July 10, 2018
To practise as a regulated health professional in Ontario, you must be a member of your profession’s regulatory college and hold a certificate of registration. Regulated health professionals are required by law to deliver competent, ethical and professional services, and are accountable to the public through their respective colleges.
An international medical graduate (IMG) is defined as someone who has completed their postgraduate residency training outside of Canada or the United States and/or who has graduated from a medical school outside of Canada or the United States whose medical degree is recognized by the World Health Organization (WHO).
As an IMG, navigating your way through licensing and certification in Ontario can be challenging, time consuming, and complicated. Learn more about practice requirements, licensing and certification in Ontario and how HealthForceOntario Marketing and Recruitment Agency can help you achieve your goals.
Ontario Registration Requirements for IMG Jobs in Canada
The College of Physicians and Surgeons of Ontario (CPSO) regulates the practice of medicine in Ontario and issues certificates of registration to physicians to allow them to practise. An IMG who wishes to obtain an Ontario Certificate of Independent Practice through the CPSO must first meet the following registration requirements set out by the College:
- Degree in medicine from an acceptable medical school.
- Passing results on the Medical Council of Canada (MCC) Examinations.
- Certification, by examination, by the Royal College of Physicians and Surgeons of Canada (RCPSC) or the College of Family Physicians of Canada (CFPC).
- Completion in Canada of one year of postgraduate training or active medical practice with pertinent clinical experience.
- Canadian citizenship or permanent resident status. Please visit Citizenship and Immigration Canada for more information.
Please review the pathway to certification for IMGs explained below. For additional summaries of the registration requirements for International Medical Graduates, please visit:
- “Practising in Canada”: Physiciansapply.ca guide to becoming a practising Physician in Canada.
- “International Medical Graduates”: Section of the CPSO website that inludes qualifying requirements, information about observerships, and links to services for IMGs.
Pathway to Certification
Degree in Medicine from an Acceptable Medical School
IMGs must verify their medical degrees through physiciansapply.ca. A comprehensive and up-to-date list of all the medical schools in the world, as recognized by the WHO, can be found in the World Directory of Medical Schools.
The physiciansapply.ca account also allows access to a variety of other services within the medical community, including access to apply for the MCC Examinations.
Submit Documents to Physiciansapply.ca
IMGs must verify their medical degrees through physiciansapply.ca. The physiciansapply.ca account also allows access to a variety of other services within the medical community, including access to apply for the MCC Examinations.
The MCCEE and NAC OSCE are required when applying for postgraduate medical training (residency) positions in Ontario. The MCCQE1 and MCCQE2 are optional prior to medical residency in Canada training, but must be completed in order to obtain licensing.
The Medical Council of Canada Evaluating Examination (MCCEE) is a computer based, multiple choice examination aimed at assessing basic medical knowledge in the main disciplines of medicine. The MCCEE is required to register with the CPSO.
Passing the MCCEE gives access to the National Assessment Collaboration Objective Structured Clinical Examination (NAC OSCE) which is an assessment required of all IMGs applying for postgraduate training positions (residency). The NAC is an Objective Structured Clinical Examination (OSCE) which uses clinical scenarios to assess readiness of IMGs for Canadian residency training.
Passing the MCCEE also gives access to the Medical Council of Canada Qualifying Examination Part 1 (MCCQE1). Passing the MCCQE1 and completion of 12 months postgraduate training is required for the Medical Council of Canada Qualifying Examination Part 2 (MCCQE2). The required 12 month training for the MCCQE2 can be done anywhere in the world.
The Medical Council of Canada examination program will undergo significant changes that will take effect in 2018 and 2019. International Medical Graduates should visit the MCC Assessment Evolution website and become familiar with the changes and how they might be impacted.
Residency Application and Interview
To obtain registration to practice in Ontario, physicians must have a specialty designation from either the College of Family Physicians of Canada (CFPC) or the Royal College of Physicians and Surgeons of Canada (RCPSC).
Eligibility for certification from CFPC can be obtained through the completion of 24 months of family medicine residency training in accredited programs in Canada and the United States.
Eligibility for certification from RCPSC can be obtained through the completion, in Canada, of a RCPSC-accredited residency program.
IMGs can obtain residency positions by applying through the Canadian Residency Matching Service (CaRMS) through the Postgraduate Year 1 (PGY1) pathway. CaRMS is a national, not-for-profit organization that provides an electronic application and computer matching service to complete medical residency in Canada.
Positions are granted to the most suitable candidates. Approximately 2,000 IMGs apply through CaRMS each year for approximately 200 residency positions in Ontario. Because of the limited number of positions available each year, the process can be challenging and highly competitive.
Only the most suitable candidates are selected based on the following:
- Obtaining good scores on the MCC exams, including NAC OSCE;
- Professional practice experience – recency of practice (program dependent) ;
- Past performance in medical school;
- Excellent communication (verbal and written) skills;
- Reference letters;
- Complete and professional CaRMS application; and
- Your interview (if invited).
The above criteria do not guarantee medical residency in Canada. Please visit the CaRMS website to view the full list of eligibility requirements.
Prior to beginning a residency training position, IMGs must attend a Pre-Residency Program at Touchstone Institute, and obtain a Postgraduate Education Certificate of Registration with the College of Physicians and Surgeons of Ontario (CPSO).
CFPC or RCPSC Certification
Following the successful completion of residency training in their respective specialty, IMGs become eligible to take the CFPC or RCPSC examination that is required to apply for licensing from the CPSO.
Once all of the registration requirements for a Certificate of Independent Practice are met, an IMG can apply to the CPSO for registration.
Return of Service for Internationally Trained Physicians
An IMG who successfully completes a training position will be required to fulfill a 5-year Return of Service (ROS) contract in an underserviced community in Ontario. The ROS agreement is signed with the Ontario Ministry of Health and Long-Term Care.
Canadians Studying Medicine Abroad
Are you in medical school abroad? Are you thinking about attending medical school abroad?
If you are planning to apply for a residency training position in Ontario or are planning to complete residency training outside of Canada before returning to practice in Ontario, the Access Centre can help explain what you need to do.