Abstract:
This qualitative research study used grounded theory methodology to explore the
settlement experiences and changes in professional identity, self esteem and health status
of foreign-trained physicians (FTPs) who resettled in Canada and were not able to
practice their profession. Seventeen foreign-trained physicians completed a pre-survey
and rated their health status, quality of life, self esteem and stress before and after coming
to Canada. They also rated changes in their experiences of violence and trauma,
inclusion and belonging, and racism and discrimination. Eight FTPs from the survey
sample were interviewed in semi-structured qualitative interviews to explore their
experiences with the loss of their professional medical identities and attempts to regain
them during resettlement.
This study found that without their medical license and identity, this group of
FTPs could not fully restore their professional, social, and economic status and this
affected their self esteem and health status. The core theme of the loss of professional
identity and attempts to regain it while being underemployed were connected with the
multifaceted challenges of resettlement which created experiences of lowered selfesteem,
and increased stress, anxiety and depression. They identified the re-licensing
process (cost, time, energy, few residency positions, and low success rate) as the major
barrier to a full and successful settlement and re-establishment of their identities.
Grounded research was used to develop General Resettlement Process Model and
a Physician Re-licensing Model outlining the tasks and steps for the successfiil general
resettlement of all newcomers to Canada with additional process steps to be
accomplished by foreign-trained physicians. Maslow's Theory of Needs was expanded
to include the re-establishment of professional identity for this group to re-establish levels
of safety, security, belonging, self-esteem and self-actualization.
Foreign-trained physicians had established prior professional medical identities,
self-esteem, recognition, social status, purpose and meaning and bring needed human
capital and skills to Canada. However, without identifying and addressing the barriers to
their full inclusion in Canadian society, the health of this population may deteriorate and
the health system of the host country may miss out on their needed contributions.
