Integrating internationally educated health professionals into Canada's health workforce: A synthesis of policy reforms and implementation experiences.

BACKGROUND: Internationally educated health professionals (IEHPs), including internationally educated nurses (IENs), are central to addressing global and Canadian health workforce shortages. Canada faces a projected shortfall of over 117,000 nurses by 2030, increasing reliance on IEN recruitment and retention strategies. This paper synthesizes evidence from a nationally funded nursing workforce policy review, a targeted scan of IEN and IEHP reforms, and a Nova Scotian case study to inform policy directions. METHODS: A layered analysis was adopted to integrate findings across the three evidence streams. (1) An analysis of national and international nursing workforce policy reforms and strategies including an umbrella review, comparative policy analysis, and expert insights (2) A targeted scan of provincial, national, and international IEHP policies and strategies; and (3) A Nova Scotian case study drawing on expert insights and learnings from provincial implementation. RESULTS: Five key domains emerged. First, licensure and education pathways are being expedited in Canada, while international exemplars emphasize structured bridging and adaptation. Second, practice readiness and retention supports are expanding but remain uneven. Third, equity and inclusion are inconsistently operationalized. Fourth, first-voice leadership is critical to ensuring policies reflect IEN lived experience. Fifth, effective integration depends on intersectoral alignment across immigration, regulation, and settlement systems. CONCLUSIONS: Canada has made progress in expanding entry pathways and supports for IENs and IEHPs, but reforms remain fragmented and uneven across provinces. A pan-Canadian IEN/IEHP implementation strategy with embedded evaluation is seen as essential to inform cross learning opportunities and key policies.