I know it’s not the best practice to harbor regrets but there are many things I might have done differently if I knew then what I know now. I sincerely hope this post and any other posts on this blog providing Canadian IMG advice would help educate my readers and guide your decisions regarding your plans to practice here. Not to sound discouraging, you should know that many IMGs are never able to practice medicine in Canada. Some end up doing odd jobs, following alternate career paths or even returning home. Second thing to note is that most programs require that you at least have permanent residency status unless you are being sponsored by your government. For info on immigrating to Canada, read HERE.

Now for more uplifting information!
1. CONSIDER MEDICAL SCHOOL. I think that the best way for a foreign national to practice medicine here is to go to medical school here. However, this is not very easy as getting admission into a medical school is extremely competitive. Moreover, I imagine that the costs of medical education for foreigners might be very costly. There are currently seventeen medical schools in Canada and they usually require that you have an undergraduate degree and sit for the MCAT. For a full list of medical schools in Canada, please click HERE. If you don’t mind going back to school for ONLY two years, you can also apply for a 2-year medical school/clinical clerkship and you automatically become a Canadian medical graduate when you complete it. These programs are listed below:

medical students in training
2. COME HERE AFTER COMPLETING A POST-GRADUATE TRAINING OR AFTER SOME EXPERIENCE AS A GP. As a specialist, you have a higher chance of practicing medicine here and you might be eligible to sit for three exams: The ROYAL COLLEGE OF PHYSICIANS & SURGEONS OF CANADA exams, PRACTICE READINESS ASSESSMENT (PRA) and the Medical Council of Canada’s Therapeutics Decision Making (TDM) exam. The TDM is only required for IMGs interested in family medicine. Please also take note that this route has more opportunities for doctors with family medicine training. In some countries, family medicine is not really a specialty, so if you have recency of practice and at least 24 – 36 months of post-graduate experience in general practice, you might be eligible for this assessment. You will need to contact the PRA program in your province to determine your eligibility. Saskatchewan, Manitoba and British Columbia currently accept experienced GPs. Alberta only accepts family physicians who have official Family Medicine training.

The Royal College exams are for all other specialties (besides Family Medicine). The routes they take are either the Approved Jurisdiction Route or the Practice Eligibility Route to certification for specialists (PER).


For the PER for specialists, the Royal College exam is followed preceded by the provincial PRA. Read more about it Here. When you have passed the PRA and received a license from your province, then the next step is to go challenge the Royal Exams.

The following sites provide more information on Provincial PRA programs:

3. APPLY FOR A RESIDENCY PROGRAM. For a Canadian IMG, this is the most competitive, emotionally and financially stressful route to take to achieve a medical career, and it is the only way to go if you don’t have recency of practice or you have less than 24 months of post-graduate experience. There are several national standardized exams organized by the Medical Council of Canda (MCC) which must be passed before you can apply for residency:

  • Medical Council of Canada Evaluating Examination (MCCEE)At the moment, you must pass this written exam before proceeding to the next exams in the process. However, from 2018, the NAC and MCCEE exams can be taken in any order. It currently costs $ 1,780 but this is subject to change as well as the other MCC exams. Also, take note that the last session of the MCCEE will be written in November 2018.
  • National Assessment Collaboration Examination (NAC-OSCE) This exam and the MCCEE are only taken by IMGs. It is an objective structured clinical examination (OSCE) that includes a series of stations where you are presented with typical clinical scenarios and the patients are actors. Current cost $2,470
  • Medical Council of Canada Qualifying Examination (MCCQE) Part I (MCCQE1) This exam is written by Canadian and International medical graduates, and it has two components: multiple choice and fill-in-the-blank clinical decision-making. You need to do this exam before you commence your residency. Current cost $1,105
    • After passing the NAC-OSCE and MCCEE, you are almost eligible to apply for a residency program but you must first scale the IELTS. You MUST have a minimum of 7 in each component (reading, writing, listening and speaking).
    • If your application is accepted by a program, you get selected for an interview. The more programs you apply for, the higher your chances of getting an interview. I hope!
    • After the interview, you are expected to rank all your interviewed programs in order of preference.
    • There is a day called MATCH DAY where the programs are matched to your preferences and hopefully, you get matched to a program!
    • After you get ‘matched’, most programs require you to undergo another clinical assessment period. The span varies between programs (usually 4 – 6 weeks) and this guides the program’s final decision to keep you or not.
    • If you pass this assessment period, your acceptance into residency is confirmed and that’s not it! You have to stay on your toes so you don’t get kicked out!

4. APPLY FOR A POSITION AS A CLINICAL ASSISTANT. In this position, even though you will be well enumerated and respected, you will continue to work as a supervised ‘doctor’ and there is no option to work independently. If you desire to work in an unsupervised environment, then this is not for you. Although each province has its own eligibility criteria for these clinical assistant positions, clinical experience is a general requirement. Learn more:

If my description above seems looks too complicated, check out this diagram:

Simplified pathway for Canadian IMGs
Simplified practice pathway for Canadian IMGs

Do you have any questions you want me to respond to by posting about it? Please leave your comments or feel free to send an email to internationalphysiciantraining@gmail.com for further clarification.

P/S: There is another clinical exam called the Medical Council of Canada Qualifying Examination ( MCCQE) Part II which you can take after passing the MCCQE1 but it is not a requirement for residency application. You can take it during residency as that’s when Canadian medical graduates do theirs.

*Edited on 1st December 2018*