By Alia Dharssi:Calgary Herald
This is part 4 of Alia Dharssi’s series, Workers Without Borders. To see the series in its entirety, click here.
For Brazilian pediatrician Iraj Khalili Nasrabadi, one of the hardest parts of flipping burgers in a Calgary McDonald’s in 2015 was hearing news of rural Albertans desperate for family doctors.
He would have gladly served them if given the chance.
After arriving in Canada in 2010, Nasrabadi passed three medical exams required to work in Canada and spent 18 months shadowing a Canadian doctor. He also became a Canadian citizen.
But he hadn’t secured a residency – the last step for becoming a doctor in Canada – after three years of applying to programs across the country, even though he had 16 years of experience as a doctor in Brazil.
“You cannot use your skills, your talent, your experience,” said Nasrabadi, who decided to become a pediatrician as a 10-year-old in Iran, but studied medicine in Brazil after the Baha’i community to which he belongs was persecuted during the Iranian Revolution.
“Little by little, I came to this decision that, for the moment, I cannot do anything more here in Canada.”
So, in January 2016, Nasrabadi returned to Brazil, leaving behind his wife and two children in Calgary, so he could work as a physician and earn more money for his family.
Immigrant doctors like Nasrabadi, as well as nurses and other well-educated newcomers across the country, are struggling to obtain Canadian accreditation and find work in their field, even in professions where there is demand for their skills.
“Our problem is that, since about 1990, we have not been able to fully make the best use of our immigrants,” said Michael Bloom of the Conference Board of Canada.
“We know that because they haven’t reached the level of pay, of income that matches the Canadian-born. They haven’t done as well as the previous generations of immigrants.”
Economic immigrants and their dependants make up the bulk of those admitted to Canada each year. Last year, Canada accepted more than 170,000 of them.
“We are in competition with the United States, the United Kingdom, Australia for immigrants,” said Immigration Minister John McCallum during a speech in June.
“What we should do in light of this aging population, in light of the fact that Canada has always been built on immigrants, we should seek out the best and brightest.”
Canada is recognized worldwide for its system for recruiting talented immigrants, but it often fails to give these same people a chance to use their qualifications once they arrive, leading to huge costs for the Canadian economy.
There is such a big mismatch between immigrants’ skills and the jobs they end up doing that only about a quarter of internationally educated immigrants are working in many regulated professions across Canada, according to 2011 data.
“There’s a joke in Toronto that the best place to have a heart attack is in a cab because there’ll be a doctor driving that cab,” said Margaret Eaton, executive director of the Toronto Region Immigrant Employment Council.
In reality, fewer than one per cent of immigrant doctors drove taxis, according to the 2011 National Household Survey.
But almost half never get to practice medicine in Canada.
Instead, they wind up as nurses, sonographers and care aides, among other related fields that don’t use their full skill set, even though they may have years of experience abroad.
This is a common experience for skilled immigrants.
Academic studies show that those who do find work in their field often end up working below their level of qualifications.
In Ontario, many foreign-born and educated engineers have ended up becoming IT managers, janitors and truck drivers, 2011 data shows. Top jobs for foreign-born and educated accountants outside of their field include bookkeeping, serving food and working as cashiers.
Part of the problem can be chalked up to the fact that, in recent years, immigrants have been more likely to come from countries like India, China and the Philippines, where the education system is different from the European countries, where immigrants flowed from in decades past.
In many cases, they may also have a lower level of English skills.
The cost of this mismatch is significant.
In 2015, the Conference Board of Canada estimated that if Canadian employers and professional regulatory bodies did a better job of recognizing immigrants’ skills, they would earn an additional $10 billion to $12.7 billion annually and would pay more tax.
Added to that is the huge emotional toll on these newcomers, especially when they wind up working survival jobs in cleaning, fast-food restaurants and retail, said Naghmeh Rezvani, a career practitioner at the Centre for Newcomers in Calgary.
In January 2015, the Conservative government introduced a new system for selecting skilled immigrants called Express Entry that tries to tie permanent residency to the economy.
Those with a job offer backed by a labour market impact assessment, which proves they were selected because no Canadians were available for work, receive bonus points that help them get permanent residency more quickly.
Last year, cooks, food service supervisors and retail store supervisors were among the top 10 invited occupations because they had such jobs in hand. They made up almost one out of every five immigrants selected.
This outcome has critics concerned. They say immigrants employers hire are not necessarily the same as those who will boost Canada’s economy in the long run.
“All it is is their first job,” said David Cohen, a Montreal immigration lawyer. “A lot of candidates with excellent human capital are being squeezed out.”
The federal government is looking at doing away with the labour market assessment requirement but plans to increase the role of Express Entry in the future.
Having a job offer on arrival does have benefits. Immigrants who come without one struggle to find work because they lack Canadian experience, soft skills and social networks that would help them break into their field.
The Canadian labour market is “very parochial,” said Kelly Thomson, a York University professor who studies foreign professionals.
