Canada recruits internationally educated health professionals. Credential recognition is only part of the challenge

Canada is actively recruiting internationally educated health professionals to address workforce shortages, while also working to streamline the process of credential recognition. The 2025 federal budget allocated $97 million over five years, starting in 2026–27, for the Foreign Credential Recognition Action Fund, which focuses on improving recognition in the health and construction sectors.

However, recognizing qualifications is just one aspect of the challenge; another crucial factor is professional integration, which examines whether these professionals enter appropriate employment, utilize their skills and experience, advance professionally, and remain within Canada's health workforce. As a researcher studying the experiences of Nigerian-trained health professionals in Canada and Nigeria, I have observed that the gap between credential recognition and professional integration can be significant.

While credential recognition determines if a person's training meets the standards for registration, integration delves into the career progression afterward. National data reveal that in 2021, only 57.7% of employed, internationally educated health professionals were working in health occupations. Recent reforms indicate that governments are addressing these barriers through various initiatives, such as supported practice, work placements, mentoring, and other pathways into employment.

These measures acknowledge that assessment and integration are distinct outcomes. Credential assessments confirm that individuals have met essential professional requirements, but labor-market outcomes reveal whether internationally educated professionals can ultimately employ their training. My research, conducted before the pandemic, involved interviewing 59 Nigerian-trained health workers in the Greater Toronto Area and 63 health professionals in Lagos and Ibadan, Nigeria.

Most participants faced difficulties obtaining professional registration and finding work in their respective fields. Some even had to switch careers or return to school, like a Nigerian-trained nurse who became a personal support worker due to her Nigerian nursing qualification being deemed less valuable than a degree. Another physician-in-training, who expected a smoother transition, opted for a registered practical nursing program to support his family.

Participants in Canada shared that three-quarters of their relatives, friends, and colleagues in Nigeria approached them for migration advice, often cautionary. They warned that migration might not be advisable for those already employed in Nigeria. Meanwhile, in Nigeria, 81% of respondents intended to migrate, with Canada being a top choice, but only 39% had sought advice from someone who had previously migrated.

Professional integration is a shared responsibility among multiple levels of government. While the federal government plays a central role in immigration selection and funding programs supporting credential recognition and labor-market integration, provinces and territories oversee their health workforces and are primarily responsible for professional recognition and licensure.

Enhancing integration necessitates action across these systems. Provinces, territories, and professional regulators should expand pathways beyond assessment, introducing supervised practice placements, bridging positions, and competency-based approaches that recognize prior practice. Existing federal programs already support measures like supervised practice, work placements, mentoring, and other employment pathways.

Governments and regulatory bodies should enhance outcome reporting, including time to licensure, occupational placement, and attrition rates, broken down by country of training and profession. Improved data would make patterns of delays and occupational underutilization more apparent, offering a stronger basis for evaluating whether reforms are effectively improving professional integration.

The federal government and provinces and territories should align immigration selection with health workforce planning and professional regulation to ensure Canada leverages the skills of internationally educated health professionals more effectively.