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Several factors influence the number of health care providers entering and leaving practice. Entries can include new graduates at the beginning of their career, professionals who have newly migrated to the area from within or outside Canada, and those returning after extended time away. Exits could be due to retirement, migration out of a region, career changes or other factors.

Most provinces and territories saw an increase in entries into direct care roles for family physicians between 2019–2020 and 2021–2022,Footnotei and for nurse practitioners (NPs) and other regulated nurses between 2020 and 2022.Footnoteii Over the same time period, most provinces and territories also saw an increase in exits for family physicians and nurses. For NPs, exits tended to be stable in the period 2020 to 2022. An increase in entries paired with an increase in exits can mean an increase in staff turnover, even if there is no overall loss of staff. More information can be found in CIHI’s recent report, Taking the pulse: Measuring shared priorities for Canadian health care, 2024.Reference1

In 2021–2022,Footnotei most provinces and territories experienced an increase in family physicians per population, except Newfoundland and Labrador, Nova Scotia and Manitoba, which faced a decrease. Nearly all provinces and territories experienced an increase in NPs and other regulated nurses per population in 2022.Footnoteii Reference1 Further data on trends in jurisdictions can be found using the Quick Stats tool in the Download the data section of this report.

Numbers of family physicians entering and leaving direct care roles increased in most provinces/territories

Notes
Data on family physicians is presented by fiscal year.
Data excludes physicians practising in Quebec.Family physicians include those practising in general practice, family practice, community medicine and public health, and palliative care medicine. 
Results reflect family physicians who received payment for publicly insured services during the specified year and who were included in the National Physician Database. 
Payment includes various payment types, such as fee-for-service, salary and block payments.

Source
National Physician Database, Canadian Institute for ºìÁì½í¹Ï±¨ Information.

Numbers of nurse practitioners entering direct care roles increased in most provinces/territories; exits remained stable

Notes
Results reflect the number of nurse practitioners who are registered in the jurisdiction of their employment and who are employed and providing direct patient care. If that data is unavailable, results reflect supply, which is the number of nurse practitioners registered to practise in the jurisdiction.
Supply data was reported instead of the direct care workforce for the following: 

• 2020: Prince Edward Island and Manitoba

• 2021: Manitoba

• 2022: Prince Edward Island, New Brunswick, Manitoba and the Northwest Territories/Nunavut (combined)

Northwest Territories and Nunavut data is presented as a combined total.
Results for Prince Edward Island in 2021 were not reported due to data quality issues. 
Please refer to Nursing in Canada, 2023 — Methodology Notes for more details.

Source
ºìÁì½í¹Ï±¨ Workforce Database, Canadian Institute for ºìÁì½í¹Ï±¨ Information.

Numbers of regulated nurses entering and leaving direct care roles increased in most provinces/territories

Notes
Results for nurses represent a combined result for registered nurses (RNs), licensed practical nurses (LPNs) and registered psychiatric nurses (RPNs) if regulated in the province or territory.
Results reflect the number of nurses who are registered in their jurisdiction of employment and who are employed and providing direct patient care. If that data is unavailable, results reflect supply, which is the number of nurses registered to practise in the jurisdiction.
Supply data was reported instead of the direct care workforce for the following: 

• 2020: Prince Edward Island (LPNs and RNs), Manitoba (RNs) and British Columbia (RPNs)
• 2021: Prince Edward Island (RNs) and Manitoba (RNs)
• 2022: Prince Edward Island (RNs), New Brunswick (LPNs and RNs) and Manitoba (RNs) 

ºìÁì½í¹Ï±¨does not collect record-level RPN data from the Yukon.
Data for nurses is presented as a combined total for the Northwest Territories and Nunavut.
Record-level entry or exit information is not available and therefore not reported for the following: 

• 2020: New Brunswick (LPNs), Yukon (LPNs) and Nunavut (LPNs) 
• 2021: Yukon (LPNs), Northwest Territories (LPNs) and Nunavut (LPNs) 
• 2022: Yukon (LPNs and RPNs) and Nunavut (LPNs) 

Please refer to Nursing in Canada, 2023 — Methodology Notes for more details.

Source
ºìÁì½í¹Ï±¨ Workforce Database, Canadian Institute for ºìÁì½í¹Ï±¨ Information.

Internationally educated health care providers (IEHPs) have long been a part of Canada’s health workforce. IEHPs may enter Canada’s health workforce through various pathways based on their profession and the jurisdiction in which they seek to practise.

In 2023, nearly 14% (n = 84,083) of selected health care workers in Canada were internationally educated. The groups with the largest numbers of IEHPs were registered nurses (RNs) at 37,341 (45% of IEHPs), family physicians at 14,182 (17% of IEHPs), pharmacists at 12,863 (15% of IEHPs) and licensed practical nurses (LPNs) at 10,828 (13% of IEHPs).

Over the past 10 years, the number of internationally educated family physicians remained stable, while almost all other professional groups saw an increase in numbers, the highest being among RNs, LPNs, pharmacists and physiotherapists. More than 11,000 internationally educated RNs were added, the largest increase compared with other providers — the most drastic increase occurred in the last 4 years. Among LPNs and physiotherapists, the increases in IEHPs were more gradual, culminating in more than a doubling of total headcounts by the end of the decade. Physiotherapists experienced the largest proportional increase of IEHPs (from 14% to 24%) compared with all other professional groups.

Community settings were the most common sector of employment for internationally educated pharmacists (90%), physiotherapists (65%) and occupational therapists (49%), while other IEHPs were more distributed across health sectors. Further analyses to compare common sectors of work among Canadian-educated providers may highlight differences in career outcomes.

