| IMG Routes to Licensure in Ontario |
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IMG-Specific
Programs
IMG Programs
General Information
Eligibility Requirements
Application Process
Selection Process
About the Program
Contact Information
General Information
To practise medicine in Ontario, whether as a family practitioner or specialist, IMGs are expected to have the Canadian postgraduate qualifications required for an independent practice certificate. The College of Physicians and Surgeons of Ontario (CPSO) regulates the practice of medicine in Ontario and issues certificates of registration to doctors to allow them to practise.
The core requirements for an independent practice certificate in Ontario, for graduates of Canadian medical schools as well as IMGs, are as follows:
- A medical degree from an acceptable medical school.
- Canadian citizenship or permanent resident status.
- Passing results on the Medical Council of Canada (MCC) Qualifying Exams, Parts I and II (MCCQEI and MCCQEII). (Most IMGs must pass the MCC Evaluating Exam before being eligible to take the Qualifying Exams.)
- Completion in Canada of one year of postgraduate training or active medical practice, or completion of a full clinical clerkship at an accredited Canadian medical school.
- Certification by either the Royal College of Physicians and Surgeons of Canada (RCPSC) or the College of Family Physicians of Canada (CFPC).
The CPSO may waive certain of these requirements on a case by case basis.
Training and Assessment Positions for IMGs in Ontario
Ministry of Health and Long-Term Care funded training and assessment positions in the medical education system provide an opportunity for IMGs who do not meet all of the CPSO’s registration requirements to obtain the additional qualifications they need to be eligible for registration to practise medicine in Ontario.
Since 2004, Ontario has funded at least 200 training and assessment positions for IMGs each year. These positions are a combination of entry level residency training positions, advanced level residency training
positions, and Practice Ready Assessment positions (see below). Roughly half the training and assessment positions the Ministry funds for IMGs are in family medicine, which is a two-year residency program. Physicians in specialities or sub-specialities require four or more years of residency.
Information about these IMG positions and other routes to licensure in Ontario is available from the
Access Centre for Internationally Educated Health Professionals, a unit of the HealthForceOntario Marketing and Recruitment Agency.
The Access Centre provides internationally educated health professionals, including IMGs, with:
- contact information and referrals to the regulatory body in the appropriate field;
- links to education, retraining, and assessment programs;
- information about standards for professional qualifications, licensing and registration processes;
- ongoing case management;
- assistance in finding the most effective path to professional practice, including alternative professional avenues.
E-mail: AccessCentre@healthforceontario.ca
Website: www.healthforceontario.ca
Entry Levels
The following kinds of training or assessment positions are offered to IMGs in Ontario, depending on their level of skill, training, and practice experience.
Entry Level Training Positions (PGY1)
IMGs may apply for PGY1 positions by competing in the Canadian Residency Matching Service (CaRMS) national match, which matches candidates to PGY1 positions in participating medical schools. In the first iteration of the match process, IMGs compete for dedicated positions. Those who are not offered a position in the first iteration may apply for a position in the second iteration. The second iteration is blended and IMGs compete directly with Canadian Medical Graduates (CMGs).
For more details on the match process, visit the CaRMS website at www.carms.ca.
To strengthen their applications for PGY1 positions through the CaRMS match, IMGs may choose to undergo an assessment by the Centre for the Evaluation of Health Professionals Educated Abroad (CEHPEA), which provides standardized evaluation and orientation services for IMGs and other internationally educated health professionals.
CEHPEA offers the comprehensive clinical exam (CE1) to IMG candidates applying to PGY1 residency positions. The CE1 is offered approximately eight times a year. [Note that as of 2008, academic program directors at Ontario medical schools have made the CE1 mandatory for entry into residency programs in some of the medical specialties.] For further information, please consult the CEHPEA website at
www.cehpea.ca.
Advanced Level Training Positions (PGY2+)
Eligible IMGs who do not require a full residency program may apply for Ontario medical training at an advanced postgraduate residency level. In order to be considered eligible for advanced level training, applicants require at least one year of postgraduate education in the specialty to which they are applying.
