Registrar’s message: steps taken to expand pathways to licensure
These are challenging times for British Columbians seeking access to care in the face of health human resourcing shortages. The College is working closely with the Ministry of Health to identify solutions to address the physician shortage and provide opportunities for qualified IMGs to be licensed in BC’s health system.
Following is an overview of the initiatives undertaken this past year to expand pathways to licensure.
On November 27, 2022, the BC government announced plans to increase the number of international medical graduates (IMGs) practising in BC by
- introducing a new associate physician class of licensure,
- introducing a new restricted class of registration that will allow physicians who trained in the US and who hold American Board of Medical Specialists (ABMS) certification in emergency medicine, internal medicine, or pediatrics to practise medicine in British Columbia with limits and conditions, and
- expanding the Practice Ready Assessment program.
Associate physician class of licensure
In January of this year, amendments to the Bylaws for the new associate physician class of licensure came into effect: section 2-25 associate physician – acute care; and, section 2-26 associate physician – community primary care.
Associate physicians are not licensed for independent practice; they are employees of the health authorities and must work under the supervision of the attending physicians in programs that have been accredited by the College. There are six programs that have recently received accreditation and are now eligible to hire associate physicians. Currently, two associate physician registrants have obtained licensure with many more actively proceeding through the application process. The College anticipates accrediting 27 more programs and registering approximately 140 registrants in the associate physician – acute care class by the end of this fiscal year.
Community primary care
The College is working with the Ministry of Health and health system partners to develop a structure that enables associate physicians to work in community primary care settings. As this is a new classification, planning is required to ensure appropriate and safe integration of associate physicians into community primary care settings. This includes establishing an employment and compensation model as well as a regulatory framework with supporting policies on clinical supervision. It is important that policies and processes are in place to ensure associate physicians are supported to deliver quality medical care in a team-based environment to BC patients.
Interested applicants are encouraged to engage with Health Match BC (HMBC), the free health professional recruitment service funded by the Government of BC. HMBC supports applicants in navigating a pathway to practise medicine in the province, including guiding them through the licensing and registration process, and matching skills and interests to employment opportunities throughout BC.
USA certified class of licensure
The new USA certified class permits a registrant trained in the United States who holds American Board of Medical Specialists (ABMS) certification in emergency medicine, internal medicine, or pediatrics to practise medicine in British Columbia with limits and conditions granted by the Registration Committee. A registrant in this class is responsible and accountable for their medical practice. Pediatrics and internal medicine specialists can practise in community settings. There are currently 15 applications for registration being processed.
Practice Ready Assessment Program
The College is a key partner to PRA-BC and is working to accommodate increased levels of applicants as the program is looking to triple its capacity to complete assessments by 2024/25.
The College does not currently have physician assistants (PAs) as a class of licensure. The decision to introduce PAs into BC’s health-care system rests with the provincial government. If the government decides to introduce PAs to BC, the College will proceed with appropriate licensing and regulation.
Medical regulatory authorities (MRAs) across Canada agree that there would be value in a pan-Canadian licensure system. However, enabling this would require constitutional changes and federal regulatory oversight, which would be complicated to implement in a country as large as Canada, where every province administers a different Act. More flexible options that are easier to implement include licence portability agreements, which would allow provincial regulators to license out-of-province physicians temporarily while retaining the authority to regulate.
The College is continuing to work with the other MRAs to find viable solutions that minimize administrative burdens on physicians who hold licences in several jurisdictions and improve access to care, particularly to patients in remote communities.
Heidi M. Oetter, MD
Registrar and CEO
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