Lost to Boston: Nova Scotia-trained doctor says residency red tape forced her to leave

In a province where shortcomings in health care make headlines any given day, a Dalhousie-trained physician says she was forced to take a position in the United States, though she would have preferred to stay in Nova Scotia.

Born in India, Dr. Taha Khan finished her medical training at Dal in 2019.

Enrolled as part of an ongoing partnership between Dal and a university in Malaysia, she fell in love with the region and was anxious to stay when her studies finished. But a roadblock appeared when she realized there was no residency waiting for her.

"During my time at Dal, it sounds like there was a change in policy, perhaps. It's unclear exactly what happened," said Khan from her office in the Boston Medical Center.

"[It] essentially meant that visa-requiring medical graduates could no longer match to residencies in Canada, at any residency program at any university across Canada. It basically meant that we needed either permanent residency status or citizenship in order to match. Now that made it tricky because in order to get permanent resident status, you need to have a job offer, which, in our case is residency."

"So, it was sort of a catch-22," said Khan, adding Boston, Mass., is a great city, and hospital staff have been very welcoming.

In a late-day email from Nova Scotia's Office of Healthcare Professionals Recruitment, officials said:

"The province is working to improve health care for Nova Scotians and that means recruiting, retaining and training more people who can provide that care. We have many initiatives underway and are open to all ideas that could help us move this priority forward.

"Currently, the federal government requires international students training to become a doctor to have their permanent resident status to be matched with a residency opportunity in Nova Scotia. We know there is high demand for residency opportunities in this province, including Nova Scotian students studying at Dalhousie University.

"The Province is reaching out to find out more about this situation."

Opposition parties say the province shouldn't be losing doctors on technicalities.

"These kinds of things we hear that just need to be addressed immediately," said Susan Leblanc, the NDP health and wellness spokesperson.

"There is no good reason why people who are being trained in Nova Scotia are then being asked to leave."

Liberal Leader Zach Churchill, a former health minister, says red tape has to be eliminated.

"We've got to be working to ensure that medical professionals, doctors, nurses -- anybody else we need that are practicing or training here -- can stay and work," said Churchill.

Founded in 1868, Dalhousie Medical School has churned-out generations of some of the best doctors anywhere. But the school says it's partnership with International Medical University in Malaysia is now winding down.

"Since 1996, Dalhousie University has partnered with the International Medical University (IMU) in Malaysia to train third and fourth-year medical students leading to a Canadian medical doctorate degree from Dalhousie University. We are proud of the exceptional IMU students who have graduated from Dalhousie University and what has been accomplished with our partnership with IMU," said Dr. Darrell White, senior associate dean for the Faculty of Medicine via email.

"When the IMU program was developed, the Canadian Residency Matching Service (CRMS), which is the national platform used for matching candidates to medical schools, had different residency/citizenship requirements than those that currently exist. While opportunities still exist for IMU students to remain in the region, their medical school seats are supernumerary positions that are funded by the students and do not have corresponding residency positions.

"Developing residency training positions is a collaborative effort each year between the Department of Health and Wellness, Dalhousie Faculty of Medicine, and Nova Scotia Health. There are several elements that factor into residency seats, such as funding level, projected need in the province and physician training capacity.

“Our formal agreement with IMU concluded with the 2022/2023 academic year, and we are welcoming our final cohort of three students next year for the Class of 2025. Dalhousie Medical School has undergone significant expansion over the past five years, and we are focused on providing undergraduate medical education opportunities that better reflect the current residency matching process," the email concluded.

Canada's Immigration Minister -- a Nova Scotian himself -- says, while health care is technically a provincial responsibility, his department is always ready to step up and smooth the way for more doctors.

"If provinces or institutions want to partner with the federal government to help piggyback on some of the measures we've already introduced to make it easier for health-care professionals to come to Canada, they're going to have a willing partner in our office," said Sean Fraser, MP for Central Nova.

Fraser says Ottawa has made some significant changes already.

"We recently waived the requirement that a person not be self-employed when to come through certain economic streams for physicians," Fraser said.

"We've changed the rules under our federal economic streams to make it easier for the federal government to actually select newcomers by the sector that they work in, and we intend to use that this year to recruit more health-care workers."

Fraser said Ottawa has also earmarked more than $90 million towards foreign credential recognition: "So when we do find a skilled newcomer who can come here and practice, they're not going to end up working in a position that they're over-qualified, or driving a taxi when they could be working as a surgeon or a family doctor."

Although she's settled into her life in Boston, Dr. Khan still misses Halifax.

She keeps up on the news and stays in touch with friends from medical school, but says not much has changed.

"As far as I know, a lot of them are either turning sights to the United States, the U.K. or going back to their own home countries. So, you have Canadian medical graduates who would prefer to stay there, but are unable to," she said.

"You have people who are familiar with the Canadian medical system who are there, who very much want to stay in Nova Scotia, and are willing to go to rural parts of the country and province that are under-served. So you have people who are ready and willing to do that and all they need is a visa status in order to do that so from my perspective, it's simple enough," she said.

A perspective from a medical professional who could technically work anywhere -- except the place she wants to.