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Sur le marché du travail, le rendement de l'expérience que les immigrants ont acquise avant de s'installer au Canada ne cesse de décroître. Nous examinons donc, dans cet article, la portabilité du capital humain en analysant, en lien avec l'éducation et la langue, la concordance entre l'emploi occupé dans le pays d'origine et l'emploi occupé au Canada. Nous montrons que les nouveaux immigrants qui occupent au Canada le même emploi que dans leur pays d'origine ont un revenu plus élevé. Toutefois, en moyenne, l'expérience sur le marché du travail dans le pays d'origine n'apporte aucun avantage ; en fait, seuls les hommes qui maîtrisent l'anglais tirent profit de leur expérience de travail dans leur pays d'origine. De plus, les liens que l'on observe entre la concordance entre l'emploi avant et après l'immigration et les compétences en anglais, d'une part, et l'éducation, d'autre part, sont également surprenants: pour les deux sexes, l'éducation n'influence les revenus à la hausse que chez les immigrants qui occupent le même emploi au Canada que dans le pays d'origine ou qui ont de solides compétences en anglais. Le faible rendement de l'éducation que l'on observe en général chez les nouveaux immigrants semble donc être en fait le résultat de la combinaison d'un rendement nul chez certains et très élevé chez d'autres. Par ailleurs, la maîtrise de l'anglais est la seule composante du capital humain qui apporte un avantage dans tous les cas. Given the declining returns to pre-migration labour market experience, human capital portability is explored for new immigrants focusing on pre-and post-immigration occupational matching, and its interactions with education and language. New immigrants who match occupations obtain an earnings premium, but surprisingly, on average, even they obtain no return to their pre-migration labour market experience. Only males with substantial English proficiency who also match occupations receive any return to such experience. Moreover, occupational matching and English skills are also seen to interact with education in an unexpected way. For both sexes, only those with a match and/or strong English proficiency obtain a positive return to their schooling. The commonly observed low rate of return to education for new immigrants appears to be a combination of zero for some and a large return for others. Of the varieties of human capital studied, only English language skills are universally rewarded.

Economie outcomes of former Temporary Foreign Workers (TFWs) and former international students (ISs) are compared to those of Skilled Worker Principal Applicants who have no Canadian experience at the time of landing. Controlling for only variables from the immigration points system, former TFWs have both higher earnings and employment rates, while ISs are no lower. When models are estimated separately by gender, male immigrants who were former TFWs have superior outcomes. Overall, the evidence provides support for the Canadian Experience Class in that former TFW, and to a lesser extent IS, status provides signals regarding immigrants' labour market integration. Dans cette étude, nous comparons la situation sur le marché du travail de deux catégories de citoyens qui ont immigré au pays en suivant des processus différents : d'une part les anciens travailleurs étrangers temporaires (TET) et les anciens étudiants étrangers (EE), et d'autre part les travailleurs qualifiés admis à titre de demandeurs principaux qui n'avaient aucune expérience de travail canadienne au moment de leur arrivée. Quand nous tenons compte des seules variables liées au système de points, nos résultats montrent que les revenus et le taux d'emploi sont plus élevés chez les TET mais moins élevés chez les EE. Quand on estime les modèles en tenant compte du sexe, on observe que la situation sur le marché du travail des immigrants hommes qui sont d'anciens TET est meilleure. Globalement, nos résultats indiquent que la situation des TET - et celle des EE, mais dans une moindre mesure - sur le marché du travail étant meilleure, cela fournit des informations intéressantes sur l'intégration des immigrants au marché de l'emploi.

Canada has long struggled to maintain an appropriately sized physician workforce. The recruitment of foreign-trained physicians over recent decades and, starting in the mid-2000s, increased domestic enrollments in medical schools has led to Canada currently having an historically high physician-to-population ratio. However, concerns about physician shortages and burnout, as well as limited access to physician care,9,10 continue. Previous analyses of physician supply and demand have not adjusted for both population aging and evolving physician hours of work, despite discussions of these factors being quantitatively important. To provide insights into the aforementioned challenges -- and to inform the profession, the public and governments in planning regarding the appropriate number of new physicians who should enter practice -- we analyzed data from 1987 to 2020 to quantify increasing demand because of an aging population and changing service supply given declining physician self-reported hours of work.

