Dr. Komal Ambaliya, who studied medicine in India and has worked internationally, says she cannot get her medical licence in New Brunswick because she has neither been recruited by a hospital nor has access to an assessment centre for the required testing in the province.Photo: Submitted

Original Published on Jul 30, 2022 at 20:56

By Rhythm Rathi, Local Journalism Initiative Reporter

A Quispamsis doctor who studied in India says she cannot practise medicine in New Brunswick, despite the ongoing doctor shortage, without first either returning to medical school or undergoing an assessment in another province.

And that’s because New Brunswick lacks an independent assessment centre for international doctors who aren’t recruited by hospitals in the province, according to Ed Schollenberg, registrar of the province’s College of Physicians and Surgeons of New Brunswick.

Dr. Komal Ambaliya has a bachelor of medicine, bachelor of surgery (MBBS) from Saurashtra University in Gujarat, India. She’s also got three years of experience as a practising general physician in Qatar, U.A.E. She and her husband Vishal Ambaliya immigrated to Newfoundland and Labrador in 2018 before moving to New Brunswick in 2021 due to her husband’s employment.

But the Ambaliyas say they started to regret their move after contacting the College of Physicians and Surgeons of New Brunswick and hospitals in the province.

They say they learned the only way for some internationally educated medical graduates to get licensed in New Brunswick was to get hired by a hospital because it has the capacity to do assessments, but in order to get hired at a hospital, they were told graduates already with licences from the province’s regulatory college were preferred.  

“It’s like chicken and egg,” said Vishal Ambaliya. “They don’t give a job without a licence, but [the] licence [authority] says you need a job to get licence.”

“I gave up,” said Dr. Komal Ambaliya. “I was thinking in future I will not [be] able to do anything.”

According to her research, Ambaliya says she’ll either need to clear a few exams and go back to medical school in Canada, or pass the exams and become eligible for the National Assessment Collaboration’s Practice-Ready Assessment (PRA), a fast-track program for international physicians.

Seven provinces across Canada offer the assessment program as a route to licensure for international physicians who have completed residency and practised independently abroad. After a clinical field assessment over a 12-week period, successful candidates complete a return of service in a rural area of the province of assessment, according to the Medical Council of Canada website. 

But New Brunswick doesn’t offer a PRA program nor does it have any independent assessment centre for international doctors, meaning recruitment through a hospital is the only option for some international doctors, confirmed Schollenberg, with the College of Physicians and Surgeons of New Brunswick.

“Really, all I can end up telling people is that who can practise in New Brunswick is controlled by the hospitals through the regional health authorities, and it really does not have much to do with us,” Schollenberg said.

“If there is no door open there, potentially there is no door open anywhere in the province.”

Province considering fast-track program

That could change, though, under the New Brunswick Health Action Plan.

Department of Health spokesperson Adam Bowie said the province is “prioritizing the exploration and development of a practice readiness assessment (PRA) program for international medical graduates” under that plan.

“We want to enable international medical graduates to be able to practise in some capacity and provide services to New Brunswickers,” he continued in a statement Wednesday. “This is for both the benefit of these graduates, who can then use their skills and training in New Brunswick, and for the benefit of the health system overall.”

According to the health department, 25 per cent of physicians practising in New Brunswick have a medical degree from outside of Canada, and seven per cent have completed all their training outside of the country. 

Some countries have training and education that align well with Canada’s system of medical education and post-graduate training, Bowie noted. Those include the United Kingdom, the United States, Ireland, Australia, New Zealand and South Africa.

International doctors can sometimes be filtered out during the hiring process for New Brunswick hospitals, Schollenberg said, if there are candidates already with their medical licences ready to practise in the province. 

The Telegraph-Journal requested comment from both Horizon and Vitalité health networks about their hiring practices for international doctors. Neither provided comment as of press time.

Doctor’s son experiences the medical system firsthand

The Ambalyias know firsthand the staffing crunch in the province’s health-care system.

They had to take their two-year-old son to the Saint John Regional Hospital after he developed a fever and they feared an infection. 

“We didn’t have any family doctor,” Vishal Ambaliya said, noting they had been waiting for a doctor for a year before they were able to get one.

The couple says they left the emergency room with their son after waiting for four hours without getting medical treatment.  

But this is just a small example of the health-care crisis they’re seeing in the province. 

On July 12, a patient died in the emergency room of Dr. Everett Chalmers Regional Hospital in Fredericton while reportedly waiting for medical care. Days later, Dorothy Shephard was replaced as health minister by Bruce Fitch, Horizon Health Network president and CEO Dr. John Dornan was ousted from his role, and the boards of Horizon and Vitalité health networks were replaced by provincially appointed trustees.

At their latest meeting in Pictou, N.S. on June 29, Atlantic Canada’s four premiers admitted that despite a willingness to see physicians and surgeons take on patients across the entire region in efforts to get them the care they need faster, there aren’t any doctors to share.

As of July 21, more than 65,000 New Brunswickers were on a waiting list for a family doctor, the health department told Brunswick News, and yet a family doctor looking to set up a practice in greater Moncton last year was told by Vitalité Health Network that there were no physician vacancies in the area.

In an interview this week, Health Minister Bruce Fitch addressed social media posts from doctors who say they are looking to practise in the province but had not gotten a call about available positions. Fitch said he is willing to take calls from doctors himself.

“We need doctors,” said Dr. Mark MacMillan, president of the New Brunswick Medical Society, in an interview. “Our training numbers are lower than what our attrition rate is.”

Dr. Komal Ambaliya is now currently preparing for the post-graduate studies college matching exam to become a Licentiates of the Medical Council of Canada. That exam that would make her eligible for a PRA program in another province simultaneously.

She is trying to open every possible avenue to resume her practice by studying for more than 10 hours a day, according to her husband Vishal Ambaliya. That could ultimately mean practising medicine in another province.

“You don’t give it to us here, we will move,” Ambaliya said.

– With files from Adam Huras, Andrew Waugh, Catherine Morrison and Sarah Seeley

This item reprinted with permission from The Telegraph-Journal, Saint John, New Brunswick