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Canadian-born family doctor struggles to come home through a wall of red tape – CBC.ca

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Canada is grappling with a severe shortage of family doctors — but Canadian-born family physicians working abroad are fighting to obtain the paperwork they need to practise here.

Dr. Stephanie DeMarchi, a general practitioner born in Hamilton, Ont. who has worked in Australia for the past ten years, is one of those doctors.

She trained at the University of Queensland and spent her residency and years as a GP working in rural Australia. She now wants to come home to Canada to take over from her mother, a family doctor in Hamilton who is retiring soon.

But a tangle of red tape has made the process an arduous one. She’s been in a battle with Canada’s health-care bureaucracy for nearly 16 months to get the licence she needs to practise.

In April 2022, DeMarchi first opened a Physicians Apply account under a program run by the Medical Council of Canada (MCC), the body that evaluates medical graduates and physicians.

In October, she sat for an eight-hour MCC exam testing medical knowledge. She said the test set her back a few thousand dollars.

Then she moved with her Australian husband and two young children to Canada. She said she assumed the process would be complete in the near term, since she’s already a practising doctor.

That didn’t happen — she still doesn’t have what she needs to work in Canada.

DeMarchi said she had to move back to Australia by herself to keep her Australian licence current while the MCC works to verify documents like her medical degree, post-graduate certificate, resume and police background check.

Dr. Stephanie DeMarchi is pictured on a beach with her family.
DeMarchi, right, said she had to move back to Australia by herself to keep her Australian licence current while the Medical Council of Canada works to verify her documents. Her family stayed behind in southern Ontario. (Submitted by Stephanie DeMarchi)

Those documents must be approved by the MCC before it can issue a “licentiate,” something anyone looking to practise medicine in Canada must have in order to apply for a licence.

She said she’s been holed up in Gundagai, a small town in rural New South Wales about 390 kilometres from Sydney, living in a caravan park and working at a local practice while her family is far away in southern Ontario.

“It all feels so intentional, like they just don’t want me,” DeMarchi told CBC News.

“The process just has to change. It’s not only affecting lives but it has the real potential to destroy lives as well.

“I don’t know why Canada wouldn’t want to have these skilled workers in a time of crisis. I don’t know why they haven’t created a much more polished, efficient system.”

WATCH: Canada is losing out on hundreds of qualified doctors each year. Here’s why 

Canada is losing out on hundreds of qualified doctors each year. Here’s why

5 months ago

Duration 2:07

Canada is losing out on hundreds of qualified Canadian doctors trained abroad who can’t practice because they find it difficult to get residencies here due to a combination of red tape and bias.

It’s not clear who exactly is responsible for the MCC and its perceived failures and shortcomings.

The MCC is a national body that operates across the country. In a statement, Health Canada said it “does not have any authority” over the “independent organization” that assesses physicians’ competence.

But Ottawa does provide the MCC with cash.

In June, it floated $28.8 million for the council’s “Modernizing Mandatory Physician Activities Enabling Safe Patient Care” framework — a lengthy name for an initiative that’s meant to make the medical credentials assessment process less cumbersome.

DeMarchi said she just wants the MCC to return her calls and emails and speedily review documents issued by a fellow Commonwealth country with a top-tier health-care system.

Tire tracks lead up to a windmill in a drought-affected landscape near the New South Wales town of Gundagai, located around 400 kilometres south-west of Sydney.
Tire tracks lead up to a windmill in a drought-afflicted landscape near the New South Wales town of Gundagai, about 400 kilometres southwest of Sydney. Dr. DeMarchi has been practicing medicine in this small Australian town while she waits for Canadian medical regulators to verify her records. (David Gray/Reuters)

In a media statement, a spokesperson for the MCC said it’s “receiving a higher-than-normal number of applications.”

“We are actively working to address the current backlog by, among other things, hiring additional staff in this area of the organization,” the spokesperson said.

But the MCC process isn’t the only hurdle facing DeMarchi and others seeking the licence they need to practise medicine in Canada.

Like other health-care related files, physician recruitment in Canada is a jurisdictional quagmire.

There’s a parallel process that would-be doctors have to go through with provincial colleges of physicians and surgeons, the bodies responsible for licensing doctors.

In theory, the MCC is supposed to be the agency tasked with gathering and verifying foreign credentials and then passing that data on to the provincial colleges of physicians and surgeons. But DeMarchi said she has run into trouble with the College of Physicians and Surgeons of Ontario (CPSO). They want her to reproduce some documents that she’s already sent to the MCC.

That might sound like an easy fix but DeMarchi has to pay a steep fee and wait for the Australian regulator to create new copies of documents she’s already provided to another Canadian health-care gatekeeper.

“That was a nightmare. It’s absolutely ludicrous,” DeMarchi said.

“They just keep telling me, ‘Look, ma’am, these things take time.’ They’re not saying, ‘This is a Canadian who’s studied and trained and she’s ready to go, let’s expedite this.’ Nope.”

