February 29, 2024 — Understanding the sources of Canada’s health workforce and the streams through which people enter health professions can help planners assess future education and recruitment strategies to meet growing population needs.
Supply of internationally educated health professionals
Internationally educated health professionals (IEHPs) have long made up a considerable proportion of our health workforce, with Canada sitting slightly above the Organisation for Economic Co-operation and Development (OECD) average for internationally educated supply.Reference1 As health worker shortages became a key challenge during the pandemic and have continued to be a major issue for health system recovery, many jurisdictions have taken steps to further bolster their workforce capacity by tapping into this resource through expedited or streamlined registration.Reference2
In 2022, pharmacists had the largest proportion of IEHPs (of those professionals discussed in this report) — more than a third of licensed pharmacists in Canada were internationally educated. This was followed by physicians, with 27% of the workforce being international medical graduates.
| Professional | 2013 | 2022 | ||
|---|---|---|---|---|
| Number internationally educated | Percentage of total supply | Number internationally educated | Percentage of total supply | |
| Physicians | 19,625 | 25% | 24,967 | 27% |
| Family medicine physicians | 11,028 | 28% | 14,303 | 31% |
| Specialists | 8,597 | 23% | 10,664 | 23% |
| Regulated nurses | 31,365 | 8% | 43,267 | 10% |
| Nurse practitioners | 172 | 5% | 366 | 5% |
| Registered nurses | 26,251 | 9% | 33,059 | 10% |
| Licensed practical nurses | 4,583 | 4% | 9,716 | 7% |
| Registered psychiatric nurses | 359 | 7% | n/r | n/r |
| Occupational therapists | 1,061 | 7% | 1,239 | 6% |
| Physiotherapists | 2,606 | 13% | 6,469 | 23% |
| Pharmacists | 7,343 | 27% | 12,469 | 35% |
Notes
n/r: 2022 data for registered psychiatric nurses (RPNs) is not reported due to data quality issues for location of graduation.
RPNs are currently regulated in the 4 Western provinces (Manitoba, Saskatchewan, Alberta, British Columbia) and the Yukon.
In Ontario, licensed practical nurses are referred to as registered practical nurses.
When data on location of graduation is unavailable for a given type of professional in a province/territory for at least one year of the analysis, it is excluded from all years to ensure comparable trending for that group.
Sources
Health Workforce Database, Canadian Institute for Health Information.
Scott’s Medical Database, Canadian Institute for Health Information, with raw data provided by iMD (© 2023 iMD Health Global Corp.).
The proportion of internationally educated nurses (IENs) in Canada has traditionally been lower compared with that of pharmacists and physicians. Despite this, IENs made up a larger percentage of those entering the nursing profession in 2022 compared with previous years. In 2017, IENs made up, on average, 8% of the newly licensed nursesFootnotei in Canada. In 2022, IENs represented an average of 12% of new nurses across the provinces and territories, an inflow of over 5,000 IENs.
Ontario (22%) and Nova Scotia (19%) had the largest proportions of IENs in their supply of newly licensed nurses in 2022. The Atlantic provinces saw some of the largest increases relative to previous years.
More information on distribution of IEHPs across jurisdictions is available in the professional-specific data tables.
Percentage of new regulated nurses who are internationally educated, by province/territory, 2013, 2017 and 2022
Text version of graph
| Jurisdiction | 2013 | 2017 | 2022 | Difference between 2022 and 2013–2021 is statistically significant (p<0.01)? |
|---|---|---|---|---|
| Pan-Canadian average | 7% | 8% | 12% | Yes* |
| N.L. | 1% | 2% | 4% | No |
| P.E.I. | 8% | 4% | 11% | No |
| N.S. | 5% | 8% | 19% | Yes* |
| N.B. | 2% | 1% | 13% | Yes* |
| Que. | 7% | 6% | 13% | Yes* |
| Ont. | 16% | 13% | 22% | Yes* |
| Man. | 13% | 13% | 14% | No |
| Sask. | 8% | 12% | 14% | No |
| Alta. | 8% | 10% | 8% | No |
| B.C. | 10% | 8% | 10% | Yes* |
| Y.T. (NPs and RNs) | 4% | 5% | 8% | No |
| N.W.T. (LPNs) | 0% | 17% | 12% | No |
| N.W.T./Nun. (NPs and RNs) | 5% | 11% | 8% | No |
Notes
* In 2022, the proportion of new nurses who were internationally educated showed a statistically significant difference (p<0.01) compared with the previous 9 years (2013 to 2021).
