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Academic Requirements and Acceptable Alternatives:
Challenges and Opportunities for the Regulated Professions in Ontario

8. Acceptable alternatives and increased access to professions

The positive impact of flexibility

Increasing the flexibility of the licensing process does have an impact. Among regulated professions, there is a significant correlation between the accessibility of acceptable alternatives and reduced disadvantage for internationally educated professionals.

This section explores that correlation, and the costs of inflexibility.

Employment disparity

To date, the most significant statistical study of profession-specific differences in employment "match rates" for immigrants and Canadian-educated people is Zietsma's 2010 analysis of 2006 census data.46 The analysis looked at how well people's field of study matched their occupation in Canada, for 15 fields of study that usually lead to a regulated occupation.

In Canada, overall:

  • 24% of internationally educated immigrants were working in the regulated profession they were trained for.
  • 62% of the people born and educated in Canada were working in the regulated profession they were trained for.

Match rates for immigrants were above the national average in Saskatchewan and Alberta, which had strong labour markets in 2006. Ontario figures mirrored national averages.

Variation among professions was considerable. For example:

  • Match rates for internationally educated immigrants ranged from 12% for lawyers to 84% for chiropractors.
  • People educated in regulated health professions had consistently higher match rates than people trained in non-health professions.
  • Non-health professionals were more likely to be working in a related but non-regulated occupation.

Flexible licensing and reduced employment disparity

Correlation

There is a correlation between more flexible licensing approaches that offer acceptable alternatives for meeting academic requirements and reduced disparity in employment outcomes between internationally educated professionals and their Canadian-born counterparts.

The smallest gaps in match rates between Canadian-educated and internationally educated people were for engineers, nurses, occupational therapists, and chiropractors (see Table 3):

  • 19% of internationally educated engineers were employed in their profession, compared to 42% of their Canadian-born counterparts. The gap between these match rates is 23 percentage points.
  • Internationally educated nurses and occupational therapists had match rates 17 percentage points lower than their Canadian-born counterparts.
  • Internationally educated chiropractors were employed in their profession at rates similar to their Canadian-born counterparts (84% versus 87%, for a gap of only 3 percentage points).

These gaps are much lower than the average: For the total study population of all 15 regulated professions combined, the comparable figure was 38 percentage points.

Table 3. Canadian professions with the least disparity in employment match rates, 2006

Profession Canadian-born-and-educated Internationally educated Gap
(in percentage points)
Total Employed in profession of training Total Employed in profession of training
Engineers 167,260 42% 157,930 19% 23
Nurses 78,880 73% 13,150 56% 17
Occupational therapists 9,345 82% 560 65% 17
Chiropractors 5,745 87% 345 84% 3
Total study population 937,050 62% 284,080 24% 38

Data Source: Statistics Canada, Census of Population, 2006 — As analyzed by D. Zietsma, 2010.47

Engineers and nurses

The engineering and nursing professions, with large numbers of internationally educated applicants, were among the early innovators in alternative assessment and bridge training. A 2007 national inventory of bridging programs lists 15 bridging programs for internationally educated engineers and 11 for internationally educated nurses — more than for any other profession.48

Ontario has led and sustained innovation in both these professions. In Ontario today, both nursing and engineering offer four categories of acceptable alternatives:

  • paper-based assessment
  • direct assessment (exams)
  • self-paced learning
  • bridging programs

Occupational therapists

Occupational therapy, while a smaller profession, has also been an innovator:

  • As early as 2000, well before the 2006 census, a McMaster University professor was offering to help internationally educated occupational therapists practise for exams.
  • In 2005, the Canadian Association of Occupational Therapists undertook a research project that led to the development of a national bridging curriculum.49

In Ontario today, the Occupational Therapy Examination and Practice Preparation Project (OTepp) is among the most condensed and inexpensive of all bridging programs for the regulated professions. OTepp offers both a complete program and a modular option for applicants who need only selected courses. The full program of five courses has a modest cost of $1,000 and lasts seven months.

Chiropractors

Chiropractors, with the lowest gap in match rates, are a unique case, as the profession has a very small base outside North America, Europe and Australasia. In those regions, the Councils on Chiropractic Education International has worked to establish agreement on international educational standards and ensure their adoption by accredited chiropractic colleges.

The value of flexibility

As this analysis suggests, employment disparities are comparatively low for professions that recognize a variety of acceptable alternatives, and where these alternatives are relatively accessible in terms of cost and time. Disparity is also low where foreign-credential-recognition is high.

The costs of inflexibility

In contrast, disparities are greater for professions where acceptable alternatives have historically been more limited and more expensive. In Zietsma's study, the gap between employment match rates for internationally educated and Canadian-born professionals rises above 50 percentage points for veterinary medicine, optometry and law (see Table 4).

Table 4. Canadian professions with the greatest disparity in employment match rates, 2006

Profession Canadian-born-and-educated Internationally educated Gap
(in percentage points)
Total Employed in profession of training Total Employed in profession of training
Veterinary medicine 6,580 83% 2,225 29% 54
Optometry 2,760 95% 340 38% 57
Law 82,615 69% 11,295 12% 57
Total study population 937,050 62% 284,080 24% 38

Data Source: Statistics Canada, Census of Population, 2006 — As analyzed by D. Zietsma, 2010.50

In Canada, various causes have contributed to these higher gaps:

  • Veterinary medicine has been characterized by the high cost of the exams that internationally educated applicants must take.
  • In optometry, a numerical cap limits the number of applicants who may take the mandatory bridging program. This in turn limits access to the profession.
  • The legal profession has required internationally educated applicants to do lengthy retraining or self-study. In recent years, the National Committee on Accreditation (NCA) has reduced its requirements, but all internationally educated applicants must still take courses and/or write exams in at least four Canadian subject areas. Law school courses can be difficult to access for individuals not enrolled in a law program. In Ontario, the University of Toronto's bridging program for internationally educated lawyers provides a structured alternative to self-study, but does not replace NCA exams. The bridging program and exams are relatively affordable, but the time investment is significant.

Correlation and causality

It is always difficult to prove causal relationships within complex social processes, where many factors influence outcomes. Immigrant employment outcomes are significantly influenced not only by access to licensing but also by employer preferences and the strength of the labour market.

Nevertheless, this analysis shows a significant positive correlation between recognition of acceptable alternatives for meeting academic requirements and stronger licensing/employment outcomes for internationally educated applicants. It may be that professions that have invested in acceptable alternatives have also developed stronger systems for recognizing international credentials.

In its 2011–12 assessments of regulated professions' licensing practices, the Office of the Fairness Commissioner made 16 recommendations related to acceptable alternatives, encouraging regulators to move towards more flexible pathways to licensing.


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Notes and references

Academic Requirements and Acceptable Alternatives:
Challenges and Opportunities for the Regulated Professions in Ontario

Exemplary Practices

The OFC gathers regulatory bodies' exemplary licensing practices so that they may learn from one another. Exemplary practices about academic requirements and acceptable alternatives are listed below.

  1. Accepting and supporting diverse applicants

    This practice acknowledges a diversity of midwifery...

  2. Clarifying documentation requirements and acceptable alternatives

    This practice will be of interest to regulators seeking...

  3. Communicating acceptable alternatives for applicants with non-accredited education

    This practice offers a visual map of pathways to registration...

  4. Communicating acceptable alternatives for meeting certification requirements

    This practice allows applicants to better understand...