Health

The House of Commons Standing Committee on Health met to study the impact of immigration policy on health care, hearing from Dr. Patricia Houston, Vice Dean of Medical Education at the University of Toronto; Dr. Amber McPherson, an emergency medicine physician; Dr. Marie Dagenais, Executive Director and Registrar of the National Dental Examining Board of Canada; and Dr. Meredith Irwin, Paediatrician-in-Chief at SickKids Hospital, representing the Pediatric Chairs of Canada.

Dr. Patricia Houston testified that the University of Toronto trains approximately 459 visa trainees per year, funded by foreign governments at $100,000 per trainee annually, generating $45–50 million for the faculty. She stated these trainees do not take provincially funded residency spots from Canadians, as the province determines domestic positions, and that the funding supports administrative structures and learner wellness. She acknowledged that the 2018 Saudi diplomatic dispute was a wake-up call but said the university has reserves to manage if funding ceased, and that it has capacity to expand provincially funded residency spots if the province provides funding. She declined to comment on human rights records of sponsoring countries, stating it is not her role, and noted the university does not evaluate such records before accepting funds.

Dr. Amber McPherson, a U.S.-trained emergency physician now practising in Ontario, described Canada’s licensing and immigration processes as burdensome, disorganized, and inconsistent, citing months of unclear communication with British Columbia before successfully licensing in Ontario. She highlighted that the Ontario provincial nominee program for physicians excludes most U.S.-trained specialists due to a terminology mismatch with the College of Physicians and Surgeons of Ontario’s “restricted certificate,” which allows full independent practice. She noted that her temporary work permit ties her to a single worksite, preventing locum coverage in rural areas, and that she is learning French to access an alternative express entry pathway for French-speaking skilled workers, despite rarely encountering French-speaking patients in her Kitchener emergency room. She strongly supported national licensure standards and streamlined permanent residency pathways for physicians from equivalent training systems like the United States.

Dr. Marie Dagenais explained that the National Dental Examining Board of Canada administers examinations required for all dentists to practise, with reciprocal agreements with the United States, Australia, Ireland, and New Zealand. She reported that only 25% of over 12,000 internationally trained dentists who have taken exams since 2011 achieve certification, with success rates varying widely by country and university. She recommended that the federal government remove dentistry from health care occupations included in dedicated immigration invitations, as prioritizing immigration based on dental credentials creates unrealistic expectations without addressing licensure barriers. She also called for expanding seats in accredited dental programs and developing a plan to address distribution shortages in rural areas, noting that Employment and Social Development Canada projects a strong risk of dentist shortages between 2024 and 2033.

Dr. Meredith Irwin testified that Canada’s pediatric subspecialty workforce is at risk due to insufficient provincially funded residency spots, an aging workforce, and systemic barriers to hiring internationally trained specialists, including Canadians trained abroad. She noted that more than half of pediatric cardiologists are over 50, and that delays in immigration and licensing threaten service delivery, increase wait times, and risk program closures. She recommended streamlining immigration processes for pediatric subspecialists, prioritizing them in existing streams like express entry, harmonizing licensure requirements across provinces, and developing national standards for recognizing training from countries with similar standards. She agreed with Dr. McPherson that training from countries like the United States is comparable to Canadian training, and that collaboration across provinces is needed to address critical shortages.

A procedural debate arose after the first panel ended early due to technical difficulties with interpretation. A motion was moved to summon Dr. Houston to appear again within one week for a full hour of testimony, citing that the committee had agreed to one hour but only received 50 minutes. The motion was supported by some members who argued the testimony was important and that the shortened time prevented full questioning. Another member moved to adjourn the meeting, and the committee proceeded to a vote on that motion.