Tuesday, May 04, 2021

What History Can Tell Us About Working as an Immigrant Nurse in Canada

By Johna Baylon,
 Local Journalism Initiative Reporter
New Canadian Media
Mon., May 3, 2021

Editor’s note: This story was first published on April 28. This version corrects the acronym OIIQ to OIIAQ.

Like many internationally educated nurses (IENs) in Canada, Jeff Kua came to the country through the Live-in Caregiver Program.

It was 2010. His grandmother in Ontario had suffered a stroke, so his uncle suggested that Kua come to Toronto as her caregiver.

With his experience as an operating room nurse in the Philippines, however, Kua knew he’d eventually return to the profession he once served and trained for.

He started preparing for his nursing registration a year after he arrived. Back then, the College of Nurses of Ontario (CNO) considered work experience as a registered nurse (RN) within the last five years as valid. This means that by the time Kua could pursue working as an RN—after completing his two-year caregiving work requirement for permanent residency, and applying for an open work permit—his clinical experience would still count.

But things had changed by the time he received his assessment from the CNO, sometime between 2013 and 2014.

“They said I had to go back to school because they changed their policy—instead of accepting nursing experience in the last five years, they [changed] it to three years,” says the 37-year-old.

“So in the time they took to assess my documents, I basically ran out of experience. So I needed to go back to school.”

Kua took the Academic Pathway for Internationally Educated Nurses Program, a graduate certificate program at George Brown College, in 2015.

Still, it wasn’t enough.

After completing the program in 2017, Kua was told he now needed university-equivalent credentials.

This requirement wasn’t mentioned in his earlier assessment letter, which outlined the ‘gaps’ in his nursing experience and provided a list of colleges that offered programs to cover those gaps.

“After I finished the two-year program at George Brown, they sent my transcript to the CNO. The response I got back was that I didn’t meet the education requirements,” says Kua. “They updated my ‘gaps’, and added more requirements.”

Kua’s experiences are not uncommon. Many IENs come to Canada through the caregiver pathway and later find it difficult to practice as RNs.


This is due to many factors, including the time and financial resources it takes to complete bridging programs and language proficiency requirements that come with expiry dates, particularly the International English Language Testing System (IELTS), where results are valid for two years. Delays in paperwork, such as PR backlogs and document retrievals from educational and professional institutions overseas, make the process more time-consuming and expensive.

This hasn’t always been the case, however.

According to Valerie Damasco, a lecturer and researcher at the Ontario Institute for Studies in Education at the University of Toronto, interviews with nurses and historical documents reveal Canada’s recruitment of nurses from the Philippines in the early 1960s—among whom was her aunt.

“I’m not sure if the correct word to use here is ‘easy,’ but certainly [Filipino] nurses fit the criteria [of nurses] they needed here,” Damasco says, referring to the ease with which IENs from the Philippines were then able to work as RNs in Canada.


Damasco is currently completing a book based on her doctoral thesis, which explores the migration of Filipino nurses to Canada from 1957 to 1969. She found that Filipino nurses arrived through direct recruitment from hospitals in the Philippines, or through the U.S., where nurses who completed an exchange program would migrate northward instead of returning to Asia.


With the shortage of nurses in Canada, it wasn’t difficult for Filipino IENs to start working in Canadian hospitals right away, says Damasco. It also helped that the nurses who were educated in the Philippines went through an American curriculum, and eventually worked in hospitals with an Americanized setup.

“If you were to ask these nurses what they did as soon as they arrived in Canada, they said they didn’t have an orientation. They started working the next day. They already knew how to manage the floors, without having to receive additional training from the hospital. They knew what they were doing,” says Damasco.

“So these were candidates that [Canadian hospitals] really wanted, who fit the criteria that they were looking for.”

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