Immigrant selection systems and occupational outcomes of international medical graduates in Canada and the United States

We analyze the process of immigrant selection and occupational outcomes of International Medical Graduates (IMGs) in the US and Canada. We extend the IMG relicensing model of Kugler and Sauer (2005) to incorporate two different approaches to immigrant selection: employer nomination systems and point systems. Analysis of the model indicates that point systems can allow IMGs to immigrate who would be unable to gain entry to the receiving country under an employer nomination system and who are subsequently unable to relicense and work as physicians in the receiving country. We apply the model to the case of IMGs migrating to the US and Canada since the 1960s and evaluate the empirical predictions from the model based on an analysis of the occupational outcomes of IMGs in Canada (where a point system has been in place) and in the US (where IMGs enter through employer nomination). In Canada, IMGs are less likely to be employed as a physician than are IMGs in the US and a large percentage of the IMGs in Canada either find work in lower skill occupations or are not employed. The empirical findings are consistent with our hypotheses based on the theoretical framework on the effects of immigrant selection systems on the probability of working as a physician in the two countries.