Vol. 24 - Nos. 1-2, Summer-Fall 2010 - Www3.carleton.ca - Carleton ...

International Settlement Canada
Volume 24, Numbers 1-2, Summer-Fall 2010
Rebuilding Professional Lives:
Immigrant Professionals Working in
the Ontario Settlement Sector *
Adnan Türegün
Inside this Issue
This study looks at the reality of a particular
group of foreign-born and -trained professionals
in Ontario. These are the professionals who did
not get to practise their respective professions
after immigration but acquired a new profession
in the form of settlement work. The study
detects their pre-immigration education and work
history, the reasons they left their countries of
origin or permanent residence for Canada, the
expectations they had, the choices they made
about pursuing professional practice, the efforts
they put towards that or some alternative goal,
and their eventual professional reconstitution as
settlement workers.
Following the Canadian trajectory of these dual
professionals has three contributions to research
into immigrant access to professions. First, their
individual experiences reveal the social processes
of inclusion in and exclusion from professional
practice. Second, unlike those immigrants who
are de-professionalized in the post-immigration
period, our target population reinvent themselves
as practitioners of a new profession – if not their
primary professions – and thus provide a more
nuanced immigrant experience. Third, their
common practice as settlement workers gives us
insight into the dynamics of an emerging profession
that is settlement work. In all three aspects,
our study can be seen as a special, immigrantcentred
exercise in the sociology of professions.
Choices within Constraints
One area existing research has paid scant attention
to are the choices that foreign-trained
individuals make – and the strategies they use
– under the given circumstances of receiving
societies. Not all of these individuals would try
to pursue professional practice in their original
fields. If they try and fail to do so, what are the
options available to them and how do they choose
one option over the other? There is also fluidity
between the options.
Three options await the foreign-trained when they
do not get to practise their destined professions:
exit, de-professionalization, and professional
rebuilding. We define the exit option as one of
withdrawal from the territory of contestation. If
they are not refugees, immigrants may return to
their countries of origin or move to a third country
for professional pursuit. Especially in its move-to-a
third-country variety, this is an option which has
been used by many health professionals in Canada.
De-professionalization may be considered an exit
option, too, since it signifies departure from the
professional field. However, we will classify it as a
separate option because it is uniquely involuntary.
Referring to a process defined by unemployment
or work which does not require any professional
skills set, de-professionalization is unfortunately
an all-too-common experience among the foreigntrained.
The third option, professional rebuilding
or re-professionalization, is the “next best thing”
to practice in the primary profession. In this scenario,
an immigrant professional acquires a new
profession which may or may not be related to his/
her original field.
Individuals may and do choose the third option for
a variety of reasons. They may just lose interest in
their original fields and take another professional
route. It may also be possible that, after calculating
the cost of getting back to their fields, they will
decide that it is not worth trying and thus opt for
another profession which is less costly to pursue.
The same conclusion may also be reached after
Rebuilding Professional Lives,
continued on page 3
• Rebuilding Professional
Lives: Immigrant
Professionals Working in
the Ontario Settlement
Sector..................................1
• From the Editor ................2
• Brain Gain, Drain, and
Waste: The Experiences
of Internationally
Educated Health
Professionals in Canada...7
• Settlement versus
Employment Models........10
• Reviews.............................14
- You’re Hired…
Now What? An
Immigrant’s Guide to
Success in the
Canadian
Workplace....................14
- The Big Wait. ..............16
• Canadian Council for
Refugees, Fall 2010
- Racial Profiling...........18
- Convention on the
Rights of the Child:
Canada’s
Compliance..................19
• Canadian Council for
Refugees, Spring 2010
Consultation
- Refugee Women
Reuniting with
Their Family................23
- Domestic Violence:
Next Steps.....................24
• ResCanNet Bulletin.........26
*
The research informing this article is funded by CERIS – The Ontario Metropolis Centre. A full research
report will be released in early 2011.

From the Editor
In recent years, there has been an increasing
level of policy activity concerning immigrant
access to professions and trades. The provinces
are the main theatre of activity concerning this
segment of the labour market since it falls under
provincial jurisdiction. Although constitutionally
limited in regulating occupations, the federal government
has become just as active (e.g., Foreign
Credential Recognition Program and Foreign
Credentials Referral Office). Moreover, there are
signs of federal-provincial collaboration, which is
INSCAN
International Settlement Canada
Published quarterly by
Centre for International Migration and Settlement Studies
(formerly Research Resource Division for Refugees)
Room 2106 DT, Carleton University,
1125 Colonel By Drive, Ottawa, Ontario K1S 5B6
Telephone: 613-520-2717; Fax: 613-520-3676
E-mail: inscan@carleton.ca
Web site: http://www.carleton.ca/cimss/INSCAN.html
Editor: Adnan Türegün
Editorial Assistant: Suha Diab
Administrator: Nermin Ibrahim
Translation: Sinclair Robinson, Nandini Sarma
Layout and Printing: Carleton University Graphic Services
Editorial Advisory Board:
Kevin J. Arsenault, Harald Bauder, Chedly Belkhodja, Tara Blanchard, Sarah
Bukhari, Sherman S. M. Chan, Victoria M. Esses, Joseph Garcea, Jean McRae
The publication of this issue is made possible through financial assistance
provided by Citizenship and Immigration Canada.
Additional copies are available for $7.50 (+.98 GST).
Back issues of INSCAN are available for $5.50 (+.72 GST, single issues).
Subscriptions are $25.00 (+$3.25 GST).
Please enclose payment with orders and make cheques payable to: Carleton
University (CIMSS).
The views expressed in this publication are solely those of the contributors and do
not necessarily reflect the opinions of the Centre for International Migration and
Settlement Studies.
G.S.T. #118838937 ISSN #0845-2466
a necessary condition of national progress in this
area. In 2009, for example, the Forum of Labour
Market Ministers from the federal, provincial, and
territorial governments drafted a “pan-Canadian”
framework for the assessment and recognition of
foreign-earned qualifications.
These efforts may have resulted in heightened
public awareness of the immigrants’ lack of access
to regulated occupations and even in improved
conditions for “foreign credential recognition” as
the first step towards access. However, it remains
to be seen whether existing efforts will actually
increase immigrant access. In the meantime,
foreign-trained professionals – immigrants and
refugees alike – continue to live the haphazard
reality of the Canadian labour market.
This issue focuses on that reality. Adnan Türegün
provides a summary report on his study of immigrant
professionals working in the Ontario settlement
sector. Conducted in collaboration with the
Ontario Council of Agencies Serving Immigrants,
the study explores dynamics of access to professions
and entry into settlement work as a second
profession. A team of researchers led by Ivy Lynn
Bourgeault at the University of Ottawa look at
the experiences of three groups of internationally
educated health professionals (doctors, nurses,
and midwives) in British Columbia, Manitoba,
Ontario, and Quebec. And they do so by differentiating
three segments within each group: those
practising their professions, who are in progress, or
redirecting their efforts. A third feature article, by
S. Gopikrishna of the Scarborough Housing Help
Centre in Ontario, makes an interesting distinction
between the settlement and employment aspects of
the newcomer experience and examines them in the
cases of Canada, Australia, and the United States.
Best wishes for 2011.
2 INSCAN Vol 24 ( 1-2 ) 2010

Rebuilding Professional Lives, continued from page 1
failed attempts. It is quite conceivable that some
people will see and practise the “second profession”
as an interim solution or springboard to
the original one. Conversely, they may use it as a
strategy to avoid complete de-professionalization.
They may even justify it as a continuation of their
original practice. In any case, while it is socially
bounded, professional rebuilding includes an element
of “rational choice.”
The employment of immigrants with various occupational
backgrounds in the settlement sector is illustrative
of both micro and macro processes which
are at work in the field of professions. In addition
to making a decision to pursue settlement work
as a second profession, these immigrants are also
engaged in identity maintenance or reconstruction.
For them, one of the building blocks of self is identifying
with a profession and a professional community.
That identification has come to define who
they are and where they are located in relation to
others. However, the immigration process disrupts
the continuity. Facing the prospect of identity loss
and its possible destructive consequences, they turn
to other avenues to find meaning again in their work
lives. This is where the settlement sector emerges
as a credible and familiar alternative because many
of them have already been there, seeking help for
their settlement and employment needs.
Immigrant employment in the settlement sector
also reveals macro processes such as convergence
of individual trajectories and professionalization
of a line of work. By convergence of individual
trajectories, we mean the process whereby people
of vastly different professional backgrounds end
up in the same but less prestigious profession. This
brings back the whole issue of social closure on
account of immigrant status, race, and sex but also
calls for a focus on public policy choices in relation
to immigration and settlement. As an emerging
sector, the settlement sector lacks professional and
organizational standards at the provincial level,
let alone the national level. This allows a certain
degree of permeability for immigrants to access
settlement work. It is no coincidence that, regardless
of their previous lines of work, immigrants
came to the settlement sector “in droves.” As the
professionalization of settlement work deepens,
however, we may expect a less permeable profession
with, among other things, clear boundaries,
entry rules, and performance measures.
Research Methodology
Conducted in collaboration with the Ontario Council
of Agencies Serving Immigrants, this study is
based on an online survey and in-depth interviews.
The target population for the online survey were
the professionals working in the Ontario settlement
sector who are trained abroad in areas other
than settlement work. From August to November
2009, a total of 228 responses were received to
the questionnaire. Seventy-three of these were
excluded from the analysis for various reasons.
The instability of the evolving internet medium
and the particular focus of the study account for
the relatively high rate of exclusion. As a result,
only 155 responses were included in the analysis.
Our sample is not random and thus has no claim
to representativeness. We do not know the size
and composition of the foreign-born population in
Ontario’s settlement sector workforce, which would
be necessary to attempt at random sampling. Based
on anecdotal evidence, we can only suggest that the
foreign-born settlement workforce is a much larger
population than the respondents to this survey.
From October 2009 to March 2010, we also had
face-to-face, in-depth interviews with 19 of those
respondents to the online questionnaire who expressed
interest in an interview and who gave their
contact information. The interviewees were selected
in consideration of representation from both
sexes, regions of origin, primary professions, and
settlement work positions. As well, we interviewed
six settlement agency representatives who are in
a position of authority to make hiring decisions.
In the rest of this article, we present a summary of
the findings mainly from the online survey.
A Summary of Findings
Demographic Profile
Like broader social services, immigrant and refugee
settlement services are a female-dominated
sector. Women constituted 79 percent – and men
only 21 percent – of the 155 respondents to the
survey. Our respondents are also a relatively young
group with 58 percent being under the age of 45.
Another 32 percent are in the 45-54 age group.
Four-fifths of the sample come from non-traditional
source regions – a ratio which is coincidentally
similar to that of Canada’s permanent resident
intake in recent years from these regions.
Three quarters of the respondents belong to racial
minority groups. Again, this ratio parallels recent
Conducted in
collaboration with
the Ontario Council
of Agencies Serving
Immigrants, this study is
based on an online survey
and in-depth interviews.
INSCAN Vol 24 ( 1-2 ) 2010
3

