Internationally-Educated Health Internationally-Educated Health Professionals Seeking Entry into the Professionals Seeking Entry into the Canadian Labour Market:Canadian Labour Market:Exploring Adjustments of Post-Secondary Exploring Adjustments of Post-Secondary InstitutionsInstitutions

Lillie Lum, Lillie Lum, Ph.D.Ph.D. York University, Ontario, Canada York University, Ontario, Canada

88th National th National Metropolis Conference, March 23-26, 2006 Metropolis Conference, March 23-26, 2006

AcknowledgementAcknowledgement

Research jointly funded by Social Sciences Research jointly funded by Social Sciences and Humanities Research Council and Humanities Research Council

(SSHRC), Human Resources and Skills (SSHRC), Human Resources and Skills Development Canada (HRSDC) & Development Canada (HRSDC) &

Industry CanadaIndustry Canada

Co-Investigator: Sheryl Nestel, OISE/UTorontoCo-Investigator: Sheryl Nestel, OISE/UToronto

Employment Integration Employment Integration Problems for ImmigrantsProblems for Immigrants

► Underutilization of highly qualified, skilled Underutilization of highly qualified, skilled new immigrants (Statistics Canada, 2002) new immigrants (Statistics Canada, 2002)

► Exclusionary regulatory process, ie. gate Exclusionary regulatory process, ie. gate being narrow (Alboim et al. 2005)being narrow (Alboim et al. 2005)

► Increased numbers of skilled immigrants but Increased numbers of skilled immigrants but downward trend in earnings within last downward trend in earnings within last decade (Reitz, 2005)decade (Reitz, 2005)

► Solutions are ineffective in addressing Solutions are ineffective in addressing health professions skill shortage; supply health professions skill shortage; supply and demand problems persist (C.N.A., 2005; and demand problems persist (C.N.A., 2005; Hawthorne, 2001) Hawthorne, 2001)

Context: Context: WWhat is unique about Western Health hat is unique about Western Health Professions ?Professions ?

► Governed by profession-specific regulatory Governed by profession-specific regulatory colleges, eg. College of Physicians and colleges, eg. College of Physicians and Surgeons, College of Nurses, College of Surgeons, College of Nurses, College of Teachers….Teachers….

► All members must demonstrate competence All members must demonstrate competence in pre-determined profession-specific in pre-determined profession-specific standards (C.N.A., 2005)standards (C.N.A., 2005)

► Bridging education programs is often a Bridging education programs is often a requirement prior to licensure or registrationrequirement prior to licensure or registration

► Healthcare in North American is highly Healthcare in North American is highly standardized and technology-based practicestandardized and technology-based practice

Regulated ProfessionsRegulated Professions

REGULATORY COLLEGES REGULATORY COLLEGES HAVE delegated authority HAVE delegated authority through legislationthrough legislation

set policies, procedures set policies, procedures and practices for admitting and practices for admitting new members to the new members to the registryregistry

issues licences or issues licences or registrationregistration

role to protect public and role to protect public and members through members through ensuring standardized ensuring standardized competencies are met.competencies are met.

Success rates of International/Canadian Success rates of International/Canadian Health and Other Candidates on Registration Health and Other Candidates on Registration

ExamsExams (Ontario Regulators for Access, 2003)-38 Professions(Ontario Regulators for Access, 2003)-38 Professions

0

20

40

60

80

100

120

a b c c d f g h i j

International

Local

Professional Bridging Professional Bridging Education Education

► Bridging Education ProgramsBridging Education Programs

Post-secondary educational programs offered Post-secondary educational programs offered by either community colleges (diploma by either community colleges (diploma granting) and universities (degree granting) granting) and universities (degree granting) to provide additional knowledge/skills based to provide additional knowledge/skills based on credential and competency assessments; on credential and competency assessments; part or full time status; varies from several part or full time status; varies from several months to 2 years.months to 2 years.