Evaluation by CEHPEA is mandatory for acceptance into an advanced level residency position. Applicants who meet the basic eligibility requirements may write the
Speciality Specific Written Examination (SWE) and take a
Specialty Specific Clinical Examination (CE2), designed to test applicants’ appropriateness for advanced level training or Practice Ready Assessment (see below). The SWE and CE2 are available in a limited number of specialty areas.
In addition to the SWE and CE2, the evaluation for acceptance into an advanced level residency position includes a portfolio review and an interview. For the most up-to-date list of specialties offered, please check the CEHPEA website at
www.cehpea.ca.
The medical schools make the final selection of candidates for advanced level positions.
Practice Ready Assessment (PRA)
IMGs with recent practice experience may apply for a six month assessment in a supervised clinical setting at a medical school in Ontario to determine whether they need further training or whether they are ready to enter directly into practice. Upon completion of the six month assessment, if they are deemed practice ready, they can apply for registration from the College of Physicians and Surgeons of Ontario. The PRA is available for both family medicine and specialty positions.
Evaluation by CEHPEA is mandatory for the PRA program, and includes the SWE and the CE2. Selection of candidates is the responsibility of the program directors of the residency programs at Ontario’s medical schools.
There are three possible outcomes for candidates who complete the PRA:
- They are deemed practice ready and may apply for certification from the College of Family Physicians of Canada (CFPC) or the Royal College of Physicians and Surgeons of Canada (RCPSC) and for registration with the CPSO; or
- They are found lacking in a particular area but are considered to be suitable for further training. Postgraduate education for a period of up to two years is prescribed; or
- They are found significantly lacking in a number of areas such that two years of postgraduate training would not be sufficient to remediate the deficiencies, and they are dismissed from the program.
Number of Positions Per Year
Ontario offers 200 or more training and assessment positions annually for IMGs. In 2006/07, 218 IMGs and in 2007/08, 235 IMGs, were offered training and assessment positions, exceeding the Ministry’s target of 200.
Language of Examination, Assessment and Training
English.
Dates and Deadlines >>
Prior Postgraduate Training:
Not required.
Recency of Practice/ Clinical Training Criteria:
Please refer to the website of the College of Physicians and Surgeons of Ontario (www.cpso.on.ca)
Disciplines Offered >>
Return-of-Service Agreement (ROS)
IMGs who obtain Ministry-funded assessment or training positions are required to provide
five years return-of-service in a Ministry-approved underserviced community in return for their training or assessment.
Costs
For the latest information on application costs, please consult CaRMS (www.carms.ca) and/or CEHPEA (www.cehpea.ca).
Past Program Statistics
Since 2004/05, Ontario has increased the number of training and assessment opportunities for IMGs from 90 to a minimum of 200 per year. In the last two years Ontario has exceeded the target of 200 training and assessment positions: 218 were offered in 2006/07 and 235 in 2007/08.
Annual Number of IMG Training and Assessment Positions
| Year |
2002/03 |
2003/04 |
2004/05 |
2005/06 |
2006/07 |
2007/08 |
| Reported capacity |
90 |
100 |
200 |
200 |
200 |
200 |
| Total # of positions offered |
106 |
109 |
165 |
156 |
218 |
235 |
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Eligibility Requirements
For information about the CaRMS eligibility requirements, please consult the CaRMS website at
www.carms.ca.
For information about CEHPEA’s eligibility requirements, please visit
www.cehpea.ca.
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Application Process
Information about applying for the CaRMS match can be found at www.carms.ca. For information about the CEHPEA application process, please visit the CEHPEA website at
www.cehpea.ca.
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Selection Process
As described above, the selection processes for training and assessment positions for IMGs who do not meet all of the CPSO’s requirements for registration depend on the entry level for which the IMG is applying (please refer to
Entry Levels). Selection decisions are made by individual medical schools in Ontario.