Eighty-eight percent of
the respondents have
a Bachelor’s or higher
degree: 43%, Bachelor’s;
35%, Master’s; and 10%,
doctorate (including
degree in medicine,
dentistry, and veterinary
medicine).
When asked what led them
to expect professional
practice in Canada, the
respondents answered
in the way that reveals
the contradictions of
Canadian immigration
policy and practices.
trends in Canadian immigration. The sample
represents all major religious groups but does not
necessarily do so proportionally. It is also noteworthy
that over 10 percent reported no religious
affiliation.
Pre-Immigration Education and Work History
Eighty-eight percent of the respondents have a
Bachelor’s or higher degree: 43%, Bachelor’s; 35%,
Master’s; and 10%, doctorate (including degree
in medicine, dentistry, and veterinary medicine).
The respondents show a great variation in field
of education. The top 10 fields of education are
presented in Table 1:
Table 1. Top 10 Fields of Education
Field of Education
Number
(%)
Business Administration and 21 (13.55)
Management
Education 18 (11.61)
Arts, Language, and Literature 17 (10.97)
Science 14 (09.03)
Law 11 (07.10)
Engineering 9 (05.81)
Social Science 8 (05.16)
Social Work 8 (05.16)
Journalism and Communication 7 (04.52)
Medicine, Dentistry, and 6 (03.87)
Veterinary Medicine
Three quarters of the respondents earned their
highest educational degrees in the country of origin
and a further 17 percent, in a third country. Given
the age composition of the sample, only 10 percent
earned their highest educational degrees before
1980 and a great majority (71%), in the 20-year
span from 1985 to 2004.
Four-fifths of the respondents reported having work
experience in their fields of education before they
had come to Canada. For this group, we asked in
what capacity they worked. The responses vary
widely but all indicate core professional responsibilities.
A majority (55%) practised their professions
before coming to Canada for a period of six
to 15 years.
Immigration to Canada
A great majority (86%) of the respondents are relatively
recent immigrants arriving in Canada since
1995. An even greater proportion (92%) arrived
directly in Ontario. Forty-five percent reported
coming under the economic class; 26 percent,
under the family class; 15 percent, as protected
persons; and 11 percent, under other categories.
For those who came under a category other than
economic and family classes (44 respondents in
all), we also asked if they made a refugee claim
in Canada. The group is split down the middle: 22
claimed refugee status, 21 did not, and one declined
to answer. Sixty-four percent of the respondents
have Canadian citizenship. We can infer that most
of the remaining 36 percent were permanent residents
at the time of the survey.
Pursuing Professional Practice in Canada
In the context of the core interests of the study, we
asked the respondents if they actually came to Canada
with the expectation to practise the professions
that they were qualified for. Seventy percent had
the expectation and 30 percent did not. When asked
what led them to expect professional practice in
Canada, the respondents answered in the way that
reveals the contradictions of Canadian immigration
policy and practices. Forty-four percent mentioned
their educational and professional assets, 12 percent
linguistic assets, and eight percent personal
characteristics such as diligence and dedication
to the profession. Thus, 64 percent emphasized
individual, asset-based traits. Twenty-one percent
were encouraged by systemic or situational factors
such as the points system, Canadian equivalency of
education and degree, and shortage of professionals
in the field. Nearly one quarter of the respondents
were led to believe by what we categorize as information
agents, including Canadian officials in
overseas visa offices, immigration consultants, and
print and electronic media in countries of origin.
For 14 percent, Canada’s reputation as a land of
opportunities was the source of optimism about
professional prospects. 1
It may be one thing to expect professional practice
and quite another to actually do something about
it. However, when asked if they actively tried to
get back into professional practice once in Canada,
the respondents answered in the positive at a level
(72%) slightly higher than that of expectation.
Before probing types of active search, we asked
those who were not involved in active search why
they were not. More than half of the responses (32
of 60) concern individual, asset-related reasons
(loss or change of interest; pursuance of further
education; lack of English and accent in English;
lack of information, network, and other support;
personal or family need to survive; and lack of
professional experience) and the rest, systemic
and situational reasons (difference in professional
system, registration/employment difficulties, and
discrimination and other barriers). The latter group
1
Because of the multiple responses, percentages exceed 100 in this and several other distributions to follow.
4 INSCAN Vol 24 ( 1-2 ) 2010

can be considered the responses of those who were
discouraged by factors external to them.
The types of active search tried by the majority of
the respondents were searching for a job (96%),
seeking help from institutions and individuals
(92%), taking job search workshops (71%), volunteering
(65%), and taking courses to upgrade
skills (56%).
Those who sought help from institutions and individuals
were given a number of choices to mark.
The majority of the respondents sought help from
settlement service agencies (70%), individuals
practising (or trying to practise) one’s profession
(59%), and employers in the profession (58%).
Forty-seven of the 106 respondents searching for
a job related to their professions were successful.
When asked about their post-immigration job titles
in the professional field, 12 of the 47 respondents
mentioned titles which are directly related to settlement
work. These respondents form part of a larger
group who see in settlement work a connection to
their primary professions on account of their education
and work in the pre-immigration period. It is
no coincidence that, when asked why they left their
post-immigration jobs in the professional field, a
large number (19) responded in the negative to say
that they still keep their jobs. This is yet another
indication of a group who relate settlement work
to the line of work they had prior to immigration.
We were curious to hear from those who were
involved in some type of active search for, but
could not achieve, professional practice in Canada.
We thus asked them what they thought prevented
them from getting back to professional practice
particularly in Ontario. Fifty-two of the 78 possible
responses put the blame squarely on systemic
and situational factors (professional registration
process, Canadian experience requirement, institutional/systemic
barriers, and various forms
of discrimination) while 19 responses held the
individual and the family/community accountable
(lack of preparedness, resources, and support).
It was also important to know what other types of
jobs our respondents had in the Canadian labour
market before turning to settlement work. Sixtynine
percent of the respondents said yes and 29
percent, no to the question “Did you have any
job(s) in Canada not related to your qualification
before your employment in the settlement sector?”
When we look at where the former worked, we see
a concentration in the low end of the service sector.
Forty-three respondents mentioned sales, marketing,
and customer services; 20 respondents, what
is generally called the hospitality industry; and 13
respondents, janitorial, maintenance, and housekeeping
services. Thus, 76 respondents worked in
the most exposed segments of the service sector at
some point in their Canadian labour market participation.
Another 12 toiled in goods processing
and circulation.
This picture becomes even clearer when the nature
of the jobs is factored in. Seventy-seven of the
respondents held “survival jobs” as sales/service
assistants, representatives, or associates (51) and as
manual workers (26). Only 15 of the respondents
had jobs with administrative, coordinating, supervisory,
or managerial content.
Yet it is also important to note that the majority of
the respondents stayed in the non-professional and
non-settlement field for a relatively short period of
time, three years or less. This is testimony to their
success in getting out of the cycle of “survival
jobs” and in eventually reinventing themselves as
professionals in the settlement sector.
When asked why they left these jobs, the respondents
overwhelmingly cited dissatisfaction with
job content and a desire to practise their primary
professions or a new profession such as settlement
work. Only 23 respondents left such jobs out of
necessity (business downsizing or closure, end of
contract, and insufficient pay or hours).
Shifting to Settlement Work
For 35 percent of the respondents, the single most
important reason for contacting a settlement agency
for the first time in Ontario or another province
was – ironically – to seek help for employment
in the primary profession. This was followed by
volunteering (18%), looking for work at the agency
(15%), and seeking help for initial settlement needs
(15%).
Forty-seven percent of the respondents had their
first settlement job in the same agency which they
contacted for the first time in the settlement sector.
In giving their reasons for seeking employment in
the settlement sector, the respondents placed heavy
emphasis on altruism as well as on continuity with
pre-immigration professional activity. Fifty-two
mentioned that they wanted to help newcomers
by using, among other things, their personal experiences
in coming to and settling in Canada.
Similarly, 12 respondents wanted to give back to
the ethno-cultural or broader community. Another
group, comparable in size to the one emphasizing
altruism, made a connection between settlement
work and main line of work in the country of origin:
Thirty-two reported having either education,
experience, or interest in the settlement sector
while 30 saw their primary professions as relevant
to settlement work. Only 20 respondents sought
employment in the sector out of necessity.
For 35 percent of
the respondents, the
single most important
reason for contacting a
settlement agency for the
first time in Ontario or
another province was –
ironically – to seek help
for employment in the
primary profession.
INSCAN Vol 24 ( 1-2 ) 2010
5

Another interesting finding
related to professional
development is that twothirds
(or 104) of the
respondents have received
some form of professional
training since joining the
sectoral labour force.
In parallel to their young demographic profile
and recent immigrant status, the respondents are
relative newcomers to the settlement sector as
employees. Seventy-four percent began working
in the sector in 2000 or later and 54 percent, in
2005 or later.
Expectedly, in their first sectoral employment,
a large majority (70%) of the respondents had
a non-supervisory, “frontline” position such as
settlement worker/counsellor, community/outreach
worker, administrative assistant/receptionist, program
support worker/assistant, and employment
counsellor/specialist. As can be seen in Figure
1, only 18 percent held a position which entailed
coordinating, supervisory, managerial, or directorial
responsibilities:
Figure 1. First Settlement Job Titles
When asked if they still held the same position,
39 percent responded in the positive (no change
in job title) and 47 percent in the negative (change
in job title), which indicates a considerable degree
of positional mobility. When we look at the current
settlement job titles of those who experienced
positional mobility, we can see a clear shift towards
positions involving coordination, supervision, management,
or direction. The number of respondents
holding such positions is 37, which is almost equal
to the number of respondents still holding nonsupervisory
positions (38).
An interesting question for us was whether those
who experienced positional mobility also experienced
organizational mobility, that is, changed
employer in the sector. Of the 91 respondents
the question applied to, 38 stayed with the same
employer, 31 had a different employer, and 22 did
not answer.
Another interesting finding related to professional
development is that two-thirds (or 104) of the respondents
have received some form of professional
training since joining the sectoral labour force.
This may speak well of the future of the Ontario
settlement sector.
In order to gauge the respondents’ satisfaction with
settlement work, we asked them if they had ever
wished to go back to practice in primary profession
since joining the sector. The sample is split right
down the middle: 58 said “yes,” 58 said “no,” and
as many as 39 did not answer – which can also
be taken as a sign of vacillation. When we asked
this question by adding the proviso “given the opportunity,”
the number of those who wished to go
back to primary professional practice increased
only slightly, to 64, with no change in the number
of respondents choosing not to answer.
Concluding Remarks
Based on a series of cross-tabulations, we have
found pre-immigration work experience in the field
of education as the single most significant factor
in post-immigration pursuit and practice of the
primary profession as well as in longing for it. This
has important implications for immigrant access
to professions and for immigrant selection policy.
Respondents still have the primary profession in
the back of their minds when they do settlement
work. In their work with and for newcomers, they
find a connection in different forms and varying degrees
to their primary professions. By establishing
this connection, they make sense of the multitude
of investments that they have made for and in their
previous careers.
As for settlement work per se, a preliminary analysis
of responses to open-ended survey questions
and in-person interviews reveals that respondents
place heavy emphasis on the personal, inner satisfaction
they get from, and the social obligation
they feel towards, settlement work. For many,
settlement work is a “calling.” This bodes well for
the professionalization of settlement work since
vocational dedication is one of the hallmarks of
any profession.
6 INSCAN Vol 24 ( 1-2 ) 2010

Brain Gain, Drain, and Waste:
The Experiences of Internationally Educated
Health Professionals in Canada
Ivy Lynn Bourgeault,
Elena Neiterman,
Jane LeBrun, Ken Viers,
and Judi Winkup,
University of Ottawa *
Canada has historically relied on internationally
educated health professionals (IEHPs)
to address shortages in rural and remote
locations and hard to fill positions within its health
care system. It continues to do so and, while this
has been true for medical and nursing labour in the
past, this is now also true for midwives. At the same
time, we hear of numerous accounts of IEHPs who
are not able to practise their professions in Canada.
The barriers to practice for IEHPs – what some
have labelled the “brain waste” problem – have
recently become a significant concern for Canadians.
The difficulties this causes are not limited to
the Canadian context – in terms of lost labour, and
possible solutions to its human resource crises –
there are important implications for the countries
from which health care providers migrate.
This study was designed to fill some of these gaps
in our knowledge by examining:
• the experiences of internationally educated
physicians, nurses, and midwives who were
pursuing professional integration, who have
achieved it, and who have decided to redirect
their efforts; and
• the barriers and facilitators they experienced
along the way that they feel influenced their
relative success at becoming integrated into
provincial health care systems in Canada.
From the outset we decided to gather the perspectives
of the IEHPs. This was intended to supplement
the policy recommendations that have been
made through stakeholder consultations, because
the issues that have come to the attention of Canadian
stakeholders may or may not be a true
reflection of IEHP experiences. The analysis took
a comparative approach between professions, as it
allowed us to contrast the process and outcomes of
various models of integration across professions.
We conducted interviews from June 2007 to February
2008 with 67 international medical graduates
(IMGs), 70 internationally educated nurses (IENs),
and 39 internationally trained midwives (ITMs),
recruited through a variety of means in four provinces
– British Columbia, Manitoba, Ontario, and
Quebec – and in two languages. The participants
were purposively sampled according to whether
they were practising their professions (23 IMGs; 52
IENs; 17 ITMs), in progress (22 IMGs; 12 IENs;
14 ITMs) or redirecting their efforts (22 IMGs; 6
IENs; 8 ITMs). Based on these conversations, we
traced their experiences, from their decision to
come to Canada, through the process they undertook
to get here, and then examined the barriers and
facilitators to their professional and labour market
integration. We include some of their recommendations
for policy to improve the situation for others
who follow their path.
Deciding to Leave and Come to Canada
The majority of our IMG respondents came from
Eastern Europe, followed by the Middle East and
South America, East Asia, and Western Europe in
equal numbers. The three most common regions
of birth for IENs were Western Europe, Eastern
Europe, and the U.K. Most of the ITMs we interviewed
were born in Canada – a fact which largely
reflects of the relative lack of Canadian educational
opportunities for midwives – followed by Western
Africa and Western Europe and then the U.K.
close behind.
It is difficult to tease apart the “push” and “pull”
factors that cause IEHPs to emigrate from their
home countries to Canada. Most, however, choose
Canada as a country of destination as it 1) has a
relatively easy process of immigration; 2) has the
reputation of a country with political and economic
stability; 3) has fair international politics; 4) promotes
multiculturalism; and 5) gives the impression
that health care providers are in demand.
Immigration to Canada
The first step for most health care providers is the
national system of immigration although, for some,
this is a second step following recruitment. While
there are tremendous differences in immigration
preparations undertaken by our respondents, it is
possible to categorize them into having followed
one of four different routes: 1) independent immigration,
through one of two possible immigration
entry points (economic or family class); 2) immigration
to Canada through recruitment agencies
(largely economic class); 3) immigration to
Canada with the help of agencies that solely provide
The participants were
purposively sampled
according to whether
they were practising their
professions (23 IMGs;
52 IENs; 17 ITMs), in
progress (22 IMGs;
12 IENs; 14 ITMs) or
redirecting their efforts
(22 IMGs; 6 IENs;
8 ITMs).
*
Contact: Ivy Lynn Bourgeault, Ph.D., CIHR/Health Canada Chair in Health Human Resource Policy and Scientific
Director, Ontario Health Human Resource Research Network, .
INSCAN Vol 24 ( 1-2 ) 2010
7

