Explaining unequal access to the medical profession: licensing policies for immigrant physicians in Canada and the United Kingdom

While the Global North increasingly relies on internationally trained family physicians to address labour shortages, countries diverge in their licensing policies and control over access to the medical profession. This thesis analyses the causes of internationally trained family physicians’ licensing policy divergence between Canada and the United Kingdom. Both countries attract a significant number of internationally trained family physicians, yet access to the medical profession differs. I argue that different institutional arrangements determine the entry and alignment of licensing actors to influence the policy making process, thereby shaping the extent of professional closure by the medical profession. Using theory testing process tracing, I demonstrate that Canada’s federalist system permits greater and more powerful veto points to crowd out other actors, thus retaining a high degree of professional closure. In contrast, the UK’s unitary state enables greater interaction with other actors involved in ITFPs’ policy making process, resulting in fewer veto points and less dominance by the medical profession to inhibit professional closure.