Part 1 of the series: What’s working in Canadian immigration?

Canada has struggled with health-care staffing for years. By 2023, the numbers were grim. Statistics Canada counted more than 28,000 vacant registered nurse and psychiatric nurse jobs across Canada in the first quarter of 2023, up 24 percent from a year earlier. Another 13,620 licensed practical nurse jobs sat empty.

Manitoba felt the strain as much as anywhere else, even after the province became the first in the country to let internationally trained nurses, already licensed elsewhere, skip the extra tests usually required for accreditation in August 2022. That bold move wasn’t enough.

Nurses across Manitoba logged more than a million hours of overtime in 2022, according to the Manitoba Nurses Union, and the gaps were widest outside Winnipeg. CBC Manitoba reported that by January 2023, the nursing vacancy rate in the Southern Health region was nearly 27 percent, more than double its 2019 level. In Interlake-Eastern, more than a third of nursing positions were unfilled. In Prairie Mountain, nearly a quarter were unfilled.

In the north, the gaps had been worse for years. In late 2021, the Manitoba Nurses Union said nearly half of Thompson’s nursing jobs were vacant—more than 50 positions.

That is the city where Chi Fuentebella would later settle.

For rural communities, these gaps come at a cost. When a hospital can’t fill a shift, the emergency room cuts hours or closes, and families drive farther for care. Towns without reliable health services struggle to keep workers and employers. In November 2022, Manitoba announced a $200-million plan to recruit, retain, and train health-care staff.

Part of the answer lay overseas.

The province, with Immigration Minister Jon Reyes on the mission, chose the Philippines, a country with which Manitoba already had a history.

In 2008, a delegation visited the Philippines on behalf of four regional health authorities and returned with 131 conditional job offers. Of those, 123 were accepted, and by December 2009, 120 nurses had arrived.

Researchers who followed them found that many were still living and working in rural Manitoba a decade later. A general labour memorandum of understanding signed in 2010 formalized the relationship. Jon Reyes, who held the immigration portfolio and is of Filipino descent, said he knew many kababayans (fellow Filipinos) would want to come to Manitoba to work in health care.

In February 2023, nearly 20 health-care professionals from Manitoba boarded a plane bound for Manila, Cebu, and Iloilo. Their goal was simple: scythe away the costs and confusion that keep skilled workers from starting new lives in Canada.

The offer to qualified Filipinos? A job lined up before leaving home, paid travel, up to three months of housing and settlement support, covered immigration and credentialing costs, a workplace mentor, and paid bridging education if needed.

Officials pre-screened applicants before they ever sat down for an interview. They needed a nursing degree, at least two years’ experience in acute or long-term care, and a recognized English test.

Over the next five days, officials interviewed more than 400 people. By the time they flew home, Manitoba had sent out 348 letters of intent—about 190 to registered nurses, 50 to practical nurse equivalents, and 110 to health-care aides.

Health Minister Audrey Gordon backed the mission with money and muscle. Her department contributed $100,000 to send University of Manitoba nursing faculty to Manila in July 2023 to conduct in-person clinical competency assessments, and the University of Manitoba signed a memorandum of understanding with World Citi Colleges, a leading Philippine educational institution, to expand virtual assessments in future rounds.

What set this offer apart was its focus on the nurse as a whole person, not just a résumé. Chi Fuentebella was one of the beneficiaries.

In 2023, Chi was scrolling through social media when a post caught her attention. Manitoba officials were coming to the Philippines to recruit nurses. She had been a registered nurse since 2009 and was already looking for ways to build a career abroad. For her, it was "a Canadian dream," and she grabbed the opportunity.

She was one of nearly 350 qualified candidates identified during the mission and the first to complete the entire hiring process. 

Seven months after her interview, in September 2023, she landed at Winnipeg airport with her family, and officials greeted them on the tarmac. "We packed our lives into two 23-kilogram suitcases and started over in a place that was unfamiliar to us," she says.

They spent that first night in a Winnipeg hotel before driving north to Thompson. "We arrived during fall, and the autumn colours were such a wonderful sight to see, a memorable welcome to our new home." She says the support went well beyond the first weeks. "Having our housing arranged may sound like a practical detail, but when you arrive in a new country with your family and your belongings in two suitcases, it means so much."

