Eleven years later, the 36-year-old is still working tirelessly to find work as a physiotherapist in Edmonton.
Moura is one of 800 international students looking to be certified as a physiotherapist in Canada. But they face obstacles — particularly a national competency exam that about 40 per cent, including Moura, have failed.
Canadian post-secondary schools have taken notice of the issue and are looking to shrink the skills gap for internationally educated students.
The University of Alberta launched a two-year pilot project this week for 17 international students hoping to pass the exam and practise in Canada.
"I always, always dreamed about something like the bridging course," said Moura, who’s part of the inaugural class at the school. "I think this is absolutely amazing — one in a million."
The first time Moura took the exam was 2011.
She said the time leading up to it was extremely stressful as she dealt with interminable paperwork over her training in Brazil. While she waited, she worked labour jobs for which she was overqualified.
“I wasn’t prepared because I didn’t know what to expect from the exam.”
Part of that difficulty comes from international differences in the scope of practice, said Linda Woodhouse, an associate professor in the University of Alberta's physical therapy department.
For example, in countries such as the Philippines, physiotherapists often get direct orders from doctors, while physiotherapists in Canada directly assess individuals and decide on treatment.
“The standards and the context of clinical practice and the cultural differences are such that to pass a written and clinical exam is very difficult for people coming in,” Woodhouse said.
Bernadette Martin, associate chair of the department, said the university is hoping to change that with the 13-month course.
There is flexibility for students, many of whom already work as physical therapy assistants. The program, funded by a Health Canada grant, blends distance, web and in-person components in Edmonton and a satellite campus in Calgary.
Other schools are considering similar studies, Martin said.
The University of Toronto already has its own program, and others are likely to spring up at the University of British Columbia and the Université de Montreal, she said.
Demand for physiotherapists is on the rise due to aging baby boomers, said Michael Brennan, chief executive of the Canadian Physiotherapy Association. Supply, meanwhile, is diminishing. In Alberta, 20 per cent of 2,400 physiotherapists are planning to retire in the next five years.
Intake at post-secondary schools is limited. Admission into the graduate, entry-level physical therapy program at the University of Alberta is capped at 110 students.
"We recognize that the Canadian labour force and our health education system probably won’t be able to keep up with that demand," Brennan said.
The staffing gap is partly being filled with improvements in training and education for physical therapy assistants, he added. Moura was able to find work as a physical therapy assistant five years after arriving in Canada in 2007.
The shortage is especially being felt in rural areas, said Dianne Millette, registrar for the Physiotherapy Alberta College and Association.
"Rural areas do have a hard time attracting and retaining physical therapists across Canada," she said.
The hope is that internationally educated students can help shrink the overall gap. Out of the 17,000 physiotherapists working in Canada, 12 per cent are internationally educated.“Internationally educated students are an important supply component to the whole human health resources market here and always have been,” Millette said.
For Moura, the effort to attract more international students means an end to a painstaking decade of waiting.