Quarterly Advocacy Roundup Internationally Trained Physicians of Canada

Reporting Period: January – April 2026

Executive Summary

From January to April 2026, ITPC advanced a coordinated national advocacy strategy focused on reducing systemic barriers faced by internationally trained physicians (ITPs). Throughout this period, ITPC strengthened its role as a key national voice by grounding its advocacy in evidence from its Specialist ITP Report, ensuring that stakeholder engagement, policy discussions, and recommendations were consistently data-driven and reflective of real-world ITP experiences.

1. Advancing Practice-Ready Assessment (PRA) and Licensure Pathways

ITPC engaged directly with national and provincial stakeholders, including the Medical Council of Canada and the College of Physicians and Surgeons of Manitoba, to advocate for more accessible and scalable Practice-Ready Assessment (PRA) pathways.

Drawing on evidence from the Specialist ITP Report, ITPC highlighted several critical system gaps:

• The urgent need to expand PRA capacity nationwide to address physician workforce shortages

• The recency-of-practice requirement as a major and often exclusionary barrier, particularly affecting ITPs already residing in Canada

• The importance of recognizing international clinical experience alongside Canadian experience

These data-driven insights informed ITPC’s policy recommendations, including increased flexibility in eligibility criteria and the integration of structured preparatory and mentorship programs to support ITP success.

2. Promoting the Clinical Assistant / Associate Physician (CA/AP) Ladder-to-Licensure Framework

A central pillar of ITPC’s advocacy during this period was the promotion of a competency-based “ladder-to-licensure” framework, integrating Clinical Assistant (CA) and Associate Physician (AP) roles as formal pathways toward independent practice.

Informed by findings from the Specialist ITP Report, particularly the widespread loss of recency of practice among ITPs. ITPC advanced CA/AP roles as critical mechanisms to maintain and restore clinical competency.

At key engagements with regulatory bodies, including the College of Physicians and Surgeons of New Brunswick, CPSM, and stakeholders in Nova Scotia we advocated for:

• CA/AP roles as practical solutions to recency-of-practice barriers

• Recognition of the need for standardized verification systems for supervised clinical experience in CA/AP roles

• Opportunities to align supervised practice in CA/AP roles with formal licensure progression pathways

  
  

Across jurisdictions, stakeholders consistently recognized that evidence from ITPC’s report supports the scalability and necessity of structured, supervised clinical roles as part of a modernized licensure system.

3. Addressing Immigration–Licensure Misalignment

In a strategic engagement with Immigration, Refugees and Citizenship Canada, ITPC used data from the Specialist ITP Report to highlight systemic disconnects between immigration pathways and medical licensure processes.

Key evidence-based advocacy points included:

• The paradox of highly skilled physicians being admitted through immigration streams while facing prolonged barriers to licensure

• Data demonstrating that a significant proportion of ITPs, many with extensive postgraduate training and independent practice experience, remain unable to practice

• The widespread loss of recency of practice among permanent residents and citizens due to lack of access to clinical opportunities

• The burden of duplicative documentation requirements across multiple institutions

Based on these findings, ITPC proposed actionable, system-level solutions:

• Establishing a national immigration licensure task force

• Standardizing documentation processes across jurisdictions

• Expanding CA/AP roles nationally to preserve clinical competency

These recommendations aligned with emerging federal priorities on foreign credential recognition and workforce integration.

4. Strengthening National and Provincial Partnerships

ITPC expanded its collaborative footprint through targeted engagements with key organizations, including:

• College of Physicians and Surgeons of Newfoundland and Labrador

• College of Family Physicians of Canada

• PACE Nova Scotia and the Physician Extender Program (Nova Scotia)

• Health Canada

Across these engagements, ITPC consistently leveraged evidence from its Specialist ITP Report to inform discussions, ensuring that stakeholder conversations were grounded in data rather than anecdotal experience.

Key advocacy areas included:

• Promoting equitable access to training and licensure pathways

• Highlighting policy inequities, including return-of-service (ROS) constraints affecting ITP residents

• Identifying opportunities for mentorship programming, particularly for ITPs navigating PRA and supervised practice pathways

These partnerships laid the groundwork for future collaboration in program development, policy design, and system-level reform.

5. Advancing Research to Inform Policy and Systems Change

ITPC’s advocacy throughout this period was anchored in its Specialist ITP Report, which served as the primary evidence base informing stakeholder engagement and policy recommendations.

In parallel, ITPC advanced several complementary research initiatives, including:

• A global mapping of postgraduate medical training systems to support credential recognition

• Ongoing collaboration with the Federation of Medical Regulatory Authorities of Canada on jurisdictional recognition frameworks

• A research initiative positioning ITPs as strategic assets within Canada’s healthcare system

• Writing of the research report for the Ladder-to-Licensure research project

Together, these efforts ensure that ITPC’s advocacy remains evidence-based, solutions-oriented, and aligned with evolving stakeholder needs.

Key Cross-Cutting Insights

Across all engagements, evidence from the Specialist ITP Report consistently reinforced several key system-level challenges and opportunities:

• Recency of practice remains the most significant barrier to licensure for ITPs

• Clinical Assistant and Associate Physician roles represent the most viable and scalable solution to address this gap

• There is growing national momentum for PRA expansion and reform

• System fragmentation, particularly between immigration and licensure systems, continues to limit efficient workforce integration

• Mentorship and structured support systems are critical to improving ITP outcomes

Conclusion

This period reflects a significant acceleration in ITPC’s advocacy impact. By aligning evidence from the Specialist ITP Report with strategic stakeholder engagement and policy development, ITPC is contributing to a more coordinated and responsive approach to integrating internationally trained physicians into Canada’s healthcare system.

Sustained collaboration across federal, provincial, and regulatory partners will be essential to translating this momentum into tangible, system-wide change.

Internationally Trained Physicians of Canada (ITPC)

www.itpsofcanada.ca | policy@itpsofcanada.ca