AUSTRALIA-CANADA ROUNDTABLE ON FOREIGN QUALIFICATION RECOGNITION

AUSTRALIA-CANADA ROUNDTABLE ON FOREIGN QUALIFICATION RECOGNITION April 13-15, 2011 Committee for Economic Development of Australia (CEDA) Melbourne Office Level 13, 440 Collins Street, Melbourne, Australia ANNEX 1 An Overview of Selected Occupations

INTRODUCTION To supplement the backgrounder, Annex 1 provides an overview of Australian and Canadian qualification recognition processes across the following occupations: accountants, architects, dentists, engineering technicians and technologists, pharmacists, physicians, physiotherapists, registered nurses, and two skilled trades (electricians and plumbers). Focusing primarily on the target occupations included in the Pan-Canadian Framework for the Assessment and Recognition of Foreign Qualifications*, the selection criteria also considers other key factors, such as the level of demand in Canada and Australia, migration flows for each occupation, and progress on mutual recognition. Summarizing input from national organizations representing regulatory bodies, the overview consists of a one-page synopsis for each of the selected occupations in Canada and Australia. The synopses highlight labour market information, qualification recognition processes, as well as challenges and progress related to foreign qualification recognition. While some details may not be readily available for all the selected occupations, the following template was used to ensure consistency in the information gathered: What is the labour market outlook for this occupation? What is the size and character of current migration flows? The Qualification Recognition Process Who is involved in academic and credential recognition? What is the recognition pathway for domestically-trained professionals? What are the requirements for internal mobility? How is the recognition pathway different for foreign-trained professionals? What are some current issues with foreign qualification recognition? What are some recent developments in overseas services and pre-arrival assessment? What types of mutual recognition agreements have been signed? *Target occupation for December 31, 2010: architects, engineers, financial auditors and accountants, medical laboratory technologists, occupational therapists, pharmacists, physiotherapists, and registered nurses; target occupations for December 31, 2012: dentists, engineering technicians, licensed practical nurses, medical radiation technologists, physicians, and teachers (K-12) 1

ACCOUNTANTS REGULATED PROFESSIONS AUSTRALIA Chartered Practice Accountant (CPA) Chartered practice accountants are prominent on Australia s Skilled Occupation List, including auditors, company secretaries and corporate treasurers, financial brokers, and actuaries, with state/ territory nominated list extending to management and taxation accountants. The scale of recent arrivals has also been highly significant. From 2004-05 to 2008-09, accountants were the main GSM profession - 40,054 primary applicants, including 5,933 in 2008-09 (the great majority admitted onshore through the studymigration pathway). Once partners are factored in, GSM arrivals in accounting were higher at 42,975. By contrast the scale of 457 visa arrivals is slight, with 3,450 accountants and 60 corporate treasurers employer-sponsored selected the same 5 years. Analysis of Australian Census data highlights the cumulative significance of these flows. By 2006 44% of Australia s professional accountant workforce was overseas-born, with a striking 33% of the total arriving from 2001-06. China (excluding SARS) was the major source (4,782), followed by India (4,067), the UK/ Ireland (1,288), Sri Lanka/ Bangladesh (1,115), and Malaysia (1,001). The Qualifications Recognition Process There is no statutory definition of accountant in Australia. Certified practicing accounting courses are accredited to agreed professional standards by the Certified Practising Accountants of Australia (CPAA), the Institute of Chartered Accountants in Australia (ICAA) and the National Institute of Accountants (NIA). To secure registration to practice, domestic students typically qualify through 3 year Bachelor courses with an accounting major or Master s degree. Innovative Graduate Certificates of Chartered Accounting Foundations programs also exist, qualifying more than 1,300 students to professional accounting academic entry requirements since 2007. CPAA, ICAA and NIA (on an equal basis) are the gazetted GSM assessment authorities for the Skilled Occupation List. Stage 1 involves English language assessment, with IELTS 7 at all levels now required (a major initiative). Qualifications equivalence is then defined. To meet the requirements for a nominated Australian and New Zealand standard, prospective migrants must have a formal qualification assessed as comparable to an Australian Bachelor degree covering at least nine of 12 designated curriculum areas, with each nominated occupation having four mandatory core knowledge fields 1. Immigrant accountants in recent years have been associated with highly variable employment outcomes including large numbers of international students who qualified onshore. In 2006 just 27% of degreequalified accountants who had arrived in Australia the previous 5 years were employed as accounting professionals (large numbers being de-skilled). This compared with 63% of recently arrived nurse migrants and 53% of those qualified in medicine. As demonstrated by the major Australian study to date on the study-migration pathway, students youth, lack of experience, and inadequate English have been major barriers, in addition to inadequate levels of English many employers seeking IELTS 7 or higher to facilitate complex communication with clients 2. A range of training programs are now in train to address this. Most notably, 17 national providers have been accredited to deliver the Skilled Migration Internship Program Accounting (SMIPA) to international accounting graduates across all states. 2,321 graduates had commenced by 2010, with over 500 successful completions. 2

The three accounting bodies also have a strong commitment to developing multilateral agreements. CPA Australia, for example, has established offices in Vietnam, Fiji, London (covering Europe) to facilitate accountant flows, in a context where 1 million Australian expatriates are overseas in any one year and disproportionate numbers are qualified in accounting. Globalization rather than social justice is driving this liberalization, with mutual recognition agreements negotiated with a range of professional accounting bodies. Changes to assessment are being explored for example in response to an exhaustive external review by the Canadian Institute of Chartered Accountants to help reinforce the ongoing rigour and relevance of the Chartered Accountants Program while further strengthening mutual recognition of the Program s high standards among the best international Chartered Accountants bodies 3. Multiple capacity-building initiatives are also in train (for example in relation to China and Pakistan). CANADA Certified General Accountant (CGA) In Canada, there are three main designations for professional accountants: Certified General Accountants (CGAs), Certified Management Accountants (CMAs), and Chartered Accountants (CAs). There continues to be a strong demand for accounting services (tax, audit, and advisory services), and the trend towards a highly skilled, well-educated workforce, coupled with increasing demand in the services sector, will bode well for those who choose accounting as a profession. The demographic makeup of the profession is such that Canada will have to rely, in part, on foreign-trained accountants to meet future demand; however, the profession was recently removed from the new list of 29 in-demand occupations eligible for immigration under the Federal Skilled Worker class. Detailed information on the size and character of current migration flows to Canada is not available for this profession; however, the three top source countries for foreign trained accountants are China, India, and the Philippines. The Qualification Recognition Process The provincial regulatory authorities, known as CGA associations and Ordre des CGA in Quebec, assess qualifications using harmonized processes and national standards established by the Certified General Accountants Association of Canada (CGA-Canada). Candidates must have a university degree, pass the qualification program for CGAs, and complete 36 months of approved, full-time work experience. With the exception of candidates coming from jurisdictions where CGA-Canada has entered into a mutual recognition agreement (MRA), foreign qualifications are assessed against CGA standards. The CGA Program of Professional Studies has many entry points to reflect the skills and educational background of candidates. For instance, credit may be awarded to candidates who possess a university degree and work experience. Meeting the requirements of Chapter 7 of the Agreement on Internal Trade (AIT), CGAs have full mobility in Canada with the exception of Ontario, where the provincial government has taken an exception under the AIT for its public accounting regime. The CA and CMA designations have somewhat different but comparable qualification requirements. Some of the current issues with foreign qualification recognition are related to language proficiency and barriers to practical experience, such as business culture and limited employment opportunities. Improvements can also be made to further harmonize processes across jurisdictions. Recent developments in overseas services and pre-arrival assessment include enhancing information resources abroad, exploring options for offshore examinations, and working towards improving and harmonizing self-assessment processes. Currently, CGA-Canada has MRAs with the UK-based Association of 3

