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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.

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-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 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 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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Mitchell throws two TD passes as Ticats earn important 37-21 home win over Redblacks

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September 14, 2024

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HAMILTON – It remains faint but Bo Levi Mitchell and the Hamilton Tiger-Cats still have a playoff pulse.

Mitchell threw two touchdown passes as Hamilton defeated the Ottawa Redblacks 37-21 in the CFL’s annual Hall of Fame game Saturday afternoon. The Ticats (4-9) earned a second straight win to move to within six points of the third-place Toronto Argonauts (7-6) in the East Division.

Hamilton visits Toronto on Friday night.

“Obviously they’re (wins) huge now,” Mitchell said. “We didn’t do ourselves any favours by getting into this position and not being able to really control our own destiny.

“But right now, we need certain people to win at certain times. Our job is to go out there and try to win the next five, then the next three after that.”

Mitchell finished 20-of-27 passing for 299 yards and an interception. He entered weekend action leading the CFL in passing yards (3,383) and TD strikes (21).

Greg Bell’s 15-yard TD run at 11:30 of the fourth and two-point convert put Hamilton up 36-21 after backup Jeremiah Masoli led Ottawa on two scoring drives. Following a 13-yard TD strike to Andre Miller at 2:53, Masoli found Dominique Rhymes on a 10-yard touchdown pass at 7:43 before Khalan Laborn’s two-point convert cut Hamilton’s lead to 29-21.

“When you’re scoring from (15) yards out on a run play, that makes offence easy,” Mitchell said. “It’s one of those things when you get down there as a quarterback, it takes you sometimes five, eight, 10 plays and now it’s ‘OK, now we have to create some stuff and find something.’

“When you hand the ball off and you’re scoring from (15) yards, it makes the offence really easy.”

Ottawa (8-4-1) would have clinched a playoff spot with a victory.

Ottawa committed six turnovers (three interceptions, two fumbles, once on downs) before an announced Tim Hortons Field gathering of 22,119. Lawrence Woods III also returned a punt 83 yards for a touchdown at 11:51 of the first quarter that put Hamilton ahead 10-3.

“You’ve got to bring your best every single week and this wasn’t our best, all of us, from coaches to the players,” said Ottawa head coach Bob Dyce. “If you don’t play great for four quarters, I don’t care who you’re playing you’re not going to have a successful day.

“We should’ve made the tackle (on Woods), we had him wrapped up it’s that simple. Even though we didn’t make the play on that, there should’ve been extra bodies there to clean it up when he did break the tackle.”

Hamilton also tied the season series with Ottawa 1-1. The teams meet again at TD Place on Oct. 25.

“If we didn’t turn it over today I would’ve said we played really well offensively and that to me is what the biggest difference is,” said Hamilton head coach Scott Milanovich. “Even the turnovers today (interception, fumble), at least they were in their end and we weren’t giving them a short field.

“The biggest play of the game was Woodsie’s return. It got us jump-started, gave us the lead and we were kind of off after that.”

Ottawa starter Dru Brown was 17-of-27 passing for 164 yards and an interception. Masoli entered late in the third and finished 13-of-19 passing for 183 yards with two TDs and two interceptions, but Dyce said Brown will start next weekend against Montreal (10-2-1), which earned a 19-19 tie Saturday night with Calgary (4-8-1).

The Canadian Football Hall of Fame’s ’24 class of S.J. Green, Chad Owens, Weston Dressler, Vince Goldsmith and Vince Coleman, along with builders Ray Jauch and Ed Laverty (posthumously), was honoured at halftime. All were enshrined Friday night.

Steven Dunbar Jr. and Ante Litre had Hamilton’s other touchdowns. Marc Liegghio kicked two field goals, three converts and two singles.

Ottawa’s Lewis Ward booted two field goals and a convert.

Mitchell culminated a five-play, 96-yard march with a 20-yard TD pass to Litre at 13:34 of the third. It followed Jonathan Moxey’s interception.

Liegghio’s single at 7:05 of the third put Hamilton up 22-6.

Mitchell’s 54-yard TD strike to Dunbar at 14:18 of the second staked Hamilton to its 21-6 halftime lead. The advantage was well-deserved as the Ticats had more first downs (12-six), net offensive yards (260-144) and scored on both offence and special teams.

Mitchell was 14-of-20 passing for 210 yards and a TD, but his interception cost Hamilton at least a field-goal attempt. Dunbar had five receptions for 113 yards and the touchdown.

