ImanITP

ITP vs IMG: Why Words Matter for Canada’s Internationally Trained Physicians

Written by Dr VK. Gbenro and Dr T Hussain (Policy, Advocacy & Research Committee, ITPC)

Introduction

Ever wondered why the term “International Medical Graduate (IMG)” is used so widely to describe physicians who received their training abroad? At first glance, the phrase appears official and established. It’s seen throughout the Canadian Resident Matching Service (CaRMS), the Medical Council of Canada (MCC), and the Royal College of Physicians and Surgeons of Canada (RCPSC). For decades, IMG has served as the umbrella term for all physicians educated outside Canada.

However, there’s been a gradual but meaningful shift. Increasingly, organizations and advocacy bodies are beginning to recognize the term “Internationally Trained Physician (ITP)” as a more accurate and inclusive descriptor. This evolving language reflects a growing acknowledgment that many internationally trained doctors are not merely “graduates” seeking their first opportunity to practice, but experienced physicians with years, often decades, of professional expertise.

This positive change in terminology is more than linguistic; it’s cultural. Each time ITP replaces IMG, it signals respect, recognition, and a step towards equity within Canada’s healthcare system. Highlighting this ongoing transition helps strengthen our collective advocacy and situates ITPC at the forefront of that movement.

It’s also important to clarify that ITPC fully supports internationally trained physicians at every stage, including those who are truly “international medical graduates” in the literal sense, having recently completed medical school abroad. This shift in terminology is not intended to diminish or exclude new graduates, but rather to ensure that language reflects the full spectrum of internationally trained doctors and respects the diversity of their pathways into Canadian healthcare.

Each of these institutions defines an IMG as a physician who earned a medical degree from a school outside Canada or the United States. But for those of us who are internationally trained, that label doesn’t tell our full story.

The term IMG often fails to reflect the experience, skill, and professional identity of those who have practiced, taught, and served communities for years before arriving in Canada. Most importantly, it reduces trained, experienced physicians to the level of new medical graduates.

It’s time to talk about why that matters, and why the term Internationally Trained Physician (ITP) offers a more accurate, dignified, and inclusive description of who we are.

While intended as neutral, the term “graduate” implies incompletion, as though internationally trained doctors are fresh out of school, awaiting their first patient. In reality, most ITPs have long and successful practice histories.

In short, the term “IMG” doesn’t match the lived reality of internationally trained physicians.

This article argues that ITP is the more respectful, precise, and equitable way forward.

2. The Profile of the ITP in Canada

Who is the typical ITP? The answer may surprise you.

Recent reports, including Assessing ITP Practice Readiness: Where the Current Tools Fall Short (2023), ITPs: A Diverse, Underutilised Skilled Health Human Resource (2022), and the ITPC Specialist Report: Access to Licensure for Specialist ITPs: A Labyrinth of Barriers; Actionable Solutions (2025), paint a clear picture of who Canada’s internationally trained physicians (ITPs) really are.

More than 13,000 internationally trained physicians in Canada are currently not practicing medicine because of licensing and systemic barriers, making them one of the country’s most underutilised health human resources.
On average, ITPs bring 7–10 years of post-graduate clinical experience before immigration, often having served in hospitals, community clinics, academic roles, and leadership positions abroad.
Many possess specialty training in areas such as primary care, internal medicine, obstetrics, paediatrics, surgery, psychiatry, and anaesthesiology, while a growing number hold advanced degrees, international fellowships, or public health credentials.
The Specialist Report (2025) further highlights that nearly 60% of ITP specialists had completed full residency and board certification in their country of training before arriving in Canada.

ITPs undergo rigorous medical education, clinical practice, and patient care training as our ongoing ITP-PGT hub shows.

Framing internationally trained professionals as graduates rather than physicians fails to reflect this reality. The data clearly show that ITPs are not trainees waiting for their first opportunity to practice; they are seasoned clinicians whose expertise continues to enrich the global medical community. And yet, the persistent use of IMG subtly suggests that the international physician lacks legitimacy. This signals a deeper issue: systemic discrimination based on where one was trained, not how well one can care for patients.

3. Diversity, Equity, and Inclusion (DEI)

In today’s Canada, conversations around Diversity, Equity, and Inclusion (DEI) are reshaping how institutions treat human experience, and medicine is no exception.

The term IMG undermines DEI principles because it fails to recognize international expertise as equal expertise. The title homogenizes a group of skilled professionals, masking the diversity of their training, cultures, and perspectives.

By contrast, ITPs embody diversity that strengthens Canada’s healthcare system:

Cultural competence enhances care for multicultural patient populations.
Global medical expertise introduces broader diagnostic and treatment perspectives.
Linguistic diversity bridges communication gaps for immigrant and refugee patients.

By adopting the term ITP, Canada acknowledges that diversity in training is an asset, not a barrier. It also aligns language with national DEI values, like equity, recognition, and respect.

4. Respect, Identity, and the Power of Words

Language holds power.

Calling someone a graduate subtly implies that they’re still “becoming” a physician, rather than being one. But a physician denotes earned identity, years of study, practice, and service.

Many ITPs express that being labelled an “IMG” feels diminishing, erasing their hard work and professional worth. Shifting to ITP restores respect. It recognizes that, regardless of where they were trained, these individuals are already physicians.

This shift matters to regulators, employers, patients, and the physicians themselves. It fosters dignity, pride, and inclusion within the profession.

Changing one word doesn’t fix systemic barriers like limited residency positions or lengthy licensing pathways, but it’s a step toward recognition and respect, the first step in meaningful reform.

5. The Real Faces of ITPs

Behind the statistics are real people, physicians who dedicated their lives to healthcare long before arriving in Canada:

“I’m a general practitioner from Trinidad and Tobago with five years of experience. I also have a background in anaesthesiology and paediatrics. I’m an ITP.”

“I’m a cardiologist from Nigeria, with over a decade of interventional and teaching experience. I’m an ITP.”

“I’m a family physician from India with rural and urban healthcare experience. I’m an ITP.”

“I’m a pediatrician from Ukraine who led community vaccination programs and trained residents. I’m an ITP.”

Each story reflects excellence that transcends borders. Their stories remind us that talent, compassion, and dedication to patients are not confined by geography.

Conclusion

So why choose ITP over IMG?
Because words matter, and so does respect.

Internationally Trained Physician accurately represents who we are: experienced, skilled professionals with a shared commitment to health and humanity.

The term IMG diminishes; ITP affirms. This is more than semantics; it’s a declaration of dignity and unity among those who have chosen to serve Canada and its people.

Let’s change the narrative. Let’s celebrate identity and accuracy in one phrase:

I'm an ITP. #imanITP

Contacting us from the media?

Email advocacy@itpsofcanada.ca