When Ibukun arrived in Canada in April 2024, she already had five years of experience as a medical doctor in Nigeria, where she treated chronic illnesses and supported maternal and child health.
At the moment, she works as a youth support worker in Guelph, assisting people dealing with homelessness, mental illness and substance use. (Ibukun requested that NCM withhold her last name.]
She said, “It was a difficult adjustment realizing I couldn’t immediately practise medicine, but I chose to keep helping people while building new skills.”
Her experience reflects a wider reality across Canada, where many internationally trained immigrant women in healthcare remain unable to practise, despite growing labour shortages in the field.
A system under strain and underused
The Government of Canada has introduced programs to help internationally trained professionals integrate into the workforce. But in Canada’s decentralized system, licensing for regulated professions is controlled by provincial regulators, and credential assessments do not guarantee the right to practise.
The result is widespread underemployment with more than one-quarter of immigrants with foreign degrees working in jobs below their qualifications, even as immigrants make up about one in four healthcare workers in Canada.
“Lengthy, expensive and competitive”
Before moving, Ibukun expected a licensing process, but not its complexity.
“I thought the transition would be more straightforward. What surprised me most was how lengthy, expensive and competitive it is,” she said.
Her journey has included credential assessments, exam preparation and the challenge of securing a residency position, one of the most competitive steps for internationally trained doctors.
Years later, she is still preparing for exams while balancing work and family life.
“I currently have an MD degree which I have evaluated with the Medical Canada. I just need to take exams which will cost about $6,000.
“It is a step-wise process; initially creating a physician account on MCC website costs $322. Then source verification of the credential cost $232. The credential evaluation cost $132,” she added.
The financial burden of the licensing process can be significant. According to the Medical Council of Canada’s fee structure,internationally trained doctors must pay hundreds to thousands of dollars at multiple stages.
A one-time account setup on physiciansapply.ca costs $335, while credential verification is $232 per document. The Medical Council of Canada Qualifying Examination (MCCQE) costs $1,500, and the National Assessment Collaboration (NAC) exam costs $3,320. Most of these fees are non-refundable, even if candidates are unsuccessful.
Working, but not as trained
In her current role, Ibukun provides crisis intervention and emotional support, work that still draws on her medical training.
“I respond to mental health crises and drug overdoses,” she said. “My ability to assess situations quickly is essential.”
Still, she feels the gap.
“Yes, my clinical skills are underutilized compared to my previous role as a physician,” Ibukun added.
Jennifer Yu, an internationally trained psychiatric nurse and psychotherapist, shares a similar experience. After relocating, she found a job as an employment specialist with the Open Door Group. Her role is to support people facing employment barriers.
Yu said, “I will draw on my healthcare background and leverage my skills in case management, stakeholder collaboration, and client support to provide person‑centred employment planning.
“I also actively use these skills in my volunteer work, supporting people with illness, caregivers, and other vulnerable groups. While this is different from my previous clinical and corporate roles, it continues the same focus on helping people navigate complex situations and builds transferable leadership skills for community impact.”
“Immigration is a process of adaptation, it’s about finding where your strengths create impact. Professionally, this has sharpened my versatility, applying client relationship building, risk assessment, compliance expertise, and wellbeing program design across sectors from healthcare/benefits to employment support.
Personally, it’s built resilience, patience, and appreciation for growth through change, showing meaningful impact comes in many forms.”
It can take five years to start over
For many internationally trained professionals, the path to licensure is costly and uncertain.
Carolina Silva, a liaison officer with Société de développement économique de la Colombie-Britannique (SDECB), says the barriers are often underestimated.
“The financial cost is significant. For some, exam fees can represent a month’s salary,” she said.
Language requirements and Canadian-specific exams also pose major hurdles.
“There is a misalignment of expectations. Many think they’ll be licensed within months, but it can take years, sometimes up to five years for physicians,” Silva added.
While credential barriers affect many immigrants, women face additional challenges.
Silva describes this as “double marginalization.”
“Women are more likely to work below their qualifications,” she said.
Family responsibilities often mean prioritizing immediate income over long-term licensing goals. Many take on survival jobs, leaving little time to prepare for exams.
Ibukun says balancing family and career has required difficult choices.
“I’ve had to prioritize financial stability at times, which delayed my professional goals,” she said.
The “deskilling” trap
Over time, these delays can lead to ‘deskilling,’ when professionals lose confidence or leave their fields entirely.
“We see highly skilled professionals give up and settle for support roles just to survive,” Silva said.
She calls it a “silent crisis” affecting thousands across Canada.
Canada continues to recruit healthcare workers from abroad, but Silva argues the problem is misunderstood.
“We don’t just have a shortage of workers, we have a shortage of licensed opportunities for people already here,” she said.
The result is a system where skilled professionals remain sidelined while patients face long wait times.
Despite the challenges, many remain determined.
“Yes, I still hope to practise,” the Nigerian-born physician said. “Success means continuing to grow and make an impact.”
Her advice to others is simple: “Prepare early, stay resilient and remain open to different pathways. Your skills are [still] valuable.”
Dayo Ojerinde
Dayo Ojerinde is a multimedia journalist with over 10 years of experience covering health and social issues, with a focus on human-centred and data-driven reporting.