(*Some of the immigrant physicians featured in these stories have chosen to remain anonymous because of fear of reprisal from the medical system if they speak out publicly)
I'm originally from Iran. I received my Medical Diploma in 1997 from one of Iran’s leading Medical Schools in Tehran. After graduation, I worked as a general practitioner in rural and underserved areas for two years. I came first in the obstetrician-gynecologist residency entrance exam and completed a four year residency in 2003. I worked as an Obstetrician/gynecologist for eight years initially in an academic hospital and then in the largest and busiest centre in Iran with 25 deliveries per day. I had a good amount of knowledge and experience during the 10 years of practice in Iran.
As a result of the social and political unrest in Iran, my husband and I made the decision to leave. We had applied to Canadian Immigration as skilled workers in 2005. After about six years our application was approved. We immigrated to Canada in 2011. We moved to Vancouver, BC.
Because we applied as skilled workers and were approved because both my husband and I were physicians, I expected that after a while maybe two years or three years maximum, we would be able to get into the medical system and work as physicians again.
Even knowing that getting into a residency position in Canada is very hard, I thought that because of my experience and if I passed all the exams and followed all the rules, I would have a chance.
So from the moment I landed in Vancouver, I went to the library and started studying for the exams. There were five exams I had to take. I had to take the TOEFL five times because the required scores are hard to meet. All the scores for Reading, Listening, Speaking and Writing have to be the same. Even though I scored 96 out of a 100 overall three times, I had to retake the exam three times because my listening score was 23 and my writing was 28. It is really unfair and it doesn’t make sense at all.
After two to three years, I was ready to apply to the Canadian Residency Matching Service (CaRMS). I obtained my LMCC and passed the NAC OSCE as well. I also started volunteering to strengthen my CV and became a visiting researcher at UBC. I took a course – Professional Communication for Internationally Educated Health Professionals (IEHPs) at KWANTLEN POLYTECHNIC UNIVERSITY in BC. I worked in different positions such as a clinical trainee in Family Medicine and Clinical Surgical Assistant in Calgary, hoping to get matched to an Obstetrician/gynecologist residency.
There were just three OB GYN positions offered to IMGs across the whole country: one in Ottawa, one at McMaster, and one in Toronto. I realized that this is more about luck, like a lottery than a residency match. With just three positions I realized it would be impossible for me as there would be hundreds of other experienced IMGs applying for these OB GYN positions. So I expected to be rejected and decided to apply for a family medicine match. I thought that with my OB GYN experience I would have a fair chance at a match. I participated in CARMS twice but did not receive any interviews in OB GYN or Family Medicine. I decided to move to Calgary to apply for the clinical and surgical assistant program. I was eligible for a conditional license as an Obstetrician/gynecologist specialist in Calgary but was rejected for any positions because I was not a graduate of a Canadian or American medical school. So after a few months, I was unemployed again. In 2015, after four years of struggling I realized that I would probably not be able to make it. I had spent a lot of money and I was totally traumatized. I experienced a lot of frustration and embarrassment. I really paid a high emotional and financial cost over the four years and yet my husband and I were unemployed and we had used up all of our savings from Iran. It also put a lot of pressure on our family and my son.
I had to apply for a line of credit to cover my family expenses and the high cost of the exams and the expensive courses I had to take. I am still paying the line of credit off even after five years.
I started to search for positions in the US and I got an Observership in California. Everybody was very helpful. In the US the approach is totally different for IMGs. The people in medicine I have been in contact with are very friendly and are open to help. I continued my work as a visiting researcher for 1.5 years in the US and completed the US Medical Licensing Examination (USMLE) steps and received the ECFMG certificate. After publishing a couple of papers, I was finally matched to a general surgery preliminary residency in 2017 followed by Preliminary 2 in general surgery in another medical center in the US. In 2020, I was matched to an Obstetrician/gynecologist residency at another medical center. After three years of residency I got my license as a physician in NY and I am looking forward to completing my residency and becoming a Board Certified physician in the US.
I wanted to share my experience because every day I hear about one of my friends who has a lot of knowledge and good experience and who came to Canada hoping that they would find a position but are still unemployed. They are underutilized and it’s not fair to them or the Canadian people who have to wait such a long time to see a specialist or don’t have access to a primary care physician. IMGs have experience and have passed all the exams with good scores and deserve an opportunity to practice in Canada. The experience for IMGs in Canada destroys families because if they cannot afford the expense of living in Canada and the cost of exams, they have to go back and forth to their country to earn a living or they end up in other non-medical jobs or professions when they have the knowledge and experience in medicine and can be an asset to this filed field especially now during COVID.
I don't understand why the system works like this in Canada and why they lose the physicians that they need.