Foreign nurses recruited to Quebec under a provincial government program encountered “major obstacles” upon arrival, including a lack of housing, daycare spaces and transportation, according to an internal report.

A rigid training program, culture shock, and fear of failure caused significant stress among recruits, the report produced by the Immigration Ministry said. It suggests they were not properly informed about the program’s requirements or the reality of life in Quebec .

The $65 million initiative, announced in 2022, aims to bring 1,500 foreign nurses to Quebec by 2028 to work in regions with severe nursing shortages. Candidates receive government-funded training at CEGEPs and are paid $500 per week.

However, the November 2024 report on the first phase of the program, obtained through the Act respecting access to documents held by public bodies, paints a picture of a poorly organized project that did not prepare foreign nurses for what awaited them when they left their homes to come to Canada.

“Early on, major obstacles to the installation of participants were encountered during the start of phase 1,” the report reads.

“In most regions, project participants faced challenges that complicated their integration and could have had a negative impact on their full participation in the refresher training,” it says.

A nurse who spoke to The Canadian Press about the program said he didn’t know what he was getting into until he left his home country in Africa in June 2023. He requested anonymity for fear of reprisals.

He said the Quebec government had described the program as “refresher training” and did not expect the heavy course load over several months intended to bring the foreign nurses’ experience into line with Quebec standards.

“We were treated like children. (…) The right information was not revealed to us,” lamented the man who obtained his nursing diploma in his home country in 2019.

The internal report noted several problems with settling in for nurses in various regions of Quebec , often far from urban centers. Finding affordable housing was a challenge, especially for those arriving with up to five children. Lack of credit history further disadvantaged them, the report said.

In the Gaspé, modular units were finally built to house some foreign nurses.

The lack of daycare spaces has forced some recruits’ spouses to stay home to care for the children. Furthermore, many regions lack an efficient public transportation network, forcing nurses to obtain a Quebec driver’s license and purchase a car—an unexpected expense for some.

“These issues (…) highlighted the importance of presenting an honest portrait of the costs and challenges associated with living in Quebec and in the destination region,” the report states.

The government ultimately spent about $16 million on the first phase of the program, or about $77,000 for each of the 207 nurses recruited.

“I don’t understand why these issues were not properly taken into account when developing this program,” denounced Fo Niemi, director general of the Center for Research-Action on Race Relations.

Training-related difficulties

The report reveals difficulties related to the training program itself, which lasts nine to fourteen months, highlighting that the shortage of labor in the health system made it difficult to find teachers and internship supervisors.

The document also reports that students felt intense stress at the prospect of failure. If recruits fail a course, they are expelled from the program and lose access to financial support, including the part-time work as a caregiver included in the program. In theory, they can re-enroll, but while waiting for classes to be offered again, they are not allowed to work, a situation that can last for months.

The nurse who spoke to The Canadian Press failed a placement in the program in June 2024. He was able to re-enroll in January, but in the meantime, he had to borrow money from friends to pay his rent and buy groceries.

According to him, the consequences of failure were not clearly explained before his arrival. If he had known how the program worked before coming to Canada, he would not have left his country.

“I’m not happy,” he said. “At least (in my home country) I had my family—my brothers, my sisters. (…) But that’s not the case here in Canada. I don’t have money to send home or to do anything, because the money I have is for groceries.”

The government stays the course

In response to the access to information request, the government also released reports from each of the CEGEPs that participated in the first phase of the program. The documents detail a multitude of challenges, including a heavy workload and an intensive training program that many recruits found insurmountable.

Colleges found that many foreign nurses experienced culture shock, and some struggled to adapt to the French vocabulary and accent spoken in Quebec . One CEGEP noted that discussions around abortion and medical assistance in dying “created emotional and ethical tensions” for some students.

“The intense academic pace and the severe consequences for failure have caused students great stress,” the report said.

Despite the challenges, most foreign nurses successfully complete the training program. Xavier Daffe-Bordeleau, spokesperson for the Ministry of Immigration, reported that by the end of February, 867 people had successfully completed the “refresher training,” including more than 90% of students from the first two phases.

The fifth phase of the program is underway, and the government hopes to achieve its goal of recruiting 1,500 nurses by 2028.

The ministry spokesperson also said that most students in the following phases received an offer of accommodation before arriving in Canada.

“Building on the experience gained from previous cohorts, the combined efforts of supporting people from abroad several months before their arrival have helped minimize the pitfalls associated with the settlement process,” Mr. Daffe-Bordeleau emphasized in an email.

The office of Immigration Minister Jean-François Roberge did not respond to requests for comment.