Moving from One Professional System to a (seemingly) Similar One: Surprising Challenges and Issues of Policy and Governance

Health professions currently appear to be under more scrutiny, especially regarding their interactions with management, other professionals as well as their governance. Among all discussions about global mobility, few analysis look at national variations in these domains, and their repercussions on contexts of entry into professional practice as a foreign-trained professional. This presentation will use data collected among French health professionals in Quebec, as well as professional orders and other institutional actors of the professional system, in a research project conducted from 2013 to 2015. Health professions included are doctors, nurses and pharmacists. Our research looked at how French professionals entered professional practice in Quebec, identifying factors facilitating or hindering their entry in the professional system. French health professionals have used mutual recognition agreements (MRAs) since 2010. Since 2014, use of these MRAs has generated sufficient data to allow for analysis and conclusions. We will use further data from an ongoing research on professional orders’ strategies to implement public protection while facilitating admission of these foreign-trained professionals.  Our main objective will be to describe how (and if) actors of the professional system, and their institutions, learn in this process. For instance, although analysis has suggested some adaptations that would ease their entry, issues of equity with local-trained professionals can limit the feasibility of such innovations. Elsewhere, problems of coordination and budgeting result in shortage for compulsory training measures. Among future trends, taking into account the role of political impetus and comprehensive inclusion of all main actors appear as the main lessons to be drawn from the experience of these MRAs. Finally, this overview illustrates the importance of considering specific contexts characterizing entry to a professional field as a foreign-trained professional, taking into account the professional systems of origin and destination.