Canada - World Health Organization Regional Office for Europe
Canada - World Health Organization Regional Office for Europe
Canada - World Health Organization Regional Office for Europe
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<strong>Health</strong> systems in transition <strong>Canada</strong><br />
4.2.2 Professional mobility of health workers<br />
Physicians are highly mobile in <strong>Canada</strong> and the competition <strong>for</strong> physicians<br />
among and within provincial and territorial health systems has been intense<br />
since the late 1990s. This has resulted in significant inter-provincial mobility.<br />
Two-thirds of physicians who leave a province or territory move to another part<br />
of <strong>Canada</strong> rather than abroad (CIHI, 2010d). When doctors do move abroad,<br />
most move to the United States. As can be seen in Table 4.9, there has been a<br />
steady net migration of doctors into <strong>Canada</strong> <strong>for</strong> the past three decades largely<br />
due to the influx of international medical graduates (IMGs).<br />
Table 4.9<br />
Net international migration of physicians, <strong>Canada</strong>, by decade, 1980–2009<br />
Decade Moved abroad<br />
Returned<br />
from abroad New IMGs Net migration<br />
Average annual<br />
impact on stock of<br />
physicians (%)<br />
1980–1989 3 244 1 806 5 216 3 778 0.9<br />
1990–1999 5 541 2 091 4 755 1 305 0.2<br />
2000–2009 2 859 2 000 7 181 6 322 1.0<br />
Source: CIHI (2010d).<br />
Although the overall impact of migration appears to have had a marginal<br />
impact on the overall domestic supply of physicians, Table 4.9 obscures the<br />
extent to which some provinces are highly reliant on IMGs: <strong>for</strong> example, in<br />
the past decade, almost 50% of new physicians in Saskatchewan are <strong>for</strong>eign<br />
educated, the majority from developing countries, especially South Africa.<br />
Indeed, some ministries of health in association with the provincial medical<br />
bodies have established programmes to facilitate and speed up the licensure of<br />
IMGs, many of whom, at least initially, migrate to underserviced areas in the<br />
country (Dumont et al., 2008).<br />
Nurses are also mobile and the shortage of nurses has intensified competition<br />
among the provinces, territories, RHAs and independent hospitals over the past<br />
decade. As a consequence, salaries and wages have risen well above the rate<br />
of salaries outside the health sector (CIHI, 2011b). In the 2000s, approximately<br />
7–8% of the nurse work<strong>for</strong>ce was originally educated outside <strong>Canada</strong>. Some<br />
jurisdictions and health organizations have actively recruited nurses from other<br />
countries, such as the Philippines (CIHI, 2010d; Runnels, Labonte & Packer,<br />
2011).