A British Columbia Supreme Court justice has struck down the province’s requirement that Canadian doctors trained overseas work for years in rural and remote communities before they can practise anywhere else, ruling the policy unlawful and giving the province 60 days to respond.
Justice Matthew Kirchner found on Sept. 15, 2026, that the Health Ministry never had the legal authority to force internationally trained medical graduates into “return of service” contracts, which bound them to underserviced regions for two to three years under penalty of breach fees that reached roughly $900,000 for psychiatrists and $480,000 for family doctors, according to court documents cited by CBC News and CTV News. The judge concluded the contracts violated the doctors’ liberty interest, the constitutional principle covering a person’s right to choose where they live and work, and said the arrangement offended “individual dignity and independence.”
The case was brought by the Society of Canadians Studying Medicine Abroad, known as SOCASMA, on behalf of Oliver Kostanski, who trained in Poland after growing up in Vancouver, and Harris Falconer, then a medical student in Barbados. Both are Canadian citizens who, like an estimated 1,000 Canadians who study medicine abroad each year, returned home to compete for a fraction of the residency spots open to graduates of Canadian and American schools. B.C. reserves just 58 residency positions annually for internationally trained candidates against 288 for domestic graduates, and international graduates can pursue only five of the roughly 70 specialties available to their Canadian-trained peers, according to the petitioners’ case.
That underlying quota system, often described in the case as a “two-stream” structure, was not part of what the court struck down, and it remains fully in place. Brian Samuels, the lawyer for the petitioners, called the ruling a mixed result: doctors can no longer be legally compelled into rural service contracts once they land a residency spot, but the far larger barrier, the scarcity of spots for internationally trained Canadians in the first place, was untouched.
Health Minister Ravi Kahlon said the return of service requirement was designed to solve a real problem, telling reporters the program was “critically important for us to be able to continue to attract health care workers in rural communities,” and that the ministry would review the decision before deciding how to respond within the court’s 60-day window.
What happens to the doctors currently partway through their contracts is one of the questions the ruling leaves open, since the judge suspended the declaration of invalidity rather than making it take effect immediately, giving Victoria time to redraft the requirement or replace it with something that survives legal scrutiny. Rural and remote communities across B.C. have relied heavily on internationally trained doctors to fill gaps left by a broader national physician shortage, so any redesign will have to grapple with the same recruitment pressure that led to the rule in the first place.
B.C. is not the only province leaning on internationally trained doctors this way. Ontario runs its own return of service agreements for international medical graduates matched through the national CaRMS process, and similar obligations exist in other jurisdictions grappling with rural physician shortages, meaning the legal reasoning in Kirchner’s decision could invite fresh challenges elsewhere if it withstands an appeal. For now, the ruling changes the terms doctors face once they get a residency spot in B.C., but it leaves untouched the much narrower doorway that decides who gets one at all.
Via CBC News and CTV News. Read the original reporting here.
