Licensing international medical graduates
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* T.B. MacLachlan

Rodney Andrew and Joanna Bates recently reported on an attempt to manage the significant problems surrounding the licensing of international medical graduates (IMGs) in British Columbia.1 The financial burden must be significant, yet this solution only accommodates 6% to 8% of eligible applicants. It will not satisfy the BC applicants who are not selected, nor the many more scattered across the country.

It should be no surprise that none of the successful candidates has left Canada for the United States, since this is becoming more difficult these days. The fact that only 4 candidates were recognized to have attitudinal difficulties is not surprising either. Most faculty give only lip service to this topic, and avoid it if possible.

I found parts of the report unclear. If, as they say, "No passing grades are set; IMGs compete against each other at each step ...," how are the top 2 candidates selected? The assumption would be that a bell curve was created from the grading system and a cut-off determined. If the selection is based on subjective evaluation, BC may face appeals by those not chosen. How is this eventuality avoided?

Finally, the federal government has created this problem, since immigration is a federal authority. IMGs should be clearly informed about the licensing problems they will face before they arrive in Canada. The federal government decides who is allowed to immigrate to Canada and knows the professional status of immigrants. It should either be prepared to tell the IMGs that most of them will be unable to practise in Canada, or it should pay the total cost of the selection process and the training required.

The BC Human Rights Commission's ruling involving 5 foreign-trained physicians must be appealed.2 The commission seems to be unaware of the provincial college's role in protecting the Canadian public.

## References

1.  1. Andrew R, Bates J. Program for licensure for international medical graduates in British Columbia: 7 years' experience. CMAJ 2000;162(6): 801-3.
    
    [Abstract/FREE Full Text](http://www.cmaj.ca/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiQUJTVCI7czoxMToiam91cm5hbENvZGUiO3M6NDoiY21haiI7czo1OiJyZXNpZCI7czo5OiIxNjIvNi84MDEiO3M6NDoiYXRvbSI7czoyMjoiL2NtYWovMTYzLzMvMjYwLjIuYXRvbSI7fXM6ODoiZnJhZ21lbnQiO3M6MDoiIjt9) 

2.  2. Kent H. College to appeal discrimination ruling. CMAJ 2000;162(6):854.
    
    [FREE Full Text](http://www.cmaj.ca/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiRlVMTCI7czoxMToiam91cm5hbENvZGUiO3M6NDoiY21haiI7czo1OiJyZXNpZCI7czo5OiIxNjIvNi84NTQiO3M6NDoiYXRvbSI7czoyMjoiL2NtYWovMTYzLzMvMjYwLjIuYXRvbSI7fXM6ODoiZnJhZ21lbnQiO3M6MDoiIjt9)