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The Law of Work
Health CareImmigrationStudent Post

Challenges Faced by Immigrants Working in the Medical Field

by Sadaf Saljooki May 8, 2020
written by Sadaf Saljooki May 8, 2020

Written by Sadaf Saljooki, 3L, University of Ottawa, Faculty of Law

Throughout history, Canada has encouraged immigration of well-educated workers in order to further Canada as a multicultural country and to improve its economic conditions. Yet, not all these educated workers are able to obtain positions in the professions in which practiced in their home countries. Research suggests that immigrant labour market success in professional areas of work has decreased over the years.[1] In particular, foreign trained medical workers are less likely to obtain positions in their field and are often forced to resort to occupations unrelated to their skills.[2] Of course, Canada’s universal healthcare system seeks the most skilled and experienced health care workers, but these workers tend to be predominately native-born. Of the relatively few immigrants who succeed in securing such positions, their foreign education and credentials are replaced with new Canadian credentials, providing them with an advantage. According to literature on immigrant medical field workers, human capital, social capital, cultural capital, and access to ethnic economies all contribute to immigrant labor market success. 

Increased human capital, which refers to one’s individual skills, knowledge and experience, assists immigrants in securing their envisioned employment positions sooner.[3] When it comes to public sector work, like the medical field, immigrants tend to take longer periods of time to secure such positions because these positions are more regulated in terms of credentials and experience.[4] There are clear obstacles for immigrants with foreign qualifications seeking employment in the publicly operated medical field. Yet, some obstacles, such as recognition of qualifications, can be overcome with volunteering.[5] Aside from allowing immigrants to be better integrated into society, volunteer networks create new community relationships. Volunteering is a risk-free (albeit unpaid) opportunity for immigrants to gain valuable job-oriented skills, such as knowledge, language, and communication skills. Other scholarly work has supported the relationship between volunteer experience and employability by noting how often immigrants who volunteer gain Canadian experience and obtain positions.[6] Similarly, evidence suggests that immigrants who are unable to uphold “social networks, and institutional affiliations” experience “lost opportunities”.[7] Immigrants who fail to assimilate into Canadian society are more likely to lose economic status and face decreased employability. Therefore, volunteering allows immigrants to gain access to the labor market, to make valuable social connections, and to obtain knowledge on the cultural norms and practices of the host society. 

The level and adaptability of skills possessed by immigrant medical workers affects employability. Research on immigrant nurses in Canada suggests that immigrants who rely on their prior experiences and knowledge are more likely to secure positions as nurses.[8] Those who are willing to “learn and practice the Canadian way of doing things” are better at gaining positions.[9] Immigrants equipped with the skills to assimilate into the Canadian healthcare system and its social environment are better suited to finding employment. Immigrants who can transfer their skills in culturally pertinent ways are more likely to secure positions within the medical field.[10] Other scholars support this notion, emphasizing how immigrants can obtain medical field positions by effectively transferring their skillsets to fit those of the host culture.[11] Similarly, immigrants who can keep up with emerging technologies and increasingly complex care techniques are more successful in securing Canadian medical field positions.[12] In such ways, immigrants’ available skills are influential in their ability to secure medical field positions, by increasing their human capital. 

Another factor encouraging immigrants’ employment success within the medical field stems from social capital, which relates to one’s social network or relationships. Specifically, immigrants’ social networks tend to influence their ability to secure medical field positions. For instance, those holding public sector positions are more likely to have connections with others working in the same field.[13] Likewise, studies note that immigrants’ “family and ethnic based interpersonal networks” encouraged public service jobs and perceived government jobs to be less discriminatory.[14] Social networks not only help to secure positions in the public sector, but also guide immigrants towards such occupations by emphasizing the benefits of such work. Even though government positions tend to de-value foreign credentials, immigrants are still encouraged by their social networks to obtain public sector positions through increased human capital. For instance, “individual initiative, social networks, and… non-discriminatory employment practices” encourage immigrants to obtain public sector positions.[15] Therefore, immigrants with social networks and such characteristics are more likely to become employed within the public sector.

Furthermore, immigrants securing medical field positions tend to have elevated “cultural capital”, which refers to one’s tastes, education, knowledge, manner of speech, dress style and the like. For instance, immigrants with Canadian education tend to fare better in the medical field employment market because their education is perceived as trusted and valuable. Immigrants with credentials from the host country tend to fare better, especially in a government regulated market, such as medicine, where quality is prioritized. Evidence also suggests that, “ease of verification of documents, equivalency in terms of educational levels…and comparability of nursing education curricula and clinical practice settings” improve chances of obtaining a Canadian medical license to practice.[16]In these ways, cultural capital obtained from Canadian education improves immigrants’ abilities to obtain positions within the medical field. 

