Enhancing support for International Medical Graduates entering the Manitoba practice environment

By Wendy Elias-Gagnon

Manitoba is a cultural mosaic and the physician force is a testament to this.

Diversity within the medical profession is representative of the patient population in the province. Thirty-three per cent of practicing physicians in Manitoba have obtained their medical degrees internationally. This includes people from Canada who pursue medical training abroad and those who are born and trained internationally. 

Despite this diversity, The College of Physicians and Surgeons of Manitoba (CPSM) heard concerns from International Medical Graduates (IMGs) about the difficulties they encounter in practice. Concerns that came up repeatedly included registration issues, the assessment process, access to training and orientation, not enough mentorship and resources, and racial discrimination. CPSM invited a diverse group of IMGs to participate in focus groups to explore the issues further. 

“It was clear Manitoba needed a well-structured support system for IMGs,” said Dr. Nader Shenouda, a family and emergency medicine physician and CPSM president. He speaks from firsthand knowledge. ​“After listening to the issues raised by my colleagues, and as an IMG myself, I believe it is critical to ensure those with limited or no experience in the local practice environment have access to appropriate orientation, mentorship, and resources.” 

A collaborative approach 

With Dr. Shenouda as chair, CPSM established an IMG working group in 2024, which includes representatives from Doctors Manitoba, the Manitoba College of Family Physicians, the IMG Program at the University of Manitoba, Manitoba Health, Shared Health, and registrants with medical degrees obtained internationally, a clinical assistant and public representatives. 

The plan is to establish an orientation program, develop professional expectations and advocate for a peer network in the province. 

The working group’s first task is developing an orientation program. 

Having everyone at the table will ensure the orientation is comprehensive and serves the intended purpose of better preparing and supporting physicians new to the Manitoba practice environment, many of whom go on to practice in rural, northern, or remote communities. 

Fundamental topics such as Manitoba’s healthcare system and the role of physicians within it, anti-racism and trauma-informed practices, patient-centred care, documentation and maintenance of patient records and team-based practice will be covered in the orientation. 

“We need to be open to learning and growing together,” said Dr. Ganesan Abbu, a family physician and working group member. 

Dr. Abbu believes professionalism and mutual respect are key to successful collaboration between internationally trained physicians entering a new practice environment and physicians on the receiving end. ​“Recognizing the diverse expertise and experiences that international physicians bring; we need to commit to creating an inclusive and supportive workplace. This means upholding standards of ethical practice, communication, and patient-centred care.” 

Gaining insights from experience 

The group’s second priority is developing a standard of practice for physicians beginning their practice in Manitoba.

They are in the data-gathering stage and are launching a survey to learn more about the first-hand experiences of IMGs. They also want to hear perspectives from those with experience receiving and welcoming IMGs into their environments. 

“Patients and the health care system win when all physicians —regardless of their training background— are empowered to provide safe, effective, and compassionate care,” said Jeremy de Jong, interim director of registration at CPSM, who leads the group. 

De Jong believes the group is moving in the right direction and looks forward to receiving comprehensive feedback to ensure the orientation program and standard of practice address the needs identified. 

“Through respect, professionalism, and shared learning, we will build a healthcare community that thrives on trust, excellence, and patient-centred collaboration.”

He encourages everyone to participate in the survey, which will be anonymous and distributed to all CPSM registrants this spring.

Services for (MLPIMG) Program Participants

Doctors Manitoba is committed to supporting internationally trained physicians who are trying to acquire their license to practice in Manitoba. IMGs contribute significantly to the Manitoba healthcare system and patient care but are often separated from their families, culture and support systems.

One step has been reviewing our supports to participants in the Medical Licensure Program for International Medical Graduate (MLPIMG) program.

Unlike residents, MLPIMG participants have not been able to become DRMB members due to historical membership categories enshrined in the by-law.

The Board has made recommendations to change this and to increase our support by voting on a by-law change at the May 2025 AGM.

In the meantime, early in 2024 we took action to increase what we offer to the program participants:

• access to the practice advice and compensation team to discuss their return of service contracts and support them as they transition out of the MLPIMG program
• access to our Mentorship Program as mentees
• access to PAR peer support, and counselling for themselves, spouses, and adult children