I have been receiving quite a number of inquiries regarding IMGs practicing as specialists here in Canada. I’ll try to answer this question based on the information I’ve researched on the web AND experience of my friends here in Canada.

To reduce the length of this post, I have included numerous links to necessary websites and information you can read in more detail.

Before I go on, there are some important points you need you to know first.

  1. To practice here, you need to be a permanent resident or citizen.
  2. You need a provincial license to practice your specialty in whatever province you settle in.
  3. All specialists will usually eventually have a College of Family Physicians of Canada/CCFP certificate (for family physicians) or Royal College Certificate (for all other specialties).
  4. Based on the country you obtained your specialty certificate, there are two classifications:
  • Approved-jurisdiction. These approved jurisdiction certificates are from 29 international jurisdictions that the Royal College has assessed and deemed to have met Royal College standards. They are from South Africa, Singapore, Hong Kong, Australia, New Zealand, Switzerland, United Kingdom and Ireland.
  • Others/Non-approved jurisdiction routes.

Graduates from the U.S are not considered international medical graduates. They are matched similarly to Canadian Medical Graduates.


There are 3 pathways to get the Royal College Certificate:
1) Approved-jurisdiction route is for international medical graduates who have completed specialty training outside of Canada or the United States in any of the approved jurisdictions that I mentioned.
2) The Practice Eligibility Route for specialists for other internationally trained physicians. The deadline for every year is the April before the year you want to practice. So, for example, you want to start practicing 2020, the deadline for application is April 2019. After they approve your application, you will then sit for the Royal College Exam in your specialty. To be eligible, you need to have been in practice for a minimum of 5 years (2 of which must be in Canada). Please read more HERE.
3) Practice Readiness Assessment Route
Each province has its Practice Readiness Assessment procedure and not every province performs an assessment for IMG specialists.

If you want more information specific to GPs or Family Physicians, I have written a post outlining the steps. Click HERE to read it.


To obtain a provincial license, you need to do your province’s Practice Readiness Assessment. I will now talk briefly about each province’s procedure.

    1. Quebec. There are two routes: The Clinician – Practice Ready Assessment route(Restrictive permit) and the Arrangement de reconnaissance mutuelle (ARM) Québec-France – Practice Ready Assessment route (PRA). Please visit their websites for more details HERE and HERE.
    2. Ontario. This province only takes IMGs from approved jurisdictions (listed above) or doctors trained via residency in the U.S or Canada. If you receive your Royal College Certificate or CCFP certificate from another province, I believe that they will also accept you.
    3. Alberta. Conducts assessments for both family medicine specialists and other specialists but you need to:
      – be currently practicing or at least have practiced in the last 3 years prior to your application,
      – have passed your IELTS,
      – have your LMCC Certificate [have passed your QE1 and QE2] or in the process of working towards it. Please read THIS for more details.
      – apply to them to assess your qualifications.
      Depending on their assessment, they can put you on either the general register or provisional register. I believe the general register means you can work without supervision. The provisional register means you need to have an Alberta Health Services ‘sponsor’ to work with for a period of 6 months, after which they will decide whether to assess you or give you a full license. Getting a sponsor is not always very easy as I have heard of specialists unable to get anyone to sponsor them. Not to discourage you as everyone’s situation is different though!
      For more information on the pathway to independent practice in Alberta, please click HERE and HERE.
    4. Manitoba. You will need to fulfill certain criteria including a pass mark on your MCC exams and have above 7 in IELTS, etc. Please read THIS GUIDE for more information on these criteria. When you are given a conditional registration, you can then apply for The Practice Ready Assessment (PRA) – Specialty Practice Program, and you will be granted a position only when you have an approved sponsor and a job offer in a specialty which is regarded to be in high need in Manitoba. Please read THIS for more information. When you complete the PRA-Specialty Practice program, you will be expected to fulfill their return-of-service obligations per sponsorship agreement. In addition, you are expected to complete a one-year mandatory Mentorship Program through the IMG Program. For General Practitioners or Family Medicine physicians, please read THIS and THIS.
    5. British Columbia and, Saskatchewan. These provinces only conduct Practice Ready Assessments for family medicine specialists. If you want to work as a specialist in these provinces, you would need to be assessed in another province and get your Royal College there before moving there.
    6. Newfoundland and Labrador: Their assessment process seems very reasonable but spaces are limited. Please click HERE.

The following provinces/territories do not have Practice Ready Assessments. If you want to practice there, you can earn your certification in another province and then move there.

      1. New Brunswick. Please read THIS.
      2. Yukon. To practice in this territory, you need to have a current full license in another Province or Territory of Canada that is a party to the Agreement on Internal Trade, your LMCC, and a certificate or fellowship from any of the following bodies: the Royal College of Physicians and Surgeons of Canada or The Collège des médecins du Québec (on or after October 16, 2007), or the College of Family Physicians of Canada. Please read more HERE. Download the Yukon pathway to recognition HERE.
      3. Nunavut. Contracts are only being offered at present to family physicians with full, unrestricted registration in other Canadian jurisdictions and those who are active members of the College of Family Physicians of Canada. Preference is given to family physicians holding the CCFP designation. Please read more HERE.
      4. Northwest Territories. Please read THIS
      5. Prince Edward Island. They do not offer any assessments but they do give contracts to doctors. It is not clear on their website the steps involved. You will have to get in touch for further information. Please visit the website of the College of Physicians and Surgeons of Prince Edward Island HERE. HealthJobsPEI also has some information HERE.

I have done my best to create an algorithm illustrating the process for specialists to practice in Canada. I hope this helps simplify things for y’all!

IMG specialist pathway in Canada