Chartered Certified Accountants, CPA Ireland, CPA Australia, and l Ordre des experts-comptables de France. ARCHITECTS AUSTRALIA Architects/ landscape architects feature on Australia s GSM Skilled Occupation List, in addition to the broader state/ territory and employer nominated schemes (the latter including a vast array of occupations) 4. Demand in the field is significant. From 2004-05 to 2008-09, architects, building and surveying professionals were the third top profession imported through the GSM - 11,339 primary applicants, including 3,159 in 2008-09 (virtually all selected offshore). The scale of arrivals has risen rapidly in recent years, and once partners are factored in, total GSM arrivals rise to 14,600. By contrast the scale of 457 visa arrivals is to date slight, with 770 architects employer-sponsored the same 5 years, including 140 in 2008-09 5. The Qualifications Recognition Process Australian architecture courses are accredited by the Architects Accreditation Council of Australia (AACA), recognised as the national organisation responsible for advocating, coordinating and facilitating national standards for the registration of architects in Australia and for the recognition of Australian architects overseas by the relevant Registration Authorities. Constituted by nominees from all State and Territorial Architects Registration Boards in Australia, AACA is not a registration authority but makes recommendations to the various Boards. The decision to register architects for legal practice thus lies at state level 6. Domestic students qualify through 5 years of tertiary study the majority of Australian courses now offered at Master s degree level. To secure professional registration, architects must demonstrate they have a recognised academic qualification in architecture or acceptable equivalent; have a period of training through experience followed by successful completion of the AACA Architectural Practice Examination (APE); and have secured state/ territory registration through the relevant Architects Board. Migrant architects are required to demonstrate equivalence to Australian standards, plus an IELTS score of Band 6. Stage one involves a Provision of Assessment for GSM migration purposes. Stage two requires portfolio submission (for recent graduates) or a Review of Graduate Equivalence for mature applicants with at least 10 years supervised experience following training. In line with the Trans-Tasman agreement New Zealand qualifications are automatically recognised, along with National University of Singapore M. Architecture degrees since 1998. Migrant applicants lacking recognised qualifications are eligible to take the National Program of Assessment (NPrA), which is recognised by all Australian registration authorities as an alternative to successful completion of an accredited professional Australian qualification in architecture. The NPrA involves response to a Project Brief within 6 months, through development of a report with companion design drawings (in line with the National Competency Standards in Architecture). Following this architects must take and pass the three-part Architectural Practice Examination (combining oral, written and practice components), before applying to a state/ territory Board for professional registration 7. These pre-accreditation hurdles appear to be substantial. Based on Annual Reports low numbers of foreign architects appear to secure full registration, despite the recent scale of arrivals. In New South 4

Wales, the major immigrant-receiving state, just 35 overseas-qualified applicants were interviewed in 2008-09, with 27 granted equivalence. In Western Australia in 2009-10 5 migrant architects reached interview, with 4 deemed successful. Important regional recognition developments are in train 8. In 2000 the Asia Pacific Economic Cooperation Architect project was adopted, following an Australian government proposal. With the support of 15 participating economies, this sets a common basis for the recognition of professional competence to facilitate the regional mobility of those on the APEC Architect Register. Discussion is also underway with the US regarding mutual recognition. CANADA Similar to many other sectors, the architectural labour force is aging due to demographic trends in Canada. The exit rate in the profession is expected to rise over the coming decade, which will increase the replacement demand. In fact, immigration is now a significant source of labour force growth in the architectural industry, accounting for over a quarter of new entrants and an even higher percentage in some regions. The Qualification Recognition Process Provincial and territorial licensing authorities (eleven Associations of Architects) are responsible for the recognition of professional qualifications, and architects have full mobility across provinces and territories as established under Chapter 7 of the AIT. To qualify for registration, candidates must apply to the provincial licensing authority and the following must be assessed: education, experience, and an examination. If the professional degree is not from an accredited Canadian School of Architecture or an American School of Architecture accredited by the National Architectural Accrediting Board (NAAB), the candidate s education must be certified by the Canadian Architectural Certification Board (CACB). The candidate must also complete a three-year internship (some foreign experience is recognized depending on the policies of the licensing authority) and successfully pass the Examination for Architects in Canada (ExAC). The Architect Registration Examination (ARE) developed by the National Council of Architectural Registration Boards (NCARB) in the US is also recognized by Canadian licensing authorities. For foreigntrained candidates to qualify for registration in Canada, they must demonstrate successful professional experience as an architect for seven years following licensure or registration abroad. Lacking such experience will likely require a formal credential assessment and enrollment in internship programs. To improve foreign qualification recognition in the architectural industry, there is a need to ensure proper assessment and recognition of prior experience without compromising existing professional standards. Other challenges include training requirements, accessing sufficient and clear information, language issues, and labour market competition in bigger cities. The Canadian Architectural Licensing Authorities (CALA) are moving towards the Broadly Experienced Foreign Architect (BEFA) process, which will allow foreign-trained candidates to have their competency assessed at one time rather than in the three steps described above. The proposed system will include an on-line self-assessment tool, and the responses and supporting material provided by foreign candidates would be reviewed by assessors, culminating in an interview in Canada by an expert panel. The process is currently in the pilot phase, with the objective of going operational in 2012. In terms of mutual recognition, Canadian regulators and the NCARB in the US have an agreement that establishes reciprocal registration of architects practicing in a jurisdiction with a signed Letter of Undertaking. While a Tri-National MRA was concluded by regulatory authorities from Canada, Mexico, and the United States in 2010, exploratory discussions are underway with respect to a possible MRA 5

