Thursday, September 29, 2022

Beyond local: how rural Canada can attract and retain international health care providers

Common approaches often focus primarily on attraction, but do not address the reasons why they leave.

This article by Natalya Brown, Nipissing University; Melissa Kelly, Toronto Metropolitan University, and Victoria Aces, Western University originally appeared on The Conversation and is published here with permission.

Smaller communities in Canada, especially those located in rural areas, find it difficult to attract and especially retain health care professionals, leading to poor health outcomes.

For example, in March 2022, physician shortages in northern Ontario forced the emergency department in Red Lake to close for 24 hours, and people with medical emergencies had to travel more than 200 kilometers to the nearest hospital. It fell In the same area, recruitment and retention challenges lead to staffing shortages of nurses and personal support staff. Similar situations exist in many small communities across Canada.

It should come as no surprise that all five Northern Ontario cities participating in the Rural and Northern Immigration Pilot, designed to bring more immigrants into smaller communities, are prioritizing health care professionals. But can they keep them?

Recruiting internationally educated health care professionals (IEHPs) to work in underserved communities is nothing new. However, the challenges of keeping them in these communities remain. As immigration researchers, we have recently documented the challenges of retaining newcomers in small communities across Canada, focusing on the IEHP.

Why Popular Approaches Don’t Work

Common approaches used to encourage IEHPs to operate in smaller communities often include “return of service” agreements, which require IEHPs to practice within the province or territory as a way of licensure. Work in unqualified areas for years. For example, the practice-ready assessment programs of the National Assessment Collaboration for International Physicians offered in seven provinces require a return of service commitment to the province’s rural area.

These somewhat coercive strategies are ineffective in the long term because they focus primarily on attracting IEHPs to smaller communities and do not address the reasons why they leave. These reasons include social and occupational isolation.

Factors driving social isolation for the IEHP in small communities include distance from family members and social connections, limited access to settlement services that can facilitate connections to the community, the lack of a large immigrant population, and cultural and religious Access to support, limited employment and educational opportunities for family members, and experiences of racism and discrimination.

Factors that promote professional isolation in small communities include long work hours and limited time off for vacation due to the small size of the health care team, and limited opportunities for professional growth and advancement within a group of peers. IEHPs may also find that they lack the general skill sets needed to practice in small communities, which can differ significantly from urban health care.

While many of these factors apply to all health care professionals, whether Canadian-born or internationally trained, others are unique to IEHPs in their sense of isolation and their motivation to move to a larger urban center. add to.

because of living

Several strategies can be used to support retention of the IEHP, including training and experience in small community health care. As an example of the importance of training and experience, the Northern Ontario School of Medicine (NOSM) has increased the number of physicians and dietitians practicing in small communities in Northern Ontario.

NOSM graduates are familiar with the needs of these communities and, due to their specialized training, are prepared to serve them for a long time. Once established in a community, professional networks and professional development opportunities can also help IEHP overcome professional isolation.

In addition, IEHPs will be more likely to live in smaller communities if their families are happily settled in the community and are socially connected. The first step is to address casteism and discrimination in the community. Also, IEHP spouses may need special assistance to find employment related to their field of study. Children of IEHP can benefit from the connection of educational and extra-curricular activities.

perfect fit

Efforts should also be made to attract IEHPs with characteristics that make them more likely to persist. IEHPs who are from small or rural communities may find it easier to adapt to living and working in smaller communities in Canada, which may make them more likely to live.

Communities should also explain what kind of lifestyle they can offer the IEHP, and the IEHP should know what to expect as fit improves. IEHPs may be attracted to smaller communities because of the housing, educational and outdoor leisure opportunities offered, or because of the sense of security and community that some smaller centers can provide. Importantly, these location characteristics may be more appealing to IEHPs who are at a certain point in their lives. People who make homeownership a priority or raise children may be more likely to meet their needs in a smaller community.

For the upcoming Municipal Nominee Program, in which communities will have a greater role in selecting new immigrants, a key measure of success will be how the program addresses labor shortages and retention in key areas such as health care. The ability of small communities to make perfect matches and address professional and social isolation will be essential for the IEHP.Conversation

Natalya Brown, Associate Professor of Economics, Nipissing University; Melissa Kelly, Research Fellow, Canada Excellence Research Chair (CERC) in Migration and Integration, Toronto Metropolitan University, and Victoria Aces, Professor, Department of Psychology, Western University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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