The health care system in Ontario is in crisis while internationally trained physicians (ITPs) continue to face systemic barriers to becoming licensed and returning to practice. This policy brief examines the investments required and benefits to be realized by implementing three measures that can improve access to care, equity, and sustainability within Ontario’s health care workforce:

• Implementing Practice-Ready Assessment (PRA)
• Equitably expanding access to medical residency training
• Enabling pathways for ITPs to practice as Clinical Assistants under a defined class of registration. This could be designed as a training/laddering program to provide recency of practice and access to additional targeted training to meet requirements for independent licensure

Together, these measures have the potential to rapidly increase the physician to population ratio and number of physician-extenders throughout Ontario, leading to improvements in health care equity, patient health and wellbeing, and health human resource system effectiveness and skills use. They also have the potential to bring about cost savings in health spending.

In the context of a rapidly transforming health care system, addressing this issue will require new forms of collaboration and cooperation between stakeholders to address this complex issue and to implement and scale sustainable solutions.