between Canadian Architectural Licensing Authorities (CALA) and the Architects' Council of Europe (ACE) member association regulators. With respect to the mutual recognition of educational credentials, the Canberra Accord was signed in April 2008 to facilitate the portability of education credentials between Australia, Canada, China, Korea, Mexico, the UK, and the US. DENTISTS AUSTRALIA Dentistry features on Australia s Skilled Occupation List, along with virtually every major health profession. Despite the scale of intakes being small, the significance of this migration is rapidly growing. From 2004-05 to 2008-09, 512 GSM PA s were admitted, including 151 in 2008-09 (two-thirds selected offshore). The scale of these arrivals has tripled since 2004-05, when just 62 PA s were selected. A further 590 dentists arrived through the 457 temporary category in these 5 years, including 160 in 2008-09 (compared to 80 five years earlier). By 2006, 52% of Australia s dental practitioner workforce was overseas-born, with 22% having arrived from 2001-06 (a major proportional contribution). India was the primary source at this time (320), followed by the UK/ Ireland (125), North Africa/ the Middle East (128), the Philippines (88) and Central/ South America (78). The Qualifications Recognition Process Dental science courses are accredited by the Australian Dental Council (ADC), which develops national accreditation standards for education and training leading to registration as dental practitioners and specialists (in addition to technologists, therapists and hygienists) 9. The ADC also takes a leadership role in developing national statements of attributes and competencies for the dental and oral health professions. It is the gazetted authority to assess international dental graduates (IDG) qualifications pre and post-migration for GSM purposes, in addition to access to full registration on arrival. The ADC assesses the caliber of training in IDG source countries in comparison to Australian practice standards, and the knowledge, clinical skills and professional attributes of overseas qualified dental/ oral health practitioners who seek registration. Since July 2010 the ADC advises the Dental Board of Australia on these matters. (Comparable accreditation functions are undertaken by the medical, nursing, physiotherapy and pharmacy national bodies described in the sections to follow. This will not be repeated for the sake of brevity.) To secure registration to practice, Australian students qualify through 5-7 year degree/s - course length reflecting whether they commence with school leaver or graduate entry status. Overseas qualified dentists are required to demonstrate their completion of a dental degree or diploma (at least 4 years full-time academic study at a recognized university), completion of required pre-registration clinical experience, full registration in country of training or practice, and a certificate of good standing from the relevant registration authority. (Again, these requirements are standard across the health professions.) By 2006, just 37% of IDG s secured dental employment in Australia in their first 5 years. Outcomes were poor for a range of birthplace groups - for instance just 5% of dentists from Central/ South America securing dental employment, 7% from the Philippines, 21% from China, 23% from India (a rapidly growing major source) and 35% from India/ Bangladesh 10. These outcomes contrasted markedly with those for recent IDG s qualified in South Africa (89% employed as professional dentists), Malaysia (84% - many who had qualified in Australia), and the UK/ Ireland (82%). 6

Only New Zealand trained dentists to 2010 were accorded automatic recognition, in line with the Trans- Tasman Agreement. In April 2010, the Dental Councils of Canada and Australia also agreed to mutual recognition subject to Canada s requirement for Australian graduates to sit the national exam (in line with recent Canadian graduates). Once their paper-based applications have been assessed, nonrecognized IDG s are required to sit and pass Australia s Occupational English Test (to assess migrant health professionals English competence in speaking, listening, reading and writing tests in 13 fields). The equivalent to IELTS Band 7 is required (OET B) standard in Australia from 2006 across all clinical health occupations. Following this, IDG s must pass the ADC Preliminary Examination of dental knowledge (2 multiple choice question [MCQ] papers of 80 items each, plus 3 questions based on clinical scenarios/practice), then a comprehensive Clinical Examination delivered over 6-7 days in dental teaching hospitals and clinics (currently around 18 exam sessions per year). Standards are aligned to the knowledge and competence of recent Australian dental school graduates, with IDG s allowed unlimited attempts to pass, so long as their OET and Preliminary Examination passes remain valid. From 2000 to 2009 1,048 IDG s were deemed eligible for registration in Australia through the ADC assessment pathway an extraordinary contribution. Demand for assessment has grown markedly. For example in 2000 just 105 IDG s took the Preliminary exam, with a 15% success rate, compared to 608 in 2010 (27% passing). Clinical pass rates were higher that year, at 43%. Candidates diversity, differential training systems, and levels of English represent major challenges, along with the resources available to deliver the requisite Clinical exams in the context of rising dental migration. By 2011 the ADC was assessing candidates from 120 source countries, trained in over 400 dental schools, including multiple schools within a single university (for example in India). Growing numbers of dental graduates are also selected onshore, having qualified with Australian dental degrees in a context where 387 international students were enrolled by 2009, along with growing numbers in clinical doctorate specialist training courses 11. CANADA Due to increased demand from baby boomers and the percentage of the population with employment related dental plans, high employment growth has been anticipated for the profession; however, underserviced populations remain an ongoing challenge. While there are concerns that immigration may not compensate for the rising labour demand, the proportion of registered dentists trained abroad ranges from 2 percent in small provinces to over 17 percent in the largest province of Ontario. Current trends indicate the top source countries to be India and the Middle East while others include Iran, the UK, Romania, the Philippines, Poland, Iraq, and Egypt. The Qualification Recognition Process The organizations involved in qualification recognition are the National Dental Examining Board of Canada (NDEB), the Royal College of Dentists of Canada (for Specialists), the Commission on Dental Accreditation of Canada, Universities and the Association of Canadian Faculties of Dentistry, as well as the Provincial Dental Regulatory Authorities and the Canadian Dental Regulatory Authorities Federation (CDRAF). The recognition pathway for those trained in Canada involves the completion of an accredited Canadian, American, or most recently Australian program and the successful completion of the national examination. Before proceeding with the national examination, foreign-trained professionals must either complete a two-year bridging program or the NDEB Equivalency Process, which includes a voluntary self assessment online, credential verification against fraud, an assessment of fundamental knowledge to verify basic training, and the assessment of clinical skills consisting of two examinations. 7

