Canada recruits internationally educated health professionals. Credential recognition is only part of the challenge

Canada is recruiting internationally educated health professionals to help address health-care workforce shortages, while governments are also trying to make it faster and easier for newcomers to have their qualifications recognized.

The 2025 federal budget proposed $97 million over five years, beginning in 2026–27, for the Foreign Credential Recognition Action Fund focused on improving recognition in health and construction.

However, recognizing qualifications is only one stage. Another important measure of success is professional integration: whether internationally educated professionals enter appropriate employment, use their previous skills and experience, progress professionally and remain in Canada’s health workforce.

As a migration and labour-market researcher, I have studied the experiences of Nigerian-trained health professionals in Canada and Nigeria. My research suggests the distance between credential recognition and professional integration can be considerable.

Integration is a trajectory

Credential recognition answers a specific question: Does this person’s training meet the standards required to register here? It’s a necessary gate-keeping function, and regulators are right to apply it.

Integration asks something harder: What happens to the career afterward? National data illustrate the difference. In 2021, only 57.7 per cent of employed, internationally educated health professionals were working in health occupations.

Recent reforms show that governments are trying to address these barriers. Some programs now go beyond credential assessment to support supervised practice, work placements, mentoring and other pathways into employment. These initiatives recognize that assessing a qualification and successfully integrating a professional into the workforce are related, but different, outcomes.

This is why recognition alone cannot measure successful integration. Licensing and credential assessments tell us who has met important professional requirements, but labour-market outcomes tell us whether internationally educated professionals can ultimately use their training.

What the professionals themselves reported

Between 2015 and 2016, as part of my doctoral research, I surveyed and interviewed 59 Nigerian-trained health workers living in the Greater Toronto Area, and 63 health professionals working in Lagos and Ibadan, Nigeria. Participants came from a range of health-care occupations, with nurses making up the largest group.

Although I conducted my fieldwork before the pandemic, more recent national data show that the underuse of internationally educated health professionals’ skills remains a concern in Canada.

In Canada, participants described difficulties obtaining professional registration and finding work in their fields. Some returned to school or changed careers. One Nigerian-trained nurse, for example, worked as a personal support worker because her Nigerian nursing qualification was not considered equivalent, as it was a diploma rather than a degree.

Another participant, who had worked as a physician in Nigeria, began the process of seeking registration as a doctor after arriving in Canada. When she realized the pathway would be more difficult than she had expected, she switched to a registered practical nursing program so she could graduate and support her family.

Participants described experiences that show why credential recognition and professional integration are not the same: assessing qualifications is one step, but using previous skills and experience in one’s profession is another.

Migration experiences travel back home

The most striking finding came from what participants in Canada were telling people back home.

Three-quarters said relatives, friends and colleagues in Nigeria had approached them for migration advice. Their guidance was measured and often cautionary.

One told me plainly that migration was not advisable for someone already holding a job that supported them in Nigeria. Another advised prospective migrants to keep their position and visit Canada before giving it up.

I describe this as transnational information brokerage. Migrants interpret their own licensing, employment and financial experiences and translate them into practical warnings.

Meanwhile, in Nigeria, 81 per cent of respondents intended to migrate, and 61 per cent named Canada, but only 39 per cent had sought information from someone who had actually gone.

What current policy should take from this

Professional integration does not fall neatly within the responsibility of a single level of government. The federal government plays a central role in immigration selection and funding programs that support credential recognition and labour-market integration.

At the same time, provinces and territories oversee their health workforces and are primarily responsible for professional recognition and licensure, often through regulatory bodies. Improving integration therefore requires action across these systems.

Three requirements follow:

Provinces, territories and professional regulators should expand pathways beyond assessment, including supervised practice placements, bridging positions and competency-based approaches that recognize demonstrated prior practice. Existing federal programs already support measures such as supervised practice, work placements, mentoring and other pathways into employment.

Governments and professional regulators should improve outcome reporting, including time to licensure, occupational placement and attrition, disaggregated by country of training and profession. Better-co-ordinated data would make patterns of delay and occupational underutilization more visible and provide a stronger basis for assessing whether reforms are improving professional integration.

The federal government and the provinces and territories should better align immigration selection with health workforce planning and professional regulation. Canada should more closely link health professional recruitment through its immigration system to realistic pathways into professional practice, rather than leaving newcomers to navigate a fragmented licensing system after arrival.

When Canada recruits health professionals, it implicitly promises that their expertise is needed. That obligation should not end at permanent residence.