In light of the escalating shortages in the health workforce, Canada needs to transition from a norm of personal likability to an emphasis on objective qualifications or merits in the recruitment and retention of physicians. While team unity and interpersonal compatibility are crucial, placing too much importance on “fit” or likability tends to exclude skilled physicians, especially immigrants and racialized minorities, who might not align with the cultural background, communication styles, or social behaviors favored by those in charge. This approach undermines equity, worsens staffing shortages, and hampers healthcare delivery. Subjective likability is often influenced by unconscious bias, which may adversely affect hiring and workplace relationships.

The healthcare system in Canada is increasingly reliant on foreign-trained physicians, with immigrants accounting for more than a quarter of all physicians. Despite recognition of credentials, clinical skills, and language proficiency, numerous foreign-trained doctors encounter invisible barriers in hiring, workplace assimilation, and advancement. One major obstacle is the informal assessment of likability, frequently linked with cultural congruence or social comfort, which places those from diverse ethnic, linguistic, or religious backgrounds at a disadvantage. This ethnocentrism suggests that highly qualified immigrant doctors may be overlooked not due to a lack of skills, but because they are perceived by hiring teams as “too assertive,” “not warm enough,” or “not fitting in with the culture.” These subjective assessments of likability often go unrecorded, yet they hold substantial influence.

When likability serves as a gatekeeping tool, it proves economically and operationally detrimental. Health systems throughout Canada are facing challenges such as staff burnout, prolonged wait times, and service shutdowns. Nevertheless, numerous qualified physicians residing in Canada remain underutilized or excluded due to informal criteria that prioritize subjective likability over technical skills and professional integrity. A system that favors familiarity over diversity shuts out opportunities for innovation and resilience, particularly in multicultural patient environments where a diverse staff is beneficial. A 2023 report from the Institute for Canadian Citizenship (ICC) revealed that increasing numbers of immigrants are departing from Canada. Daniel Bernhard, ICC’s chief executive, stated, “We are now seeing people coming to Canada and then saying, ‘Ah, no thanks,’ and moving on.” Additionally, the number of such individuals continues to rise. We believe the scarcity of opportunities and other services is contributing to this trend.

Canada must move away from giving precedence to subjective interpersonal comfort and instead prioritize competence, communication, and contribution. This transformation demands that healthcare leaders and hiring panels receive training in structured interviews, anti-bias assessment methods, and objective performance metrics. Peer support and mentorship initiatives should be designed to be explicitly inclusive, incorporating mechanisms to ensure that marginalized physicians are woven into team dynamics and decision-making processes. Leaders within the health system must question the belief that coherence relies on uniformity. In fact, diverse teams can demonstrate greater innovation, adaptability, and suitability in addressing the needs of Canada’s increasingly varied population.

Canada needs to redefine the characteristics of a “good fit” by transitioning from selection based on comfort to inclusion based on performance. Only by embracing differences and dismantling subjective barriers can the health system cultivate the diverse, resilient workforce it urgently requires. Indeed, “we don’t have to like people to work with them.”