Health-care professionals are still having difficulty moving across borders within Canada despite provincial governments' efforts to reduce barriers to labour mobility.
Provincial governments agreed in December 2008 to a deal that was supposed to make it easier for professionals to transfer their licences between provinces.
But some doctors say the colleges who are responsible for approving licences aren't respecting the provincial agreement. "This is something that was agreed amongst the politicians but it was not agreed amongst the physicians," said Dr. Rubens Barbosa, a Brazilian-trained anaesthesiologist working in Edmundston, N.B., who recently had an application to transfer his licence to Ontario rejected.
The responsibility for who does and doesn't become licensed is left up to bodies that are run by physicians in each province.
The problem is that these colleges "are reluctant to accept a law that was proposed by the politicians and they're doing whatever they can to prevent this from happening," said Barbosa.
Provincial governments were hoping the changes would help fill in holes in the skilled workforce. Many provinces — including Ontario, Saskatchewan and Manitoba — are currently facing a shortage of doctors as many residents are unable to find a family physician.
About four million Canadians, or about 12 per cent of the population, don't have a family doctor, a 2009 poll conducted for the College of Family Physicians of Canada suggested.
A spokeswoman for the Ontario College of Physicians and Surgeons, the organization that rejected Barbosa's application, denied the charge that it doesn't respect the mobility law.
"The CPSO respects labour mobility," Kathryn Clarke wrote in an email.
But the body that represents colleges across the country said they are aware that those working to transfer special licences across provincial boundaries are still facing challenges.
Differing standards
The issue is that restrictions on special licences, which can include requiring the holders to be supervised by more experienced physicians and only allowing them to operate if the province has a shortage of the physicians' specialty, are not equivalent across provinces.
"We are working on how we could facilitate for them a mobility from one jurisdiction to another taking into account the fact that they don't have a full licensure," said Dr. Yves Robert, the president of the Federation of Medical Regulatory Authorities of Canada.
Robert said he expected a new agreement that would bring in a common set of standards for specially licensed physicians between provinces would be approved within a year.
The majority of physicians who practise with special licences in Canada are internationally trained, said Dr. William Lowe, a past president of the MRAC.
They usually use these as a stepping stone to becoming fully accredited and eventually helping to address the country's doctor shortages.
Barbosa said he has consulted with the Canadian Medical Protective Association, an organization that provides doctors with legal advice, and it is currently looking into the issue on his behalf.
Luce Lavoie, the director of communications for CMPA, did not confirm or deny that was the case. She also declined to comment on the overall issue of labour mobility for doctors because the organization has yet to issue a policy position on it.
Few approvals despite law
Numbers maintained by the colleges suggest the changes to the Agreement on Internal Trade, which was updated in April 2009 with the new labour mobility provisions, have done little to change the number of physicians moving from one province to another.
The College of Physicians and Surgeons of Nova Scotia has granted licences to about 250 applicants since April 2009, six of those under the labour mobility provisions.
"The numbers have not changed dramatically at all," said Bruce Thorne, manager of policy and communications for the college, referring to the approvals they've given since the new provisions were introduced.
The College of Physicians and Surgeons of Alberta has approved five applicants under the new labour mobility provisions out of a total of about a thousand approved in 2009 and 2010, said spokeswoman Kelly Eby.
They have another 22 who are currently in the application process.
The Ontario college rejected 26 applicants who had applied under the labour mobility provisions between January 2010 and April 2011, said Clarke. Most of these people had restricted licences.
Many other licensing bodies don't maintain numbers showing how many applicants who applied under the labour mobility provisions have been approved or rejected.
Barbosa had applied under the inter-provincial mobility rules the provinces had promised would bring an end to the restrictions for physicians.
The College of Physicians and Surgeons of Ontario rejected his application in December 2010.
Colleges are only required to accept an application under the labour mobility provisions if they have a similar category in their licensing process.
The Ontario college did not grant Barbosa a licence because they said there was no equivalent category in Ontario, a copy of the decision reached by the province's Health Professionals Appeals and Review Board reads.
But Barbosa disputed that claim, saying he already had a full licence he has been operating under for five years.