Brown completed 13-of-21 passes for 127 yards.

Liegghio’s missed 47-yard attempt went for the single at 12:45 to put Hamilton ahead 14-6. It followed a Kiondre Smith catch that was ruled incomplete and at the very least cost the Ticats a first down that would’ve kept the drive alive.

Ward’s 30-yard kick at 9:15 had pulled Ottawa to within 13-6.

Liegghio’s 19-yard field goal at 5:13 pushed Hamilton’s lead to 13-3. It followed the defence stopping Ottawa’s Dustin Crum on third-and-one, giving the Ticats possession at the Redblacks 40.

Liegghio’s 47-yard field goal opened the scoring at 2:42 before Ward tied in with a 24-yard boot at 8:44.

UP NEXT

Redblacks: Host the Montreal Alouettes (10-2-1) next Saturday, Sept. 21.

Tiger-Cats: Visit the Toronto Argonauts (7-6) on Friday.

This report by The Canadian Press was first published Sept. 14, 2024.



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Toronto FC downs Austin FC to pick up three much-needed points in MLS playoff push

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September 14, 2024

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TORONTO – Needing three points to keep their playoff push alive, Toronto FC’s Jonathan Osorio and Deandre Kerr stepped up with first-half goals against Austin FC on Saturday with goalkeeper Sean Johnson doing his bit at the other end.

A 76th-minute goal by Austin’s Owen Wolff made for a nervy ending but TFC hung on for a 2-1 win.

While Toronto (11-15-3) remains on the Major League Soccer playoff bubble in eighth place in the Eastern Conference (the eighth- and ninth-place teams in each conference square off in a wild-card playoff with the winner facing the top seed in the conference), other results went their way.

Seventh-place Charlotte, 10th-place Atlanta and 11th-place Philadelphia all lost while ninth-place D.C. United tied.

Toronto midfielder Alonso Coello called it “a game we had to win.”

“It’s a big win … To see that fight tonight was important,” added coach John Herdman.

Austin (9-12-7) came into the game in 11th place in the West, two points below ninth-place Minnesota. The Texas side has won just one of its last six league games (1-4-1).

Austin outshot Toronto 7-6 (6-2 edge in shots on target) in the first half but found itself trailing 2-0 at the break as Toronto took advantage of its chances and the visitors didn’t in their first-ever visit to BMO Field, before an announced crowd of 25,538.

Toronto had a dream start, catching Austin on the counterattack in the seventh minute. A sliding Austin player dispossessed an onrushing Kerr, who had been set free by a long ball from Coello, but the ball bounced to Osorio, who beat goalkeeper Brad Stuver with a rising shot.

It was the Toronto captain’s second goal of the season in league play and his 65th for TFC in all competitions. Only Sebastian Giovinco (83) and Jozy Altidore (79) scored more in Toronto colours.

TFC went ahead on another counterattack in the 30th minute after an Austin giveaway. Osorio found Richie Laryea outpacing his marker and the wingback unselfishly sent a perfect low cross across goal for Kerr to knock home for his third of the season.

Wolff, the son of Austin head coach Josh Wolff, made it interesting with his late strike. The 19-year-old U.S. youth international, controlling a long ball, beat defender Raoul Petretta and then waited out Johnson before slotting it home for his first of the season.

Toronto survived a nervy six minutes of stoppage time as Austin pressed for the equalizer. Austin outshot Toronto 14-9 (8-3 in shots on target) and had 52.5 per cent possession.

The win evened Toronto’s home record at 7-7-0, while Austin slipped to 3-8-3 on the road.

It was a costly evening for Austin with defender Brendan Hines-Ike, midfielder Jhojan Valencia and star attacker Sebastian Driussi allpicking up cautions to miss Wednesday’s game with Los Angeles FC due to yellow-card accumulation.

Toronto defender Shane O’Neill will miss Wednesday’s game against visiting Columbus for the same reason. Toronto could be short mid-week, too. The hope is veteran centre back Kevin Long, who missed Saturday’s game after tweaking his hamstring in training, will be good to go.

Toronto has five games remaining, including three more at home as it looks to return to the post-season for the first time since 2020 when it lost to Nashville after extra time at the first hurdle.

It is a challenging road.

TFC hosts Columbus, the New York Red Bulls and Inter Miami while playing away at the Colorado Rapids and Chicago Fire. All but Chicago are in playoff positions.