There are a number of
barriers which IEHPs
face while seeking
to integrate into the
Canadian workforce.
Some are unique to their
individual professions,
some are similar across
health professions, and
some are similar to the
migration of highly skilled
workers generally.
The primary facilitator
identified was the various
bridging programs that
have been established,
which not only help to
upgrade skills but also
assist with the amorphous
cultural competency
problems.
assistance with immigration per se, without helping
immigrants find work (which could be either
economic or family class); and 4) entry to Canada
as refugees. The largest proportion of respondents
came as skilled workers but this proportion is far
greater for the IENs and IMGs than for the ITMs.
There were almost as many ITMs who came as
family class members as who did so as skilled
workers; far fewer IENs and IMGs came as family
class members than as skilled workers. Those who
found it most difficult to integrate into their professions
were those who came as refugees, followed
by those who came independently. Those who were
recruited were most likely to have largely positive
labour market outcomes in the health care sector.
Barriers to Professional and Labour
Market Integration
There are a number of barriers which IEHPs face
while seeking to integrate into the Canadian workforce.
Some are unique to their individual professions,
some are similar across health professions,
and some are similar to the migration of highly
skilled workers generally. All of the IEHPs we
interviewed faced very similar barriers in terms of:
their English or French language skills, particularly
those which are profession-specific; financial difficulties
related to the requirements for licensure
which are compounded by the time-consuming and
seemingly bureaucratic nature of the process; and
the challenge posed by the lack of opportunity to
gain Canadian cultural competency.
Our IMG participants described two key barriers
specific to their professional integration process.
The first relates to the three standardized Medical
Council of Canada (MCC) examinations. The
other, more challenging, barrier is the relative lack
of access to residency training programs. Many
also felt that they were unable to find a temporary
position during their transition to practise medicine.
Many respondents complained about lack of
positions which would allow them to utilize their
health care skills by working in a related field.
Many IMGs felt that, since the chances of them
getting into medicine were very low, the time that
they spent on preparing for the exams would be
less likely to feel wasted if they could have found
a job in a health care setting.
In additional to the language and cultural competency
barriers that were salient for IENs, and the
problems with the perceived culturally laden nature
of Canadian Registered Nursing Exam, an additional
barrier unique to this profession is related
to level of education – degree or diploma. IENs
often have to decide which process of accreditation
(Licensed Practical Nurse, or Registered Nurse)
to take without actually knowing the difference
between different levels of nursing in Canada.
Another barrier to satisfactory integration cited
by IEN respondents is a lack of full recognition of
education and work experience.
ITMs in Canada identified two unique barriers to integration:
1) the challenges of the relative newness of
the profession, which result in both a low number of
available preceptors to date and, until most recently,
a lack of availability of integration programs; and
2) the difficulties posed by the primary care model
of Canadian midwifery and its requirement to offer
midwifery services in home settings.
There are a number of consequences that directly
result from these professional integration barriers
for the IEHPs we interviewed. For many, it means
downward professional mobility. Although some of
this may initially be a strategic choice on the part of
the IEHP themselves, in most cases, it is imposed.
The added dimension of being considered overqualified
for many other positions in health care
makes the situation for IMGs particularly difficult.
Facilitators to Professional and Labour
Market Integration
The key facilitators to integration that were most
salient to the IEHPs included making as many
arrangements for integration as possible prior to
immigration. Several of the IEHPs also felt that appropriately
targeted information sessions available
at the outset and throughout the immigration and
integration process facilitated their success. The
primary facilitator identified was the various bridging
programs that have been established, which not
only help to upgrade skills but also assist with the
amorphous cultural competency problems. They
nevertheless had some concerns with the accessibility
of bridging programs in terms of available
spots, geographic availability, and financial constraints;
and the coordination of those programs,
in terms of the design of the program and who is
in charge and, in some cases, the content, which
they feel should be more adequately tailored to fit
the needs of IEHPs. Finally, they described how
alternative routes to utilize health professional
skills can be both a facilitator to integration, and
an end in and of itself, for those deciding to redirect
their efforts.
Policy Recommendations
Our participants suggested the following general
recommendations for changes to policies or programs:
• Improve access to health sector and professionspecific
language training;
• Address financial difficulties through an IEHPtargeted
loans program and counselling to
8 INSCAN Vol 24 ( 1-2 ) 2010

improve the labour market positions of IEHPs
during the professional integration process;
• Make information available from multiple
sources and at multiple points in the integration
process – but with a consistent message about
the process and likely outcomes; and
• Increase opportunities to gain cultural competence
both formally and informally.
The IMGs specifically suggested that there be a
higher likelihood of a residency position for those
who pass MCC exams, approximating chances
of Canadian medical graduates who successfully
pass exams. IENs suggested that an approach that
focuses on competency, rather than “one-size-fitsall”
examination and credential-based approach,
be considered. ITMs suggested that the range of
modalities for midwifery practice be expanded
but, in the meantime, allow for some on-the-job
shadowing to gain insight into the Canadian primary
care model.
Comparisons and Conclusions
Many of our findings and recommendations are
consistent with earlier research and policy briefs.
This is an indication of the stability of some of the
key issues, and of the fact that our participants are
not unique in any particular way that would limit
the transferability of our findings. Our comparative
approach, however, does allow us to make some
important and unique contributions to this policy
literature. With respect to interprovincial differences,
although all provinces we studied had relatively
similar requirements for obtaining a licence,
IEHPs immigrating to each of these provinces had
somewhat different experiences. The availability
of bridging opportunities, the perceived willingness
of health authorities to integrate IEHPs, and
the availability of informal social networks made
each province different in its perceived readiness
to accept IEHPs and integrate them into the
local workforce. IEHPs both recognize and denounce
some of these jurisdictional differences.
They call for simpler, standardized, and nationally
based licensing requirements. With respect
to inter-professional comparisons, although many
similarities between professions were found, the
logistical structure around licensing varied from
one profession to another. While IMGs and ITMs
reported the greatest difficulties around licensing,
IENs also had their share of struggles, which varied
in complexity according to their country of origin
and their destination province. Interviewing IEHPs
at different stages of the process of integration gave
us a unique opportunity to assess the differences in
the experiences of IEHPs at these different stages.
Take Home Messages
• Most of the internationally educated health professionals (IEHPs) whom
we spoke to approached their migration to Canada with a sense of optimism
and hope of being productive members of Canadian society and
bringing their skills and knowledge to their new home.
• Most found it difficult to tease apart the “push” and “pull” factors that
cause IEHPs to emigrate from their home countries to come to Canada.
They typically choose Canada as a country of destination as it: 1) has a
relatively easy process of immigration; 2) has the reputation of a country
with political and economic stability; 3) has fair international politics; 4)
promotes multiculturalism; and 5) gives the impression that health care
providers are in demand.
• Knowledge of the perceived shortages in health care creates a great deal
of confusion to these IEHPs when they face insurmountable barriers to
obtaining a license to practise and respond to the health care needs of
the Canadian population. Receiving points for their education in their
immigration application process further compounds this confusion.
• Those who found it most difficult to integrate into their professions were
those who came as refugees, followed by those who came independently
in either the economic or family class; those who were recruited – and
this was more likely for IENs – were most likely to have largely positive
labour market outcomes in the health care sector.
• All of the IEHPs we interviewed faced very similar barriers in terms
of their English or French language skills, particularly those which are
profession-specific; financial difficulties related to the requirements for
licensure which are compounded by the time-consuming and seemingly
bureaucratic nature of the process; and the challenge posed by the lack
of opportunity to gain Canadian cultural competency. The strongest
barrier for IMGs is the lack of residency positions; for IENs it is the
level of education; and ITMs are confronted with the small size of their
profession, its relative newness, and the primary care model of practice.
• Key facilitators to integration include: encouraging IEHPs to make as
many arrangements as possible prior to immigration; making appropriately
targeted information sessions available at the outset and throughout the
immigration and integration process; the creation of more and expanded
assessment and bridging programs; and clarifying routes to alternative
employment options to utilize IEHPs at their highest skill level.
• Key recommendations for changes to policies or programs include:
1) Improve access to health sector/profession-specific language training;
2) Address financial difficulties through an IEHP-targeted loans program
and counselling to improve the labour market positions of IEHPs during
the professional integration process; 3) Make information available
from multiple sources and at multiple points in the integration process
and ensure that this information conveys consistent messages about the
process and likely outcomes; and 4) Increase opportunities to gain cultural
competence, both formally and informally.
• Many of our findings and recommendations are consistent with earlier
research and policy briefs. This should be taken as an indication of the
stability of some of the key issues, and of the fact that our participants
are not unique in any particular way that would limit the transferability
of our findings. Our comparative approach does, however, allow us to
make some important and unique contributions to this policy literature.
INSCAN Vol 24 ( 1-2 ) 2010
9

S. Gopikrishna * Settlement versus Employment Models
Can there be an optimal
mix of settlement and
employment services?
Introduction
The Scarborough Housing Help Centre (SHHC)
provides housing and homelessness prevention
services in the communities of Scarborough and
Markham on the eastern side of the Greater Toronto
Area. Both communities attract a significant number
of newcomers (defined as immigrants who have
arrived in the last four years) who, when given a
choice between accessing settlement services and
employment services, focus on the employment
component. These newcomers see employment as
the nucleus around which their settlement in, and
adaptation to, the new country can be shaped. The
presence of artificial barriers such as the lack of
Canadian experience precludes employment with
the result that the average newcomers would be
unemployed or underemployed even when they
are ready to become citizens as a result of three
years of residence in Canada. 1 The lack of specific
attention to the settlement component (i.e., without
reference to employment) eventually results in a
housing crisis. For example, the family may be at
risk of homelessness because they can no longer
afford to pay rent. The SHHC is asked to intervene
in such a situation. While such interventions have
positive impact, there is the invariable feeling that
much more could have been accomplished had the
intervention taken place before the onset of the crisis.
Such housing crises can be prevented through
a specific and deliberate focus on the settlement
component, irrespective of employment-related
success. Our organization investigates ideal relationships
between the settlement and employment
components of newcomer integration to prevent
such crises.
Research Questions
We explore the relationship between the processes
of settlement and employment as defined below:
Settlement: process of establishing oneself in
the new community by accessing community
resources and connections.
Employment: process of finding a job in one’s occupation
through adequate recognition of credentials
and networking with employers.
Given the above:
• Can there be an optimal mix of settlement and
employment services?
• Is there an ideal relationship between settlement
and employment services?
We deliberately embrace the widest possible definitions
of settlement and employment to satisfy a
wide range of interpretations and experiences.
It is our understanding that a model which has
the broadest possible parameters should be able
to satisfy a narrower interpretation of the same
parameters.
Methodology
We first examined the interaction of the newcomer
settlement and employment processes in Ontario,
Canada by identifying differences between contemporary
reality and model assumptions. After
noting gaps and contradictions between reality
and model assumptions, we examined similar
processes in other countries, namely, the United
States and Australia, to see if similar challenges
were there and how they were resolved. We then applied
the learning to the existing Canadian model
to suggest changes intended to make the existing
interaction of settlement and employment more
realistic and efficient.
Settlement Process in Ontario
Ontario receives the major share of immigrants
coming to Canada, of which a majority come to
Toronto. More than 116,000 immigrants came to
Ontario between July 2009 and July 2010. Approximately
83,000 immigrants settled in Toronto.
Unlike provinces such as Manitoba and British
Columbia, Ontario does not use a specific mechanism
or strategy to choose immigrants based on
local labour market needs. The selection process
for immigrants who settle in Ontario is the general
process of immigration defined by the federal
government, namely, a “skill-based selection.”
This process selects newcomers on the basis of a
combination of their educational background and
work experience, thus focusing on their ability to
settle and find work in Canada. In other words, it
looks at the potential of the newcomer to integrate
into Canadian society as opposed to an actual track
record of settlement in the country.
*
Executive Director, Scarborough Housing Help Centre, a non-profit organization serving the housing needs of the communities of Scarborough and
Markham, Ontario, .
1
In this paper, the time required for an immigrant to complete the process of citizenship is interpreted to be four years based on contemporary
processing times. While newcomers may complete eligibility criteria with three years of presence on Canadian soil, the processing of their
applications takes approximately another year. Newcomers are eligible for services during the time their applications are being processed, which
means a four-year period of service eligibility.
10 INSCAN Vol 24 ( 1-2 ) 2010

