Assessing Employment Setting Preferences Among Internationally Educated Rehabilitation... (Mar 2010)

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Title: Assessing Employment Setting Preferences Among Internationally Educated Rehabilitation Providers in Ontario, Canada
Principal Applicant Title(s) Institutional Affiliation Funding Amount Anticipated Completion Date
Dr. Michel D. Landry Assistant Professor Dept. of Physical Therapy and Health Policy, Management and Evaluation at University of Toronto $17,250 September 2010
Co-Applicant(s) Titles(s) Institutional Affiliation(s)
Ms. Susan Baptist Professor,
Associate Appointment
School of Rehabilitation Science,
Dept. of Psychiatry at McMaster University
Ms. Molly Verrier Associate Professor Dept. of Physical Therapy and Graduate Dept. of Rehabilitation Sciences at University of Toronto
Dr. Andrea Baumann Associate Vice-President Global Health, Faculty of Health Sciences at McMaster University

 mlandry2Biography of Principal Investigator: Dr. Michel D. Landry is an Assistant Professor in the Department of Physical Therapy at the University of Toronto, and an Adjunct Assistant Professor in the School of Public Health at the University of North Carolina at Chapel Hill (USA).  

Prior to receiving his doctoral degree, he held clinical and senior management positions within the private rehabilitation sector in Ontario, and within international humanitarian aid and development agencies in Central America and Eastern Europe.  

He is a health policy and heath services researcher.  His area of research is the interface between available supply (financial and human resources) and increasing demand for health and rehabilitation services across the continuum of care in Ontario, Canada and within the global community. 

He is also the Past-President of the Canadian Physiotherapy Association, and lectures widely on the changing structure of rehabilitation services across Canada and internationally.


The demand for rehabilitation services appears to be growing across Ontario. Factors precipitating this increase in demand include (but not limited to) an aging population, increasing public expectations and improved survival following acute trauma and illness. Rehabilitation services have incrementally become a core element of the provincial landscape. The roster of regulated and non-regulated people who provide rehabilitation service is a complex matter; however, occupational therapists (OTs) and physical therapists (PTs) are generally considered to be the largest cohorts of regulated providers of rehabilitation services in Ontario. Although further empirical research evidence is required, it has been suggested that there is a gap between the demand for rehabilitation, and the supply of providers. The results of this gap may indeed have implications at the individual and system-level, especially given the expected future growth in demand. There are many strategic approaches to narrow the gap between demand and supply, including enhancing the role of rehabilitation 'extenders', and the infusion of additional provider who have been educated outside the country. The latter strategy of internationally educated rehabilitation providers has not received much attention in the peer-reviewed or grey literatures.

There has been speculation and debate regarding the role of internationally educated health professionals, and much of the research to date has focused on the physician and nursing workforce. In general, the literature suggests that this cohort represent a rich but underutilized source of human capitol. In a 2006 report from the Canadian Alliance of Physiotherapy Regulators it was suggested that there are an increasing number of PTs educated in non-English or non-French speaking countries applying for registration across Canada. The report also highlights that employment was a significant barrier for international educated PTs; more specifically, it was signaled that only 59% among those who successfully completed national competency examinations were able to easily secure employment in their chosen field. Such data for international educated occupational therapists remains unknown.

In this study we will explore the complexities that surround employment preferences among internationally educated OTs and PTs in Ontario. We will use quantitative research methods to examine where internationally educated OTs and PTs have chosen to practice, and how likely they were to remain in that same practice setting year-to-year using a longitudinal provider registration database (1999-2007). Next, we will use qualitative research methods to conduct a series of key informant interviews to explore employment preferences among internationally educated OTs and PTs who are participating in a bridging program, but who have not yet passed competency examinations. The quantitative (historical trends) and qualitative (prospective perceptions) data will be triangulated in order to explore the issue of employment setting where internationally educated OTs and PTs prefer to practice, and where they actually practice. This will be the first study to our knowledge to explore practice setting preferences among internationally educated rehabilitation providers in Canada, and the results can be used by multiple stakeholder in order to more efficiently integrate educated rehabilitation providers into the provincial health workforce strategy.

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