The Toll It Takes

by Tim Gorman

The words don’t get any easier to hear. Similar words, time after time, member after member frustrated, confused, angry, tired and losing hope. “Sometimes I feel like I don’t know who I am anymore because I’m not a doctor and I used to be. I’m like nobody now.”¹ Indeed. Who are you now?

I often try to imagine how it feels to go from being a respected physician in your country—a pediatrician, psychiatrist, family doctor—to living in Canada. You face a long road of cultural obstacles, qualifying exams, language exams, OSCEs, MMIs, fully aware that there’s a slim chance you’ll practice medicine here. It must be exceptionally difficult. And alongside the loss of so many other things, it must be heartbreaking.

While it’s true we’re currently seeing more members than ever achieving their goals and getting licensed in Canada, we see many more who don’t. To make it worse, the process of selection is often perceived by IMGs as arbitrary and confusing. “The system is subjective. Unfortunately, I don’t understand how it works. Nobody understands how it works.” Another member put it this way: “Nobody knows if after passing all the exams if you will be in the system. Nobody knows why [the answer] is yes or no. If I pass everything successfully, put me in the system. Give me my license. Give me the opportunity to work as a physician.” If it were only that simple.

“I actually cried. The competition is so much. I felt like, ‘Oh my God. What am I going to do? I’m in Canada and this is happening to me.”

The seemingly arbitrary process isn’t the only thing that frustrates. Many IMGs don’t realize how many others are fighting to get into the same residency positions as they are. One of our members had this to say when realizing her good NAC-OSCE score wasn’t going to cut it. “I actually cried. The competition is so much. I felt like, ‘Oh my God. What am I going to do? I’m in Canada and this is happening to me.’ That competition. Sometimes it gets to you.”

To be sure, the road to licensure in Canada can be a difficult one. It can lead foreign trained physicians through survival jobs and stresses they couldn’t have previously imagined. “We are working together as nursing attendants. I’m driving a school bus as well in the morning and afternoon. In the meantime, I’m studying, doing Observership, going to classes and courses. And we still have lots of problems. I’m not talking about only financial, I’m talking about parents, relatives. I’m talking about the situation at home. It’s very tense. You don’t know if you’ll be successful.” It’s a significant blow for most IMGs coming to Canada full of hope.

It’s especially significant when you consider the top five reasons IMGs choose to come to Canada in the first place:²

  • socioeconomic or political situations in their home country;
  • better education for their children;
  • concerns about where to raise children;
  • quality of facilities and equipment;
  • lack of opportunities for professional advancement.

In addition, many IMGs felt they were misinformed regarding the likelihood of securing a residency position in Canada. As a result, many regret their decision to move to Canada and feel shame because they need to take on survival jobs while in the process.

At AIMGA we do our best to understand and to empathize with the realities of our member’s lives and for the most part, I believe we do. But it’s not the same as living with the toll it takes every day. We don’t have to live with loss of status, of identity. We don’t have to risk our manicured, surgical hands doing construction work when the bills are overdue. We don’t have to look our family members in the eyes and explain that what we hoped for is not coming anytime soon. The toll it takes is palpable.

It’s a lot to think about. There are many things to reconcile. Perhaps one of our members put it best when she simply said, “We want our kids not to feel disappointment when they look at us.”

The toll it takes is real. We see it every day. Perhaps it’s time to talk about it.


1. All quotations are from interviews with AIMGA members.
2. Aisha Lofters, Morgan Slater, Nishit Fumakia, and Naomi Thulien, “Brain Drain” and “Brain Waste”: Experiences  of International Medical Graduates in Ontario, Toronto, DovePress, 2015.

1 thought on “The Toll It Takes”

  1. Oh, wow great, Ok, you said it all!!
    well do you think the officials here in this country who are in charge of this matter don’t know every word you mentioned?
    I pet you they do!! but as they usually say “who cares”
    We have to understand that we are IMGs taking their kids opportunities. We should not hide this fact!!
    yes we are immigrants just like every one came to this country in the first place; however, the system wants the IMG and all professionals to cover the needs of this country without jeopardizing the best opportunity for the first comer!!
    I mean lets face it, wouldn’t be wonderful to have a taxi driver who’s use to be a successful cardiologist in his original country? of course they’ll like it, no more worry to die from a heart attack while you’re in a taxi!!
    what’s really troubling, is that this country immigration system still calling and promoting for professionals (and only professionals) of other countries to immigrate, and only to make their life miserable!

Leave a Reply

Your email address will not be published. Required fields are marked *