There’s often a bit of confusion over ELP (English Language Proficiency) when it comes to licensure, so CanAm Physician Recruiting has been looking into rumours of recent changes. Here’s what we’ve learned:

The issue of ELP was discussed at a recent meeting of the Federation of Medical Regulatory Authorities of Canada (FMRAC), held in Fredericton.

Every province has a different set of standards. British Columbia and Alberta adhere to the pan-Canadian standard and apply that to even francophone medical schools here in Canada, and Saskatchewan does the same — except they will exempt a Canadian Studying Abroad (CSA) if they have a passing mark in Grade 12 English 1030 or 1040.

Prince Edward Island famously made headlines for denying licensure to a Canadian-born doctor simply because her medical school was not listed on the English Proficiency Policy adopted by the FMRAC and the College of Physicians and Surgeons of PEI.

In Nova Scotia, however, there appears to be room for exemptions. Saba University of Medicine was added as an exempted school/country in 2013, and individual applications are sometimes exempted based on the discretion of the College of Physicians and Surgeons of Nova Scotia.

We are told the CPSNS may look at referring to passing grades in high school English when it comes to licensing a Canadian studying abroad, providing these courses are somewhat standardized across the country. However, in some provinces a recent immigrant is only required to pass “English as a second language” in order to graduate from high school, so it remains to be seen if this solution would work.

The CPSNS’s policy may be changed in the coming months, so stay tuned for more information as it’s available. In the meantime, here is our perspective …

CPSNL conforms with ELP standard set out by FMRAC but ads that if post-graduate training was completed in an English country, it will exempt the physicians. However, if the physician has taken an ELP exam and failed to meet the minimum standard which CPSNL requires, then they will demand the physician to retake the exam.

CanAm became aware of this policy when a Saudi IMG radiologist who had completed seven years of post-graduate training at McGill and passed the FRCPC, MCCEE and MCCQE but had answered “Yes” to the pre-application question “Have you ever taken an English Language test?”

This candidate, whose spoken English is better than most Canadians, has passed the TOEFL-Ibt /IELTS seven times but has failed to obtained the minimum standard set out by CPSNL in the verbal category. Although he has passed the minimum standard in each component of written and verbal English, just not on the same exam.So being 110% truthful on the pre-application has caused great frustration.

The cost of ELP is $300 U.S. so this physician who has interviewed and obtained an job offer to work in one of Canada’s most rural regions where the local dialect is so thick you would think they speak a foreign language. To make matters worse, he is a radiologist who would have very little to no interactions with patients — not to mention, living in a rural location where it would be doubtful that anyone would pass the ELP test.

CanAm would like to see a registrar from each College across Canada take the TOEFL-ibt or IELTS exam and publish the results. We are betting 50% would not meet the minimum standard set out by FMRAC. CanAm has witnessed numerous physicians taking the ELPs exams multiple times. Does it make sense that a physician can pass the MCC and even Royal College exams but not have a basic grasp of the English language? I guess common sense is not that common. What happen to picking up the phone and interviewing the candidate?