The proportion of Canada's doctors who were trained in other countries has dropped by a third since the 1970s, according to a new report released Thursday.

All provinces and territories showed a decline in the proportion of doctors who were trained abroad.

The Canadian Institute for Health Information said 33 per cent of doctors got their medical degree abroad in the 1970s, compared with 22 per cent in 2007.

All provinces and territories showed the same trend in their physician workforces.

The decline may be largely due to the retirement of physicians who were trained in Britain and Ireland and started practising in Canada decades ago, alongside a smaller proportion of new foreign-trained doctors setting up practice in the country, the report's authors say.

More than one-quarter, 27 per cent, of Canada's foreign-trained doctors actually grew up in Canada but studied overseas, the report's authors found, cautioning against equating international medical graduates, or "IMGs," with "foreign doctors."

During the study period, the main providers of international medical graduates shifted to South Africa (13.9 per cent), India (8.6 per cent) and Egypt (3.6 per cent).

Many of the main providers of international medical graduates have historically shared a language with Canada, or were influenced by British, American or French administrative systems. These factors affect how credentials from elsewhere are viewed in Canada, and may facilitate other licensing requirements, according to the report.

Moving between provinces

Foreign-trained doctors are a declining proportion of the physician workforce, but those from developing countries are a growing share of that group, said the lead author of the report, John David Stanway, senior analyst of health human resources at CIHI.

In all provinces except Ontario and Quebec, doctors in rural areas were more likely to be foreign-trained than doctors in urban settings.

In 2007, Quebec (10.7 per cent) and Prince Edward Island (13.8 per cent) had the smallest proportion of foreign-trained doctors in their physician workforces, while Saskatchewan (48.8 per cent) and Newfoundland and Labrador (35.2 per cent) had the largest.

Migration patterns within Canada also varied for foreign-trained doctors.

Foreign-trained doctors who started practising in the early 1970s were more likely to still be practising in the same jurisdiction after 10 years (83 per cent) compared with their counterparts from the early 1990s (65 per cent).

"In the past, international medical graduates from the U.K. and Ireland tended to have the same mobility pattern as Canadian-educated medical graduates, meaning that they didn't tend to move as much," said Geoff Ballinger, manager of health human resources at CIHI.

"But now, these days, international medical graduates, regardless of where they're from,… tend to be more mobile than Canadian-educated medical graduates."

Rural doctors

The report did not look at why. Ballinger speculated that since international medical graduates probably haven't had the same opportunities to put down roots in a community compared with doctors trained in Canada, it may be easier for IMGs to move around.

Factors such as professional opportunities and satisfaction also play a role in physician mobility, said Dr. Anne Doig, new president of the Canadian Medical Association.

Doctors working in rural areas have fewer colleagues to rely on for support and may get tired out after five years, she said.

Doig suspects Canada's reliance of foreign-trained doctors will continue to go down as domestic training capacity increases.

"We do believe there is a need for international exchange for knowledge reasons and for medical teaching, medical practice, medical research. The exchange of ideas requires that there be some in and out migration," Doig said, adding recruitment must be done ethically to avoid draining resources from other places.

With files from The Canadian Press