Mariana da Silva Jardim is an unemployed immigrant physician in what is now known as Vancouver, BC.
A while ago I saw an ad on the Internet from a physician, in Ontario, looking for an international medical graduate (IMG) to work, as a medical assistant, for $15 (Canadian) per hour.
I am an immigrant and an IMG, but my partner is neither. Born and raised in British Columbia (BC), and not a doctor, when he saw this wage offering, he was surprised. He hadn’t worked a job that paid that little since he was a teenager decades ago.
I left my family, my friends, my culture and my medical career in March of 2019. After I finished my medical residency, my partner convinced me to emigrate, saying “we need more doctors in Canada”. I have now heard the same speech from his family (his mother, a family physician herself), friends and from almost every Canadian I have met so far. But does the Canadian healthcare system need or want immigrant physicians?
As of 2019, 26% of Canadian physicians were IMGs (immigrants and non immigrants). In Saskatchewan, 1 in every 2 physicians is an IMG. At the same time, around 15% of Canadians still do not have a regular healthcare provider and Canada ranks 27th out of 36 OECD countries on number of doctors per 1000 population.
So, yes, it seems reasonable to say that Canada might benefit from people like me. And, in fact, our medical degrees, postgraduate training and experience as physicians count as valuable points facilitating our immigration to the country. So why, when we arrive, does it appear that our education and skills are undervalued?
As much as I imagine that the physician offering the job position was doing so with really good intentions, I could not avoid thinking: “Is this how much a foreign doctor’s knowledge and competency are worth?” – less than the minimum livable wage for the area. That is what we are worth, while spending thousands of dollars trying to become a practitioner in the country.
Every year, hundreds of immigrant physicians land in Canada, but for every inspirational story there are many more less successful ones. There are those who decide to postpone, or give up, their clinical practice dreams and there are those who end up driving taxis, babysitting or mopping as a way to get enough resources for paying all of the expenses in the path to become a clinical physician in Canada. And I am no different.
For a year, I worked in a homeless shelter in a lovely small town, in a position where I had to mop, cook, unclog and clean. There I learned about a side of Canada different from the untarnished facade – the homelessness, opioid crisis and marginalization of Indigenous peoples and minorities – and, although I am extremely thankful for the opportunity I had, that was also the place where I experienced my personal “brain waste”.
During that year I craved the challenge of an intriguing clinical case, the unique human connection of the physician-patient relationship and the rush of adrenaline when facing a human being who needs urgent care. I missed the clinical thinking and the feeling one has when receiving a “thank you” from a patient. I missed using parts of my mind I have been nurturing for the past decade.
As I had spent half of my year’s income on expenses related to (one day) practicing medicine in Canada, my partner and I decided to move to a metropolitan area in search of better opportunities for my professional growth. Here I found myself reading yet another interesting job position. “Medical Student Immunizer – COVID-19 vaccinations” for $28.33 per hour – this time in BC. I tried to apply but, as I am just an immigrant physician and not an enrolled medical student in Canada, I did not fulfill the requirements and could not get the job.
Some people might wonder: “Why don’t these doctors just go back to their home country?” The answer is very simple. When most of us emigrate because of socioeconomic or political situations and worry about providing the best life possible for our children, how does one go back? When those are the reasons why my Canadian partner did not want to stay in my home country, how do I convince him otherwise?
In the next three years, Canada’s government is planning to admit a total of 1,2 million Permanent Residents (PR). Immigrant physicians, inevitably, will be part of the sum. And the questions I am presenting will continue to exist for as long as there will be physicians with useable skills who are not allowed to practice in the medical field.
The truth is no system is fair, and Canada is seeking to make it better for immigrant physicians. But changes are only incremental and slow to be implemented. In the meantime, many of Canada’s doctors of tomorrow are mopping floors today and wishing to use their brains in the ways they spent so many years training for.