‘Brain drain’ in reverse: Two surprising trends reshaping Ontario’s physician workforce

Two physician workforce trends in Ontario deserve far more attention. The Ontario Physician Reporting Centre (OPRC) has released its 2025 physician workforce data, and one finding immediately stood out.IMGsInternational medical graduates are becoming an increasingly important part of Ontario’s physician workforce.Looking at physicians whose medical degree was obtained outside Canada and the U.S., the number of practicing physicians increased by:8.17% in 20248.93% in 2025That’s roughly three to four times faster than growth among Ontario or other Canadian medical graduates.This isn’t happening by chance.Over the past several years, Ontario has expanded residency opportunities for internationally trained physicians. Previous OPRC data also showed a 218% increase in internationally trained physicians entering Ontario residency programs between 2019 and 2025.For years we’ve discussed how difficult it is for internationally trained physicians to enter practice in Ontario.There is still much more work to do.But work by PGME programs, teaching hospitals/clinics, practice-ready assessment pathways, and the CPSO appear to be translating into measurable workforce growth and diversification.U.S. doctors arrivingThe second trend surprised me even more. The number of U.S.-trained physicians practicing in Ontario also accelerated :9.21% in 20249.32% in 2025Historically, annual growth was much lower. For years we’ve framed physician migration as a one-way brain drain from Ontario to the U.S. These data suggest that narrative is becoming outdated.While we would need bilateral migration data to confirm, Ontario is clearly becoming a more attractive destination for U.S.-trained physicians than it was even a few years ago.When the data are split by specialty, another pattern emerges. Family medicine saw particularly strong growth in internationally trained physicians.Meanwhile, the increase in U.S.-trained physicians was driven primarily by specialists, with specialist numbers increasing by 10.7% in 2025.That challenges the assumption that specialists predominantly leave Ontario for the U.S. While that may still be true in some highly specialized fields, these provincial data suggest physician migration is becoming far more balanced than the traditional "brain drain" narrative implies. Anecdotally, my own department has recruited approximately 15 U.S.-trained internists over the past three years.Ontario’s physician workforce is changing. We’re training and integrating more internationally educated physicians while simultaneously attracting more physicians trained in the U.S. That is an encouraging sign that recent investments in physician training, licensing, and recruitment are paying off.For many patients, however, these workforce gains may not yet translate into better access to care. The next challenge is not simply growing the physician workforce—it’s matching physicians to community needs through better provincial workforce planning.Dr. Haroon Yousuf is an internist in Hamilton and was recently voted in as OMA president-elect. This item originally appeared on LinkedIn.

‘Brain drain’ in reverse: Two surprising trends reshaping Ontario’s physician workforce

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