The Canadian government takes the business of
welcoming newcomers very seriously. It offers a
wide range of settlement and employment services
targeted at them. The preferred vehicle to offer
these services are publicly funded non-profit agencies.
Some of these agencies provide immigrant
services, some employment-related services, and
others both. If we examine the structure of funding
streams in the not-too-distant past (before funding
devolved from Human Resources and Skills
Development Canada [HRSDC] to Employment
Ontario), we notice that all settlement services
were funded by Citizenship and Immigration
Canada (CIC) while almost all employment-related
services (with the exception of Job Search Workshops)
were funded by HRSDC. Such a clear division
of funding responsibilities, coupled with the
fact that the programs target the same populations
(i.e., immigrants and refugees who are landed) and
have the same criteria (open to newcomers in their
initial years in Canada with loss of eligibility upon
becoming citizens), lend credence to the belief
that the Canadian government saw settlement and
employment as parallel, independent processes.
It is important to see how this assumption of parallel,
independent processes is viewed by service
users. The non-profit organizations referred to in
this discussion work with their clients through a
client-centred model, a model according to which
the client is the ultimate arbiter of his or her
settlement and employment trajectories. Given the
educational experience and skills of newcomers
(not to mention what they perceive to be the “certificate”
of employability from CIC as expressed
by the admission of them to Canada), employment
is prioritized over settlement. A statement such as
“Give me employment and I can take care of the
settlement part myself!” is more the norm than an
exception. This perspective makes employment
the primary process whose success defines that of
settlement (secondary process). In other words,
settlement becomes a dependent variable of employment.
What appears to be a reasonable assumption
on the part of the newcomer contradicts the
model as conceived by the government: Whereas
the government sees employment and settlement
as parallel, independent components, the client’s
assumptions make settlement a dependent variable
of employment.
Putting employment before settlement is also problematic
in view of the fact that artificial barriers
such as the Canadian experience requirement and
the lack of foreign credential recognition make it all
but impossible for newcomers to find employment
in their areas of training. At the end of four years,
when newcomers are ready to become Canadian
citizens and are consequently ineligible for newcomer
services, they would still be underemployed
or unemployed. The reliance on employment as the
pre-condition of settlement would mean that these
people are not just unemployed or underemployed
but also unsettled.
Thus, the main issues in the interaction of settlement
and employment in a Canadian context concern
the varying degrees of importance attached
to employment and settlement by policy makers
and newcomer clients. There is also a variation
in the perception of how employable the client is
across stakeholders such as CIC, employers, and
clients themselves.
The American Model
As Canada’s neighbour, the United States competes
for a similar pool of immigrants and its model of
settlement and employment is thus worth examining.
The most common way to immigrate to the
United States is to obtain a job offer from a U.S.
company and utilize the job offer as the vehicle
to become a permanent resident. The would-be
immigrant uses the job offer to get a visa to enter
the United States and then applies for permanent
residency again on the basis of the job offer. Many
would-be immigrants go to the United States as
students, obtain a degree, and use the degree as the
means to secure a job. As discussed earlier, the job
becomes the means to obtain permanent residency.
The importance of employment is underscored by
the fact that employment is needed to commence
and complete the process of immigration. Job
loss at an intermediary stage delays the process to
become a permanent resident.
The strong emphasis traditionally placed by the
United States on self-reliance challenges the need
for settlement services, when not contradicting it.
Proponents of self-reliance argue that, if newcomers
have the ability to obtain jobs from outside
the country or obtain advanced degrees before
obtaining jobs, they have the ability to integrate
into the local community without access to specialized
services. The need for settlement services is
not perceived as important; such services, where
available, are patchy and the outcome of local
community needs and dynamics rather than of
any systematic federal or state investment. Indeed,
the only settlement services that one consistently
notices are citizenship classes.
The Australian Model
The importance of Australia as a comparator lies
in the fact that it arguably competes with Canada
for the same pool of newcomers. The Australian
system of choosing newcomers on a points basis is
modelled after the Canadian system. Peter Wilen-
Whereas the government
sees employment and
settlement as parallel,
independent components,
the client’s assumptions
make settlement a
dependent variable of
employment.
Proponents of selfreliance
argue that, if
newcomers have the
ability to obtain jobs from
outside the country or
obtain advanced degrees
before obtaining jobs,
they have the ability to
integrate into the local
community without access
to specialized services.
INSCAN Vol 24 ( 1-2 ) 2010
11

It is difficult to complete
the employment and
settlement processes
simultaneously.
ski, the lead bureaucrat responsible for shaping
the Australian immigration system in the 1970s,
was impressed and influenced by the Canadian
approach to immigrant settlement when he was
working in Ottawa in the 1960s.
The Australian system is interesting in that it
underwent major changes in approaching to the
settlement of newcomers. The “populate or perish”
ideology of the 1970s resulted in a system that was
heavily settlement-focused. It was common for
newcomers to be reimbursed for travel to Australia
expenses and to receive short-term financial assistance.
By the 1990s, financial deficits paved the
way for changes in the system and a new model was
adopted as a result, which lasted to this day. In the
new model, a lot of attention is paid to newcomer
selection; the Australian government believes
that the immigrants who can integrate best into
Australian society are those whose profiles closely
match with those of native-born Australians. Australia
prefers newcomers who are fluent in English
and who have their credentials recognized before
arrival. Specifically recognizing that settlement
services result in “short-term stability,” the Australian
government offers three principal streams: 1)
Settlement Grants Program which offers funding
for up to three years for a specific objective; 2)
Adult Migrant English Program which provides
language instruction in a variety of settings; and
3) Translating and Interpreting Service National
offered directly by the government. Access to services
under any of the three programs is limited to
the next of kin of the principal applicant for up to
two years. The principal applicants cannot access
these services.
The process is significant in that there is the recognition
of the importance of a settlement component
although the service is time-limited and restricted
to the next of kin of the principal immigrant.
Comparative Lessons
If we look at the interaction of settlement and
employment in the three systems that have been
examined here (i.e., Canadian, American, and
Australian), we come to the following conclusions:
• Employment is a process that takes place
around the time newcomers arrive in a country
or after a significant time gap during which
they acquire local education and skills. This
is borne out by the experiences of immigrants
to the United States, who obtain a job before
arrival or enter the country as students and
spend considerable periods of time to acquire
local degrees before joining the job market.
• This conclusion is also supported by the perception
of job readiness in the Australian context
where the principal applicant is deemed to be
job-ready immediately upon arrival, unlike the
family members who are given up to two years
to become job-ready. Interestingly enough, this
perspective is also buttressed by the examples
of Canadian immigrants who arrive in Canada
as graduate students and acquire local degrees
before obtaining employment in a period of two
to four years.
• Settlement can take place before employment or
employment can take place before settlement.
In the cases of immigrants who enter the United
States to obtain a degree before obtaining employment,
it is evident that the time spent as
students is also the time when they familiarize
themselves with the country, internal systems,
and other components of settlement. In other
words, the students are completely settled and
grounded in the American method of doing
things by the time they start applying for
employment. On the other hand, immigrants
specifically entering the country as a result
of employment offers by U.S. companies use
employment as a means to settle themselves
(e.g., software developers recruited in India or
China).
• It is difficult to complete the employment and
settlement processes simultaneously. Notwithstanding
the enormous flexibility offered by a
system where the newcomer can work on either
or both components, it is difficult to concentrate
on both processes and complete them at
the same time. This is evident in the cases of
Canadian immigrants and principal immigrants
in the Australian context where the initial emphasis
is on the employment process without
adequate attention to the settlement component.
The lack of success on the employment front
forces the newcomer to come up with ad hoc
solutions for settlement while trying to refocus
on employment. Such rapid shifts in focus at a
given point in time make it impossible for either
component to be completed.
A Recommended Model for Canada
Based on the learning in the previous section, we
recommend that:
• Employment search commence well in advance
of arrival in Canada. Newcomers may seek
employment in Canada via the internet well
in advance of their arrival. This approach is
supported by the examples of academicians
recruited outside Canada to work at a Canadian
university or anecdotal evidence of newcomers
finding employment in the oil industry in
Alberta at the height of the boom a few years
ago.
12 INSCAN Vol 24 ( 1-2 ) 2010

• Settlement may precede employment. Should an
immigrant not obtain employment in Canada by
the time s/he arrives, one may assume that employment
will be found only after a significant
period of time during which the newcomer must
concentrate on the settlement component – i.e.,
acquisition of housing, volunteer or placement
positions, and education. Newcomers who are
unable to find employment before or just after
arrival need to adjust themselves to the reality
of Canada and acquire sufficient experience or
education before attempting to re-enter the job
force.
• Settlement requires orientation to civic engagement
and participation in a Canadian setting.
Newcomers must be oriented to how Canadian
society works and how Canadian government
policies are developed. An interesting unfolding
of such processes may be found in the case of
a young U.K.-born immigrant, Mark Andrews,
who arrived in British Columbia in the 1980s.
Andrews went to law school at the University
of British Columbia and acquired a law degree.
However, the Law Society of British Columbia
refused to admit him as a member since he was
not a Canadian a citizen, this preventing him
from practising as a lawyer. A legal appeal by
Andrews to overturn the stipulation resulted
in a landmark decision by the Supreme Court
of Canada in 1989. Andrews v. Law Society of
British Columbia struck down the citizenship
stipulation to qualify for membership in the
provincial law society.
• Legal action is one of the strategies which has
not been used effectively to date to challenge
and break down the vexatious and artificial
Canadian experience requirement for obtaining
employment. Many newcomers come from
environments where they are not familiar with
Canadian law and policy making processes and
may have concerns about legal involvement as a
result of their negative experience in the country
of origin. It would be interesting to see if such
barriers can be struck down by the use of legal
tools. Such a development would permanently
alter the interaction of settlement and employment
components throughout Canada.
INSCAN Vol 24 ( 1-2 ) 2010
13

