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Internationally trained doctors provide same level of heart attack care as Canadian physicians


A new study from the Institute for Clinical Evaluative Sciences (ICES) has found that doctors who obtain their training outside of Canada provide virtually the same standard of care for heart attack patients as those who are educated here.

Researchers tracked over 127,000 Ontario heart attack patients admitted between 1992 and 2000 to acute care hospitals. They compared the mortality rates, and use of secondary prevention medications and invasive cardiac procedures of patients treated by international medical graduates (IMGs) versus Canadian medical graduates (CMGs).

The mortality rates of IMG- and CMG-treated patients were not significantly different at both 30 days (13.3% vs. 13.4%) and one year (21.8% vs. 21.9%) following their heart attack. Patients treated by both groups also had similar likelihoods of receiving secondary prevention medications at 90 days following hospital discharge, and invasive cardiac procedures at one year.

“This information places the care provided by internationally trained doctors into perspective and should reassure patients and policy makers about their ability to deliver high quality heart attack care,” said lead author and ICES research fellow Dr. Dennis Ko.

“These similarities are likely a testament to the careful screening and training process before licensure is granted to all physicians in Ontario. The findings also speak to the ability of internationally trained physicians to become familiar with Canadian standards regarding the treatment and management of heart attack patients.

“Our next steps should be to confirm these findings in different areas of medicine, and to evaluate the ability of internationally trained medical graduates working in other jurisdictions,” added Dr. Ko.

The study, “Quality of care of international and Canadian medical graduates in acute myocardial infarction”, is in the February 28, 2005 issue of the Archives of Internal Medicine.

Author affiliations: ICES (All authors); Division of Cardiology, Schulich Heart Centre, Sunnybrook and Women’s College Health Sciences Centre (Dr. Ko); Division of General Internal Medicine and Clinical Epidemiology and Healthcare Research Program, Sunnybrook and Women’s College Health Sciences Centre (Dr. Tu); Departments of Medicine (Dr. Tu), Public Health Sciences (Drs. Austin, Chan, and Tu), Health Policy, Evaluation and Management (Drs. Chan and Tu), and Family and Community Medicine (Dr. Chan), Faculty of Medicine, University of Toronto.

ICES is an independent, non-profit organization that uses population-based health information to produce knowledge on a broad range of healthcare issues. Our unbiased evidence provides measures of health system performance, a clearer understanding of the shifting healthcare needs of Ontarians, and a stimulus for discussion of practical solutions to optimize scarce resources. ICES knowledge is highly regarded in Canada and abroad, and is widely used by government, hospitals, planners, and practitioners to make decisions about care delivery and to develop policy.


  • Julie Argles
  • Media Relations Officer, ICES
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