The only previous meeting between Toronto and Austin was in May 2023, when Zardes scored a 91st-minute winner to give Austin a 1-0 win over visiting Toronto, which was then mired at the bottom of the Eastern Conference. That loss prompted a post-game outburst from Italian star Federico Bernardeschi about TFC’s drab play.

Then-coach Bob Bradley benched Bernardeschi for the next game.

Current coach John Herdman made four changes to his starting 11 with Bernardeschi and Osorio returning from suspension and Coello and Kerr also slotting in. Coello, who had missed the last eight league games with a hamstring injury, was impressive in his 59-minute return.

Both Toronto and Austin suffered home losses last time out going into the international break. Toronto was beaten 3-1 by D.C. United while Austin lost 1-0 to Vancouver.

—

Follow @NeilMDavidson on X platform.

This report by The Canadian Press was first published Sept. 14, 2024.

The Canadian Press. All rights reserved.



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CF Montreal finds its groove with 2-1 win over Charlotte

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September 14, 2024

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MONTREAL – CF Montreal is back in the win column after securing a 2-1 Major League Soccer win over Charlotte FC on Saturday night at Stade Saputo.

Montreal’s form had suffered of late, with just one win in MLS since July, but Laurent Courtois’ squad showed a level of poise and control over the tempo of the game that had not been seen since the beginning of the season.

“What we’ve changed in the last few weeks or months in terms of our methodology or coaching, is nothing. We did the exact thing, We had the exact same words, and we expressed them the exact same way,” said Courtois. “Today, everything just clicked.”

Caden Clark scored for the first time as a Montreal (7-12-9) player in the 23rd minute, in addition to Bryce Duke’s goal three minutes later that ended up being the winner, while Tim Ream found the back of the net for Charlotte (10-10-8).

Montreal had the first major scoring chance of the match after 15 minutes of play. With a free kick roughly 25 metres away from goal, Gabriele Corbo sent a near-perfect shot smashing off the crossbar.

Montreal would continue to dictate the tempo in the opening phase, finding first blood just seven minutes later.

Following a phenomenal triple-save from Charlotte goalkeeper Kristijan Kahlina, the ball fell to Clark who volleyed the ball into the wide-open net, picking up his first goal for the club.

“I think you don’t lose the feeling (of scoring), everything happens for a reason, you just can’t lose yourself in the chaos,” said Clark, who had missed a full season due to injury and was briefly without a club, but was grateful for Courtois’ confidence in him.

“(To have a coach’s confidence) is huge and is something I’ve had both ends of so you just can’t take advantage of that in the wrong way. I’m going to keep my discipline with the game plan and keep my head right.”

With momentum completely on their side, the home side doubled the lead just three minutes later. Montreal continued to build up play on the left flank and found a streaking Raheem Edwards in behind the defence who cut the ball back to Duke, sending the Stade Saputo crowd into a frenzy.

Just after the half-hour mark, Charlotte pulled one back through a set piece — something Montreal has struggled defending all season — as Ream rose above everyone at the back post to score his first with his new club.

The second half began in a similar fashion to the end of the first, with Charlotte pressing high up the pitch and forcing several turnovers in dangerous areas. After surviving the pressure, Montreal began to regain control of the game near the hour mark, enjoying the lion’s share of the possession while Charlotte looked to hit back on the counterattack.

“I think when we conceded that goal we were like ‘here we go again.’ 2-1 is a tough lead before halftime … and at the beginning of the half we kind of shot ourselves in the foot and they pressed a bit more, they moved a bit more forward and that opened some gaps,” said captain Samuel Piette.

“I was happy with that, it shows character. At the end of the day, we just wanted the three points and that’s what we got.”

As the game progressed, Charlotte pushed harder to find an equalizer but to no avail. With only one shot on target conceded, the second-worst defence in the league put up an impressive front and confidently rebuffed every single Charlotte attack.

“I’m a big fan of the back five’s performance in their discipline, competitiveness, and synchronization with balls in behind,” said Courtois.

“We can’t explain sometimes in a game it’s not there, they’re capable and today they showed it. Let’s see tomorrow.”

UP NEXT

Both teams are back in action on Sept. 18 away from home as Montreal will look to avenge a 5-0 rout against the New England Revolution while Charlotte visits Orlando City SC.

This report by The Canadian Press was first published Sept. 14, 2024.

The Canadian Press. All rights reserved.



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