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About the Program
Please refer to General Information and Eligibility Requirements above.
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Contact Information
HealthForceOntario Marketing and Recruitment Agency
163 Queen Street, 2nd Floor
Toronto, ON M5A 1S1
Canada
Toronto - 416-862-2200
North America - 1-800-596-4046
International - 1-800-596-4046 ext. 4
Hours of Operation:
Monday, Wednesday and Friday: 9 a.m. - 5 p.m. EST
Tuesday and Thursday: 9 a.m. - 8 p.m. EST
AccessCentre@healthforceontario.ca
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Other Programs
Repatriation Program
Under the Repatriation Program, the Ministry offers funding to physicians who are Canadian citizens or permanent residents and who have completed postgraduate residency training elsewhere but require up to two years of additional training to meet the certification requirements of the RCPSC. The program is open to graduates of Canadian, US, and international medical schools.
The Ministry does not limit the number of physicians in the program and will fund all eligible participants who obtain a training position. The availability of positions is dependent on system capacity and varies year to year.
For further information, please email
ppuprogramofficer@ontario.ca or visit http://www.health.gov.on.ca/english/providers/ministry/recruit/repat/repat_mn.html.
Registration through Practice Assessment Program (RPA)
The Registration through Practice Assessment (RPA) program is administered by the CPSO. It provides a pathway to registration in Ontario for physicians, including IMGs, who are currently practising in another Canadian province or the US and who do not meet certain CPSO registration requirements (e.g., certification by RCPSC or CFPC). The RPA involves an intensive on-site assessment of the physician’s current practice and bypasses the need for Royal College and other certification processes. Further information is available on the CPSO website at www.cpso.on.ca.
CPSO Restricted Certificates of Registration
The CPSO may issue restricted certificates of registration, in certain circumstances, to individuals who have not successfully completed all of their examination requirements. For further information, please see www.cpso.on.ca.
Recent Changes: Increasing Access to Practice in Ontario
In June 2008, the Ontario government announced a number of initiatives to create more opportunities for qualified, safe and competent internationally trained doctors to enter medical practice in Ontario.
As part of its overall plan, the government passed legislation, the
Increasing Access to Qualified Health Professionals for Ontarians Act in November 2008. The legislation amends the
Regulated Health Professions Act, 1991 to place a duty on health regulatory Colleges to work with the Minister of Health and Long-Term Care to ensure that Ontarians have access to qualified, skilled and competent health professionals, as a matter of public interest.
In addition, the governing council of the CPSO recently approved four new pathways to registration that make it possible for certain physicians licensed in other parts of Canada or the United States to more easily become registered to practice in Ontario. The new policies came into effect December 1, 2008.
The new pathways apply to the following groups of physicians:
- Physicians with a Canadian medical degree and postgraduate training without RCPSC or CFPC certification –
Pathway 1.
- International medical graduates (IMGs) with Canadian postgraduate training without RCPSC or CFPC certification and practising independently in Canada –
Pathway 2.
- Physicians with a Canadian or US medical degree with US postgraduate training and certification –
Pathway 3.
- IMGs with US postgraduate training and certification –
Pathway 4.
The CPSO council also consulted on two proposed pathways that would make it easier for international medical graduates to become registered to practice in Ontario:
- Non-Family Medicine Specialist IMG with Postgraduate Training and Certification Approved by the RCPSC –
Draft Pathway 5.
- Medical Degree from other than an Approved Jurisdiction with Postgraduate Training not Approved by RCPSC and Practising Independently in Canada –
Draft Pathway 6.
Draft Pathways 5 and 6 have not been approved.
The Ministry and the CPSO continue to work together to ease the transition to practice of internationally trained doctors.
More information about registration policies in Ontario, including alternative pathways to registration, is available on the CPSO website at
www.cpso.on.ca. Future updates will also be posted on the Ministry website at www.health.gov.on.ca.
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