Consistent with the Agreement on Internal Trade (AIT), all of the provincial dental regulatory authorities updated and signed a new mutual recognition agreement in 2009 to remove disparities in accreditation and examination across the country. The shortage of facilities, faculty, and funding to address demand, especially for specialists, is a major concern for the profession. Other more general challenges include international disparities in training, cultural differences, and limited collaboration across professions. As for recent improvements, the NDEB Equivalency Process is a significant development that enhances foreign qualification recognition. There is also a reciprocal agreement with the United States and Australia respecting the recognition of accredited dental training. ENGINEERING TECHNICIANS AND TECHNOLOGISTS AUSTRALIA Engineering technologists/ technicians feature prominently on Australia s Skilled Occupation List, including civil and electrical engineering technicians and draftspersons, radio communication technicians, and telecommunication field engineers, technologists and network planners. Electronic, mechanical, metallurgical or materials and building engineering technicians are also sought under the state/ territory sponsored skilled occupation schemes. The scale of Australian demand is significant. From 2004-05 to 2008-09, mechanical and engineering tradespersons were the second top trade imported through the GSM 4,329 primary applicants, including 832 in 2008-09 (the great majority selected offshore 826). This compared to 11,339 professional engineer arrivals (the fourth top GSM group). Employer-sponsored demand is also robust. In the same period 2,340 mechanical engineering, 1,170 building and engineering, 990 civil engineering, 990 electronic engineering and associate professionals arrived through the 457 visa, along with 1,410 engineering technologists (330 in 2008-09), yielding 6,900 in total. Australia s level of dependence on engineering migration is high. For example by 2006 52% of degree-qualified engineers in Australia were overseas-born, with 28% of the total workforce having arrived in 2001-06. The Qualifications Recognition Process Engineering is a semi-regulated occupation in Australia, with Engineers Australia (EA) the national competency authority responsible for the accreditation of engineering education programs. In line with this, it evaluates programs leading to the award of engineering degrees and diplomas by educational institutions in three career categories: Professional Engineer, Engineering Technologist, and Engineering Associate. The standard Australian engineering technology qualification is a relevant undergraduate degree, in contrast to professional engineering courses where qualifications are gained by 4 year Bachelor courses or (in a recent innovation) at Masters degree level. The National Generic Stage 1 Competency Standards, revised from 2009-2011 and approved by the Council of Engineers Australia in February 2011, define the competencies required to commence practice in each occupational category - providing a reference point for the assessment of entry to practice for those with a qualification not accredited within Australia or recognized by the relevant international accord 12. To secure recognition for migration purposes, GSM applicants must supply evidence they have achieved scores of IELTS 6 or above on all 4 language tests; provide a certified copy of their testamur (degree, diploma or certificate), plus other career-related documentation for review. Australia, as a signatory to the Sydney Accord, also 8

provides mutual recognition for engineering technologists qualified in Canada, Hong Kong, Ireland, New Zealand, South Africa and the UK (noting also the Washington Accord for professional engineers). Engineering is a very outward looking field in Australia. Around three-quarters of migrant engineers secure immediate recognition, including those applying as technologists. Additional mutual recognition agreements are now being explored beyond the Sydney Accord, the APEC Engineer Register (to enhance regional mobility), and the Engineering Technologist Mobility Forum (to develop, monitor, maintain and promote mutually acceptable standards and criteria for facilitating the cross-border mobility of experienced engineering technologists more broadly). A number of significant challenges however remain. The first is certainty of assessment, in this semi-regulated field associated with strong temporary entry. While pre-migration assessment is mandatory for GSM applicants, employersponsored temporary technologists bypass screening. According to a senior EA informant, in 2008-09 around 9,500 engineers arrived with either degree or diploma level qualifications, compared to 9,800 engineering graduates Australia-wide. They could have self-enumerated qualifications for all we know, or they could be exceptionally qualified we have no idea. We might see them if they wish to join us, but if they are here for a short stay they probably wouldn t. A second concern relates to category slip for example an engineering technologist securing professional engineering work, or being de-skilled in the context of Australia s current unmet demand for engineering technicians. A third challenge concerns state variability in terms of registration requirements. CANADA As the labour market outlook for this occupation is significantly positive, there is already concern that there may not be enough technicians and technologists to respond to the current needs of the Canadian economy, let alone future demands. Not including the US, the majority of technically-trained immigrants come from China, India, the Philippines, the UK, and France. Although the latest in-flow numbered around 15,000, many of those claiming to be engineers tend to only qualify as technicians or technologists in Canada. The Qualification Recognition Process Provincial registrars and their supporting review committees are involved in qualification recognition. To become certified, all candidates must graduate from an accredited technology program (or proof of sufficient academic qualifications), obtain at least a year of relevant Canadian experience, successfully complete the professional practice exam and a course on professional ethics, and make payment of membership dues. Since all provincial associations have signed the Canadian Council of Technicians and Technologists (CCTT) inter-provincial mobility agreement, the only requirement for internal mobility is certification, i.e. a designation awarded in one province is recognized by all the other provinces. A key challenge with foreign qualification recognition is the inability of provincial registrars to quickly assess academic qualifications earned overseas. To expedite the assessment process, the CCTT developed the International Qualifications Database (IQDB), which contains almost 9,000 records of technology programs at polytechnics around the world. Registrars simply log onto the IQDB website and access information on technology programs that have been assessed at either the technician or technologist level. While the number of records continues to grow, the database is far from being an exhaustive list of technology programs offered around the globe. As the term engineer can have a wider range of meanings abroad than in Canada, it is important to ensure that a technically trained 9

individual is guided to occupations within the technology professions when they do not qualify as engineers. A recent development is the Canadian Technology Immigration Network (CTIN), which is both a web portal attached to the WIC and a network of immigrant serving agencies that have come together to serve the needs of technicians and technologists who have emigrated to Canada. The portal provides comprehensive information on the technology professions in Canada, labour market information, and a self-assessment tool that can be used to initiate the process of certification while still overseas. The site also allows employers to post their recruitment needs and, when matched with individuals holding the requisite qualifications, facilitates pre-arrival contact between an employer and a potential employee. There are currently two international mutual recognition agreements establishing substantial equivalency of academic qualifications from accredited technology programs among signatory states. The Dublin Accord is an agreement for the mutual recognition of Engineering Technician qualifications while the Sydney Accord establishes mutual recognition of qualifications for Engineering Technologists or Incorporated Engineers. Building on the Sydney Accord, the Engineering Technologists Mobility Forum is a full mobility agreement for highly qualified and senior technologists. PHARMACISTS AUSTRALIA Pharmacy is not a key health workforce migration field to date for Australia, in contrast to Canada. By 2006, there were just 4,962 degree-qualified migrant pharmacists resident - 8% of the total pharmacy workforce, including 749 who had arrived in the previous 5 years. Reflecting this, limited public data exist on their employment or registration outcomes. In May 2010 pharmacists were also removed from Australia s new Skilled Occupation List a move anticipated to substantially cut arrivals. An exception is the state/ territory sponsored lists, which currently facilitate the entry of hospital, industrial and retail pharmacists. The Qualifications Recognition Process To secure registration to practice, domestic students qualify as pharmacists through 4 years of tertiary study - course length reflecting whether students commence with school leaver or graduate entry status. The Australian Pharmacy Council (APC) is the national body representing the Australian state and territory pharmacy registering authorities. Established in 2002, the aim was to enable a national approach to pharmacy regulation and accreditation, supporting the registering authorities primary goal of protecting the public. In line with this the APC takes a leadership role in developing and implementing nationally consistent policies, processes and approaches to pharmacy practice, regulation and registration, accrediting pharmacy schools and programs, authorizing agencies to accredit continuing professional development activities, conducting examinations towards eligibility for registration, and assessing the qualifications and skills of pharmacy graduates towards Australian registration and permanent residency. The challenges for migrant pharmacists are comparable to those described for other migrant health professionals; however, fewer bridging options exist given the modest scale of flows. Within this context the APC has been responsible for initial paper-based review of qualifications, experience and English ability. In 2009-10 the top countries of training for stage 1 APC eligibility assessments were Egypt (38%), 10