The literature also emphasizes the ways in which ethnic economies influence immigrant labour market success within the medical field. Research refers to a phenomenon known as “taste-based discrimination” which leads employers to “prefer to hire individuals of similar ethnic or language backgrounds”.[17] Immigrants benefit from applying to environments where employers share similar immigrant status. In other words, there exists a “separate economy for immigrants” that helps to provide employment when “opportunities are limited”.[18] Such ethnic economies benefit immigrants experiencing disadvantages in the labor market by increasing social capital and supplementing for limited human capital. Similarly, it may be easier for immigrants seeking employment in the medical field to find co-ethnic economies given the globalization of the healthcare system. Therefore, largely immigrant-based environments are advantageous for immigrants seeking similar work and may not be difficult to locate.  

Overall, immigrants can secure positions in the medical field by scoring high on cultural, social, and human capital. In terms of cultural capital, immigrants with Canadian education and English proficiency are more likely to be employed. In terms of human capital, immigrants with volunteer experience, transferrable skills, Canadian experience and training, as well as foreign experience and training are more likely to obtain positions. Similarly, immigrants who obtained medical field positions tended to hold high levels of social capital stemming from social networks. Likewise, immigrants with opportunities to apply in areas with an immigrant-based ethnic economy were more likely to obtain medical field positions. In seeking multicultural environments or geographical areas frequented by immigrants, immigrants could overcome institutional discrimination and gain medical field positions in such areas. Immigrants who score low on these forms of cultural, social, and human capital and who do not have access to opportunities in immigrant-based areas will find it extremely difficult to secure employment in the Canadian health sector.

Sadaf Saljooki, “Challenges Faced by Immigrants Working in the Medical Field” Canadian Law of Work Forum (May 8 2020): https://lawofwork.ca/?p=12458


[1]Jeffrey Reitz et al., “Immigrant Skill Utilization: Trends and Policy Issues” (2014) 15:1 Journal of International Migration and Integration 1-26.

[2]Guo, Shibao, “Difference, deficiency, and devaluation: Tracing the roots of non-recognition of foreign credentials for immigrant professionals in Canada” (2009) 22:1 The Canadian Journal for the Study of Adult Education 37. 

[3]Kristyn Frank, “Immigrant Employment Success in Canada: Examining the Rate of Obtaining a Job Match.” (2013) 47:1 International Migration Review 76-105.

[4]Ibid.

[5]Femida Handy and Itay Greenspan, “Immigrant Volunteering: A stepping stone to integration?” (2009) 38:6 Nonprofit and Voluntary Sector Quarterly 956-982.

[6]Bauder, Harald, “Labor Movement: How Migration Regulates Labor Markets” (2006) Oxford University Press 19-34.  

[7]Li, Peter, “The Role of Foreign Credentials and Ethnic Ties in Immigrants’ Economic Performance” (2008) 33:2 Canadian Journal of Sociology 291.

[8]Gina Higginbottom, “The Transitioning Experiences of Internationally-Educated Nurses into a Canadian Health Care System: A Focused Ethnography” (2011), online: BMC Nursing <http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3152934/>.

[9]Ibid at 11.

[10]Charles Mpofu and Clare Hocking, “’Not made here’: Occupational Deprivation of Non-English Speaking Background Immigrant Health Professionals in New Zealand” (2013) 20:2 Journal of Occupational Science 131-145.

[11]Larissa Remennick, “Professional Identities in Transit: Factors Shaping Immigrant Labour Market Success” (2013) 51:1 International Migration 152-168.

[12]Linda Ogilvie et al., “Licensure of Internationally Educated Nurses Seeking Professional Careers in the Province of Alberta in Canada” (2007) 8:2Journal of International Migration and Integration 223-241 [Ogilvie].

[13]Gregory Lewis et al., “The Representation of  Immigrants in Federal, State, and Local Government Work Forces” (2014) 15:3 Journal of International Migration and Integration 469-486.

[14]Jimy Sanders, “Nativity, Human Capital, and Government Employment” (2007) 36:1 Social Science Research 408.

[15]Ibid at 408.

[16]Ogilvie et al, supra note 20 at 235.

[17]Phil Oreopoulos, “Why Do Skilled Immigrants Struggle in the Labor Market? A Field Experiment with Six Thousand Resumes” (2009) 9:3 Metropolis British Columbia Working Paper           9.

[18]Peter Li, “The Role of Foreign Credentials and Ethnic Ties in Immigrants’ Economic Performance” (2008) 33:2 Canadian Journal of Sociology 295.

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