Reviews
Reviewed by
Matthew Kurtz * and
Sanda
Horvath-Berindea **
You’re Hired… Now What? An Immigrant’s Guide to
Success in the Canadian Workplace
By Lynda Goldman
Don Mills, Ontario: Oxford University Press, 2009, xii + 404 pages
The immigrant service sector has grown substantially
over the last decade across Canada.
This has been driven in some part by labour
market demands but also by persuasive critiques
of the widening wage gaps between established
immigrants and Canadian-born workers. The
diagnosis of immigrants’ increasingly difficult
economic integration helped secure additional
investments in Canada’s immigrant service sector,
offering support for various endeavours to further
professionalize the delivery of settlement and employment
services for new Canadians.
A clear signal of that growth in the immigrant
service sector is the entry of a major publisher,
Oxford University Press, into the market of advice
books for new immigrants in Canada. Where earlier
material had been self-published (for instance,
Wright 2007, which is particularly good), Oxford
moved into this market in 2008 with the start of
its Canadian Newcomer Series. The first volume,
Arrival Survival Canada, provided a systematic
guide to settlement issues by two of the leading
voices in Canada’s immigrant community (Noorani
and Noorani 2008). In the second book, How to
Find a Job in Canada, an internationally trained
scientist and a Canadian writer (Cheinis and
Sproule 2008) offered 145 “problem-solution” tools
to help newcomers obtain employment in Canada.
You’re Hired is the third and most recent volume
in the series. It picks up where the second title left
off, providing a well-structured series of tips on
business etiquette for immigrants who have just
obtained their first job in Canada.
The volume’s author, Lynda Goldman, is an ESL
instructor, an accomplished ESL author, and a
workplace-advice columnist for a Montreal newspaper.
She has divided her book into four major
sections and 17 chapters. Interspersed in her text
are numerous stock photos and illustrative short
stories set aside in blue font. Goldman also includes
boxes for “Canadian Business Concepts,” which
effectively summarize the chapter’s major points
about business etiquette in Canada in five lines or
less. Every chapter ends with three exercises that
reflect on the material. Some sentences from one
chapter are repeated in a later one, but with its regular
variations in voice and tone, the resulting layout
gives You’re Hired the potent look of a textbook.
The first of the four major sections invites readers
into a simple theoretical framework, then sets
the context before turning to questions about first
impressions, dress codes, and introductions during
the first week of work. The second major section
takes up communication issues: body language,
talking conventions, telephone tips, e-mail, and
business letters. The third turns to workplace relations:
management styles, team work, meals with
a client, gossip, romance, harassment, networking,
small talk, and so on. The last section deals with
time management, business travel, conferences
and parties, conducting meetings, and giving presentations.
Outside of workplace training programs, the audience
for this book is likely to be fairly specific, that
is, recent immigrants whose jobs involve office
work. That specificity is reflected in the topics
the author has chosen (cubicle courtesy, business
memos, etc) and it is reflected in her source
material: Many of those interviewed and quoted
work in the financial sector, for instance. Yet the
statistics for 2001 indicate that only 13 percent of
new Canadians had landed jobs doing office work
(business, finance, administration). Fifty percent
were employed in service, retail, and manufacturing,
for whom much of the volume will be less
relevant for their current jobs.
Moreover, those involved in the delivery of workplace
training programs may wish to proceed with
some caution before adopting this volume. The
experience of reading this textbook in its entirety
could well prove, on balance, more demoralizing
and frustrating than helpful. Three points are worth
considering. First, many immigrants are not going
to see themselves in this book. There are four
pages on hygiene, for instance, that would be inappropriate
for most new internationally educated
professionals. Its regular address in our curriculum
*
Adjunct Research Professor, Department of Geography and Environmental Studies, Carleton University, Ottawa, .
**
Placement Coordinator, Workplace Language Training, LASI World Skills, Ottawa, .
14 INSCAN Vol 24 ( 1-2 ) 2010

could lead many to conclude that we think different
standards of hygiene are a common impediment,
rather than a rare exception, for those with whom
we work. Second, the book’s overall length could
put many students off if they judge much of its
material to be a waste of time. Third, little is said
about the positive notes that immigrants have
added to the Canadian cultural mosaic over time, or
about innovative contributions that immigrants are
expected to make in Canada’s economy. Instead,
most of the volume’s information is presented as
norms and standards to which immigrants must
acclimate. On the negative presumption that immigrants
are woefully deficient, it serves as a tool
with which new Canadians can educate themselves
about the process of assimilating or fitting in. For
these three reasons, we would urge caution before
its adoption as a textbook. Nonetheless, this book
undoubtedly will be of value to workplace training
programs as a student resource and as a source for
select readings.
For future editions of this volume, two more points
are worth consideration. First, it would be helpful
to see more material discussing regular dilemmas
of integration and career development in Canada.
Statistics indicate that immigrants face many
systemic job-related challenges with regard to the
inscrutable dynamics of class, gender, nationality,
age, and communication style. Yet these challenges
are rarely addressed with compassion and
understanding in the book as it now stands. For
example, in regard to socio-economic class dynamics,
Goldman encourages immigrants to join their
colleagues in social activities, “whether it’s for
Wednesday’s bowling night, or Thursday’s pizza
lunch” (p. 48). This is sage advice, but a sensitive
and sympathetic touch would also acknowledge the
considerable financial hardship that new Canadians
regularly face prior to and during their first job,
as well as competing family obligations that colleagues
might not share when considering evening
activities. That can make such participation difficult,
and advice – for instance – as to when and
how the reader might occasionally excuse herself
or himself from such events would probably be
very welcome.
Second, Goldman uses an undifferentiated, “cultural”
approach to Canadian society. In the first few
pages, she defines culture as the norms, behavioural
rules, shared values and ideas of a group of people
– in this case, Canadians. There are a number of
benefits to this approach. The most notable is that
many newcomers will probably find this framework
very easy to understand at first blush. Yet it quickly
runs into problems with stereotypes of Canadian
workplace culture, stereotypes that many immigrants
will consider to be
too simplistic. Canada still
attracts the best and brightest
from around the world
and, in workplace training
programs, those professionals
often challenge the idea
that Canadian norms are homogeneous.
To address such
readers in future editions of
the book, it may be better to
conceptualize culture as an
evolving set of ideas, norms,
and communication styles,
one that changes through
simple adaptation, intercultural
contact, and the hardwon
challenges of groups in
Canada who did not share all
the assumptions of the more
dominant groups. Such a
differentiated, evolutionary
approach to culture would help the book’s readers
better understand the differences they see among
Canadians. It would also help newcomers better
understand how, in small but significant ways, they
too can contribute to the development of Canada’s
changing cultural mosaic.
That said, You’re Hired is certainly a welcome
addition just as it stands. To date, there is little
material available for immigrants who seek advice
about etiquette and expectations with their first job
in Canada. The book’s author has helped to fill this
gap. In the process, she faced the unenviable task of
situating and addressing an audience – immigrants
– who hold a wide variety of perspectives, needs,
and abilities. With that in mind, Goldman should
be congratulated without reservation for having
assembled a well-crafted book and a very useful
resource for settlement agencies and immigrantserving
organizations.
References
Cheinis, Efim; and Sproule, Dale. 2008. How to
Find a Job in Canada: Common Problems and
Effective Solutions. Don Mills, Ontario: Oxford
University Press.
Noorani, Naeem; and Noorani, Sabrina. 2008.
Arrival Survival Canada: A Handbook for New
Immigrants. Don Mills, Ontario: Oxford University
Press.
Wright, Daisy. 2007. No Canadian Experience,
Eh? A Career Survival Guide for New Immigrants.
Brampton, Ontario: WCS Publishers.
Nonetheless, this book
undoubtedly will be
of value to workplace
training programs as a
student resource and as a
source for select readings.
INSCAN Vol 24 ( 1-2 ) 2010
15

Reviewed by
Maria E.
Gonzalez-Spielauer *
The Big Wait
Directed by Jari Osborne and Joanne Jackson
Ajax, Ontario: Brilliant Red Media, 2010, 53 minutes
The three parallel
stories featured in the
documentary resonate
with hundreds of other
internationally trained
doctors who share the
same frustration.
The shortage of medical doctors in Canada is a
well-known, worrisome reality. The Big Wait
begins with the documentary makers visiting
Midland, Ontario, an underserviced community
that wants to attract and retain doctors. Using this
example, the film begins contrasting the community’s
desperation for medical attention with the
hopelessness of the foreign-trained physicians who
cannot practice.
The narrator points that, aside from over 4 million
people in the health system nationwide waiting
for a family physician, doctors overwork in an
exhausting attempt to meet demands. At the same
time, thousands of international medical graduates
(IMGs) who successfully immigrated to Canada
wait for an opportunity.
The film then follows, for a period of four years
starting in 2005, three internationally trained doctors
who are determined to achieve their medical
licences in Canada. The sequence shows the doctors’
complex and often discouraging journeys
towards that goal.
Such is the case of Dr. Sara Chhetry, a passionate
physician who came to Canada in search of a safer
life for her family and with high hopes for her
professional future. Dr. Chhetry, a graduate of the
Tribhuvan University in Nepal (whose medical program
was designed in collaboration with the University
of Calgary Medical School), also has a rich
international experience, including work with the
Canadian Red Cross in India and a Master’s degree
in community health at the University of Toronto.
With all her academic and practical achievements,
she has waited for four years just to be interviewed
for a residency position in Canada. She competed
with 1,200 applicants for one of the 92 positions
available but, to her great disappointment, did
not succeed. While realizing that the competition
was fierce, she still had a hard time coping with
the outcome. Finally, Dr. Chhetry worked her way
around the system and moved to Ottawa where she
got a volunteer medical observership.
Just like Dr. Chhetry, Dr. Chander Gupta (a radiologist
from India) came to Canada to pursue
medical practice. As well, Dr. Gupta was backed
with several years of experience, and persistently
invested resources and time to get a residency
position. Although he completely agrees on the
* Associate Writer, CIMSS.
importance of rigorous IMG testing, he feels that
there are far more hurdles than he expected and that
the process is extremely difficult. He was initially
confident that he would achieve his objective in a
reasonable time but the obstacles he encountered
made him seek alternate paths to entering the system.
He eventually got a fellowship in Calgary. The
consequence, however, was at least 18 months of
separation from his family in Toronto, a very difficult
time for all. After almost five years of trying,
Dr. Gupta got a restricted licence to practise as a
radiologist in Alberta.
After experiencing similar hardships, Dr. Mohamed
Meghji (the third physician portrayed in the
film) could not see any clear path for his career.
In his experience, rules would change constantly,
making it close to chasing a moving target. Even
worse, he began doubting himself. With a rich
professional background and top marks in accreditation
tests, Dr. Meghji had to find an alternative
course of action towards becoming a licensed
doctor in Canada. He and his family of Southeast
Asian origin left their home country Kenya due
to political and social discrimination. They immigrated
to Canada, seeking fairness and hoping
for a good future. With a 10-year medical practice
in Kenya, Dr. Meghji opted for a satellite residency
program at the Southern Illinois University School
of Medicine’s Family Practice Centre. He was
quickly admitted but the price was very high: He
had to separate from his family for three years.
After completing his residency program, he came
back to Canada primarily for family reasons. He
was finally recruited to practise family medicine
at Health Force Ontario.
The three parallel stories featured in the documentary
resonate with hundreds of other internationally
trained doctors who share the same frustration.
Throughout his interview, Dr. Gupta expressed
with dismay the feeling that the system was unfair
to him but even more to the communities in need of
timely medical care. In the film, the limited number
of residency openings for IMGs is constantly
pointed as the bottleneck.
The Big Wait does not just exemplify the ambiguity
of the journey that IMGs have to take to obtain a
licence, but also reproaches the effects on public
health and people’s morale. Mainstream and immigrant
communities have equally experienced
16 INSCAN Vol 24 ( 1-2 ) 2010

the long and frustrating process of registering in
the practice of a family doctor, getting a surgery
or medical appointment, and even achieving
emergency attention. The failure to recruit foreigntrained
and ready-to-work physicians seems not
only absurd in itself but also a threat to the population’s
quality of life.
Dr. François-Gilles Boucher, Deputy Chair of the
Department of Family Medicine at the University
of Ottawa, admits that many candidates who were
turned away would have made excellent family
physicians. Unfortunately, he does not provide
any insight into the limited number of residency
offerings to IMGs. A real issue is the process itself.
Why let IMGs go through such painful journeys
and hardships that leave some of them personally
and professionally destroyed?
Nevertheless, there is the other, brighter side of the
coin. Examples include the successful recruitment
and retention of IMGs and medical students by
communities in need such as Midland; a gradually
increasing number of residency places available for
foreign-trained doctors every year; and the hope
for other IMGs inspired by the three doctors who
somehow found a way to get back to practice in
their field.
With only about nine percent of medical residency
positions being reserved for IMGs though, the main
challenge is to find more effective ways to improve
the licensing process for the foreign-trained doctors.
As things stand now, many foreign-trained
doctors like the three doctors featured in the film
will have to find creative ways to entering the medical
system. The status quo has the risk of turning
Canada’s brain gain into brain drain.
The Big Wait is a convincing and vivid account
of the challenges faced by internationally trained
physicians in Canada. As such, it must be seen
by all stakeholders in immigrant access to health
professions and other occupations.
INSCAN Vol 24 ( 1-2 ) 2010
17

