Midwife Faiza Abdullah is one of five midwives working at Hawthorne Midwives, serving Milton, Ont., and the surrounding neighbourhoods.Sammy Kogan/The Globe and Mail
When Faiza Abdullah came to Canada as a refugee in 2016, she encountered one big obstacle to her dream of becoming a licensed midwife.
It wasn’t that she didn’t know how to deliver babies. She had done so for years as an obstetrician-gynecologist in her native Syria. The problem was that Ms. Abdullah didn’t speak much English, and she couldn’t find a language program that taught terms such as pre-eclampsia, dilation and cervical effacement.
“For me, every word in the book was new because I came from zero,” Ms. Abdullah said. “I came as somebody who studied medical language in Arabic.”
Fortunately for Ms. Abdullah, an acquaintance introduced her to Eva Grunfeld, a physician and professor at the University of Toronto, who agreed to tutor Ms. Abdullah weekly in a campus coffee shop.
The sessions turned out to be a boon for both women. Ms. Abdullah, now a practising midwife in Milton, Ont., picked up medical English faster than she would have otherwise, while the now-retired Dr. Grunfeld was inspired to start a volunteer program that she hopes will provide her and other Canadian doctors a sense of purpose in retirement.
In September, Dr. Grunfeld and ACCES Employment, a Toronto not-for-profit agency that helps newcomers find jobs, will launch Health English Language Pro, or HELP. The program will pair Canadian physician volunteers with internationally trained MDs looking for work in the health sector, whether as doctors or other professionals. An eight-week pilot phase involving four pairs wrapped up in the spring.
“It’s a really unique niche,” Dr. Grunfeld said. “I’m thinking of it as something valuable for the volunteer, just like it’s valuable for the newcomer. I’m thinking of it as a partnership.”
Born in Syria, Faiza Abdullah left as a refugee in 2013, eventually arriving in Canada in 2016.Sammy Kogan/The Globe and Mail
Dr. Grunfeld and ACCES are starting the program at a moment when all levels of government have vowed to streamline the processes by which foreign-trained doctors, nurses and other health professionals become licensed to practise in Canada.
In the face of a national health human-resources shortage, federal Health Minister Mark Holland and his provincial and territorial counterparts said at their annual meeting in Charlottetown last fall that ensuring immigrant doctors can work in their field was a top priority.
The number of internationally trained doctors practising medicine in Canada rose to 24,967 in 2022, up from 19,625 in 2013, according to the Canadian Institute for Health Information. Their share of total doctors in the country rose to 27 per cent from 25 per cent during that period.
But many other permanent residents with health experience can’t break into the sector, according to Statistics Canada. In 2021, about 67 per cent of internationally educated physicians were working in health care, compared with 95 per of doctors who trained in Canada.
Cameron Moser, the senior director of services and program development at ACCES Employment, said that although his agency and others offer bridging programs to help immigrant health workers find jobs and get licensed, the process remains onerous, especially for doctors.
The HELP program isn’t meant to dismantle those licensing barriers. It’s designed to help newcomer doctors learn enough medical English to surmount them, with the moral support of veteran physicians delivered through a dozen one-hour conversations over video.
Mr. Moser said that during the pilot project, newcomer doctors reported that the virtual sessions lessened their professional isolation. “A lot of what we heard from them was how much additional confidence they developed,” he said.
Some already spoke English but benefited by learning the Canadian acronyms and abbreviations that make up what Dr. Grunfeld calls “the secret language” of medicine.
“It’s just part of the conversation flow between two physicians who are trying to communicate quickly with each other,” she said. “That is very difficult to penetrate if you haven’t trained locally.”
Pilot participant Ibidun Ajuwon practised general medicine in Nigeria before moving to Canada last year. Although she speaks English fluently, she still found her conversations with retired Winnipeg doctor Jeff Sisler illuminating.
The talks helped her understand certain “nuances” of Canadian practice, such as its emphasis on confidentiality when diagnosing and treating patients.
Faiza Abdullah has been working as a midwife at the clinic for over four years now, and pulls on her previous international training as an obstetrician-gynecologist to help deliver care to clients.Sammy Kogan/The Globe and Mail
“Where I’m from, the cultural difference is most people in Nigeria, it’s more like they want their family to know,” she said. “In Canada, you really have to dot your i’s and cross your t’s to be sure that the patients really want their family members to know.”
Dr. Sisler said talking with Dr. Ajuwon was a great way to stay engaged in medical education after retiring as a family doctor and executive director of professional development and practice support at the College of Family Physicians of Canada.
He and Dr. Grunfeld hope other retired physicians will feel the same way. HELP plans to launch a website and begin a wider search for volunteers in the fall, Dr. Grunfeld said.
In the meantime, she and others involved in the development of the program are spending the summer drafting more written materials to guide conversations, including case studies that would allow newcomers to role-play their medical English in realistic scenarios.
The hope is that formal HELP pairings will be as successful as the informal pairing of Ms. Abdullah and Dr. Grunfeld.
After walking from Syria to a Jordanian refugee camp while pregnant with her fourth child and then moving her family to Canada, Ms. Abdullah was eager to start earning a living. That is why she pursued midwifery instead of a Canadian medical licence.
She worked hard to learn enough English to qualify for a one-year midwifery bridging program at what is now Toronto Metropolitan University. She struggled to read medical textbooks on her own at the library every day until she connected with Dr. Grunfeld.
“Without Eva, I might have been able to get into the program the next year, or the next year,” Ms. Abdullah said. “But with her help, I got in in a very short time.”