Certification and Licensure
International Medical Graduates (IMGs) have several pathways to obtain the necessary certification and licensure to practice medicine in Canada:
For IMGs from non-approved jurisdictions, completing a Canadian residency program through CaRMS is the most common pathway. This typically involves:
- Passing the Medical Council of Canada Qualifying Examination (MCCQE) Part 1
- Passing the National Assessment Collaboration Objective Structured Clinical Examination (NAC OSCE)
- Applying through the Canadian Resident Matching Service (CaRMS)
- Completing residency training
- Passing Royal College or CFPC certification exams (depending on chosen specialty)
The CaRMS application process is highly competitive. Key factors include high QE1 and NAC scores, strong letters of recommendation (ideally from Canadian physicians), research experience, a compelling personal statement, and a strong CV. Recent clinical experience is also highly valued.
Here is a general outline of the CaRMS application timeline:
- Registration opens in July for the match cycle starting the following year.
- Applications open in September, program descriptions become available.
- Applications to programs are submitted between November and December, including necessary documents.
- Interviews are conducted from January to February.
- Match results are released in March.
- Second iteration of the match takes place in April, with a smaller number of available positions.
You can apply to multiple provinces and programs, but you must meet the specific eligibility criteria for each. Applying broadly increases your chances of matching. See the CaRMS website for details.
Physicians who have completed postgraduate training in jurisdictions whose credentials are recognized by either the CFPC or RCPSC are often exempt from additional Canadian residency training. They can apply directly for licensure with their provincial regulatory authority.
- General Practitioners/Family Physicians: In some cases eligible for provisional/restricted licensure and can start practicing after completing necessary paperwork, assessments and potentially a supervised practice period. May be eligible to take the Certification in Family Medicine without examination route (CCFP-COE).
- Specialists: Must obtain recognition of their specialty certification from the RCPSC and may need to write additional exams and/or complete supervised practice requirements to be eligible for full licensure.
The following organizations set requirements and any applicable assessments for these pathways to licensure:
Check provincial licensing websites for details on specific pathways for various specialties and approved jurisdictions.
If you have completed postgraduate training AND have recent clinical experience, several provinces offer Practice-Ready Assessment (PRA) programs. These allow IMGs with training from non-recognized jurisdictions to demonstrate competency without repeating residency training.
Key features of PRA programs:
- Assessment periods can vary but usually are around three months of supervised practice. Followed by a return-of-service agreement (usually 2-3 years). May need to take Therapeutics Decision-Making (TDM) exam depending on specialty and province.
- Available in provinces such as British Columbia, Saskatchewan, Manitoba and Nova Scotia. Check each province's PRA program website for specific eligibility criteria and assessment details.
In addition to the above, there are other, less common pathways, including:
- Clinical Assistant (CA) / Associate Physician (AP) Licensure: Some provinces offer licensure for IMGs to work in a supervised, non-training capacity. This can provide clinical experience in the Canadian healthcare system. Alberta and Manitoba have established CA/AP pathways, while BC has a similar program for APs. Note that CA/AP positions do not usually count towards the clinical practice requirements for PRA programs.
- The IMG Program in Manitoba: For IMGs looking to get into FM training. Similar to PRA. Has its own requirements.
- Fellowships: If you are already a specialist, you can pursue fellowship training in Canada. This can provide an entry point into the Canadian medical system and may lead to opportunities for licensure and/or academic positions.
- Academic Positions: IMGs with research experience and publications can pursue academic or research-related positions in Canadian universities or hospitals. While this is not a path to clinical practice, it can allow you to stay connected to the medical field and build connections.