I have been receiving quite a number of inquiries regarding IMGs practicing as General Practitioners/Family Physicians 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 also included several 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.
- To practice here, you need to be a permanent resident or citizen.
- You need a provincial license to practice your specialty in whatever province you settle in.
- All Family Physicians will usually eventually have a College of Family Physicians of Canada/CCFP certificate (for family physicians).
- 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 getting into practice as a family physician:
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) Doing Residency. I have talked about that extensively in previous posts.
3) Practice Readiness Assessment (PRA) Route
Each province has its Practice Readiness Assessment procedure and not every province performs an assessment for IMG specialists. Please read THIS and THIS for more information.
This post is specifically for the PRA Route.
PROVINCIAL LICENSING THROUGH THE PRACTICE READINESS ASSESSMENT ROUTE
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. 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!
AIMGA has outlined these steps very nicely. Please click HERE to read more.
For more information on the pathway to independent practice in Alberta, please click HERE and HERE.
3. Manitoba. You will need to fulfill certain criteria including a pass mark on the MCCQE, IELTS results, etc. For eligibility requirements, please click HERE.
The application process involves the following steps:
– Simultaneous application to the IMG Program at the University of Manitoba and College of Physicians and Surgeons of Manitoba.
– If successful, you will be invited for sn interview.
– Take the Therapeutic Decision Making (TDM) Examination
When you are given a conditional registration, you will be granted a position only when you have an approved sponsor.
The actual PRA MB-FP comprises of an assessment which is three months in duration and has 3 components (Clinic 1 for four weeks, Clinic 2 for another four weeks, and Acute care in ER setting for four weeks). You are evaluated after each rotation, and poor evaluation in any of the three components will result in immediate release from the program.
When you complete the PRA MB-FP, you will be expected to fulfill their return-of-service obligations per sponsorship agreement (usually 4 years). Please read THIS for more detailed info.
4. British Columbia. Similar to other provinces, will need to fulfill certain criteria including a pass mark on the MCCQE 1, NAC (scores of more than 75 or 416) or MCCQE2, IELTS results, etc. For eligibility requirements, please click HERE.
The application process involves the following steps:
– Register with Health Match BC and upload your CV. Download guidelines for creating your CV HERE. Download a sample application CV HERE.
– Indicate interest in the PRA-BC through your Health Match BC account.
– You will receive the PRA-BC application form through your Health Match account.
– If your application is approved, it may be reviewed again by the College of Physicians and Surgeons of BC (CPSBC). If you then receive a positive ruling of eligibility for registration from the CPSBC, you may then be invited to sit a TDM exam in Vancouver.
– If you pass your TDM exam, you may be referred to health authorities for interview, selection, and admission to the PRA-BC.
– You would usually be sent to a rural community. To improve your chances of being selected, it is advised that you obtain certifications in the following: Advanced Trauma Life Support (ATLS), Advanced Cardiovascular Life Support (ACLS), Pediatric Advanced Life Support (PALS), and Neonatal Resuscitation Care/Program (NRC/NRP).
The actual PRA-BC comprises of a 12-week Clinical Field Assessment (CFA).
When you complete the PRA-BC, you will be expected to fulfill their return-of-service obligations (usually 3 years). Please click HERE and visit the PRA-BC website for more info.
The PRA for Saskatchewan is called SIPPA (Saskatchewan International Physician Practice Assessment). The first thing to do is to download and go through the Pre-Screen Checklist to determine your eligibility. If you are eligible, you can take the TDM. You can then apply to the SIPPA. If you are selected for the SIPPA, it will consist of an Orientation period followed by a 12-week Clinical Field Assessment (CFA). When you complete the SIPPA, you will be expected to fulfill their return-of-service obligations (usually 3 years). Please click HERE for more detailed info.
6. Newfoundland and Labrador: Their assessment process seems very reasonable but spaces are limited. Please click HERE. They are however not receiving new applications at this time.
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.
- New Brunswick. Please read THIS.
- 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 the College of Family Physicians of Canada. However, if you have passed your MCCQE1 and MCCQE2, there may be an opportunity to acquire a limited licence for family physicians. Please contact the Yukon Medical Council for the most current information. Please read more HERE. Download the Yukon pathway to recognition HERE.
- 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.
- Northwest Territories. Please read THIS
- 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.
- 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 CCFP certificate from another province, I believe that they will also accept you.
If you have been successful getting work through any provincial PRA, I’d love to hear your story and share with other IMGs. Please drop a comment or send me an email at firstname.lastname@example.org. ❣️
I have recently completed my residency from USA last year and want to move to Canada..As I have passed out last year only, I don’t have any clinical experience.
So, what should be my next step.Will anyone take a FM specialist who has freshly graduated-my preffered provinces are Ontario, BC, Alberta
Yes USA FM residency is accepted in Canada. You shouldn’t have any issues
I have one more question
Will a US resident applying in Canada not face any problems
An excerpt from an article I came across
Depending on the regulations of the provincial colleges of physicians and surgeons, US doctors must either undergo a period of supervision (usually several months to a year) or complete the Medical Council of Canada exams, or both, to obtain a full license to practise in Canada.
There are numerous procedural delays, and doctors are often required to show that they have a job before they are allowed to start the process. This can lead to a period of unemployment, said Dr. Bridget Reidy, who moved north two years ago and has worked as a locum doctor in Prince Edward Island, as a full-time physician in Ontario and is about to start a job in BC.
“I think a lot more doctors would want to work in Canada if [the licensing process] was easier,” she said, adding that the barriers are a shame since most provinces “desperately need doctors.”
Since the credentials of US-trained doctors are recognized by the College of Family Physicians of Canada (CFPC), Philpott doesn’t understand why the provincial colleges put barriers up.
“The provincial colleges are slapping the CFPC in the face,” said Philpott. “I guess they feel they have a greater understanding of certification than our own national bodies.”
Of course there will be hurdles to cross but it will be much easier than graduates from other countries. If you read the article, this doctor has had two jobs and is about starting her third job. It depends on the province. You’ll need to read the specifications of each province. Ontario had actually made it easier for US trained graduates. Please read this https://www.cpso.on.ca/Physicians/Registration/Requirements
The success rate while applying to CaRMS is so low that i sometimes wonder if its even worth trying or should i apply somewhere else like usmle..have you heard any stories of ppl matching in 1-2nd attempt…a frnd of mine matched after 8 yrs
Hi Dan, although it’s low I have one friend who matched in her first attempt after graduating from medical school more than 10 years and a few more friends who matched on their second attempt. There’s no harm in trying but also doing the USMLE pathway simultaneously just in case
I saw one interview recently of a cad img who did grad from australia and got into anaethesia residency..he said even in the img pool..you only have a chance if you have done mbbs from a western country like aus,uk,ireland etc
You’re mostly right about that but my three friends I mentioned graduated from African medical schools.