NPs: Nurse practitioners; RNs: Registered nurses; LPNs: Licensed practical nurses.
New regulated nurses are those who were licensed to practise in the reference year but not the year prior.
Canada does not currently have a national unique identifier for nurses; therefore, we are unable to discern whether a nurse obtaining a licence for the first time in a given province or territory was licensed in a different province or territory before that.
Regulated nurses are NPs, RNs, LPNs and registered psychiatric nurses (RPNs). RPNs are regulated only in the 4 Western provinces (Manitoba, Saskatchewan, Alberta, British Columbia) and the Yukon.
Data for Nunavut is not available.
In Ontario, licensed practical nurses are referred to as registered practical nurses.
For more information regarding collection and comparability of data as well as notes specific to individual provinces and territories, refer to the professional-specific methodology notes on CIHI's website.
Source
Health Workforce Database, Canadian Institute for Health Information.
Assessing potential capacity
While Canada leverages internationally trained professionals to create sufficient health workforce supply for the country, not all landed immigrants with international health education are currently employed in health care.
According to Statistics Canada, more than 250,000 landed immigrants who are IEHPs were living in Canada in 2021, but many were not working in the health sector.Reference3 Roughly 67% of IEHPs who had trained in medicine were working in health care, compared with 95% of physicians who had trained in Canada. Similarly, 69% of IEHPs who had trained in nursing were employed in a health occupation, compared with 87% of Canadian-educated nurses.Reference3
Further, when IEHPs are employed in the health sector, it may not be in the profession in which they are trained. For example, only 42% of IEHPs who had trained in nursing were employed as registered nurses, registered psychiatric nurses or licensed practical nurses. Among those trained in medicine, only 41% practised as a general practitioner, family physician, or clinical or laboratory specialist.Reference3 Future strategies to bring those not employed in their trained profession into the workforce will be valuable for boosting capacity in Canada’s health care systems.
Top occupations of internationally educated health professionals who are employed in Canada, by field of study, 2021
Text version of graph
In 2021, these were the top occupations of internationally educated health professionals, by their field of study:
Studied nursing: RN or RPN, 34%; PSW, 21%; LPN, 8%; Other, 37%
Studied medicine: GP or FP, 28%; Clinical or laboratory specialist, 13%; RN or RPN, 4%; PSW, 4%; Sonographer, 3%; Other, 48%
Studied pharmacy: Pharmacist, 46%; Pharmacy assistant, 9%; Pharmacy technician, 5%; Other, 40%
Studied dentistry: Dentist, 25%; Dental assistant, 13%; Dental hygienist, 7%; Dental technician, 7%; Other, 48%
Notes
RN: Registered nurse; RPN: Registered psychiatric nurse; LPN: Licensed practical nurse; GP: General practitioner; FP: Family physician; PSW: Personal support worker.
Internationally educated health professionals are defined as landed immigrants who hold a post-secondary certificate, diploma or degree from outside Canada in a health field of study and who reported it as their highest certificate, diploma or degree. Temporary residents and Canadian-born people who received their highest certificate, diploma or degree in health in a foreign country are excluded.
PSWs include nurse aides, orderlies and patient service associates.
RPNs are regulated only in the 4 Western provinces (Manitoba, Saskatchewan, Alberta, British Columbia) and the Yukon.
Source
Adapted from Statistics Canada. Internationally educated health care professionals in Canada: Sociodemographic characteristics and occupational distribution. Accessed November 7, 2023. This does not constitute an endorsement by Statistics Canada of this product.
Related resources
Footnotes
i.
Canada does not currently have a national unique identifier for nurses; therefore, we are unable to discern whether a nurse obtaining a licence for the first time in a given province or territory was licensed in a different province or territory before that.
References
1.
Organisation for Economic Co-operation and Development. International migration of doctors and nurses. In: Health at a Glance 2023: OECD Indicators. 2023.
2.
Canadian Institute for Health Information. Health Workforce Intervention Scan [internal document]. 2023.
3.
Frank K, Park J, Cyr P, Weston S, Hou F. Internationally educated health care professionals in Canada: Sociodemographic characteristics and occupational distribution. Economic and Social Reports. 2023.