Canadian Council for Refugees, Fall 2010 Consultation
on the theme of: Fairness, November 24-26, Calgary, Part I
Komal Minhas*
Racial Profiling
Resource Persons:
Jidiri Ndagije, Alliance
Jeunesse-Famille de
l’Alberta Society (AJFAS),
Edmonton,
Vilma Dawson, Calgary
Centre for Culture, Equity
and Diversity,
Jill Croteau, Global
Calgary,
Moderators:
Rita Acosta, Mouvement
contre le viol et l’inceste,
Montreal,
Monica Abdelkader,
London Cross Cultural
Learner Centre,
Ndagije defined racial
profiling as the use of
an individual’s race
or ethnicity by law
enforcement personnel as
a key factor in deciding
whether to engage in
enforcement.
*
Associate Writer, CIMSS.
This session focused on the impact of racial
profiling on youth in the communities of Edmonton
and Calgary and highlighted specific
initiatives taken by the panellists to prevent racial
profiling of youth and to expose areas of concern
for immigrant and refugee youth.
Jidiri Ndagije highlighted programs AJFAS has
pursued to address issues between the Edmonton
Police Service (EPS) and Francophone youth from
ethno-cultural minority groups.
Ndagije defined racial profiling as the use of an
individual’s race or ethnicity by law enforcement
personnel as a key factor in deciding whether to
engage in enforcement. Building on this definition,
Ndagije added that racial profiling is premised on
stereotyped presumptions and that it is a relatively
recent form of discrimination.
Tensions between immigrant and refugee youth
and law enforcement personnel often stem from the
youth’s negative impressions of law enforcement
officials in their countries of origin. These tensions
also stem from racial profiling of immigrant and
refugee youth by law enforcement personnel.
Ndagije emphasized the frustrations of youth with
law enforcement because of racial profiling and
the detrimental effects such treatment can have.
This unfair treatment has led to increased levels
of aggression in these youth.
This, Ndagije said, is where community groups
like AJFAS step in. AJFAS, he said, works to curb
racism and reduce youth aggression towards law
enforcement personnel.
AJFAS now collaborates with the EPS to educate
law enforcement personnel and youth about each
other. Ndagije said that AJFAS plays a bridging
role between both groups. AJFAS felt the necessity
to fill the gap between youth frustration and the
law enforcement personnel’s need for education
and awareness.
AJFAS and the EPS are on the verge of releasing a
resource for law enforcement personnel, Handbook
for Strengthening Harmony between Immigrant
Communities and the EPS. Members of the EPS
are already pushing for the resource to be available
in other languages to assist with helping other
minority communities in Edmonton.
Ndagije ended his presentation by highlighting
the creation of the Edmonton Youth Justice Committee
put into place with the help of Alberta
Solicitor General and Public Security on behalf
of its Young Offender Branch. This Youth Justice
Committee, like other justice committees, works
in partnership with the Government of Alberta
to provide citizens with the venue through which
they can be directly involved in “reconciling the
differences between the young offender, victims,
and community members.”
Vilma Dawson focused her presentation on a news
story she helped Global Calgary uncover. Jill
Croteau joined the panel to present with Dawson.
Dawson recalled the e-mails circulated a few years
ago by a group of racialized youth who were being
discriminated against at nightclubs in Calgary.
After verifying these claims, Dawson approached
the news media with the story. Dawson contacted
Global Calgary and Croteau decided to take on
the story.
Croteau followed the story and met Jaspal Randhawa,
a young Sikh man from Vancouver who had
been denied entry to Calgary nightclubs during
Stampede weekend. Randhawa agreed to being
videotaped while trying to gain entry at a few
Calgary nightclubs to catch this form of racial
profiling on camera. He was denied entry three
different times and, in one instance, was pushed
by a “bouncer.” The resulting story was called
Racism at the Door.
Randhawa went on to file a law suit against one
particular nightclub in Calgary for refusing him
entry and won a $5,000.00 settlement and apology
from the ownership.
Two years later, Croteau did a follow-up story.
This time, two black men were denied entry at
five different clubs in one night and, in one case,
were subjected to physical violence. Croteau played
both news clips for the participants. (Both clips are
available on YouTube.)
Excuses such as “it’s only 25-and-up tonight,” “you
can’t come in with running shoes,” and “it’s poli-
18 INSCAN Vol 24 ( 1-2 ) 2010

tics, guys, sorry” were used in both cases. These
kinds of excuses are often used to keep racialized
youth out of bars and clubs, said Dawson.
“Everybody doesn’t believe this stuff happens, but
it’s been happening, it’s obvious, we proved that
tonight, and it’s happening a lot,” said one of the
young men quoted in the report.
Following the release of the first report in 2004,
many nightclubs began hiring off-duty police officers
in uniform as security to justify their entry
policies. In many cases, Dawson said, these officers
would do nothing to assist those who were being
emotionally and physically abused. Following
another investigative report from Global Calgary
and with sufficient pressure from the community,
Calgary police officers were banned from accepting
these positions and wearing their uniforms for
off-duty employment.
Dawson emphasized the need to highlight these
forms of racial profiling since the effect of such
treatment is particularly detrimental for racialized
youth. She said that racial profiling is a practice
that has been happening for centuries and that the
only way to combat it is exposing every form of it.
Dawson recalled the
e-mails circulated a few
years ago by a group
of racialized youth who
were being discriminated
against at nightclubs in
Calgary.
Convention on the Rights of the Child:
Canada’s Compliance
Marija Gojmerac*
Canada is a signatory to, and has ratified, the
U.N. Convention on the Rights of the Child
(CRC) and will soon have its third and fourth
reports reviewed by the United Nations for compliance.
This workshop provided an introduction
to the convention, highlighted the rights most
relevant to the refugee and immigration system,
and explained how the CRC applies in Canada.
Linda McKay-Panos opened the session with a
discussion on refugee children and the CRC. She
began with a list of relevant international instruments
that Canada has ratified: CRC, Optional
Protocol to the CRC on Involvement of Children
in Armed Conflict, and Optional Protocol to the
CRC on the Sale of Children, Child Prostitution
and Child Pornography. The CRC is one of the
most ratified international conventions, with only
two States withholding ratification: United States
and Somalia.
The CRC has not been incorporated into Canadian
domestic law. International conventions are not
enforceable in Canadian domestic courts unless
they are implemented into Canadian law in one
of three ways:
1. The international law is copied and appended
to existing Canadian legislation that provides
domestic remedies;
2. The international law is referred to in Canadian
legislation and policy; and
3. Existing Canadian laws indirectly incorporate
international human rights principles (e.g.,
Canadian Charter of Human Rights and Freedoms)
or the courts use these principles to
interpret Canadian human rights law.
*
Associate Writer, CIMSS.
There are some non-legal forms of enforcement of
conventions, but these are persuasive rather than
binding. These include foreign diplomacy, pressure
from NGOs, universal periodical reviews by the
Human Rights Council, State reporting obligations
and the response of the United Nations to such reports,
and individual complaint mechanisms. This
last quasi-legal approach to enforcement cannot be
used for CRC violations. It can only be applied to
the International Covenant on Civil and Political
Rights. McKay-Panos made a point to note that
pressure from NGOs should not be taken lightly.
The United Nations is turning to NGOs more and
more for their expert opinions on particular subject
matters, as well as for their own reports on what
Canada is doing to comply with the convention.
In contrast to conventions, customary international
law is automatically adopted as part of Canadian
law. Customary international law principles include
the prohibition of torture, slavery, and genocide.
However, in Canada, customary law is generally
used only to support other human rights arguments
rather than being the primary reason relied on by
the court in a particular situation.
The CRC focuses on the best interests of the child
and this statement can be found in many statutes
across Canada.
Maureen Duffy addressed the specific issues that
were raised in Canada’s last two reports, as well
as issues that have been prominent since then.
Ongoing critiques have involved the detention of
refugee children. This concern has recently been
discussed because of legislation pending before
Parliament that calls for presumptive detention of
refugees arriving under certain circumstances, and
Resource Persons:
Linda McKay-Panos,
Alberta Civil Liberties
Research Centre,
University of Calgary,
Maureen T. Duffy,
Faculty of Law, University
of Calgary,
Moderator:
Brian Seaman, Alberta
Civil Liberties Research
Centre, University of
Calgary,
The CRC is one of the
most ratified international
conventions, with only
two States withholding
ratification: United States
and Somalia.
INSCAN Vol 24 ( 1-2 ) 2010
19

Canada, like many
countries, has also
encountered an
increase in the issue of
unaccompanied minors.
which does not contain an exemption for children.
Duffy noted that the legislation is in its early stages,
so it could be revised during the process, and it is
hoped that this concern will be addressed before
the legislation passes, if it does pass.
Canada, like many countries, has also encountered
an increase in the issue of unaccompanied minors.
Some of these children may be victims of human
trafficking. Challenges include establishing a
uniform policy for placement and representation
regarding these children.
Human trafficking has also increased worldwide,
as it has proven lucrative for those
engaging in it. It tends to have a disparate impact
on women and children, and it also has a heavy
impact on immigrants and refugees. Canada
recently strengthened its criminal provisions
relating to trafficking, which is a significant
positive step. Various local initiatives have been
undertaken to combat this problem, and the
Canadian government has been discussing the
possibility of implementing a national approach,
rather than the currently more localized
approach, to combat this growing problem.
Australian Refugee Film Festival
The Australian Refugee Film Festival wishes to announce that submissions for the 2011
edition of the festival are now open. Submissions are free and open to both Australian and
International films, up to 10-15 minutes in duration.
In particular, we are seeking films that address the following issues:
• Environmental displacement due to climate change;
• The refugee journey and the obstacles associated with it;
• Personal triumph stories of refugees and asylum seekers; and
• Documented work of local and international organizations with refugees and asylum
seekers.
Films do not have to be limited to the above topics; the main criterion is that the film engages
with refugee and asylum seeker issues both nationally and internationally.
Entry Deadline: March 31 2011
Contact Information:
For further information of submission rules, entry forms, and the festival itself, please
visit: or
email: .
Entries can be entered via our online server or sent via mail to:
Australian Refugee Film Festival, P.O. Box 200W, Fairfield West, NSW 2165, Australia.
20 INSCAN Vol 24 ( 1-2 ) 2010

Canadian Council for Refugees, Spring 2010 Consultation,
Solidarity and Protection: Our Obligations at Home and Abroad,
June 3-5, Ottawa, Part I
Post-Secondary Education Access Challenges
Berrak Kabasakal*
Many challenges faced by new immigrant and
refugee youth in accessing post-secondary
education remain unresolved. The issues of
access to education for the newcomer youth need
to be identified more clearly and dealt with more
effectively as part of a comprehensive process of
integration into Canadian society. In this workshop,
speakers focused mainly on the recognition
of credentials for students coming from overseas
and the barriers faced by non-status youth in the
Ontario school system.
El Mlafi, as an immigrant youth volunteering for
the Hamilton-based settlement service agency
SISO, started his presentation by telling his
personal experience - his struggle to get into a
university in Ontario. Born in Morocco, El Mlafi
spent earlier years of his school life in the Moroccan
school system. He was enrolled in a Maths
and Science Program in Morocco, which, as he
put it, was quite successful preparing students for
engineering from Grade 10 through Grade 12: “I
was quite fortunate to get my high school diploma
there.” He then moved to France to continue his
engineering studies in a “preparatory class.” After
spending one full year taking specialized courses
to prepare him to a higher engineering school, he
was profiled as a star student and became eligible to
go into second year of preparation for engineering
schools (grandes écoles d’ingénieurs).
In July 2009, El Mlafi immigrated to Canada together
with his parents. However, he did not get to
start his university education in September of the
same year for two reasons: “First, the deadlines
were gone, which is fairly understandable. The
other one is financial because I wasn’t eligible for
OSAP [Ontario Student Assistance Program].” In
order to be eligible for OSAP, one has to stay in
the province of Ontario for at least one year prior
to his/her application. “So, that one year of studying
engineering in France didn’t mean anything.
It was very frustrating for me. I probably have
already completed most of the courses that are
taught here at the first, even second year engineering
programs.”
El Mlafi also told his story of applying to McMaster
University in his current place of residence,
Hamilton. “At their website, it asks ‘Are you an
international student or a domestic student?’ I
was not an international student because I was a
permanent resident since the time of my arrival. I
was not a domestic student either because my high
school diploma was not from within Canada. So
there wasn’t a category for students like me. It took
about two to three days to only figure this out.”
Based on his personal experience, El Mlafi concluded
that “credential recognition is not only about
adults or immigrant professionals. It should also
include students who come to Canada from other
school systems.” He thus called for an institution
that is able to research some of the education
systems overseas and assess students’ credentials
accordingly. “When it’s not done properly, our
chances of going to the university is significantly
affected. They play with people’s lives. I know
some people who end up doing general labour jobs
because they couldn’t get into a university here in
Canada. If they had stayed in their country of origin,
they would have probably gotten a university
education that would bring them their dream jobs.
Why cannot they do it in Canada?”
The next presenter, Jai Sahak, discussed the barriers
faced by non-status people in Ontario with a
particular attention to the problems of non-status
youth in the Ontario school system. Sahak started
his presentation by giving a general background
on the topic. He discussed why and how people
become non-status in Canada:
• Many people come to Canada with a temporary
resident permit (on student visa, visitor visa, or
work permit). If they overstay their permit, they
become non-status.
• Many people whose refugee claim in Canada is
rejected may prefer to stay illegally rather than
returning to an uncertain future or even death.
• Many people come to Canada legally (sponsored
by an employer, spouse, or family member)
but then find themselves in an abusive
Resource Persons:
Ihab El Mlafi,
Settlement and Integration
Services Organization
(SISO), Hamilton,
Jai Sahak, Ryerson
University, Toronto,
Moderators:
Oana Grigorescu,
Canadian Council for
Refugees, Montreal,
Jennifer Rajasekar,
Thorncliffe
Neighbourhood Office,
Toronto,
Based on his personal
experience, El Mlafi
concluded that
“credential recognition is
not only about adults or
immigrant professionals.
It should also include
students who come to
Canada from other school
systems.”
*
Associate Writer, CIMSS.
INSCAN Vol 24 ( 1-2 ) 2010
21

