October 26, 2016
This article was originally published in Canadian Immigrant magazine.
By Claudia Blume
When Dr. Nishadi Silva moved with her family to Halifax in 2010, the Sri Lankan pediatrician did not know how difficult it was to enter the Canadian health system as a trained professional. Although she had already practised for 17 years as a physician in her home country – six of them as a pediatrician – she learned that in order to work in Canada, she had to go through a complex, lengthy and costly evaluation and examination process. She would also have to redo her medical residency to obtain her Canadian medical license. Worried about losing her clinical experience, she returned to Sri Lanka after 14 months, leaving her husband and son behind. She came back to Canada one year later because she missed her family, and because she did not want to lose her permanent resident status.
Dr. Silva has since passed the first Canadian medical evaluating examination, and has still three more to do. She says that even passing the exams is not a guarantee for getting one of the few medical residency spots, for which the competition is fierce.  “Many of my friends who completed all four exams did not even get an interview afterwards,” Dr. Silva says. “I therefore tried to find an alternative to be able to practise medicine, and to earn a living.”

A career option for foreign-trained doctors living in Canada

She applied to work with Doctors Without Borders/Médecins Sans Frontières (MSF), an international medical humanitarian organization that manages projects in close to 70 countries around the world. “I witnessed the great work humanitarian organizations did in Sri Lanka after the devastating 2004 tsunami,” she says. “Ever since, I have dreamed of doing humanitarian work.”
Dr. Silva’s first two assignments with MSF were in Uzbekistan, where she worked in a pediatric tuberculosis project. She was able to use the Russian language skills she learned years ago in Ukraine, where she went to obtain her medical degree when the universities in her home country were closed during Sri Lanka’s civil war.
Dr. Silva is currently spending four months as a medical activity manager in a camp for displaced people in Bentiu, South Sudan. She says that the work experience she has gained overseas is invaluable. “I have met many medical professionals from around the world during my humanitarian assignments, “she says. “It helps me to enhance my professional career.”
Like Dr. Silva, more and more foreign-trained physicians who have immigrated to Canada consider working for MSF as a viable career option.

Qualifications necessary for joining MSF

Two thirds of the physicians who apply to work with the Canadian office of the organization are international medical graduates. In the past four years, MSF Canada has recruited over 70 of them as aid workers. The majority were newcomers to Canada, while a small minority were returning Canadians who went to medical school abroad. Owen Campbell, who manages recruitment for MSF Canada, says that international medical graduates wanting to work for MSF have to meet the same requirements as Canadian-trained physicians. “MSF requires that a doctor does not have a significant clinical gap — usually not more than two years,” he says. “They need to have a valid licence to practice and provide us with a letter of good standing and three medical references from people who can attest to the quality of their practice as a medical doctor.” Diplomas and specializations are verified by a third-party credential verifier. All specialists, such as surgeons, anesthesiologists or obstetricians, must first be validated by MSF’s technical advisors — a requirement that applies to both international and Canadian-trained physicians.
If all requirements are met, the chances of being accepted are good: MSF has a great need for medical doctors in its projects around the globe. “We are particularly looking for emergency room physicians, family doctors with northern experience, obstetrician-gynecologists, anesthesiologists, surgeons and infectious-disease specialists, especially in the area of HIV and tuberculosis,” says Campbell.

International experience is a plus

Prior international experience can be a big advantage when working overseas with MSF. Dr. Emile Luzolo Mbikulu is a physician from the Democratic Republic of Congo, and first worked with MSF in South Sudan in 2012. “The pathologies I found in South Sudan were quite similar to those in the Congo, so unlike some of my Western-trained colleagues, I did not find the medical work challenging,” he says. Dr. Mbikulu decided to work for MSF after completing an Masters degree in public health in Belgium. “While I loved treating individual patients when I worked in hospitals back home in Kinshasa, I learned how vaccination campaigns can help thousands of children,” he says. “That’s why I decided to work with a humanitarian organization in countries where access to health care is limited.” Dr. Mbikulu has since also worked in the Central African Republic, Yemen and Ivory Coast. Shortly after he and his wife, a Congolese nurse, moved to Montreal with their son at the beginning of 2016, he signed a contract with MSF Canada and did a short assignment as a medical referent in Liberia.
Some physicians choose working as a medical aid worker with MSF as a long-term career option. Physicians who do multiple overseas assignments have access to learning and development opportunities, as well as the possibility to grow into senior leadership positions, allowing them to have an input towards policy and strategic objectives of the organization
Applicants need to be legally able to work in Canada, and since the matching process can take some time, only permanent residents and citizens can apply as they need to be able to freely enter and leave the country over an extended period of time.
Campbell says that, generally speaking, working outside the country does not put the permanent resident status of immigrant doctors in jeopardy, since fieldworkers are signing Canadian contracts and are paying Canadian income taxes. Campbell added that individuals should seek out professional advice to discuss the specifics of their case as immigration laws can be complex and may change.

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