DeMarchi said the CPSO recently rejected one of her reference letters because the agent reviewing it wasn’t sure if the date was formatted on a month-day-year or day-month-year basis. CPSO wants the month first.

DeMarchi said there should be a single point person who handles inter-agency paperwork issues so in-demand doctors don’t have to wade through the labyrinthian system by themselves.

“These regulatory bodies, they’re not speaking to each other. And us doctors, we’re getting the message. Canada is essentially saying, ‘We don’t want doctors, we don’t need you,'” she said.

A nurse is seen working with a patient at the Halifax Infirmary in Halifax.
A nurse works with a patient in the intensive care unit at the Halifax Infirmary in Halifax on Feb. 25, 2022. Canada is facing a shortage of health-care professionals while thousands of Canadian-born, foreign-trained doctors work abroad. (Andrew Vaughan/The Canadian Press)

But Canada does need doctors.

After years of restrained spending by federal and provincial governments and a generation of protectionist policies that restrict access to medical residency programs, Canada’s health-care system is short nearly 17,000 physicians, according to recent data compiled by the Royal Bank of Canada.

The problem is expected to get worse.

In the next five years, as the baby boomer cohort retires en masse and the population grows by some 500,000 people per year, Canada will be short an estimated 43,900 physicians, the bank reported — including more than 30,000 family doctors and general practitioners.

Rosemary Pawliuk is president of the Society for Canadians Studying Medicine Abroad and an expert on Canada’s physician licensing system.

She said bureaucratic delays such as those DeMarchi has experienced are dangerous — because they mean some sick people won’t have ready access to a qualified family doctor.

“It’s not just this physician that’s being hurt. She’s not the only one. Many, many more of us — the public — are being hurt,” Pawliuk told CBC News.

“We’ve got 6,000,000 Canadians without a family physician. They’re the quarterback for our system. The family physician reduces your suffering or refers you to somebody who can. The bureaucracy is totally blind to the fact that people are dying, literally dying and suffering because they can’t get a physician to treat them.”

Rosemary Pawliuk is seen sitting for an interview.
Rosemary Pawliuk is the president of the Society for Canadians Studying Medicine Abroad. She says the current residency selection system puts internationally trained Canadian doctors at a serious disadvantage. (Dillon Hodgin/CBC)

Pawliuk said there’s little accountability for the actions of bodies like the MCC — the federal government, the provinces and the colleges don’t have much of a say over how it operates. The web of competing organizations, each with some sort of role in the regulatory process, is a needless headache, she said.

“Every one of these entities has their own little fiefdom to develop. You just get lost in the red tape,” she said.

It shouldn’t take more than a year for a qualified physician trained in a country like Australia to get licensed to practise, she said.

“That’s outrageous, absolutely outrageous. I don’t know what the problem is or what’s going on.”

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Bad traffic, changed plans: Toronto braces for uncertainty of its Taylor Swift Era

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TORONTO – Will Taylor Swift bring chaos or do we all need to calm down?

It’s a question many Torontonians are asking this week as the city braces for the arrival of Swifties, the massive fan base of one of the world’s biggest pop stars.

Hundreds of thousands are expected to descend on the downtown core for the singer’s six concerts which kick off Thursday at the Rogers Centre and run until Nov. 23.

And while their arrival will be a boon to tourism dollars — the city estimates more than $282 million in economic impact — some worry it could worsen Toronto’s gridlock by clogging streets that already come to a standstill during rush hour.

Swift’s shows are set to collide with sports events at the nearby Scotiabank Arena, including a Raptors game on Friday and a Leafs game on Saturday.

Some residents and local businesses have already adjusted their plans to avoid the area and its planned road closures.

Aahil Dayani says he and some friends intended to throw a birthday bash for one of their pals until they realized it would overlap with the concerts.

“Something as simple as getting together and having dinner is now thrown out the window,” he said.

Dayani says the group rescheduled the gathering for after Swift leaves town. In the meantime, he plans to hunker down at his Toronto residence.

“Her coming into town has kind of changed up my social life,” he added.

“We’re pretty much just not doing anything.”

Max Sinclair, chief executive and founder of A.I. technology firm Ecomtent, suggested his employees avoid the company’s downtown offices on concert days, saying he doesn’t see the point in forcing people to endure potential traffic jams.

“It’s going to be less productive for us, and it’s going to be just a pain for everyone, so it’s easier to avoid it,” Sinclair said.

“We’re a hybrid company, so we can be flexible. It just makes sense.”

Swift’s concerts are the latest pop culture moment to draw attention to Toronto’s notoriously disastrous daily commute.

In June, One Direction singer Niall Horan uploaded a social media video of himself walking through traffic to reach the venue for his concert.

“Traffic’s too bad in Toronto, so we’re walking to the venue,” he wrote in the post.

Toronto Transit Commission spokesperson Stuart Green says the public agency has been working for more than a year on plans to ease the pressure of so many Swifties in one confined area.