India (25%) the Philippines (10%), South Africa (6%) and Nigeria and Pakistan (3% each). A Competency Assessment of Overseas Pharmacists examination is then administered for eligible overseas trained pharmacists four times a year, in London, Auckland and Australian capital cities. This includes the National Forensics, Ethics and Calculations Examination, which assesses candidates capacity to apply their knowledge to an Australian context. The primary source countries for stage 11 assessment in 2009-10 were Egypt (52%), India (17%), Zimbabwe (4%), Pakistan, South Africa and Nigeria (3% each) 13. Following July 2010, and the establishment by AHPRA of the new Pharmacy Board of Australia, a period of change and reprioritizing of functions is underway. While the APC will continue to be responsible for initial assessment of qualifications, experience and English ability, following this, eligible migrant pharmacists will undertake supervised practice and competency assessment under the Pharmacy Board of Australia (PBA) rather than the APC (a major change, with APC having previously managed migrant pharmacists to their point of registration). An orientation information tool has recently been developed and trialed by APC. The PBA has also approved the Accreditation Standards for Pharmacy Intern Training Programs 2010, and will oversee a written and oral examination for proof of competency and eligibility for full registration (with APC commissioned to develop and conduct the written component). APC is further exploring the potential of computer delivery of examinations to enhance uniformity of procedure, delivery on the same day(s) and times, faster receipt of results, and greater security. CANADA Although the issue of labour shortages was previously identified for this occupation, recent developments, including expansion of the scope of practice, the increase in the number of Canadian pharmacy students, the introduction of regulated pharmacy technicians, and changes to the delivery and compensation of pharmacy services in some jurisdictions, appear to have an effect on the labour market. However, new studies would be required to understand the level of impact of these developments. In 2009, there were 1,178 applications for document evaluation (the first step in the accreditation process) from 70 countries, with the largest numbers originating from Egypt (22%), India (16.2%), and the Philippines (11.7%). In the last few years, there have been increases in the number of applications for the document evaluation and the total number of foreign-trained pharmacists registered in Canada. The Qualification Recognition Process As members of the National Association of Pharmacy Regulatory Authorities (NAPRA), provincial and territorial pharmacy regulatory authorities (PRAs) are responsible for setting the licensure requirements in their respective jurisdictions. All PRAs, except for the province of Québec, rely on the Pharmacy Examining Board of Canada (PEBC) to assess the qualifications of both Canadian and international pharmacy graduates (IPGs) to ensure that candidates possess the knowledge and skills to effectively practice pharmacy. In the province of Québec, the assessment of qualifications is performed by the Comité d admission à la pratique of the OPQ (Ordre des Pharmaciens du Québec) for pharmacy graduates trained outside of the province and successful completion of the PEBC national examination is not mandatory. To be licensed in Canada, candidates must meet educational requirements, demonstrate competence in pharmacy jurisprudence in the jurisdiction of practice, complete Structured Practical Training Programs, satisfy language requirements, and pass a national qualifying examination (two parts). In the case of IPGs, additional steps may be required to fill identified gaps in education or training based on the requirements for Canadian pharmacy graduates. IPGs are tested for proficiency in 11

one of Canada s official languages (English or French) depending on the area where they hope to practice. With the renewal of the Mobility Agreement for Canadian Pharmacists in July 2009, signatories agree to register as pharmacists applicants who hold an unrestricted practice license in another Canadian jurisdiction of a signatory and have met the requirements set out in the agreement. In terms of key challenges, many IPGs consider the licensure process to be time-consuming and costly, and they also struggle with the accreditation examinations. To enhance existing supports to IPGs while respecting the regulators mandate of public protection, NAPRA is working on the IPG s Gateway to Canada project, which will provide an online, centralized point of entry for all foreign licensure applications, comprehensive information on the requirements and process for licensure, online selfassessment tools, and a national repository of licensing information and documentation accessible by Canadian pharmacy licensing and accreditation bodies. The Québec-France Understanding on the Mutual Recognition of Professional Qualifications was signed on October 17, 2008 to facilitate international mobility through the adoption of a common procedure for recognizing professional competence. While the agreement currently applies to five professions and eleven trades, the Quebec government intends to quickly implement mutual recognition arrangements (MRAs) in approximately a hundred professions and trades, including the pharmacy profession. PHYSICIANS AUSTRALIA Medical practitioners feature very strongly on the GSM s current Skilled Occupation List, with 30 specialities listed. Australia has an extraordinary dependence on international medical graduates (IMG s). By 2006 45 per cent of residents with medical qualifications were overseas-born, including 7,596 doctors arriving across all immigration categories the previous 5 years (double the number accepted from 1996-2001). The UK/Ireland, Other Sub-Saharan Africa, China, India, North Africa/ Middle East, Sri Lanka/ Bangladesh, South Africa and the Philippines were major source countries. From 2004-05 to 2008-09 2,593 international medical graduates (IMG s) were selected through the GSM category (partners included). These figures are dwarfed however by the scale of temporary arrivals the category with a capacity to specify doctors work in areas of need under supervision for up to 4 years (typically through various forms of conditional registration). In 2007-08 3,310 IMG s were sponsored via this route, compared to 3,270 in 2008-09, in a context where health and community services (largely doctors and nurses) was Australia s most rapidly growing temporary category 14. The Qualifications Recognition Process Australian medical courses are assessed and accredited by the Australian Medical Council (AMC), since July 2010 under contract to the Medical Board of Australia. To secure registration to practice, students qualify through 4-6 year degrees followed by a year of supervised practice (internship) - course length reflecting commencement as school leavers or graduates. The AMC is the gazetted authority to assess IMG qualifications pre and post-migration, for GSM purposes in addition to full registration. In line with dentists, overseas qualified medical practitioners are required to demonstrate their completion of a medical degree or diploma (at least 4 years full-time academic study at a recognized university), completion of pre-registration clinical experience, full registration in country of training or practice, and a certificate of good standing from the relevant registration authority. State competition to recruit and retain medical migrants however has become intense, with significant accreditation consequences 15. 12