Proportion of internationally educated health professionals stable among family physicians, increased particularly among physiotherapists and pharmacists 

Notes
* Denotes statistical significance (p<0.025) using the Mann-Kendall trend test.
Nurse practitioner data excludes Prince Edward Island, the Northwest Territories and Nunavut.
Licensed practical nurse data excludes New Brunswick, the Yukon, the Northwest Territories and Nunavut.
Registered psychiatric nurse data excludes British Columbia and the Yukon (included data covers about 50% of RPNs).
Pharmacist data excludes Newfoundland and Labrador, Prince Edward Island, New Brunswick, Quebec, the Yukon and Nunavut (included data covers about 70% of pharmacists).
Physiotherapist data excludes Prince Edward Island and the Yukon.
Occupational therapist data excludes the Northwest Territories.
In Ontario, licensed practical nurses are also referred to as registered practical nurses.

Sources
ºìÁì½í¹Ï±¨ Workforce Database, Canadian Institute for ºìÁì½í¹Ï±¨ Information.
Scott’s Medical Database, Canadian Institute for ºìÁì½í¹Ï±¨ Information, with raw data provided by Owen Media Partners Inc. (© 2024 Canadian Medical Directory).

Current data shows that family physicians and pharmacists have the highest proportions of IEHPs among new providers (i.e., those entering the supply in a given year). Among new family physicians in 2022, on average, 37% (n = 1,200) had completed their medical education abroad, which was a decrease from 40% in 2014. Additionally, the number of internationally educated family physicians entering practice without completing their medical education or residency in Canada declined to 463 (1% of family physicians) in 2023 from 515 (1.3% of family physicians) in 2014. Jurisdictional policy changes to increase the number of family medicine residency seats for international medical graduates may be contributing to the decrease of this number. Some professions saw an increase in IEHPs among their new providers, particularly physiotherapists, RNs and NPs.

Proportion of new internationally educated nurse practitioners and registered nurses more than doubled, while it decreased among family physicians over the past decade

Notes
* Denotes statistical significance (p<0.025) using the Mann-Kendall trend test.
Due to differences in data sources, data on family physicians is presented based on fiscal year, whereas data on other professionals is presented based on calendar year.
Family physician data for 2023 was not available; data for 2022 is presented instead.
Family physician data excludes Quebec, the Northwest Territories and Nunavut.
Nurse practitioner data excludes the Yukon, the Northwest Territories and Nunavut.
Licensed practical nurse data excludes New Brunswick, the Yukon, the Northwest Territories and Nunavut.
Registered nurse data excludes the Northwest Territories and Nunavut.
Registered psychiatric nurse data excludes the Yukon.
Pharmacist data excludes Newfoundland and Labrador, Prince Edward Island, New Brunswick, Quebec, the Yukon and Nunavut (included data covers about 70% of pharmacists).
Physiotherapist data excludes Prince Edward Island, the Yukon, the Northwest Territories and Nunavut.
Occupational therapist data excludes the Yukon, the Northwest Territories and Nunavut.
In Ontario, licensed practical nurses are also referred to as registered practical nurses.
Proportions of new internationally educated professionals within provinces/territories with available data were averaged to calculate a pan-Canadian average.

Sources
ºìÁì½í¹Ï±¨ Workforce Database and National Physician Database, Canadian Institute for ºìÁì½í¹Ï±¨ Information.

Understanding where IEHPs were trained can support the development of sustainable recruitment strategiesReference2 Reference3 and bridging programs.Reference4

Current data suggests that many IEHPs graduated from programs in Commonwealth countries such as South Africa, India and the United Kingdom. The Philippines continues to be the largest international source of regulated nurses — in 2023, 3.6% (n = 13,813) of the direct care nursing workforce had graduated there. This was followed closely by India, representing 2.6% (n = 9,931) of the direct care nursing workforce.

Top international places of graduation, many in Commonwealth countries 

Notes
* Due to differences in data sources, data for family physicians is presented based on fiscal year, whereas data for other professionals is presented based on calendar year.
† Family physician data for 2023 was not available; data for 2022 is presented instead.
— Data is unavailable, does not exist or is suppressed due to data quality issues.
The Commonwealth countries presented in this figure are South Africa, the United Kingdom, India and Australia.
Family physician data excludes Quebec (2014, 2019, 2023), the Northwest Territories (2014, 2019, 2023) and Nunavut (2014, 2019, 2023).
Regulated nurse data excludes New Brunswick (LPNs 2019), British Columbia (RPNs 2019, 2023), the Yukon (LPNs 2019, 2023) and Nunavut (LPNs 2014, 2019, 2023).
Occupational therapist data excludes Quebec (2014, 2019, 2023), the Yukon (2023), the Northwest Territories (2023) and Nunavut (2023).
Physiotherapist data excludes Prince Edward Island (2014, 2023), Quebec (2014, 2023), Ontario (2019) and the Yukon (2023).
Pharmacist data excludes Newfoundland and Labrador (2023), New Brunswick (2014), Quebec (2014, 2019, 2023), the Yukon (2014, 2019, 2023) and Nunavut (2014, 2019, 2023).

Sources
ºìÁì½í¹Ï±¨ Workforce Database and National Physician Database, Canadian Institute for ºìÁì½í¹Ï±¨ Information.

• ºìÁì½í¹Ï±¨ Workforce Quick Stats
• Data tables (professional-specific)
• Methodology notes (professional-specific)
• Indicator library
• Taking the pulse: Measuring shared priorities for Canadian health care, 2024