“We are preparing for something that would be akin to maybe the Beatles coming in the ‘60s,” he said.

Dozens of buses and streetcars have been added to transit routes around the stadium, and the TTC has consulted the city on potential emergency scenarios.

Green will be part of a command centre operated by the City of Toronto and staffed by Toronto police leaders, emergency services and others who have handled massive gatherings including the Raptors’ NBA championship parade in 2019.

“There may be some who will say we’re over-preparing, and that’s fair,” Green said.

“But we know based on what’s happened in other places, better to be over-prepared than under-prepared.”

Metrolinx, the agency for Ontario’s GO Transit system, has also added extra trips and extended hours in some regions to accommodate fans looking to travel home.

A day before Swift’s first performance, the city began clearing out tents belonging to homeless people near the venue. The city said two people were offered space in a shelter.

“As the area around Rogers Centre is expected to receive a high volume of foot traffic in the coming days, this area has been prioritized for outreach work to ensure the safety of individuals in encampments, other residents, businesses and visitors — as is standard for large-scale events,” city spokesperson Russell Baker said in a statement.

Homeless advocate Diana Chan McNally questioned whether money and optics were behind the measure.

“People (in the area) are already in close proximity to concerts, sports games, and other events that generate massive amounts of traffic — that’s nothing new,” she said in a statement.

“If people were offered and willingly accepted a shelter space, free of coercion, I support that fully — that’s how it should happen.”

This report by The Canadian Press was first published Nov. 13, 2024.



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‘It’s literally incredible’: Swifties line up for merch ahead of Toronto concerts

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TORONTO – Hundreds of Taylor Swift fans lined up outside the gates of Toronto’s Rogers Centre Wednesday, with hopes of snagging some of the pop star’s merchandise on the eve of the first of her six sold-out shows in the city.

Swift is slated to perform at the venue from Thursday to Saturday, and the following week from Nov. 21 to Nov. 23, with concert merchandise available for sale on some non-show days.

Swifties were all smiles as they left the merch shop, their arms full of sweaters and posters bearing pictures of the star and her Eras Tour logo.

Among them was Zoe Haronitis, 22, who said she waited in line for about two hours to get $300 worth of merchandise, including some apparel for her friends.

Haronitis endured the autumn cold and the hefty price tag even though she hasn’t secured a concert ticket. She said she’s hunting down a resale ticket and plans to spend up to $600.

“I haven’t really budgeted anything,” Haronitis said. “I don’t care how much money I spent. That was kind of my mindset.”

The megastar’s merchandise costs up to $115 for a sweater, and $30 for tote bags and other accessories.

Rachel Renwick, 28, also waited a couple of hours in line for merchandise, but only spent about $70 after learning that a coveted blue sweater and a crewneck had been snatched up by other eager fans before she got to the shop. She had been prepared to spend much more, she said.

“The two prized items sold out. I think a lot more damage would have been done,” Renwick said, adding she’s still determined to buy a sweater at a later date.

Renwick estimated she’s spent about $500 in total on “all-things Eras Tour,” including her concert outfit and merchandise.

The long queue for Swift merch is just a snapshot of what the city will see in the coming days. It’s estimated that up to 500,000 visitors from outside Toronto will be in town during the concert period.

Tens of thousands more are also expected to attend Taylgate’24, an unofficial Swiftie fan event scheduled to be held at the nearby Metro Toronto Convention Centre.

Meanwhile, Destination Toronto has said it anticipates the economic impact of the Eras Tour could grow to $282 million as the money continues to circulate.

But for fans like Haronitis, the experience in Toronto comes down to the Swiftie community. Knowing that Swift is going to be in the city for six shows and seeing hundreds gather just for merchandise is “awesome,” she said.

Even though Haronitis hasn’t officially bought her ticket yet, she said she’s excited to see the megastar.

“It’s literally incredible.”

This report by The Canadian Press was first published Nov. 13, 2024.

The Canadian Press. All rights reserved.



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Via Rail seeks judicial review on CN’s speed restrictions

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OTTAWA – Via Rail is asking for a judicial review on the reasons why Canadian National Railway Co. has imposed speed restrictions on its new passenger trains.

The Crown corporation says it is seeking the review from the Federal Court after many attempts at dialogue with the company did not yield valid reasoning for the change.

It says the restrictions imposed last month are causing daily delays on Via Rail’s Québec City-Windsor corridor, affecting thousands of passengers and damaging Via Rail’s reputation with travellers.

CN says in a statement that it imposed the restrictions at rail crossings given the industry’s experience and known risks associated with similar trains.

The company says Via has asked the courts to weigh in even though Via has agreed to buy the equipment needed to permanently fix the issues.

Via said in October that no incidents at level crossings have been reported in the two years since it put 16 Siemens Venture trains into operation.

This report by The Canadian Press was first published Nov. 13, 2024.

Companies in this story: (TSX:CN)

The Canadian Press. All rights reserved.



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