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Résumé (français)

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Résumé (anglais)

Both Canada and the United States are increasingly reliant on immigrant physicians for the provision of primary care and specialist health services, particularly in more rural regions. However immigrant physicians who obtained their medical training elsewhere face a costly and time consuming process to be licensed to practice medicine in the host country. Furthermore, key differences between Canadian and US immigration policy for skilled immigrants may mean that internationally-educated physicians migrating to Canada are less likely to become licensed to practice medicine. In this paper, we analyze the earnings, occupations and post-migration schooling decisions of immigrants with medical degrees using the 2000 United States Census and the 2001 Canadian Census. In both countries, recent immigrants with medical degrees are at a significant earned income disadvantage relative to the native born with medical degrees while immigrants from earlier arrival cohorts are at an earnings advantage relative to the native born. In Canada, immigrants with foreign medical degrees are much less likely to be employed as physicians than either the Canadian born or immigrants with Canadian medical degrees. Recent immigrants with medical degrees are more likely to be studying either full-time or part-time than are the Canadian born or other immigrants with medical degrees and this is true whether or not the individual is employed as a physician. The same is not true based on the US analysis of individuals working as physicians. This difference may be a result of the different immigrant selection systems for skilled workers and professionals. The design of the Canadian points system creates a greater risk of selecting immigrants with medical degrees who are unable to find work as physicians in Canada relative to the United States.