Introduction

Canada has both historically encouraged, and more recently relied on, internationally educated health professionals (IEHPs) to address shortages in rural and remote locations and hard to fill positions within its health care system. This has been true for medical and nursing labour, and only more recently, for midwives, due largely to our unique historical exclusion of midwifery from our formal health care division of labour. Throughout the 1970s, roughly a third of the physicians practicing in our health care system were international medical graduates (IMGs). Although this has dropped to 23% more recently, we still have a dependence on other countries to train the physicians that work here (Canadian Institute for Health Information, 2003). Canada relies on a smaller percentage of internationally educated nurses (IENs). Six to eight percent of all Registered Nurses in Canada are IENs. However, their numbers are sizeable, at over 22,000 in 2008, compared to nearly 16,000 IMGs. Due to the relatively recent integration of midwifery into various provincial health care systems (i.e., only since 1994), many practicing midwives are internationally educated, though the exact percentage of internationally trained midwives (ITMs) is unknown.

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1 Introduction 2153
2 The Context of Health Labour Migration in Canada 4143
3 Insights from the Literature on Health Labour Migration 2625
4 Our Methodological Approach 2074