Immigrant medical specialists in B.C. see little improvement following licensing reforms

Vancouver resident Dr. Hassan Moustafa was hoping that recent changes to the BC College of Physicians and Surgeons licensing bylaws would give him a direct route to getting his career back as a general surgeon.

When that didn’t happen, his next best bet was to find a supervised associate physician position. So far, that has proven difficult.

Moustafa moved to Canada in 2017, after practising independently for seven years as a general surgeon. His previous roles included heading an emergency hospital in the Kurdistan region of Iraq.

But in Canada, he hasn’t been able to find a paying supervised position that matches his experience as a general surgeon.

“I am not asking to enter independent surgical practice without assessment or supervision,” Moustafa said.

The amended licensing bylaws, which came into effect July 6, allow eligible internationally trained physicians with recognized postgraduate qualifications to apply directly for a full medical licence instead of having to work first under a provisional licence.

In a news release announcing the province’s support for the changes, B.C.’s health ministry stated it would reduce paperwork and help eligible doctors begin independent practice sooner while maintaining patient care standards.

According to the College of Physicians and Surgeons of BC, eligibility depends on recognized postgraduate training and certification; Syria and Iraq are outside the approved jurisdictions for this direct licensing route.

Physicians with training from those countries must pursue other pathways, which may require further assessment, training or supervised employment.

In an emailed response to New Canadian Media, the College identified Australia, Ireland, the United Kingdom and the United States as recognized training jurisdictions for eligible family physicians. Specialists must have completed postgraduate training and hold a "completion-of-training certificate and specialty certification” from an approved jurisdiction. “Not all specialties are approved in each jurisdiction.”

The College of Family Physicians of Canada recognizes the same four countries because it considers their postgraduate family medicine training, accreditation and certification standards comparable to Canadian requirements.

A review published in July 2022 recommended continuing recognition of the same countries for family medicine. For specialists, Canada's national certification body, the Royal College of Physicians and Surgeons, maintains a separate approved jurisdiction route.

B.C.'s College of Physicians and Surgeons' eligibility requirements consider where physicians complete their postgraduate training and the certification they hold, rather than their citizenship or birthplace. The July 2026 changes do not grant automatic licences to practise medicine.

Rosemary Pawliuk, president of the Society for Canadians Studying Medicine Abroad (SOCASMA), said licensing should depend on individual competence, not the country where a physician trained. Her organization helps Canadians educated overseas return to practise here.

Pawliuk said the changes have benefited many graduates of overseas medical schools, while immigrant physicians trained outside recognized jurisdictions continue to face barriers to assessment and training.

Meanwhile, staffing shortages continue to disrupt medical care in B.C. On Oct. 20, CJDC-TV reported that the District of Hudson’s Hope in northeastern B.C. experienced repeated shutdowns of its emergency department, which the region’s health authority attributed to staffing challenges.

B.C. is also recruiting overseas. A Sept. 21 health ministry release reported that 171 physicians, 445 nurses, 78 nurse practitioners, plus 44 allied health professionals had accepted jobs through its U.S. campaign.

[caption id="attachment_43466" align="alignleft" width="326"] Dr. Hassan Moustafa[/caption]

Moustafa supports B.C.’s recruitment efforts, but said he also wants more opportunities for physicians already living in Canada.

During the pandemic, he worked as a COVID-19 tester for a Vancouver-based private health-care company. More recently, Moustafa travelled between Canada and Iraq to practise as a licensed general surgeon in the Kurdistan region because he has been unable to find a job in his specialty in Canada.

He said he is now focusing on remaining in Canada with his family and pursuing opportunities in surgery, patient safety and quality improvement.

“The biggest consequence has been lost professional income,” Moustafa said. “I have spent years unable to work as a surgeon in Canada.”

He said he has a profile with Health Match BC, a health-care recruitment service, and that his medical credentials have been verified with the institutions that issued them.

He has applied for associate physician roles and was interviewed for one general surgery position, but lost the job to another candidate.

“In several cases, I was told that there was clinical interest or need, but that funding for additional associate physician positions was limited, paused or unavailable,” he said.

Health Match BC’s published requirements are that associate physicians have employer sponsorship and work under supervision with accredited teams. These positions permit clinical work but not independent practice. To meet the criteria, a candidate has to find a suitable job as well as meet licensing requirements.

The Health Employers Association of British Columbia’s 2024-25 annual report stated that 106 associate physicians were working in B.C.

But Health Match BC said that number came from the B.C. College’s public directory for 2024-2025; it did not confirm how many associate physicians were actually working and does not collect data on funded, filled or vacant associate physician positions in province.

The directory also doesn't distinguish immigrant physicians already living in B.C. from Canadians educated abroad or recruited from overseas.

Mervat Bazary, a Syrian specialist who arrived in Canada in 2023, is working to rebuild her career.

She practised as an ear, nose and throat specialist for 10 years before moving to B.C, then spent two years improving her English. She has recently enrolled at Douglas College in New Westminster, B.C. in a hearing instrument practitioner diploma program.

Eligible international medical school graduates can also look for residencies to complete the requirements to practise medicine in Canada. In B.C., the University of B.C.'s Clinical Assessment Program assesses international medical graduates seeking residency training in the province.

This group includes immigrant doctors as well as Canadians who studied medicine abroad. UBC reported 360 assessment participants in 2023; 358 in 2024; and 352 in 2025. The number doesn't reflect how many applied for residency positions.

Doctors who successfully complete the assessment program can apply for residency positions through the Canadian Resident Matching Service.

The UBC Faculty of Medicine stated that the number of dedicated entry-level international medical graduates positions have increased from 18 to 58 since 2010. It said all of those positions, which are funded by B.C.'s health ministry, are filled every year.

In 2024, B.C. added another 20 entry-level positions that are open to eligible Canadian and international medical school graduates.

Copyright 2026, New Canadian Media. All rights reserved.

Dayo Ojerinde, Local Journalism Initiative Reporter, New Canadian Media.