University of Waterloo: Bridging the Gap for Foreign ODs

By Evra Taylor

One of the problems facing the medical sector in North America is the tremendous number of individuals trained as physicians in their home country but unable to work in Canada and the U.S. because of differing credentials and language requirements.

The University of Waterloo has taken an important step in this regard with its International Optometric Bridging Program (IOBP). The program is designed to bring new optometric talent “home” to Canada, easing the process along the way by preparing applicants for the Canadian Assessment of Competence in Optometry (CACO), the examination required to be able to practice optometry in Canada. Bridging programs are developed through collaboration between employers, colleges and universities, occupational regulatory bodies, and community organizations.

The University Of Montreal School of Optometry also offers a bridging program, along with several other Canadian universities that do the same for family physicians and specialists, including University of Ottawa and University of Toronto. These practitioners are sometimes referred to as International Medical Doctors (IMD) or International Medical Graduates (IMGs). The various initiatives fall under the umbrella of the provincial Ministries of Citizenship and Immigration, and Citizenship and Immigration Canada.

For healthcare professionals in the ocular sector who wish to emigrate and practice here, the issue of determining whether or not an individual’s foreign credentials correlate with Canadian requirements is key, and can represent a major stumbling block. Program participants are required to undergo a Prior Learning Assessment (PLA). A second common barrier facing overseas ODs face is the lack of English or other language training.

University of Waterloo program participants receive academic and occupation-specific language training, workplace culture and communication training, and they may have the opportunity for clinical placements through two bridging programs. Both programs receive funding from the governments of Canada and Ontario.

In terms of curricula, both the Bridging One and Bridging Two streams include classroom lectures, clinical instruction and externship rotations. Bridging One covers such topics as case analysis, diagnosis and management of ocular disease, review of optics, ophthalmic equipment commonly used in Canada, contact lens practice, and jurisprudence. In addition to more than 200 hours of lectures and clinical instruction, Bridging One students are required to complete a four-week externship involving real-life patient care.

Bridging Two students receive roughly 22 weeks of academic and clinical instruction, followed by practical hands-on training in the patient clinic at the university’s School of Optometry and Vision Science under the supervision of professional optometrists. The Bridging Two content includes extensive study of English language-related topics, such as disease description, written documentation and academic reading strategies. Some of the clinical instruction overlaps with that of Bridging One; however, the second stream encompasses advanced optometric subjects, including ocular pharmacology, ophthalmic and geometric optics, ocular pathology/disease, and neurophysiology.

Academically, clinically, culturally and linguistically, the process of emigrating to any foreign country with a view toward practicing medicine can be daunting, to say the least. Ontario’s optometric bridging programs were developed in conjunction with the College of Optometrists of Ontario as a way of standardizing training for prospective immigrants, and helping them gain the knowledge and practical experience required to attain success in their new environment.

TheUniversityofWaterloo IOBPis an example of an optometric initiative that combines stringent professional requirements to ensure that patients are managed competently with the sensitivity required to address cultural bridge-building.


The next Bridging One session of the University of Waterloo’s International Optometric Bridging Program begins on June 3rd, 2013. Students will be assigned to one of two externship periods starting on August 6 th or September 3 rd, 2013.

The Bridging Two program date is still to be confirmed.