Importing doctors to battle shortage

Posted By Trevor Pritchard

Dr. Elvira Halili has just finished her overnight shift at the Children’s Hospital of Eastern Ontario when she meets her colleague, Dr. Saad Abbud, at the Ottawa shopping mall where he studies for his medical school exams.

The two foreign-born physicians – Halili is from Kosovo, while Abbud hails from Iraq – set their large Tim Hortons coffees on the food court table before launching into the circumstances that brought them to eastern Ontario.

“I’ve started my new life here in Canada,” says Halili, who immigrated with her husband and two children to Ottawa in 2000. “When I made that decision, I (also) made the decision I wasn’t going back.”

This August, after they finish their residencies, Abbud and Halili will be joining the nine other family doctors who see patients at the St. Lawrence Medical Clinic’s offices in Morrisburg, Ingleside, Long Sault, and Cardinal.

Both the clinic and South Dundas township actively recruited the two doctors, with the township’s council signing off in 2007 on two four-year, $40,000 incentive packages.

United Counties Council also offered both Abbud and Halili $25,000 last November, while the province kicked in another $15,000 over five years.

At the time counties council made their offer, South Dundas was short five family physicians – a microcosm of the provincewide doctor shortage Ontario has been dealing with for more than a decade.

“It’s so important to have them locally,” said Warden Estella Rose, who predicted $100,000 would be set aside in the counties’ 2008 budget to entice more rural physicians to S, D and G.

“We’re trying to build up a little reserve so if the opportunity knocks, we’re ready for it.”

Because both Abbud and Halili are international medical graduates, or IMGs, they’ve spent the past year topping up their education to meet Canadian standards.

Abbud graduated in 1979 from the University of Baghdad’s medical college – an “English-style” institution, he says, and one of the oldest and most respected in the Middle East.

He spent time as a physician in the Iraq army, both during the country’s conflict with Iran in the 1980s and its 1990-91 war with Kuwait.

But by 1994, said Abbud, the United Nations’ economic sanctions had made the situation for a practicing physician in Iraq “intolerable.” With his wife and three children in tow, Abbud left Iraq for Libya, where he spent a few years working in public health.

Abbud’s family applied to immigrate to Canada in 2000, and they would arrive in Montreal four years later.

As for Halili, she received her degree from the University of Pristina, Kosovo’s capital, in 1990. She had applied to come to Canada in 1998, but before the application was approved, her family had to flee to nearby Macedonia to escape NATO’s 1999 Balkan bombing campaign.

Three months later, Halili returned to her clinic, but the country itself was in shambles.

“You lost most of your savings, whatever you’d done fell through,” she recalled. “My husband lost his business.”

The family didn’t learn until 2000 that their immigration application was approved, said Halili, because the Canadian embassy had moved from Belgrade to Vienna.

While both Abbud and Halili are paying close attention to what’s happening in their home countries today – Kosovo declared its independence from Serbia only six days ago, while Iraq is still struggling to rebuild after the 2003 U.S. invasion – neither have plans to permanently return.

“I’ve started a life here. My children are doing their studies here,” said Abbud, who owns a home in Ottawa’s south end and whose oldest son is studying at Carleton University to become an engineer. “I think it’s sad what’s happening in Iraq, but still, I have a life to live here.”

Both say they’ve been impressed by the welcoming atmosphere at the St. Lawrence Medical Clinic.

“They invited me a couple of times, and I’d seen the clinics in Morrisburg, Ingleside, and (the hospital) in Winchester,” said Halili, who practiced rural medicine in Kosovo.

“People were so warm, so friendly. I felt like (I was) at home.”

According to Dr. Wayne Domanko, a physician at the clinic who helped recruit Abbud and Halili, Ontario’s doctor shortage has made competition fierce for all medical graduates, not just IMGs.

Stats from the Ontario Medical Association suggest that more than one million Ontarians, including 130,000 children, can’t find a family doctor.

The situation is particularly bad in eastern Ontario, where fewer than one in 20 general practitioners are accepting new patients, according to the College of Physicians and Surgeons of Ontario.

With a wave of doctors approaching retirement, and with the average debt load of a medical school graduate more than $120,000, it’s become a “total buyer’s market” for new physicians, said Domanko.

“You’re facing a real battle out there,” he said. “Communities are desperate. Communities are offering a lot of money.”

There are signs, however, that the situation is improving, said Domanko.

The province has funded the creation of more first-year spaces at universities for medical students, and since 2004 has more than doubled the number of training positions available for IMGs.

For now, Domanko’s more than happy to have two physicians the caliber of Abbud and Halili, who uprooted their families and moved to an unfamiliar country without knowing what laid ahead.

“That’s why I’m excited about having them: they’ve showed a tremendous amount of courage and commitment,” said Domanko.
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