ITPC call to stand with Internationally Trained Physicians (ITPs) on Return of Service (ROS) agreements

To: Saskatchewan Medical Association (SMA)

We are writing to call on the Saskatchewan Medical Association (SMA) to stand in solidarity with its Internationally Trained Physician (ITP) members. As you are likely aware, B.C. Supreme Court recently ruled that Return of Service (ROS) agreements lack statutory authorization and most importantly, infringe on our constitutional rights. 

We expect that this decision will have implications across the country, including in Saskatchewan, where ITP-specific ROS agreements are currently in place. 47% of practicing physicians in SK are ITPs. This is the highest proportion in Canada. These physicians are members of SMA.

Ensuring access to care in rural, remote, and underserved communities is imperative, and ITPs have made substantial contributions to these communities for years. While physician workforce planning is a government responsibility, it is SMA’s role as our professional association to bring an independent physician voice to policy discussions that affect its members. Recognizing equity implications of ROS policies does not conflict with supporting rural communities. These must not serve as grounds for perpetuating inequitable and unjust requirements. Rural healthcare should not rely solely on ITPs. 

As our professional association, we expect SMA to engage directly with ITPs, examine the equity of ROS requirements, and include ITP perspectives in policy discussions with the government, as well as any public commentary on the topic. 

ITPs are an important part of Saskatchewan's physician workforce and SMA membership. We deserve meaningful representation and advocacy from our professional association. 

Sincerely,

Approved by the ITPC Board of Directors 

November 4, 2026 

Learn more: www.itpsofcanada.ca/overhaul-ros