Foreign Practices: Immigrant Doctors and the History of Canadian Medicare (Volume 54)

by Sasha Mullally, David Wright

When the CBC organized a national contest to identify the greatest Canadian of all time, few were surprised when the father of Medicare, Tommy Douglas, won by a large Medicare is central to Canadian identity. Yet focusing on Douglas and his fight for social justice obscures other important aspects of the construction of Canada's national health insurance - especially its longstanding dependence on immigrant doctors.Foreign Practices reconsiders the early history of Medicare through the stories of foreign-trained doctors who entered the country in the three decades after the Second World War. By making strategic use of oral history, analyzing contemporary medical debates, and reconstructing doctors' life histories, Sasha Mullally and David Wright demonstrate that foreign doctors arrived by the hundreds at a pivotal moment for health care services. Just as Medicare was launched, Canada began to prioritize "highly skilled manpower" when admitting newcomers, a novel policy that drew thousands of professionals from around the world. Doctors from India and Iran, Haiti and Hong Kong, and Romania and the Republic of South Africa would fundamentally transform the medical landscape of the country.Charting the fascinating history of physician immigration to Canada, and the ethical debates it provoked, Foreign Practices places the Canadian experience within a wider context of global migration after the Second World War.

360 pages, Paperback

Published November 18, 2020

Reviews

[Dasha · Rating 4 out of 5]

Together, Mullally and Wright co-authored Foreign Practices: Immigrant Doctors and the History of Canadian Medicare (2020) which clearly argues for the importance of foreign doctors, particularly from countries in the “global south,” in making Canada’s Medicare possible in the second half of the twentieth century. The work challenges the narrative of “socialized” medicine in Canada that often focuses on Tommy Douglas’s effort in Saskatchewan. This work goes beyond that, painting a picture of immigration across nation and empire. In nine chapters, Mullally and Wright outline the changing medical and immigration policy in Canada, and abroad, in order to highlight Canada’s connection to the changing international medical world. In doing so, Mullally and Wright expose the intricacies of Canadian health inequalities, especially in rural areas, concern over migration and immigration, and the changing guidelines of Canadian immigration policies and medical care standards. While Canada’s medical field slowly professionalized in the early twentieth century, many Canadians went overseas to Europe to complete their education (p. 33). In the 1960s, Medicare and the new immigration act, based on the points system, prioritized immigrants with medical training. Indeed, as the need for doctors steadily grew after the Second World War and while provinces invested in expanding university programs they also required foreign-trained doctors to pick up the slack. As Mullally and Wright point out, this resulted in what was labelled the “brain drain,” in which nations such as India, Pakistan, but also Canada lost out on professional immigrants to recipient countries. Inte4restly, in the Canadian context, this was briefly reversed during the Vietnam War which saw American doctors “drain” northwards. This is all to demonstrate that an analysis of the migration patterns of foreign-trained doctors provides a unique way to examine Canada’s relationship with other nations, its curation of domestic policy, and the role of immigrants in shaping Canadian identity.
One glaring omission takes away from the book - the lack of connection to Indigenous peoples in Canada, particularly those in rural and northern communities. Considering the recent publication date it is an odd thing to fail to address or fail to address why you won't be addressing it.