The National IMG Database
Tracking the Assessment, Certification and Licensing of International Medical Graduates in Canada
Steve Slade, VP Research and Analysis
Tamara Brown, Project Manager
Canadian Post-MD Education Registry
Association of Faculties of Medicine of Canada
Tracking Successful Practices and Outcomes
The History Behind the IMG Database
Primary Drivers of FQR for Physicians
• Increased immigration of medical graduates to Canada
• Balancing our need for physicians with public safety
• Growing emphasis on foreign credential recognition and standardization
• Ethical recruitment and treatment of IMGs
Data in an Evolving ContextNumber of IMGs in the Active Physician Workforce, Canada, 1994-2008
History of the National IMG Database
2004 Canadian Task Force on the Licensure of International Medical Graduates
2005-2009 Phase 1: Foundational Activities
2010-2013 Phase 2: Development of an Analytical Agenda and Increasing Project Visibility
Phase 1: Building Partnerships
• Medical Council of Canada (MCC)
• 7 IMG assessment centres
• 17 Faculties of Medicine
• The College of Family Physicians of Canada (CFPC)
• The Royal College of Physicians and Surgeons of Canada (RCPSC)
• Collège des médecins du Québec (CMQ)
• 9 regulatory authorities
Phase 2: Outcomes and Indicators
For Example…
Outcome: Transparent, appropriate and expeditious pathways to practice
• Indicator: numbers traversing various pathways• Indicator: average time between milestone events
Outcome: Increased standardization across jurisdictions• Indicator: frequency of milestone events across
jurisdictions• Indicator: frequency of migration across jurisdictions
Tools and Strategies to Track IMGs
Effective Indicators for Evaluating Progress towards Outcomes
Four critical indicators along the path to licensure:
•Success on Medical Council of Canada (MCC) Exams
•Entry into postgraduate training (residency)
•Certification with the CFPC, CMQ, or RCPSC
•Licensure with a Canadian Regulatory Authority
MCCQEE MCCQEI MCCQEII
Number of IMGs who passed MCC Examinations, 2005-2010
10280
57623693
3462
2135
1521
0
2000
4000
6000
8000
10000
12000
14000
16000
MCCEE MCCQEI MCCQEII
Num
ber o
f IM
Gs
Medical Council of Canada (MCC) Exams
Canadian Citizens
Non-Canadian Citizens
Data in an Evolving Context Increased Number of First Year Post-MD Trainees
Source: CAPER, AFMC, 2010. Note: Excludes visa trainees.
1471 1436 1447 1579 1640 1799 1894 1976 20882273 2419
77 138 197185
289259
360404
416
467426
0
500
1000
1500
2000
2500
3000
2000-01 2001-02 2002-03 2003-04 2004-05 2005-06 2006-07 2007-08 2008-09 2009-10 2010-11
Number of PGY1 Post-MD Trainees by Place of MD Graduation, Canada, 2000-01 to 2010-11
MD Outside Canada (up 453%) MD in Canada (up 64%)
MCCEE
MCCQEI & MCCQEII
PGME
CFPC/RCPSC/CMQ
LICENSURE
Following a Cohort of Canadian Citizen IMGs
ASSESSEMENT
114
1491
461
322
144
41
CERTIFICATION WITH RCPSC/CFPC/CMQ
2522
EE
1147
QEI
1530QEII
1245
Licensed
829
PGME
1681
2008-2010
LICENSED
2604
EE
1647
QEI
1256QEII
763
Certified
633
PGME
377
2008-2010
Data Gaps versus Knowledge Gaps
Data Gaps
• Country where MCCEE is written (many write the EE abroad)
• When was citizenship gained
• Pre-medical experiences/education
• MD program experiences
Clerkship component?
Clinical elective in Canada?
PREDICTORS OF SUCCESS
PREDICTORS OF RETENTION
CROSS-JURISDICTIONAL
ANALYSIS
PATHWAYS AND PROCESSES
Knowledge Gaps – Plans for Future Analysis
ALTERNATIVES FOR
UNSUCCESSFUL IMGs
Thank you.
This project is funded by the Government of Canada's Foreign Credential Recognition Program.
The IMGs in Canada Project Team:Steve Slade, VP, Research and Analysis CAPER-ORISTamara Brown, Project Manager, [email protected] Bourgeois, Research Associate, [email protected]