The most detailed study of IMG s to date demonstrated by 2007 just a third of recently arrived medical graduates had attempted to pass the AMC s pre-accreditation exams. Of those commencing the process, 78% were medically employed within 5 years, despite just 41% by this time having secured full registration. By 2008 there was significant debate on the conditional registration scheme, which allowed thousands of IMG s to work on a supervised practice basis. As with dentistry, candidates diversity, differential training systems, and levels of English represent entrenched challenges to registration status. Mandatory English testing represents the first hurdle - an analysis of 6 years data demonstrating 41% of IMG s to fail the Occupational English Test, or be significantly delayed by it in securing registration 16. By 2006 53% of IMG s secured medical employment in Australia in their first 5 years. Rates were poor for a range of birthplace groups - for instance just 6% of doctors from China, 23% from Vietnam and 31% from Eastern Europe working as doctors. Many such IMG s reached Australia within the family and humanitarian categories untested in advance for employment attributes and registerability 17. Outcomes are significantly better for IMG s selected through the GSM program, or via temporary sponsored pathways. Between January 2008 and March 2009 4,939 IMG s sat for the Australian Medical Council s multiple choice question exam, the top 5 birthplace groups at this time being India (1,068), Sri Lanka (457), Pakistan (447), the Philippines (332) and Iran 18. The latest available data show 33,725 IMG s sat for the MCQ exam from 1978/9 to 2010/11 (first time and repeat candidates). Their pass rate was 50%. 15,963 IMG s attempted the Clinical exam in the same years, with a 55% pass rate. Many never proceed to the second exam some due to discouragement, but often due to the fact that they are medically employed, in a wide range of conditionally registered placements. Outcomes by country of training varied significantly for example ranging from 84% (UK candidates), 76% (Canada), 74% (South Africa) to 51% (for India), 49% (China), 39% (Poland) and 31% (Philippines). Native English ability and training in directly comparable medical systems were highly advantageous, as were female gender and recency of training 19. Many IMG s require substantial occupational bridging the challenge of delivering this exacerbated by their remote employment location. In the context of mounting concern for variable registration standards the federal government initiated a national assessment process for overseas qualified doctors to ensure appropriate standards in qualifications and training as well as increase the efficiency of the assessment process from 2008 20. Multiple pathways to practice have since developed, based on the research evidence. Most notably these include: 1. The fast-track competent authority pathway for doctors qualified in Canada, New Zealand, the UK, Ireland and the US (with no requirement to sit the AMC MCQ or Clinical exams, and just a year s light-touch clinical supervision to secure full registration). 2. The work-based assessment pathway for IMG s requiring greater periods of adjustment, based on 12 months clinical supervision following passes in English and the MCQ exam, leading to full registration. 3. The full AMC MCQ and Clinical exams, followed by a year of clinical supervision, for candidates deemed to require this. 4. Specialist practice pathways, based on assessment, examination (as required) and clinical supervision by the specialty Colleges. 13

Since July 2010, the establishment of the Australian Health Practitioner Registration Agency supported by the Medical Board of Australia has been a critical national reform (see Annex 2) 21. Evolving since the 1980s, a wide range of bridging options for IMG s are also offered Australia-wide, some on a subsidised, some on a fee for service basis. In recent years international medical students have also emerged as a highly attractive alternative source of supply. By 2010 over 3,000 were enrolled in Australian medical degrees, compared to 963 in 1996, with Canada the third largest source. An estimated 70% of international students transition to Australian internship training on completion of their degrees, with interest in long-term migration strongest South East Asian students. By definition these graduates have self-funded to meet Australian recognition requirements, experiencing none of the labour market barriers encountered by IMG s 22. CANADA Some studies have predicted a future shortage of physicians given the healthcare implications of an aging population while others have indicated that health outcomes among the OECD countries are not due to shortages, but are more likely the result of system design. Regardless of the debate, medical school enrolment has increased by more than 60 percent in the past decade, with over 2,800 students graduating in 2011. Provinces have also increased postgraduate positions, including those for international medical graduate (IMG) residency education. While some provinces have reported surpluses in particular specializations, new approaches to patient care will likely affect future demand. Currently, IMGs make up about a quarter of the Canadian physician population, but growth in the number of Canadian medical graduates (CMGs) and IMGs has created a relatively stable ratio of IMGs to CMGs. Recent data show that there are over 1,400 IMG physicians entering practice in Canada every year. With the shift in immigration flows, India, Pakistan, Egypt and other Middle Eastern countries have become the predominant countries of origin for IMGs over the past five to ten years. The Qualification Recognition Process There are thirteen medical regulatory authorities responsible for licensing physicians in their jurisdiction. These regulators require credentials that are source-verified through the Medical Council of Canada (MCC), which also provides assessments through the Evaluating Examination and the Qualifying Examinations. The criteria for full registration include: graduation from a recognized medical school, the Licentiate of the MCC, and certification in either the College of Family Physicians of Canada (CFPC) or the Royal College of Physicians and Surgeons of Canada (RCPSC). While there are over 120 types of provisional or restricted registrations among the 13 jurisdictions, consistent with the Agreement on Internal Trade, full registration in one province establishes mobility across Canada as long as the candidate has a Certificate of Professional Conduct (CPC). Recognition of IMGs remains the responsibility of regulators, who are developing agreement on various categories of training acceptable for provisional registration. Critical elements include appropriate postgraduate education in a recognized discipline for a standard period of time, recognition by their country through certification or other processes, as well as assessments in-practice. Current challenges include timely and valid source-verification, encouraging pre-migration assessments, evaluating comparable training, accreditation, and certification processes abroad, and ensuring appropriate assessment for the required scope of practice in the Canadian context. Some promising developments have emerged to address those challenges, such as the establishment of 500 overseas 14

