Dr. Eva Grunfeld at Massey College in Toronto on Monday. Ms. Grunfeld, the founder of HELP, says the Canadian medical community is committed to ensuring the talents of newcomer physicians don’t go to waste.Laura Proctor/The Globe and Mail
Romel Castillo, a family physician originally from Cuba, learned much more than words when he joined a fledgling program to brush up on his medical English.
He learned the unspoken language of practising medicine in Canada, where concepts such as patient privacy, cultural competency and shared decision-making can be different than in an immigrant doctor’s homeland.
“In my country, it’s like you prescribe the medication, they take it,” said Dr. Castillo, 35, who moved to Canada in 2021 and now lives in Brampton, Ont. “But here, I ask you first, ‘What are your values, your understanding of the condition?’ I share with you my knowledge, and then we make an arrangement.”
Those subtleties, which would be hard to pick up from a Spanish-to-English medical dictionary, were the most important lessons that Dr. Castillo took away from Health English Language Pro (HELP), a program that pairs retired Canadian physicians with newcomer doctors to improve their medical English over the course of about 10 virtual conversations.
On Tuesday, HELP will get a major boost when the Canadian Medical Association Foundation announces a $645,000 grant to expand the program so that volunteer Canadian doctors can share their expertise with at least 330 more immigrants like Dr. Castillo, who is working in the health system, but not yet as a doctor.
The roster of physician leaders scheduled to speak at the announcement at the University of Toronto’s Massey College shows the Canadian medical community is committed to ensuring the talents of newcomer physicians don’t go to waste, said Eva Grunfeld, the founder of HELP.
Canada is suffering from an undersupply of physicians – especially family physicians. The country was short nearly 23,000 family doctors as of 2022, according to a federal report released last January.
Some provincial governments are expanding the number of medical school seats and residency training spots, but those solutions will take years to bear fruit, said Dr. Grunfeld, a professor emerita of medicine at the University of Toronto who is retired from clinical practice.
“The deficit [of physicians] is substantial,” she added. “So, I think it’s essential to integrate the wealth of skills and resources that are already here.”
Integrating newcomer physicians into the health labour force – whether as licensed doctors or other medical workers – is the goal of Health English Language Pro.
The program isn’t meant to topple the formal barriers to Canadian licensure that frustrate many immigrant doctors. Instead, it’s designed to improve their medical English in a way that helps them navigate past the barriers themselves.
Dr. Grunfeld and ACCES Employment, a Toronto-based non-profit that helps immigrants find jobs, launched the program in 2024 after Dr. Grunfeld found fulfilment helping a Syrian obstetrician-gynecologist practise her medical English during regular meetings at a campus coffee shop.
HELP has since recruited 135 volunteer Canadian physicians for virtual conversation partnerships with 291 newcomer physicians all across the country. Some doctors volunteered with multiple partners.
ACCES Employment has been co-ordinating the program without any dedicated funding.
Now, with three years of funding, they’ll be able to scale it up, attract more volunteer doctors and serve more newcomers, according to Cameron Moser, associate vice-president of services and program development at ACCES Employment.
Jeff Sisler, a retired Winnipeg family doctor who volunteers with HELP, has noticed that immigrant participants fall roughly into one of two categories: those who struggle with English itself, and those who speak the language fluently but struggle with the nuances of the Canadian health care system or with delivering news to patients in plain English.
He recalled one newcomer doctor who used the word “expectorate” frequently when “coughing up” would be easier for patients to understand.
“You’ve got to be kind of bilingual,” Dr. Sisler said. “You need to talk with physicians, because that’s the professional environment and the way you’re judged, kind of quietly. And yet you need a different way of speaking with patients.”
Janet Nuth, a retired family and emergency physician in Ottawa who volunteered with a surgeon originally from Bangladesh, found many of their conversations revolved around handling thorny conversations with patients in Canada.
His English was already excellent. He wanted advice on scenarios such as obtaining consent for surgical procedures and discussing end-of-life decisions when families are in conflict.
Dr. Nuth was happy to provide her advice. The experience was meaningful to her as well.
“I think it really rekindles your love of medicine to see it through someone else’s eyes,” she said.