On June 27, 2023, the province announced that nearly 90 percent of those offered jobs had said yes. They had hit 309 acceptances across 31 communities, with 116 people expected to work in Winnipeg through the Winnipeg Regional Health Authority and Health Sciences Centre. 

Officials credited careful planning and coordination for the high acceptance rate.

And people did come. By February 2025, 145 recruits were working in Manitoba’s health system as part of what became known as the Philippines Recruitment Initiative. The province hasn’t published new numbers since.

The ripple effects went further. The University of Manitoba’s move to virtual clinical assessments led to a first-of-its-kind assessment centre in the Philippines, opened in October 2023 with World Citi Colleges. 

The province’s push to challenge its own regulator sped up the process not just for newcomers, but for internationally trained nurses already living in Manitoba. The College of Registered Nurses built a faster pathway for recruits from the Philippines, aiming to shave at least 12 weeks off the process.

For many, including Chi, the challenges don’t end with a warm airport welcome. Despite years of experience, most can’t work as registered nurses right away. They start as health-care aides, working their way back to the profession they know while upgrading their credentials.

Chi, a nurse with fourteen years of experience, arrived in Thompson and started as a health-care aide at Northern Spirit Manor. She says her adjustment began before she left home. "In a way, my first shift began emotionally when I signed the contract back home." She started praying, reminding herself that her role in Canada would differ from the work she knew. She calls the aide job "another way of caring for people while finding my way back to a profession I love."

One moment stayed with her. She was assisting a nurse with a wound dressing while students watched. The nurse asked for an unopened syringe, and rather than hand over the package, Chi instinctively opened it for her to take, as a colleague would. 

The nurse pointed out the gesture to the students and explained that Chi had been a nurse back home and was working toward becoming one here. "It was one of my proudest moments, not because I had done anything extraordinary, but because I felt seen."

Getting fully licensed can take years. Chi has finished the nursing re-entry program and is now waiting for confirmation of her eligibility as she prepares for the NCLEX exam—the last hurdle to becoming a registered nurse in Manitoba. She says there’s uncertainty, especially with the exam ahead, but she tries to focus on preparing and taking things step by step. She says completing the re-entry program has encouraged her and brought her closer to the work she loves.

She celebrated her third anniversary in Manitoba on September 20th.

Manitoba’s experience offers a few lessons for any province hoping to use migration to fill workforce gaps:

Not everyone is celebrating. Nurses’ groups, Philippine health officials and some of Manitoba’s own Filipino community have been asking hard questions since the mission was announced.

Is it right to recruit nurses from a country that needs them? The Philippines has its own shortage: in 2023, health officials there said roughly 40 percent of Filipino nurses had left the country or retired since the pandemic. Howard Catton, chief executive of the International Council of Nurses, called recruitment programs like Manitoba’s exploitative and said the province should invest in nursing schools in the Philippines instead. Health Minister Audrey Gordon pointed to the labour agreement between the two governments.

The nurses, though, were not pawns in this. Many, like Chi, wanted a chance to work abroad. When a province fills its shortage with nurses from another country, and those nurses want to come, who is responsible for what the other country loses?

What about the internationally educated nurses already here? The Philippine Nurses Association of Manitoba argued the province should first invest in those who live here and are struggling to become registered. One nurse who moved to Winnipeg in 2019 told CBC she could not get accredited and now works in Tennessee.

The question is, if the province can build an accelerated path for new arrivals, why did it take so long to open one for people already living here? For recruits, the question remains whether they’ll pass the exam. And if they’ll stay?

Chi Fuentebella, with fourteen years of nursing behind her, arrived to work as a health-care aide. Manitoba offers an accelerated path to licensure, and she is on it. But will she and other nurses pass the certification exams, or will some fail to get licensed and move elsewhere, like the nurse now working in Tennessee? Will the program truly help them reach their full potential, or will they remain stuck in lower roles, experienced hands doing aide work, struggling to move forward? 

There are no published pass rates for the group, and no one can say how many will still be here in five years. How will Manitoba know if this really worked?

So yes, the mission worked in the sense that the province got its nurses. But we still don’t know what it will look like years from now—how many nurses will cross the finish line, and how many will still be here when the story is measured in decades, not headlines.

Time will tell.