Être médecin diplômé à l’étranger au Québec : des parcours contrastés d’intégration professionnelle

Of the estimated 5000 immigrant physicians in Quebec in 2015, close to 2500 are employed as doctors while the rest work in other professions, either temporarily or permanently. Highly qualified immigrants are known to experience many barriers to employment, especially those who belong to regulated professions. This is especially true for medical doctors due to the complexity of the professional recognition process and the variety of institutional players involved.   The main objective of this thesis is to document the professional integration trajectories of international medical graduates (IMG) and their experiences on the Quebec labour market. My aim is to better understand the wide variety of professional integration trajectories within this professional group. Paying close attention to the strategies and the resources mobilized by the participants IMGs, I document the situation between those who enter the medical profession and those who change careers.  Using a qualitative methodology, I carried out 31 semi-structured interviews with IMGs focusing on their professional life stories pre- and post- immigration. Most of them immigrated to Quebec in the 2000s. The secondary data includes 22 non-directive interviews with different key social actors (11), as well as with IMGs (11) who had either immigrated very recently (less than two years) or were planning to. We also engaged in ethnographic observation; e.g. of associative activities.  The common thread linking the three articles that comprise the thesis is the interface between policies, practices and individuals in the process of professional integration. The varying focal points of the articles have the same objective: the exploration of the complexity of professional integration trajectories and the dialectic that exists between the micro, mezzo and macro levels. In other words, what an individual can and cannot do professionally, taking into account the influence of social relationships, institutions, organizational practices, as well as sociopolitical structures. The results shed light on the complementary and dynamic interplay that affects professional integration on several levels: 1) the macrosocial and political dimension; 2) the institutional dimension and social relationships; 3) professional identity.  Following the introduction, I present the research problem (chap.1) and the methodology (chap.2). Chapter 3 outlines the different types of integration paths of the IMGs, and presents their professional life stories. In Chapter 4 I examine the paradox that exists between immigration policies that aim to attract highly qualified migrants and regulatory mechanisms in the labour market that place limitations on many migrants. Chapter 5 presents the strategies and resources used by the IMGs and highlights the positive effect of symbolic resources. Institutional support resources, although basic to the professional recognition process, were not considered to be central by the IMGs. Instead, the informal resources were identified as playing a key role, especially IMG peers. Chapter 6 adopts a microsocial perspective and explores the dynamic character of the professional identity. It explores the importance of the conditions of belonging that may force an individual to be professionally flexible and sometimes to leave the medical profession or the country. Chapter 7 discusses the theoretical interest of a combination of analytical scales and disciplinary openness to highlight the tensions and blind spots in regard to the mobility of health professionals and their professional integration. Finally, this thesis explores the complex interplay of economic, social and symbolic resources in a context of highly fragmented institutional resources and corporate protectionism.

Keyphrases: Immigration, Immigrant, Professional integration trajectories, International medical graduates (IMG), Professional integration strategies, Professional identity, Social resources, Anthropology, Socio-anthropology of work