Photo by CCR
The Ontario Education
Act explicitly states that
no child can be denied
access to schools on the
grounds that they, or their
families, lack immigration
status in Canada.
relationship with their sponsor. If they escape
before receiving permanent resident status, they
might become non-status.
Some people have been in Canada without status
for 10, 20, or more years. People who live without
legal status are forced to live underground and work
under the table in order to avoid being noticed by
the authorities and consequently deported. For this
reason, it is impossible to provide an accurate statistic.
It is variably estimated that there are 20,000
to 600,000 non-status people living in Canada.
These people without legal status contribute to the
economy by working (mostly in less desirable jobs),
owning their own businesses, spending money in
Canada, and by paying taxes such as GST, PST,
property tax, gas tax, and other taxes that are part
of the prices of goods. Many who have a Social Insurance
Number pay income tax as well. However,
people without legal status do not have access to
welfare or other social services, including health
care services. They cannot benefit from immigration
and settlement services such as ESL classes.
Sahak, however, mentioned a few settlement agencies,
such as Access Alliance, which try to develop
some mechanisms to help non-status people with
their various needs.
Sahak stated that one of the most vulnerable groups
among the non-status people are non-status students.
Access to public education for all children
and youth under 18 in Ontario is both a right and
a requirement under provincial law. The Ontario
Education Act explicitly states that no child can
be denied access to schools on the grounds that
they, or their families, lack immigration status in
Canada. While the law is clear, Sahak argues, there
are problems regarding enrolment procedures and
other protocols in Toronto schools. He reminded
the audience of the story where four non-status
children in Toronto schools were apprehended by
immigration officials in April of 2006 over a period
of 48 hours and they ended up being deported
together with their families. This event caused
considerable anxiety among non-status families
with school-age children. Following the event,
the Toronto District School Board voted to adopt
a “Don’t Ask, Don’t Tell” policy in May of 2007
in order to protect the rights of children and their
families by not asking for reporting or sharing
information about any student’s and the family’s
immigration status.
Sahak also shared his recent experience of calling
some of the schools in Toronto, pretending to be
a parent who wants to enrol his child in school.
“After a few minutes of conversation, questions
regarding the immigration status of the child would
always come up. Even the frontline workers at
schools, the very first people I got in contact, do
not hesitate to ask about child’s documentations
such as passports, refugee papers, or visas.” This
clearly is a violation of the “Don’t Ask, Don’t Tell”
policy. In effect, this policy would prohibit schools
from requesting information about a student or
family’s immigration status. Even if immigration
status is discovered by the schools, they would
be barred from sharing this information with
government departments such as Citizenship and
Immigration Canada and Canada Border Services
Agency. Sahak emphasized that denying students
an inalienable right to education based on their
immigration status is in violation of Section 49 of
the Ontario Education Act, which asserts the right
of non-status children to have access to education
and a safe school environment.
A safe and inclusive environment for non-status
youth in Ontario schools requires an effective enforcement
of the Education Act by training school
staff, monitoring school practices, or further policy
development. “We have to make sure that immigration
documents are not a requirement for enrolment
and that this policy is adhered to in all schools,”
says Sahak. In addition, the provincial Ministry
of Education is advised to extend the scope of
the “Don’t Ask, Don’t Tell” policy to include all
schools in Ontario as part of furthering access to
post-secondary education.
22 INSCAN Vol 24 ( 1-2 ) 2010

Refugee Women Reuniting with Their Family
Marija Gojmerac*
This workshop dealt with one of the primary
issues facing refugee women today, which
is the reunification with their families. Lisa
Wyndels, a lawyer with Neighbourhood Legal
Services in Toronto, focused on the legal aspects
of reunification in her discussion of actual cases,
most of which are from eastern and central Africa.
Blanca Lopez of the Catholic Immigration Centre
reflected on cases she dealt with as a settlement
counsellor and invited the audience to share their
personal family reunification stories.
Lisa Wyndels outlined the law and the process
related to family reunification by using, as illustration,
sponsorship cases and the problems that
arise when people apply for permanent residence
for themselves and their dependents.
Wyndels stated that, when applying as a Convention
refugee, an individual simply completes the
application form, names his/her dependents, and
pays the processing fees. An assumption is made
that the applications of both the Convention refugee
and his/her family will be processed simultaneously.
However, this may not be the case, as the
processing of such applications is done in two
separate offices and the procedure in each visa
office is very different. In other words, practices
vary widely from one location to another.
In H&C (Humanitarian and Compassionate) cases,
the individual has no status in Canada and there
is no concurrent processing procedure for dependants.
According to Wyndels, the process is convoluted.
To put it simply, an individual completes
the application and lists his/her dependents. The
applicant then achieves permanent residence status
and their dependents proceed to the secondary
application process, which is family sponsorship.
The fatal mistake that refugees and immigrants
make on their applications is the incorrect identification,
or no identification, of their dependents.
The mistake could be the result of various factors,
such as a language barrier, poor advice from government
officials, or missing relatives who cannot
be accounted for at the time of application.
Section 25 of the Immigration and Refugee Protection
Act (IRPA) has been used by many refugees
and immigrants when trying to rectify the failure to
correctly include dependents. It is a grey area where
claimants can argue the extraordinary circumstances
that led to the error. Section 25 states that:
25. (1) The Minister must, on request of
a foreign national in Canada who is inadmissible
or who does not meet the requirements
of this Act, and may, on request of a
foreign national outside Canada, examine
the circumstances concerning the foreign
national and may grant the foreign national
permanent resident status or an exemption
from any applicable criteria or obligations
of this Act if the Minister is of the opinion
that it is justified by humanitarian and
compassionate considerations relating to
the foreign national, taking into account the
best interests of a child directly affected.
Two possible outcomes can result from the application
of Section 25: There could be delays and/or
the visa office could simply decline the application
altogether. To date, the use of Section 25 of
IRPA has been met with limited success in family
reunification matters.
In 2002, with the coming into force of IRPA, a new
rule came into being (Section 117(9)(d)), which
provided that, if a dependent was not named at the
time of the application for permanent residence,
then that person cannot be sponsored. This has
made reunification much more difficult, if not
impossible. However, an individual can still ask
the visa office to consider “humanitarian and compassionate”
factors under Section 25. On the other
hand, the Nairobi Report issued by the Canadian
Council for Refugees in the fall of 2009 1 appears
to have resulted in a promise of an increase in government
resources to assist with the processing of
claims in Nairobi. To date, it is not clear that any
significant improvement has been realized.
As a final solution to the problem of reunification,
claimants may have some remedy in the court system
but it is important to get the application process
right from the start: Name all of your dependants
and pay all of the fees. To ensure the success of the
application, refugees and immigrants can approach
legal clinics, settlement sector counsellors, or MPs
(Members of Parliament) for assistance.
Blanca Lopez outlined three types of applications
for family reunification: sponsorship, H&C, and
permanent residency.
She posed some questions that we should consider
when dealing with this issue. First, how does the
visa officer think about the application? Second,
how does the visa officer respond? The reality is
Resource Persons:
Lisa Wyndels,
Neighbourhood Legal
Services, Toronto,
Blanca Lopez,
Catholic Immigration
Centre, Ottawa,
Moderators:
Heather Neufeld,
South Ottawa Community
Legal Services,
Loly Rico, FCJ Refugee
Centre, Toronto,
Lisa Wyndels outlined
the law and the process
related to family
reunification by using, as
illustration, sponsorship
cases and the problems
that arise when people
apply for permanent
residence for themselves
and their dependents.
* Nairobi: Protection Delayed, Protection Denied: .
INSCAN Vol 24 ( 1-2 ) 2010
23

Blanca Lopez outlined
three types of applications
for family reunification:
sponsorship, H&C, and
permanent residency.
that visa offices have quotas that must be met and
priorities are set based on these quotas. In addition
to this limitation, some visa offices do not have
enough staff. One way of circumventing the human
resource management problem is to hire and train
people from the local community. These realities
result in different procedures in different offices.
On a realistic and positive note, Lopez stated that
there are things in the current immigration rules
and regulations that we cannot change because it is
how the system works. However, there are things
that we can do in order to improve the process. We
always have the means to solve problems.
Following the two presentations, Loly Rico, one
of the workshop moderators, presented additional
information regarding reunification efforts. If a
claimant forgets the name of a family member,
s/he can present a written argument explaining
why s/he did not mention the dependent in the
application. In order to substantiate the written
argument, the husband and the wife (who have to
be sponsored) should submit as many documents
as possible to prove that they are truly married.
Such documents would include wedding pictures,
the marriage license, and letters from friends. If
the process has been going on for some time, then
the claimant is recommended to see his/her MP,
get legal aid, or make a request to review the visa
file for administrative notes to find out if there is
a reason why the application got stuck.
Heather Neufeld, the other moderator, also commented
that there seems to be a standard practice
where visa offices tend to discriminate against
refugees from Africa. For example, for reunification
purposes, parents of African descent have
been required to submit DNA tests to prove that
their children are indeed related to them. However,
she has never seen this requirement imposed on
refugees from Latin America.
An unfortunate outcome of the separation between
refugee parents and children is the resentment that
it can generate. When children are kept separated
from their parents for a lengthy period of time, children
tend to blame their parents for the separation.
Near the end of the workshop, the floor was opened
to the audience to ask questions and submit comments.
One such question was: How long does it
take to get sponsorship? The answer is that cases
should take anywhere from nine months to one
and a half years but they can take more than seven
years. Cases from Nairobi seem to take the longest.
The difference in processing time relates to the
location of the visa office that is processing the application.
Countries with high levels of corruption
tend to experience these delays. The priority for
visa offices is to process applications for economic
immigration first and then applications for family
reunification.
In conclusion, there are many barriers to family
reunification and they do not appear to be easing.
The tone of the workshop seemed to suggest that
there has been little progress in this area. Section
25 of IRPA seems to be growing in popular usage
among refugees but, as Lisa Wyndels mentioned,
the success rate is quite low.
Marija Gojmerac
Domestic Violence: Next Steps
The biggest threat to an
immigrant woman being
sponsored by her spouse
for permanent residence
is that her spouse has
the right to withdraw the
sponsorship at any time
while it is still in progress,
up until permanent
residence is granted.
This workshop explored the challenges faced
by immigrant and refugee women who have
experienced abuse, focusing on service delivery
and legal issues. Participants also heard about
the findings of the initial CCR work in this area,
including conference calls and interviews with
service providers, lawyers, and other parties involved.
Following the presentations, the workshop
discussed strategies to move forward with a CCR
initiative on the topic.
Harmy Mendoza, an intern at the CCR, has been
working in the settlement sector for eight years,
dealing specifically with women who have been
abused. She began the workshop with a discussion
of the difference between immigrants and refugees,
explaining that immigrants move from one place
to another voluntarily whereas refugees are forced
to leave. This difference matters because it affects
the services that newcomers to Canada can access.
Mendoza’s presentation focused on a chart called
“The Index to Marginalization: Exclusion from
Social Membership,” which asked the question
“Do I Qualify?” in relation to accessing government
services. In summary, the chart showed that
different categories of refugees have access to different
types of services and each category includes
a strong deportation threat for refugee women.
The right to access to services comes with some
service delivery challenges for the settlement sector.
People working with immigrants and refugees
usually need to access specialized services, for
example, adequate translation and interpretation
services. Also, refugee women require free counselling
in order to help them deal with their abusive
24 INSCAN Vol 24 ( 1-2 ) 2010

