Canada - World Health Organization Regional Office for Europe

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