Before I came to Canada in April 2010, I was full time physiotherapist, employed by the largest private NMSK physiotherapist provider in Manchester, England. I worked approximately 6 days per week covering 3 different clinics through varying shift patterns, some early mornings, some 9-5 hours, some evening work and Saturday mornings when the clinic was busy and needed covering.
My path to Canada started after I met a beautiful girl, who turned out to be the love of my life, while on vacation in Cuba in August 2009. We shared a mutual love of exercise and health and she had her own business up and running in Toronto, Canada, so after we went back and forth between Manchester and Toronto 2-3 times we decided to see if we could make it work in Toronto. I’ve been here ever since.
Our countries are very similar in terms of the health care systems and so there aren’t really any major differences within physiotherapy practice that strike me as particularly contrasting. Physiotherapy is split between the National Health Service (NHS) and private practice in England, as it is here in Canada with Ontario Health Insurance Plan (OHIP) being the equivalent of the NHS. OHIP being mostly hospital based, as it is with the NHS and private practice being privately owned business ventures. The major practice areas are also very similar, with rotations and jobs available in NMSK, Neuro, Cardio Respiratory and Multi-Systems, with the majority of private practice clinics offering outpatient NMSK or Neuro physiotherapy.
When I arrived in Canada I was not employed. I have always been much more entrepreneurial in nature, rather than looking for employment and a steady pay check, so my wife and I built our business together and have been doing it ever since. I was not affected by the employment opportunities, when I first arrived, as I was in a perfect position to begin a business venture with my wife. We didn’t have a house and a mortgage to pay, nor did we have children at the time. It was just the two of us and we were able to pour our hearts and souls into our training business.
I was expecting to work the same hours as I had back in England, as I had experience running my own training business while I was studying physiotherapy. I knew exactly what I was getting myself into when I agreed to come to Canada to be with my wife. I had spoken extensively about living with her parents until our business took off and we could afford to buy a home. We had the perfect amount of help from her parents and they were incredibly supportive of our decision to make our life together work in Toronto.
The credentialing process was the difficult part for me. Canadian Alliance of Physiotherapy Regulators (CAPR) does not make it easy for immigrants to apply and quite frankly, some of their processes need to be reviewed. There are weeks, often months between communications from them; unclear instructions as you try to pass messages from them to your school in your home country; fees are expensive for the applications and the exams. They sent my application back 4 times and it took me 18 months, thousands of dollars plus a 12 week online training program to bring me up to speed, until my application was finally accepted. That was just to get accepted to take the exam! The exams themselves I found very challenging. Unless you have had experience with the method of examination in North America, Multiple Choice Questions (MCQ’s) and Objective Structured Clinical Examinations (OSCE’s), they can be very different from the types of testing you’re accustomed to and can be difficult to learn how to navigate. I took the written examination in December of 2014 and with very little study, failed it spectacularly! I massively underestimated the difficulty of the exam material and I found the depth of knowledge that I needed to pass the exam was much more than I currently had.
Firstly, and this is big, really, REALLY decide and ask yourself why you are coming to Canada. It may sound pessimistic and controversial, but honestly, had I known then how hard and how long it would have taken for me to be where I am now, personally, with everything else I had going on at the same time, I may have decided to stay in England, having my wife to relocate to Manchester and set up our Physio and training business there. She already had everything she needed to start work in England immediately. The correct qualifications, an EU passport to provide work and immigration papers and I was already a fully trained, fully licensed and a working physiotherapist. That being said, things have worked out excellent over here for us and now that I’ve passed, it was all so worth it. However, it was a lot of work, thousands of dollars spent, a huge time investment and going back to school as an adult, with a mortgage and kids was tough. So if you’re definitely making the decision to come to Canada, I suggest the following:
- Save money. You’ll need it for the applications and the exam fees.
- Get yourself and your family permanent residency (PR). There’s so much more help available for you if you’re a PR compared to having a work/study/traveller’s visa. The bridging program requires you to be a PR and if you’re serious about being in Canada as a Physio, you need PR status to stay and work longer term. So do it now.
- Find other immigrants and internationally educated physiotherapists who are on the same journey as you and form support groups, study groups, even just friends groups. I’ve found being an immigrant can be very lonely sometimes and finding peers here in Toronto was pivotal in helping me get to where I am now.
- Contact the leaders at the bridging program at the University of Toronto (UofT). They are fantastic, just fantastic at providing help, support and guidance.
- Apply for credentialing and pass the credential phase of the journey BEFORE you come to Canada. It may sound obvious, you may already have done it, but I didn’t and passing messages via email between 2 organizations was tough. The 18 months it took me could and should have been avoided, at least halved in duration.
- Go to the CAPR website and read EVERYTHING. Take every practice exam they have and start familiarizing yourself with the exam format.
- Finally, if like me, you were rusty and needed help getting back up to speed, invest the time and money into the Ontario Internationally Educated Physiotherapy Bridging (OIEPB) program. It’s worth every cent you’ll pay and the connections you’ll make between peers and the staff will be ones for life.