elationships and/or free legal advice to help them
with the immigration process. Such services are
sometimes found without any additional cost attached.
However, the demand is so high that women
are often faced with inaccessibility and the additional
burden to pay for them. Free access to legal
advice and counselling is essential for women who
have been abused and thus traumatized. Moreover,
memory may have been affected as a result of such
abuse. This memory loss could result in negative
outcomes when accuracy is essential for the completion
of the In-Canada Refugee Determination
Process. When a refugee woman presents her story
during the hearing to determine her refugee status,
her memory condition may affect her credibility.
Recommendations to deal with these challenges
included: a) the creation of a referral list of legal
counsels who are known by the Violence Against
Women service providers to provide exceptional
services to refugee women who have experienced
violence; and b) ensuring that a support worker
and/or advocate is always present when dealing
with other agencies since the support worker and
the proper interpretation may strongly influence
the access to proper legal assistance.
Heather Neufeld is an immigration and refugee
lawyer who works for South Ottawa Community
Legal Services in the nation’s capital. She
noted that, a woman who is sponsored from inside
Canada is subject to a sponsorship period of three
years. If she relies on social assistance during this
time period, her sponsor must return the money
to the government. Abused women who are being
sponsored by their husbands or boyfriends tend to
stay with their spouses. They are afraid of leaving
the relationship while the sponsorship is in progress
because they would be left without status. Even
if they do receive permanent residence, they are
often unaware that they have the right to leave their
sponsor. In addition to this potential threat, these
women are afraid to call the police to report the
abuse because they fear that their spouses will be
arrested or deported and that the government will
remove their children from the home. For these
reasons, there is a need to provide information to
abused immigrant and refugee women in their own
language so that they can be aware of their rights.
The biggest threat to an immigrant woman being
sponsored by her spouse for permanent residence
is that her spouse has the right to withdraw the
sponsorship at any time while it is still in progress,
up until permanent residence is granted. The humanitarian
and compassionate application is usually
the only alternative if a woman’s spouse does
withdraw the sponsorship while it is in progress.
In order for a woman to make her own humanitarian
and compassionate grounds application
independent of her husband, she must meet certain
Citizenship and Immigration Canada criteria
that show that she would experience hardship in
her home country and that she can demonstrate a
level of establishment in Canada. These criteria
or indicators could include such things as employment,
volunteer work, and enrolment in ESL
classes or other educational programs. However,
abused women are usually isolated from the world
around them and may not be in a position to engage
in such activities in order to prove establishment,
which further limits a woman’s chances of escaping
abuse. Another setback to independence is the
woman’s ineligibility for the Canada Child Tax
Benefit. Child benefits are linked to the mother’s
immigration status, not the birthplace of the
child. Without proof of establishment in Canada,
financial independence, and access to information
about their rights, refugee women continue to live
in abusive relationships.
In conclusion, the legal options available to immigrant
women seeking permanent residence in
Canada after experiencing abuse in this country are
limited and this exacerbates the abusive conditions
that they face in their daily lives.
Photo by CCR
Resource Persons:
Harmy Mendoza, Woman
Abuse Council of Toronto
and Canadian Council for
Refugees, and
Heather Neufeld, South
Ottawa Community
Legal Services,
Moderator:
Lisa Wyndels,
Neighbourhood Legal
Services, Toronto,
Free access to legal
advice and counselling is
essential for women who
have been abused and
thus traumatized.
INSCAN Vol 24 ( 1-2 ) 2010
25

Summer-Fall
2010
Volume 13.2-3
David Gangsei*
Canadian Network for the Health of Survivors of
Torture and Organized Violence (ResCanNet)
The Bulletin
Vicarious Trauma, Vicarious Resilience, and Self-Care
In the Spring 2010 edition of INSCAN, Dr. David
Este identified challenges related to working
conditions as a major source of stress in human
service workers. He presented approaches
for mitigating those stresses in order to maintain
the well-being and effectiveness of workers and
to sustain their involvement in this rewarding and
challenging field. This article complements that
work by examining the phenomenon of vicarious
trauma, its impact on those who work with traumatized
clients, and the importance of self-care.
Many immigrants, refugees, and asylum seekers
come to a country of refuge, having suffered extreme
trauma – torture, persecution, rape, murder
of family members, death threats, humiliations,
and the myriad of losses associated with war,
political, ethnic, or religious conflict and forced
migration. Frequently in our roles as intake workers,
service providers, counsellors, and advocates,
we find it important to learn about the traumas
that our clients have endured. We may need this
information to provide legal, medical, psychologi-
*
Independent consultant on
issues of mental health and
human rights, San Diego,
California, .
ResCanNet is a network of individuals and
groups across Canada that support survivors of
torture. The goals of ResCanNet are to facilitate
interaction between groups and individuals,
provide a stronger base of support to service
providers, and form a more coherent and powerful
voice to advocate on behalf of survivors.
Participation or membership in the network is
open to groups working directly with survivors
of torture; organizations and individuals working
with refugees; health groups; cultural groups;
and other interested persons.
ResCanNet is currently coordinated by the
Canadian Centre for Victims of Torture (CCVT).
Contact Person:
Mulugeta Abai, Executive Director
Canadian Centre for Victims of Torture
194 Jarvis Street, 2nd Floor
Toronto, Ontario
Canada M5B 2B7
Telephone: 416-363-1066, ext. 225
Fax: 416-363-2122
E-mail:
Website:
One way ResCanNet communicates is through
the Bulletin published in INSCAN. We would like
to sincerely thank INSCAN for this opportunity.
The Bulletin is developed by Ken Agar-Newman
of the Victoria Coalition for Survivors of Torture
(VCST). Brief submissions to the Bulletin are
invited and can be sent to Ken Agar-Newman,
2901 Queenston Street, Victoria, British
Columbia, Canada V8R 4P4; Fax: 250-370-8885;
E-mail: . The opinions
expressed in the Bulletin are not necessarily
those of ResCanNet.
ResCanNet is a member of the International
Rehabilitation Council for Torture Victims
(IRCT). IRCT is an independent, international
health professional organization which promotes
and supports the rehabilitation of torture victims
and the prevention of torture through nearly 200
rehabilitation centres and programs around the
world.
IRCT Secretariat:
International Rehabilitation Council for Torture
Victims
P.O. Box 2107
DK-1014 Copenhagen O, Denmark
Telephone: +45 - 33 76 06 00
Fax: +45 - 33 76 05 00
E-mail:
Website:
The ResCanNet representative on the IRCT
Board is John Docherty. John welcomes information
from torture survivors as well as individuals
and centres that work with survivors of torture.
He can be reached by e-mail at: .
The Website of ResCanNet can be visited at:
. If you wish to
subscribe to the list-serv “rescannetlist,” contact
ResCanNet at: .
26 INSCAN Vol 24 ( 1-2 ) 2010

cal or social services, or simply to provide support.
Often, we may be the first person to whom this
story has been told.
One of our most important skills for providing effective
service to traumatized clients is empathic
listening – the capacity to be present to their experience
with interest, compassion, understanding, and
resourcefulness. And it is precisely this empathic
stance, combined with our desire to help, that
makes us vulnerable to what the professional literature
variously calls secondary traumatic stress,
vicarious trauma, and compassion fatigue. I will
use the term “vicarious trauma” or “VT.”
Vicarious trauma is not a sign of weakness or
sickness, or an indication that we have chosen
the wrong profession. It is a natural and normal
process whereby the helper’s emotional experience
and relationships are disrupted or transformed by
exposure to, and empathic engagement with, the
painful trauma experiences of others. When we
open our hearts to hear someone’s story of torture,
loss, devastation, or betrayal, our cherished beliefs
are challenged and we are changed. Furthermore,
while we have a strong desire to make a positive
difference in the lives of those who come to us for
help, the work may be slow and overwhelming.
Many helpers face a sense of frustration or failure
when they hope for rapid success and transformation.
Empathic pain, together with disappointingly
slow progress, can translate into vicarious trauma.
Vicarious trauma is a process, not an event. It manifests
in a wide variety of symptoms, attitudes, and
behaviours, sometimes showing classic elements of
post-traumatic stress disorder. Symptoms I have
experienced myself are nightmares of myself or
someone else being tortured, intrusive thoughts
when I am away from work about a client’s trauma
story or worries about her current suffering and
welfare, feelings of irritability or disconnection
from friends and family, and hypersensitivity to
media portrayals of violence. Exposure to trauma
stories can have generalized impact on our health,
well-being, and view of the world. Examples
are feeling that we have no time or energy for
ourselves, generalized sadness, anxiety, anger or
helplessness, pessimism or cynicism about human
nature and the future, feeling inadequate and
doubting our ability to help others, feeling unsafe,
getting sick often, and flashbacks or memories of
our own past traumatic experiences.
Although we may call these experiences understandable
and even normal responses to repeated
exposure to the painful side of reality, they can
definitely cause problems, leading to impairment
in our quality of life and our effectiveness in our
work. Some consequences are absenteeism, loss of
INSCAN Vol 24 ( 1-2 ) 2010
motivation or ability to work, and even disability
or leaving the field.
Given these realities, self-care is a necessary and
essential part of both individual and organizational
approaches to the work. At both levels, it is important
to follow principles we can call A – B – C
(Awareness, Balance, and Connection).
Awareness means recognizing that vicarious
trauma is real. Simply naming it can relieve some
of the impact by providing a measure of cognitive
control. This requires formal recognition of the
issue at the management and supervisory level,
education and training for all staff, and mechanisms
for ongoing and supportive attention to the
issue. At Survivors of Torture, International in
San Diego, where I served as clinical director for
eight years, the clinical service staff has a monthly
meeting for 90 minutes, as part of the work schedule,
called VT and Self-Care. The guidelines were
confidentiality, respect, and conversation focused
only on ourselves, our VT experiences, and our
self-care activities.
Balance means maintaining a balance within
work and between work and the rest of life. At the
individual level, this means attention to healthy
lifestyle, including sleep, diet, exercise, and monitoring
for risky or harmful behaviours. Human
service workers are typically highly dedicated
people whose passion to help their clients can lead
to overwork and neglect of other aspects of life. The
endemic NGO condition of too much to do with
too few resources encourages this practice. Consciously
taking time for recreational, social, and
spiritual pursuits is essential. For me, hiking in the
mountains and listening to jazz are activities that
keep me consciously and intentionally connected to
what is positive and beautiful in the world. Limiting
exposure to violence in print and visual material,
especially before bedtime, may be important. At
the organizational level, balance means making
sure that staff members take their vacation and
making that vacation as generous as possible,
providing variety in work assignments, managing
the size and variety of client caseloads, recognizing
achievements, and ensuring mechanisms for
staff to contribute their ideas to the organization’s
program.
Contact means having specific other people with
whom to share the difficult emotions of traumaoriented
work ‒ sadness, anger, frustration, demoralization,
or fearfulness – and also the pleasures
and satisfactions of that work. In my experience,
the most helpful people in this regard are coworkers
and colleagues doing similar work. They
are most likely to be interested and to understand.
At Survivors of Torture, International, our monthly
One of our most
important skills for
providing effective service
to traumatized clients is
empathic listening – the
capacity to be present
to their experience with
interest, compassion,
understanding, and
resourcefulness.
27

This led me to coin the
term “vicarious resilience”
to describe how exposure
to our clients’ abilities
to go forward in life after
torture, tragedy, and loss
has a positive impact on
our experience of our own
lives.
meeting created a culture of awareness and trust
in which staff members frequently approach each
other informally for a “VT consult.”
A final key component of self-care is conscious
recognition and celebration of the satisfactions
and successes of our work. As clinical director
at Survivors, I noticed that some of the therapists
described the work as uplifting and inspiring. This
led me to coin the term “vicarious resilience” to
describe how exposure to our clients’ abilities
to go forward in life after torture, tragedy, and
loss has a positive impact on our experience of
our own lives. My investigations with colleagues
have identified specific dimensions of vicarious
resilience – witnessing and drawing strength from
the human capacity for healing, developing a more
realistic perspective on our own problems and
empowerment to deal with them, enhanced appreciation
for spiritual dimensions of experience,
appreciation of the positive dimensions of our own
lives, reaffirmation of the value of our work, and a
strengthened commitment to remain engaged with
our profession and our clients.
One human rights worker I spoke with said she had
been told to expect to last no more than three years
in the job. With proper attention to organizational
stressors and vicarious trauma, we can sustain our
energy and commitment even for a whole career,
sharing our much needed wisdom and experience
with our clients, our organizations, and our movements
for justice and human rights.
Resources
Este, David. 2010. “Immigrant Settlement Workers
and Self-Care: A Necessity.” INSCAN (International
Settlement Canada) 23 (4): 1, 3-4.
Gentry, J. Eric. 2002. “Compassion Fatigue: A
Crucible of Transformation.” Journal of Trauma
Practice 1 (3/4): 37-61.
Hernandez, Pilar; Gangsei, David; and Engstrom,
David. 2007. “Vicarious Resilience: A New Concept.”
Family Process 46 (2): 229-241.
Meichenbaum, Donald. 2007. Self-Care for
Trauma Psychotherapists and Caregivers: Individual,
Social and Organizational Interventions.
Downloaded from on December 24, 2010.
Saakvitne, Karen W.; and Pearlman, Laurie A.
1996. Transforming the Pain: A Workbook on
Vicarious Traumatization. New York: Norton.
28 INSCAN Vol 24 ( 1-2 ) 2010