Physician work hours directly influence patient access to health care services and play a vital role in physician human resource planning. We sought to evaluate long-term trends in hours worked by physicians in Canada, overall and by subgroup. We used Statistics Canada's Labour Force Survey to identify physicians via occupation and industry coding information. We estimated descriptive statistics and performed graphical analysis of the average weekly hours worked by physicians over the 1987-2021 period. Overall, weekly physician work hours remained stable from 1987 until 1997, after which they declined. Average weekly hours decreased by 6.9 hours ( < 0.001), from 52.8 in 1987-1991 to 45.9 in 2017-2021. Among male physicians, work hours declined notably after 1997, while those of female physicians remained relatively stable at around 45 per week. Hours worked by married physicians declined significantly, amounting to 7.4 fewer hours per week ( = 0.001). In contrast, unmarried physicians displayed a statistically insignificant decline of 2.2 hours ( = 0.3). The COVID-19 pandemic was associated with a sharp but brief disruption in weekly hours; by the end of 2020, physicians' work hours had returned to prepandemic levels. These findings may indicate a long-term shift in work preferences among Canadian physicians; male physicians may be seeking a better work-life balance, which, in turn, has narrowed the gap in hours worked by sex, with potential implications for pay equity. Policymakers and planners should carefully consider changes in hours worked, rather than just the total number of physicians, to ensure an accurate evaluation of the physician workforce.

A correlation between age at immigration and earnings is observed in Canadian census data. The evidence supports three underlying sources of the effect; first, work experience in the source country yields virtually no return in the host country; second, the return to education varies with age at immigration, and, finally, an 'acculturation' effect is observed for immigrants who are visible minorities or whose mother tongue is not English. Further, it is found that educational attainment, and relatedly earnings, vary systematically across age at immigration with those arriving around age 15 to 18 obtaining fewer years of education. JEL Classification: J61, J31

At a minimum, Canada’s observations of immigration policies, practices and outcomes in other countries have broadened and enriched the domestic policy debate, and hopefully other countries will similarly benefit from looking at Canada.

For the past decade-and-a-half, the government of Ontario has been implementing sweeping reforms in an effort to improve primary health care delivery. Altering physician-compensation models is central to this initiative. One measure of the scale of change is that in 2000 roughly 95 per cent of general/family practitioners were paid traditional fee-for-service, but by 2013 that proportion had plunged to just 28 per cent. The province has clearly succeeded in largely replacing the traditional fee-for-service payment structure with blended payment models that are mostly group-oriented and include: 1) capitation (in some cases): a single payment for providing a particular “basket” of services to a patient for a fixed period, for example a year, regardless of the number of services provided, 2) fee-for-service payment, for services outside the capitated basket and provided in special situations, and 3) various bonuses and incentives (sometimes called pay-for-performance) that mostly focus on preventive care and the management of chronic conditions. Physicians in rural and northern areas, as well as some clinics, also have salary and similar models as options. Ontario has simultaneously introduced patient “rostering” — the formalized connecting of one patient to one physician and/or physician team/group — creating a relationship better suited to delivering preventive healthcare services. However, when surveyed, many patients are unaware that they have been “rostered” meaning that at present much of the benefit must be derived from the physician side alone. It remains to be seen whether or not it is important for patients to be aware that they are rostered. Beyond its clinical benefits, rostering has appreciable rhetorical and political value, as well as potential as a planning tool in efforts to ensure that the local and provincial supply of primary care is appropriate. In a health-care system as large and complex as Ontario’s, reform is more evolutionary than revolutionary; but the province has arguably moved rapidly within this context. Expenditures have been substantial and the initiatives groundbreaking. However, the same challenges that make reform a formidable undertaking also make it difficult to readily, or quickly, measure success, especially since many changes are ongoing. It is not yet demonstrably clear to what degree the government’s goals are being achieved. At present, there are mixed and conflicting findings about whether some of these changes have moved the health system towards the intended goals of improving health-care access and quality, and patient satisfaction, let alone whether the potential improvements can justify the resources expended to achieve them. Naturally, those results we do have at this point offer insight only into the short-term effects of these changes. Especially, it is too early for sufficient evidence to have accumulated on the impact of new physician-group models on downstream costs, including drug prescriptions, specialist care, hospital costs and the use of diagnostic tests. These are, however, central questions that will in large part determine success. Also, it appears that the Ontario government could have accomplished nearly all of its goals so far without having implemented capitation, although capitation may prove beneficial in the longer term as the scarcity of physicians since the 1990s seems to be shifting towards a surplus. In this new era, the health ministry will likely need to take a more hands-on role than it has in the past, including improved system monitoring. Going forward many stakeholders should be involved in evaluating this experiment on an ongoing basis to ensure that it is serving the healthcare needs of the population in an effective and efficient way..