed in this segment. Topics include:

  • Growth of ITPO membership 
  • Who joins ITPO 
  • Criteria to join ITPO 
  • Opportunities for the public to support ITPs

The Ultimate Goals for Internationally Trained Physicians in Canada

Success is...

 Dr. Walters describes the  measures for successful integration of ITPs that will enable equitable access to the Practice Ready Assessment and Canadian clinical experiences required for the CaRMS applications. A vision of success over time for internationally trained physicians in Canada is explained. Dr. Alkhatib provides final thoughts and closing remarks. 

In this segment topics include:

  • Measures for successful integration of ITPs over time
  • Closing remarks

How to contact your provincial representative to support the Internationally Trained Physicians of Ontario (ITPO) who live in Canada as permanent residents or Canadian citizens

ITPO has made it really simple to contact your local representative by creating editable letter templates.  If you would like to invite your local representative for a chat with ITPO to discuss solutions to Canadian healthcare issues, simply follow these steps:

  1. Go to and click Policy, Advocacy and Research in the menu at the top
  2. Download the Free template and read about the proposed solutions
  3. Modify the template to reflect your personal story or concerns and request a chat
  4. Find your local representative (links provided in the table just below these steps)
  5. Send your letter by email or post
  6. Contact ITPO to let them know which representative you have contacted
  7. ITPO will represent you at the meeting

Find your provincial representative


Newfoundland and Labrador MHAs: 

ITPs have passed the tests and are ready and willing to serve Canadians

Internationally Trained Physicians were recruited or convinced to practice medicine in Canada due to the physician shortage. They were selected to enter Canada because of their profession. 

I hope we can bring more organizations together to support our Canadian healthcare system and improve the quality of life for all the people who live in this beautiful country we call Canada. 


If you would like to learn more or become a member of ITPO you can go to 

Thanks for watching!

Disclaimer: MARIA. THINK OUTSIDE THE BOX MED.UCATION serves as the exclusive communications resource for ITPO Internationally Trained Physicians of Ontario, providing exclusive offers to ITPO members who may need one-on-one support with reviewing their CVs, personal letters or interview preparations for Canadian residency programs.