Abstract

Selecting policies for integrating internationally educated healthcare professionals (IEHPs) into the healthcare workforce depends on how the underlying policy questions are defined and how the resulting trade-offs are managed. Baumann, Blythe and Ross give excellent answers to the question of how to use IEHPs to alleviate health human resources shortages while ensuring quality; this can be linked to the questions of how many providers are "needed" by the system, as well as to how they are paid, who assumes the risks of oversupply and under-supply and whether data are available to track the workforce. But the questions could also be framed as fairness to the IEHPs themselves, fairness to the countries these providers come from or even as ensuring intergovernmental coordination within Canada, where decisions about immigration are not always aligned with decisions about training and certification. Boom-bust cycles have occurred before, and proven both counterproductive and wasteful. Particularly when there are no obviously correct answers, wisdom and balance by policy makers in framing the questions is essential.