I had a personal training client I was training who knew I was a physio from England. She knew I really wanted to get my license here in Canada and she told me about a friend of hers who was a facilitator in the bridging program. She connected us and 3 months later I was at the information evening. Two months after that I sat for the admissions assessment (which I thought I bombed) and 2 months after that started the program.
I knew by that time I needed all the help I could get. I needed to go back to school. It had been 8 years since I graduated when I went to the information session and I only had 1 year of NMSK experience back in England. When I came to Canada, I went back to being a trainer and building a business and all the physio knowledge just faded away.
The bridging program is so much more than a refresher course. Its a 10 month fully comprehensive program and it covers everything from physiotherapy theory, skills and practice, concepts in Canadian healthcare, career development, networking and offers the fantastic opportunity to go on not 1, but 2 clinical internships. If like me you’re a hands on learner (most Physio’s are) the onsite weekend workshops, practical clinics and mock examinations were where I got the most out of the program. The online sessions and self directed homework study was also very well supported and the clinical internships were excellent at getting us into the work place and getting back to practice. The only negative I could say is that despite all the outstanding team mentors, content, structure and networking the course exposes you to, I still feel we should have done more to prepare us for the exams. My reasoning for this is as follows; the OSCE format is so specific, so detailed, so robot-like in its passing requirements, that even after the program finished, me and my study group still needed to learn the exam process in so much detail, it took us 3 more months of 4-5 days per week study to feel ready to attempt the exam. The bridging program does such a fantastic job of making us better, well rounded and much more professional physiotherapists, but everyone enrolled in the program has one single goal in mind. To pass the exam. A week of intense exam prep, workshops and exam skills would have been spectacular right at the end of the program.
From the moment you’re accepted onto the OIEPB program its 10 months of rubbing shoulders with some of the best physio’s in Toronto, the province, the country and the world. University of Toronto is regarded highly around the world and they have huge pull in the type of people that it can attract to teach, facilitate and network. I already had a job lined up with 2 of the facilitators who ran their own private practices before the program had even finished. I just needed to pass the exams! I’m pretty sure that most of my peers were already hand picked for jobs too.
In addition, the hospitals I worked during my internships were interested in me submitting my resume and going through the process to get on their hiring scheme, but honestly, hospital work isn’t where I see myself long term. I’ve had two job offers from clinic directors whom I met while in the bridging program and the clinic I’ve worked at as a strength coach/exercise rehabilitation specialist, have offered me a position in their clinic as a physiotherapist.
I already had a pretty good life before the bridging program as our training business has and does well. However, the added benefits the physiotherapy license will bring to the table are huge. Opportunity being the biggest difference. The opportunity to expand my business and attract new clients/patients, the opportunity to provide new services to my existing clients, the opportunity to not have to work as many anti-social hours that trainers have to, resulting in more free time for my wife and kids. Also, I question the longevity that personal and group fitness training has for coaches, but physiotherapy can take me right through and into retirement. Maybe it’s provided me with a little more financial support and mental stability.
I’ve been invited back to facilitate and take part as a volunteer for future bridging program learners and the connections I have made at UofT will one day, hopefully, lead me to completing my masters. I’d love to be back at the bridging program one day teaching exercise as rehab and treatment to its learners. Maybe even one day as a tutor on the masters program. Only time will tell, but now I’m licensed it’s opened up so many more options and doors.
Know this, some physio’s are just so book smart that they can walk straight into the exams and crush the exam first time, without the need for a bridging program, any schooling or much outside direction other than sitting down and reading text books. That was never me and it never will be. The bridging program has been the best thing I’ve done, professionally speaking, in the 10 years I’ve been in Canada. It re-ignited my passion for physio, helped me realize why I got into it in the first place and helped me get through one of the most testing times in my life. I never realized just how difficult it is for immigrants to come to a different country and try to be the same person they were back home. I have so much more respect for people who have done this before me and with less help than I.
To summarize, without the bridging program I would not be here writing this today. I wouldn’t have met my new International physio brothers and sisters, new friends and colleagues for life now. I wouldn’t have met the unbelievable staff at the bridging program, each one uniquely skilled and expertly paired in class to deliver a fantastic teaching experience. I wouldn’t have met the bridging program alumni, each with a story as deep and moving as the next about their journeys from far more exotic and interesting regions of the world than England. Experiencing the difficulties they faced and eventually overcame. The truth is, it really is much more than just passing an exam, although that’s the goal that initially got me and almost every other candidate moving. It’s a journey and it’s an adventure, one which has many twists and turns, one which humbles you at every corner and teaches you so much more about who you thought you were as a physiotherapist. It’s given me so much perspective, so much hope, so much courage and because of that, the future for me and my family is bright. I truly wish you the best of luck on your own journey and know that you will be supported by these fantastic people at the program, the alumni and in the physio network at every moment.
With love and in health,
Michael Davenport, PT
An added bonus for Michael:
During Michael’s clinical internship placement at Sunnybrook’s Holland Orthopaedic and Arthritic Centre, he assisted and starred in a series of shoulder videos. Find out how this happened in our Summer 2020 newsletter.