Internal report finds major flaws in program to recruit foreign nurses to Quebec

Foreign nurses recruited to Quebec through a provincial government program faced “major obstacles” upon their arrival, including a lack of housing, child care and transportation, according to an internal report.

A rigorous training schedule, culture shock and fear of failure caused severe stress among the recruits, says the report produced by the province’s Immigration Department.

It suggests they were not properly informed about the demands of the program 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 of the province with acute nursing shortages.

Candidates receive training at junior colleges, funded by the government, and are paid $500 a week.

But the November 2024 report on the first phase of the program, obtained through Quebec’s access to information law, paints an image of a poorly organized project that failed to prepare foreign nurses for what to expect when they uprooted their lives to come to Canada.

“Early in the launch of Phase 1, major obstacles were encountered in getting participants settled,” the report says. “In most regions, project participants had to deal with issues that complicated their integration, and which may have had a negative impact on their full participation.”

One nurse who spoke to The Canadian Press about the program said he didn’t know what he was getting into before leaving his home country in Africa in June 2023.

He spoke on condition of anonymity for fear of repercussions.

He said the Quebec government described the program as “refresher training,” and he didn’t expect the heavy, months-long course load designed to bring foreign nurses' experience in line with Quebec standards.

He had received his nursing diploma from his home country in 2019.

“We were treated like children,” he said. “The right information wasn’t given to us.”

The internal report cites several problems getting the nurses settled into various regions of Quebec, often far from the province’s urban centres.

Finding affordable housing was a challenge, especially for those arriving with up to five children in tow.

A lack of credit history put them at a further disadvantage, the report says.

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

A lack of daycare spots forced the spouses of some recruits to stay home to care for the children.

Moreover, many of the regions don’t have extensive public transit, meaning the nurses had to obtain Quebec driver’s licences and buy cars — an unexpected expense for some.

“These issues … highlighted the importance of presenting an honest picture of the costs and challenges associated with living in Quebec,” the report says, noting that many participants found themselves in a financially precarious situation.

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

“For the life of me, I don’t understand why these issues were not properly considered when this program was developed,” said Fo Niemi, executive director of the Center for Research-Action on Race Relations, a Montreal-based civil rights organization.

The review also noted difficulties with the training program itself, which lasts around nine to 14 months, pointing out that the labour shortage in the health care system made it hard to find teachers and internship supervisors.

It also found that students experienced intense stress around the prospect of failure.

If recruits fail one course, they’re expelled from the program and lose access to financial support, including the part-time work as orderlies that is included in the program.

In theory, they can re-enroll, but while they wait for the courses to be offered again, they’re not allowed to work — a situation that can last for months.

The nurse who spoke to The Canadian Press failed an internship component of the program in June 2024.

He was able to re-enroll in January, but in the interim, he had to borrow money from friends to pay rent and buy groceries.

He said the consequences of failure had not been made clear before his arrival.

If he’d known how the program worked before coming to Canada, he said, he wouldn’t have left home.

“I’m not happy,” he said. “In (my home country), at least there was family, there were my brothers and sisters. … But that’s not the case here. I have no money to send or do anything because the money I have is for groceries.”

Niemi said some nurses struggle to find jobs even after they complete their training.

He said he heard from a recruit in one region that “people don’t want to be served by Black nurses.”

In response to the access-to-information request, the government also released reports from each of the junior colleges that participated in the first phase of the program.

The documents detail a litany of challenges, including a heavy workload and an intensive training schedule that many recruits found overwhelming.

The colleges observed that many of the foreign nurses experienced culture shock, and some had trouble adapting to the vocabulary and accent of French spoken in Quebec.

One college noted that discussions around abortion and medical assistance in dying “created emotional and ethical tensions” for some students.

The recruits for the first phase of the program came from Algeria, Cameroon, Morocco, Tunisia and Mauritius.

“The fast-paced academic environment and the far-reaching consequences of failure put a lot of stress on the students,” the government report says.

Despite the challenges, most foreign nurses do make it through the training program.

Xavier Daffe-Bordeleau, a spokesperson for the Immigration Department, said that as of the end of February, 867 people had successfully completed the “refresher training,” including more than 90 per cent of students in the first two phases.

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

The spokesperson also said that most students in subsequent phases received an offer of housing before arriving in Canada.

“Building on the experience gained in previous cohorts, our efforts to accompany people from abroad for several months prior to their arrival have helped to minimize the pitfalls associated with settling in,” Daffe-Bordeleau said in an email statement.

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

This report by The Canadian Press was first published March 25, 2025.