Association of International Physicians and Surgeons of Ontario

Association helping to clear barriers for foreign-trained doctors

In just five years, the Association of International Physicians and Surgeons of Ontario (AIPSO) has evolved from an idea to a successful organization.

Founded in 1999, with the help of a grant from Maytree, AIPSO began as a handful of immigrant doctors looking to reduce barriers faced by internationally trained physicians. Membership dues and grants from Heritage Canada currently sustain the Association, which now has over 1,100 members.

“We’ve created a recognized and legitimate voice for internationally trained doctors,” says AIPSO’s executive director Joan Atlin. “Our membership is large enough now that senior officials come to us for input when they are developing policy.”

Grant Summary:
$117,600 to create a public awareness organization for internationally-trained doctors that
will conduct research, advance policy alternatives, and cultivate partnerships.

The Ontario Government borrowed heavily from AIPSO’s recommendations when it unveiled its plan to integrate immigrant doctors last fall. The Premier promised to increase the number of residency training positions open to international medical graduates, and vowed to do a better job of assessing the skills of foreign trained doctors rather than simply requiring them to re-do their post-graduate residency training. AIPSO was an influencing factor in the province’s decision to develop a program that directs foreign medical graduates into three different training programs.

“AIPSO has been instrumental in shaping the support structure for International Medical Graduates (IMGs) that now exists in Ontario,” says John Whetherby, a spokesperson at the Ministry of Health. “AIPSO continues to assist IMGs by influencing the direction of Ontario’s IMG programs while contributing to the design and operation of upcoming government initiatives.”

The association recently became a key player on a new national task force that is examining ways to reduce hurdles faced by internationally trained physicians. How has AIPSO become a force in such a short time? AIPSO president Uday Shankardass says his organization has learned the critical role that media attention plays in mobilizing public support for its issues.

“We have learned the need to catch and maintain the attention of the relevant professional regulatory bodies, as well as the public, with credible analysis of issues and solutions,” he says. Indeed, AIPSO’s issues are very much on the public mind these days. The Ontario Medical Association estimates that the province requires an extra 1,600 physicians, and nearly one million Ontarians complain that they receive insufficient health care.

In addition to producing proposals that address the public’s concern with the doctor shortage, AIPSO has also tried to develop policies that resonate with the lives and experiences of its members, Shankardass says.

One of those members is Hector Fernandez, who was a successful endocrinologist in Chile where he ran a regional diabetes authority. But when he immigrated to Canada in 1987, Fernandez ended up fixing carburetors because his foreign credentials were virtually unrecognized.

Unfortunately, the Chilean doctor arrived in Ontario at a time when healthcare planners were predicting a surplus of physicians across Canada. In order to limit access for IMGs in response to the predicted surpluses, Ontario established the Ontario International Medical Graduate Program (OIMGP), a 48-week long course that assesses whether the internationally-trained doctor is ready to start their residency. There are only a limited number of OIMGP spots available (in the 1980s there were 24 spaces, now there are 50). After completing the program, the OIMGP grad has to apply for a restricted number of residency spots. Essentially, this means that even a doctor considered fully trained in their home countries has start their residency from
scratch.

But Fernandez began to feel like he could change this system when he became active with AIPSO a few years ago.

“It opened the door for me because I knew that there was a whole team of committed, organized, and effective doctors involved,” says Fernandez. Fernandez is still not a practicing physician. However his perspective and his experiences are proving invaluable to AIPSO in its deliberations about changes to current policies and programs.

But as AIPSO grows, it becomes more difficult to ensure that the leadership retains its connection to the average member.

“When you consider the rate at which we have grown, it is no surprise that we have experienced growing pains. We started as 30 members, and now we have more than 1,100 members to answer to. All of these people have different ideas, views and needs, so you can well imagine that our task is much more complicated now.”

In the future, AIPSO will work on finding governmental structures that ensure its effective representation of a growing membership.

The association is also working on a new initiative — in partnership with stakeholders — to develop a program that will help foreign-trained physicians find related employment in other healthcare fields.