assessment centres and the development of online self-assessment programs. While both the CFPC and the RCPSC recognize previous training abroad and offer an academic certification pathway for Faculty of Medicine appointments, the CFPC has also developed a mechanism to recognize family physicians from specific jurisdictions. To date, candidates coming from the US, Australia, Ireland, and the UK may fulfill these requirements and be eligible for certification without examination. The College des medecin du Quebec also allows certain trained and practicing physicians from France to enter practice in Quebec without examination. PHYSIOTHERAPISTS AUSTRALIA Unlike pharmacists, physiotherapists are currently included on Australia s Skilled Occupation List. Their numbers however are also modest to date - just 2,409 degree-qualified overseas-born physiotherapists resident in Australia by 2006, including 469 arrivals the previous 5 years. An additional 394 recent migrants arrived in this period with diploma qualifications (unlikely to secure registration at the professional level). The Qualifications Recognition Process Australian courses are accredited by the Australian Physiotherapy Council (APC). To secure registration to practice, domestic students qualify through 4-6 years of tertiary study - course length reflecting whether they commenced as school leavers or graduates (noting a range of professional courses are now offered at Master s and Doctoral level). Despite the small scale of migration flows to date, the APC is deeply engaged with assessment and mutual recognition initiatives in terms of the GSM as the official gazetted authority. A separate role (as with other bodies) is assessment of physiotherapists applying for full registration. Along with English testing (IELTS 7 or a B on the Occupational English Test) a document-based assessment first occurs (Initial Assessment) the key criteria being applicants institution of training and recognition by the World Confederation of Physiotherapy. Once eligibility is confirmed, a Written Assessment MCQ test is administered, requiring a 55% grade to pass. Stage 3 involves a Clinical Assessment exam, where candidates interact with three patients while assessed by independent examiners. An Australian Physiotherapy Council Final Certificate is awarded on successful completion of this process 23. In 2010 the lowest number of applications was received in 6 years, with 134 approved in total including 2 Canadians. As in other fields, many applicants will pass a stage, but not proceed to full registration. Major changes to assessment are currently underway the most important since AHPRA s formation being the introduction of a Certificate of Substantial Equivalence from July 2010, which can be used to meet Australian qualifications requirements (an alternative to the examination pathway for select groups, and comparable to fast track developments in medicine). Following a 6 week evaluation process from application lodgement, the assessor s evaluation may result in approval for issue of an APC Certificate of Substantial Equivalence of Qualification, or an approval to apply to sit the Written Assessment, or no approval of equivalence. It is premature to assess outcomes at this stage. A second initiative concerns Australia-Canada bilateral mobility in physiotherapy. A 2007-2011 project is comparing the national scope of physiotherapy practice, and current jurisdictional requirements for entry to practice in each country. The aim is to explore future potential for recognition, and expand 15

mobility. As with accounting a key driver is the membership base. According to a 2000 survey of Australian physiotherapy graduates, over 40% planned overseas travel within 2 years of graduation, with similar mobility characteristic of Canadian graduates. A preliminary report was prepared for DEEWR in 2007 by the APC and the Accreditation Council for Canadian Physiotherapy. The aim was to define the necessary steps and potential barriers to mutual recognition, in a context where the two Councils affirmed considerable value in further development of the long-term project, and there were exceptional training as well as demographic similarities 24. CANADA There is no accurate demand data available regarding physiotherapy in Canada and attrition rates vary provincially; however, anecdotal evidence suggests that there are increasing vacancies in physiotherapist positions in some regions. With an aging population and the increasing focus on prevention and wellness promotion in the healthcare system, the demand for physiotherapy will likely grow as new health strategies emerge and an informed public expects to stay healthy as they age. In 2010, 168 physiotherapists moved between jurisdictions within Canada and a total of 568 applications were received at the Canadian Alliance of Physiotherapy Regulators to initiate the credential review process, with India, the Philippines, Australia, the US, and the UK making up the top 5 source countries for credentialing. The Qualification Recognition Process The Alliance, outside of Quebec, oversees the qualification recognition process for physiotherapists in Canada although external credential evaluation services are used for document authentication. Each provincial/territorial regulator is, of course, the final decision maker regarding individual registration in a jurisdiction. To be licensed in Canada, education from an accredited Canadian physiotherapy program must be met, and with the exception of Québec, the Physiotherapy Competency Examination (PCE) must be successfully completed. In 2002, the physiotherapy profession signed a pan- Canadian mutual recognition agreement (MRA) to facilitate labour mobility in response to the Agreement on Internal Trade (AIT). Recent amendments to the AIT stipulate that workers registered for in one jurisdiction will be recognized as qualified for registration by all other jurisdictions within Canada. Use of Quebec as an entry point to avoid the PCE is being monitored. Internationally-trained physiotherapists seeking registration in Canada must demonstrate language proficiency in English or French and show that their education and qualifications are substantially equivalent to those required of Canadian graduates. Additional steps may be required to fill identified gaps in the education or training of internationally educated physiotherapists, such as demonstration of prior learning, additional coursework, and supervised practice. Some of the current challenges include obtaining official documents, dealing with fraudulent documentation, considering new types of educational pathways, providing upgrading opportunities when numbers are small, and determining the best possible measure for credential evaluation. While there are no new developments concerning pre-arrival strategies, credential review, prior learning assessment, and language testing can be done overseas. To further facilitate international mobility, initial discussions on mutual recognition have begun with Australia. 16

REGISTERED NURSES AUSTRALIA Recent decades have also coincided with the rapid diversification of the nursing profession in Australia, with nurses imported on a temporary and permanent basis to compensate for chronic domestic shortages 25. From 2001-06 6,680 degree-qualified nurses migrated to Australia, compared to 3,100 from 1996-2001 (all immigration categories). Sixty-three per cent secured nursing work within 5 years (strong outcomes compared to Canada). Numbers have grown rapidly since. From 2004-05 to 2008-09 6,400 nurses were selected by Australia as GSM PA s, rising to 7,676 once partners are counted. These permanent flows were dwarfed however by the scale of 457 visa temporary sponsored arrivals. In 2007-08 3,270 temporary registered nurses were selected, plus 3,850 in 2008-09. Overall 14,950 temporary registered nurses entered Australia from 2004-05 to 2008-09, in addition to registered mental health nurses and midwives. Many went to highly dispersed sites: the primary states of sponsorship in 2008-09 being Victoria (1,010), Queensland (780) and Western Australia (750). The Qualifications Recognition Process To secure registration to practice in Australia, nursing students complete 3 year university degrees (with a Masters degree option now available) the transferral of nurse education to the tertiary sector completed in 1993, following the previous tradition of hospital-based diploma and certificate level training. The Australian Nursing and Midwifery Council (ANMC) is the gazetted authority to assess overseas qualifications pre and post-migration for GSM purposes. Seventeen categories of registered nurses are currently included on Australia s Skilled Occupation List. From 2007-2010 11,051 applications were received, the top 5 source countries being India (2,437), the UK (2,358), China (1,316), the Philippines (957) and Zimbabwe (471). 2,281 applicants received full recognition (21%), while 79% received modified approval and 9% were found unsuitable/ pending 26. The major Australian study of migrant nurses to date demonstrated that ESB nurses passed seamlessly into employment. By contrast NESB nurses must address three major hurdles 27. First, mandatory English language testing is required 1990s research finding this barred or delayed up to 67% of NESB nurse PA s from GSM eligibility, and 41% of those in Australia from access to pre-registration courses. (As noted, IELTS Band 7 or OET B is now required, the standard in Australia from 2006 for all clinical health occupations.) Second, premigration screening of professional and academic documentation is undertaken. (In the 1990s this resulted in immediate recognition for 97 per cent of ESB nurses compared to 29 per cent of NESB nurses.) Third, nurses deemed to require further training must undertake competency-based assessment courses or university upgrades. The former introduced very significant Australian qualifications recognition reform from 1989, associated with 90-95% pass rates in Victoria and 55-71% rates in NSW. Funding however has been modest, with courses restricted to migrant nurses resident in Australia. A range of challenges remain. First, labour market integration rates are strong for migrant nurses in Australia, relative to a range of comparator countries. To support this, the availability of English and bridging program options is critical. Second, while both ESB and NESB nurses secure professional employment once registration has been gained, significant and persistent labour market segmentation occurs for many NESB nurses, with East European and non-commonwealth Asian nurses disproportionately concentrated in the geriatric care sector (in the 1990s found to be at 840% greater risk of this than ESB nurses). Third, in recent years the International Section of the ANMC has been 17

