Navigating licensure and practice in Canada: A qualitative study of barriers and supports among international medical graduates

Navigating licensure and practice in Canada: A qualitative study of barriers and supports among international medical graduates

Abstract

Background: International medical graduates (IMGs) play an important role in the healthcare system and currently constitute over a quarter of the physician workforce in Canada.

Objective: Our objective was to explore the experiences of IMGs in Canada, specifically the barriers they have faced, and supports they have received throughout their career.

Methods: We conducted a qualitative interpretive study, recruiting IMGs practicing in Canada. Using purposive and maximum variation sampling, and a pilot-tested semi-structured interview guide, we interviewed 40 IMGs. We asked about their pathway to licensure and challenges they faced and support they received throughout their career. Interviews were transcribed verbatim and analyzed using a hybrid deductive-inductive thematic analysis.

Results: IMGs have multiple pathways to licensure from a direct-to-practice pathway to years of examinations and residency applications. Before licensure and early in their careers, the challenges they face include financial concerns, adjustment to a new healthcare system, discrimination, and limitations of choice in practice location or specialty. Later in their careers, their challenges are related to issues with the healthcare system such as lack of resources. Some racialized IMGs described discrimination throughout their career. All IMGs described a sense of belonging and forms of social support, including through personal contacts, professional networks as facilitators throughout their careers.

Conclusions: Efforts to support IMGs should extend beyond licensure and address broader issues related to belonging, workplace integration, and equity within the healthcare system.

Reference

El Sherif R, Migally S, Claudio F, Fortier J, Garber G. Navigating licensure and practice in Canada: A qualitative study of barriers and supports among international medical graduates. Health Policy. October 2026. https://www.sciencedirect.com/science/article/pii/S0168851026001478