Lillie Lum, Ph.D. York University, Ontario, Canada

1. Internationally-Educated Health Professionals Seeking Entry into the Canadian Labour Market:Exploring Adjustments of Post-Secondary Institutions Lillie Lum, Ph.D. York University, Ontario, Canada 8th National Metropolis Conference, March 23-26, 2006

2. Acknowledgement Research jointly funded by Social Sciences and Humanities Research Council (SSHRC), Human Resources and Skills Development Canada (HRSDC) & Industry Canada Co-Investigator: Sheryl Nestel, OISE/UToronto

3. Employment Integration Problems for Immigrants • Underutilization of highly qualified, skilled new immigrants (Statistics Canada, 2002) • Exclusionary regulatory process, ie. gate being narrow (Alboim et al. 2005) • Increased numbers of skilled immigrants but downward trend in earnings within last decade (Reitz, 2005) • Solutions are ineffective in addressing health professions skill shortage; supply and demand problems persist (C.N.A., 2005; Hawthorne, 2001)

4. Context: What is unique about Western Health Professions ? • Governed by profession-specific regulatory colleges, eg. College of Physicians and Surgeons, College of Nurses, College of Teachers…. • All members must demonstrate competence in pre-determined profession-specific standards (C.N.A., 2005) • Bridging education programs is often a requirement prior to licensure or registration • Healthcare in North American is highly standardized and technology-based practice

5. Regulated Professions • REGULATORY COLLEGES HAVE delegated authority through legislation • set policies, procedures and practices for admitting new members to the registry • issues licences or registration • role to protect public and members through ensuring standardized competencies are met.

6. Success rates of International/Canadian Health and Other Candidates on Registration Exams(Ontario Regulators for Access, 2003)-38 Professions

7. Professional Bridging Education • Bridging Education Programs Post-secondary educational programs offered by either community colleges (diploma granting) and universities (degree granting) to provide additional knowledge/skills based on credential and competency assessments; part or full time status; varies from several months to 2 years.

8. Bridging Education continued… • Success rates of students-No data available! • In Ontario, 19 of the 30 regulatory bodies can refer applicants to bridging programs • 6 of these regulatory bodies serve in advisory capacity to bridging programs • Health professions bridging programs include nursing, midwifery, medical technicians, physiotherapy and pharmacy

9. Identified Best Practices: ‘Good Bridging Programs’ (CIITE Report, 2004) • Good fit between student learning needs and program • Collaboration between key stakeholders, such as regulators and PSE • Effective profession-specific language training • Comprehensive academic and social support services • Stable program funding • Financial assistance (student loans, scholarships) and access to additional non-financial resources • Faculty development to upgrade expertise • Genuine administrative support for continuity of program • Alumni follow-up to job entry

10. $$$ many institutions report overall under-funding Bridging education is not a big revenue generator Major differences in mandate between colleges (skill development) and universities (scholarship, innovation, research) in educational philosophy and operations (Rae Report, 2005) Curriculum tends to be based on Westernized as compared to global view of healthcare/education Specialized programs, such as bridging education are not part of mainstream Operate independently of industry demands, health professions, regulatory and government directives Overview of Post-Secondary Institutional Adjustment

11. Why are there so few good programs?…. Operational Issues -limited access for students -lack of sustained program funding -debate regarding integrated or independent programming -lack of best practice standards regarding curriculum design and teaching/learning practices -tend to be marginalized from mainstream Leadership Issues -competition between colleges and university for funding -lack of collaboration between professions, industry -role of government unclear, possibly not desired

12. Proposed Changes to PSE Bridging Education • Student Perspectives • Financial support mechanisms, e.g. bursary, loans for part time students • Integrated language training courses, with a focus on technical professional concepts • Comprehensive technological and academic student services • Opportunities for socialization into profession-specific practices

13. Proposed Changes to PSE Bridging Education • PSE Institutional Perspectives • Integrated programs with sustainable funding for educational program and other student services • Faculty development in curricular and teaching practice • Increased role of government in provision of funding; support development of best practice standards • Partnerships with regulators, professional associations and employers

14. [Post-secondary Institution] for outstanding performance and lasting contribution on {name, title} Bridging EducationCertificate of Excellence Granted: November 2, 2014