actively engaged in bilateral/ multilateral agreement negotiations with Japan, ASEAN, China, Malaysia, Chile and the Gulf Cooperation Council on Free Trade Agreements, to explore future recognition of foreign nursing qualifications. This is by definition challenging given the variability in training sessions across the region. Within this context international students (as in medicine and dentistry) have emerged as a major workforce resource, with 8,690 enrolled in Australian pre-registration courses in 2009, and an estimated 30% likely to remain in Australia through two-step migration 28. CANADA According to a 2009 study by the Canadian Nurses Association, the nursing shortage will grow by almost five times in the next 15 years, and if no policy interventions are implemented, Canada will be short almost 60,000 full-time equivalent registered nurses (RNs) by 2022. As currently employed nurses reach retirement age, new nurses are graduating at an older age and annual graduation levels from nursing programs do not meet the projected demand in 2011 and beyond. The RN workforce grew by less than 2 percent each year since 2005 to a total of 266,341 RNs in 2009. The proportion of internationally education RNs (IERNs) grew slightly over the last five years, making up 7 percent of the regulated nursing workforce in 2009. In terms of source countries, 31.6 percent of IERN graduates were educated in the Philippines and 17.6 percent in the UK. A total of 8.3 percent of the RN workforce graduated from an international RN program, which represents the highest proportion of international graduates among Canadian nursing professions. The Qualification Recognition Process The regulatory bodies are responsible for setting the standards for entry into the profession, providing initial registration of both Canadian and internationally educated applicants, establishing and enforcing professional practice standards, as well as continuing competence requirements and professional conduct review processes for registered nurses and nurse practitioners. To practice in Canada, candidates must be registered with the regulatory body for the jurisdiction of practice and be a member in good standing. Graduates from approved Canadian nursing programs need to complete an entry-topractice examination or its equivalent, demonstrate good character, fitness to practice, and safe practice to be eligible for registration. In 2008, an updated mutual recognition agreement (MRA) was signed by Canadian regulatory bodies responsible for the regulation of registered nurses. The agreement stipulates that a registered nurse who has established registration in a Canadian jurisdiction will be granted registration by endorsement in another Canadian jurisdiction, provided that the applicant meets the above criteria and has met the continuing competency requirements. IERNs must meet the following additional criteria: demonstrate fluency in English or French, demonstrate that their education and practice experience meet the competencies required, and complete a period of supervised practice in some cases. Regulators face a number of issues when assessing foreign qualifications, including the difficulty of verifying foreign documents, determining substantial equivalency of international programs, and identifying differences in the scope and regulation of nursing practice abroad. Adapting to changing assessment approaches within Canada has also created further challenges. The trend toward greater harmonization and efficiency across jurisdictions needs to be balanced against the regulatory mandate of public safety although current inconsistencies have complicated the process for international applicants. Without pre-arrival assessment tools and services, internationally educated nurses are also limited to post-migration approaches to recognition. One province, however, has experimented with competency based assessments in other countries, and a range of additional pre-arrival supports have 18

also been developed, such as occupational resources, immigration portals, self-assessment tools, exam study guides and readiness tests, as well as webinars on the nursing profession in Canada. As for international agreements, Quebec has signed a separate mutual recognition agreement for the mobility of registered nurses graduating from programs within France. ELECTRICIANS AND PLUMBERS SKILLED TRADES AUSTRALIA Electricians are also included on Australia s Skilled Occupation List in the state/ territory nominated list including electrician (general), electrician (special class), lift mechanics, air conditioning and refrigeration mechanics, electrical lines workers, technical cable jointers, business machine mechanics, electronic equipment tradesworkers (general and special class), telecommunications lines workers and technicians. Demand is significant. From 2004-05 to 2008-09, electricians were the fourth top trade imported through the GSM 3,682 primary applicants, including 905 in 2008-09 (the great majority selected offshore). By contrast the scale of employer-sponsored temporary entrants through the 457 visa is modest, with 1,470 electricians entering from 2004-5 to 2008-09. Plumbers also feature on the Skilled Occupation List, including as air conditioning and mechanical services plumbers, drainers, gasfitters and roof plumbers. The scale of their arrivals is to date slight 864 GSM PA s in 2004-5 to 2008-09 (the 7 th top trade), compared to 640 457 visa entrants. The Qualifications Recognition Process To secure registration to practice as electricians and plumbers, domestic students qualify by completing extended apprenticeship pathways (3-4 year duration), aligned with technical college study. Recent innovations now target the senior years of secondary school, designed to increase workforce supply while reducing the rate of apprenticeship drop-outs (up to 50%). Based on a formal agreement between an apprentice/ trainee and an employer, the class pathway allows the apprentice to learn industry skills by combining on-the-job paid work with formal training. The Certificate III in Electrotechnology take 4 years full-time work/ study, and is solely offered through the apprenticeship pathway, with registration (for example in Victoria) through the state Office of Training and Tertiary Education. The Certificate 111 in Plumbing by contrast involves plumbing and roof work, with the potential to qualify through classic apprenticeships or shorter vocational sector courses. On completion, trade qualifications are recognized Australia-wide 29. There has been significant innovation in relation to Australia s recognition of migrant electricians courses in recent years, as is also the case for plumbing. They can be assessed by Trades Recognition Australia, which spans onshore and offshore assessment for experienced migrants applying through the GSM stream qualified in 180 vocational-sector fields. (Since July 2009, this role extends to the 457 temporary visa class.) VETASSESS also has the capacity to assess trade qualifications, along with general professional occupations (e.g. economists). A highly innovative body, described as Australia s leading assessment and workforce skills developments organization VETASSESS now has representation in over 20 countries. As an assessing authority gazetted by the Minister for Immigration and Citizenship, and an accrediting body, it has a capacity to deliver recognized Australian credentials through onshore and offshore short course training in the case of trade-qualified migrants, for instance, to ensure they secure full recognition for employment purposes at point of entry to Australia. 19