Bridging Education continued…Bridging Education continued…

► Success rates of students-No data available!Success rates of students-No data available!► In Ontario, 19 of the 30 regulatory bodies In Ontario, 19 of the 30 regulatory bodies

can refer applicants to bridging programscan refer applicants to bridging programs► 6 of these regulatory bodies serve in 6 of these regulatory bodies serve in

advisory capacity to bridging programsadvisory capacity to bridging programs► Health professions bridging programs Health professions bridging programs

include nursing, midwifery, medical include nursing, midwifery, medical technicians, physiotherapy and pharmacytechnicians, physiotherapy and pharmacy

Identified Best Practices:Identified Best Practices: ‘Good Bridging Programs’ ‘Good Bridging Programs’

(CIITE Report, 2004)(CIITE Report, 2004)

► Good fit between student learning needs and programGood fit between student learning needs and program► Collaboration between key stakeholders, such as Collaboration between key stakeholders, such as

regulators and PSEregulators and PSE► Effective profession-specific language trainingEffective profession-specific language training► Comprehensive academic and social support servicesComprehensive academic and social support services► Stable program funding Stable program funding ► Financial assistance (student loans, scholarships) and Financial assistance (student loans, scholarships) and

access to additional non-financial resourcesaccess to additional non-financial resources► Faculty development to upgrade expertiseFaculty development to upgrade expertise► Genuine administrative support for continuity of Genuine administrative support for continuity of

programprogram► Alumni follow-up to job entryAlumni follow-up to job entry

Overview of Post-Secondary Overview of Post-Secondary Institutional AdjustmentInstitutional Adjustment

► $$$ many institutions $$$ many institutions report overall under-report overall under-fundingfunding

► Bridging education is not Bridging education is not a big revenue generatora big revenue generator

► Major differences in Major differences in mandate between mandate between colleges (skill colleges (skill development) and development) and universities (scholarship, universities (scholarship, innovation, research) in innovation, research) in educational philosophy educational philosophy and operations (Rae and operations (Rae Report, 2005)Report, 2005)

► Curriculum tends to be Curriculum tends to be based on Westernized based on Westernized as compared to global as compared to global view of view of healthcare/educationhealthcare/education

► Specialized programs, Specialized programs, such as bridging such as bridging education are not part education are not part of mainstream of mainstream

► Operate independently Operate independently of industry demands, of industry demands, health professions, health professions, regulatory and regulatory and government directivesgovernment directives

Why are there so few good Why are there so few good programs?….programs?….

Operational IssuesOperational Issues-limited access for students -limited access for students -lack of sustained program funding-lack of sustained program funding-debate regarding integrated or independent -debate regarding integrated or independent programmingprogramming-lack of best practice standards regarding curriculum -lack of best practice standards regarding curriculum design and teaching/learning practicesdesign and teaching/learning practices-tend to be marginalized from mainstream-tend to be marginalized from mainstream

Leadership IssuesLeadership Issues-competition between colleges and university for -competition between colleges and university for fundingfunding-lack of collaboration between professions, industry-lack of collaboration between professions, industry

-role of government unclear, possibly not desired-role of government unclear, possibly not desired

Proposed Changes to PSE Bridging Proposed Changes to PSE Bridging EducationEducation

►Student PerspectivesStudent Perspectives Financial support mechanisms, e.g. bursary, Financial support mechanisms, e.g. bursary,

loans for part time studentsloans for part time students Integrated language training courses, with a Integrated language training courses, with a

focus on technical professional conceptsfocus on technical professional concepts Comprehensive technological and academic Comprehensive technological and academic

student servicesstudent services Opportunities for socialization into profession-Opportunities for socialization into profession-

specific practicesspecific practices

Proposed Changes to PSE Bridging Proposed Changes to PSE Bridging EducationEducation

►PSE Institutional PerspectivesPSE Institutional Perspectives Integrated programs with sustainable Integrated programs with sustainable

funding for educational program and funding for educational program and other student servicesother student services

Faculty development in curricular and Faculty development in curricular and teaching practiceteaching practice

Increased role of government in Increased role of government in provision of funding; support provision of funding; support development of best practice standardsdevelopment of best practice standards

Partnerships with regulators, Partnerships with regulators, professional associations and professional associations and employers employers

Bridging EducationBridging EducationCertificate of ExcellenceCertificate of Excellence

►[Post-secondary Institution] [Post-secondary Institution] for for outstanding performance and lasting contribution outstanding performance and lasting contribution onon

Granted: Granted: April 10, 2023April 10, 2023

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