“We have a tendency to compare them to Canadians and say, ‘Oh, they don’t speak as good English,’ instead of thinking, ‘Oh, they speak multiple languages. How is that an advantage for my business?’ or ‘They have a large international network.’”
Those in regulated professions face the biggest struggle. According to staff at the Centre for Newcomers in Calgary, it can take immigrants in many professions at least three years to transfer their qualifications, if they succeed at all.
Many don’t anticipate how hard it will be, in part because they gain entry to Canada based on their credentials.
Egyptian doctor Tarek El Maghraby, who settled in Kingston, Ont., in 2013, planned to use his expertise in radiology in Canada because the immigration system gave him points for having a PhD from the Netherlands in that field.
Instead, he is pursuing a job as a family doctor. Even though he managed a radiology department in Saudi Arabia for four years, he is unlikely to land one of a handful of nuclear medicine residencies for which he must compete with young Canadian doctors.
“It seems like you are throwing 20 years of practice into the garbage,” El Maghraby said.
Federal and provincial governments have been working on improvements.
In 2006, Ontario passed the Fair Access to Regulated Professions Act and established the Office of the Fairness Commissioner to ensure anyone who is qualified to practice a profession in Ontario can do so, even if they were educated outside.
Manitoba, Quebec and Nova Scotia followed suit.
In 2009, the federal government poured $50 million over two years into a Pan-Canadian Framework for the Assessment and Recognition of Foreign Qualifications and established a working group to implement it.
It has also hired groups that work with immigrants to offer pre-arrival services in countries like China, the Philippines and India. In this way, prospective newcomers receive information about Canadian culture and professional accreditation before arrival.
The process of getting a licence for many jobs has become easier in many professions in Ontario, but licensed immigrants still struggle to find work, said Nuzhat Jafri, executive director of the office of the Fairness Commissioner in Ontario.
Their success depends on the economy, language skills and how open employers are to hiring people with little or no Canadian work experience, among other factors, she explained.
Settlement groups like the Toronto Region Immigrant Employment Council try to break down these barriers by working with employers on projects like mentorship programs that help immigrants learn about their field and network with Canadians working in it.
Three-quarters have a job in their field within a year of completing the program, but the council doesn’t track whether the role matches their qualifications, said Eaton.
At the same time, professional bodies must account for public safety when it comes to integrating people trained abroad.
“It’s a very careful consideration of interests of patients first,” said Danielle Frechette, executive director of external relations at the Royal College of Physicians and Surgeons, noting that foreign physicians can be well-trained, but unfamiliar with Canadian illnesses.
A doctor from a tropical country may be an ace at treating malaria but have no clue how to treat a bone broken from skiing, she explained.
“If we increase the intake of (immigrant doctors), we will be able to fund employment and training position for fewer Canadians,” Frechette added. “It’s a difficult balance.”
Critics say regulatory bodies could do more to streamline accreditation processes and that there is a need for better co-ordination between the federal immigration system, professional bodies and educational institutions.
In the case of health care, policies are poorly co-ordinated across provinces and inadequate resources are dedicated to long-term national human resource planning, said Ivy Bourgeault, an expert on human resources and healthcare at the University of Ottawa.
“You’re driving blind – absolutely, completely, utterly blind – with a Mercedes because we’re talking about a multibillion-dollar industry and tiny, tiny amounts dedicated to studying the health workforce part of it.”
There are also missed opportunities to fill labour shortages. More than half of internationally educated nurses don’t manage to get accreditation to practice in Canada, even though the Canadian Nurses Association predicts the country will face a shortage of 60,000 nurses by 2022.
Every year, Canada loses nurse, doctors, accountants and other professionals that it picked to become permanent residents to the United States, where it is easier for them to get accreditation.
Ulgochi Ibediro, a nurse from Nigeria, who settled in Vancouver in 2008, discourages her friends from moving to Canada.
“I tell my friends here (in Canada), two years later you are not working. I tell them to go to the U.S. or U.K.,” said Ibediro, who didn’t get her first job as a nurse in Canada until more than three years after landing.
Matthew O’Connor, a 29-year-old Cambridge-educated doctor, married a Canadian, but he and his wife are hesitant to move to Canada because of stories they’ve heard about the system.
O’Connor’s wife is an expert in First Nations land rights in B.C. She has a doctorate from Cambridge in the topic that was funded by the Canadian government.
But, if they move to Canada, O’Connor would struggle to practice as a cardiologist because he would have to start his training from scratch and compete for just two residency spots in Vancouver.
Instead, the couple moved to New Zealand, where O’Connor’s wife advises the local government on aboriginal issues and he started practising within months.
“I’m a little bit frustrated,” he said. “We’d love to be able to go back to Canada (now) and to carry on my training there, but it essentially means we can’t.”
In spite of the challenges, many immigrants remain hopeful, willing to try new things.
Though he works in Brazil, Nasrabadi is looking for ways to crack the Canadian system, as well as alternatives to working as a physician, such jobs in medical research. He is prepared to work in remote parts of the Yukon if necessary because he loves Canada.
“I am hopeful that, some day, I’ll go back,” he said.