Foreign-Trained Doctor Credential Recognition Program Coming In Ontario

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The College of Physicians and Surgeons of Ontario says a three-month program to recognize the foreign credentials of physicians could be in place in the province by as early as next spring.

In submission to Ontario’s ministry of health earlier this year, the self-regulating body for Ontario’s medical profession proposes a 12-week program for internationally-trained physicians in Ontario.

“Practice Ready Assessment (PRA) programs are used in seven provinces across Canada to support the licensure of internationally-trained physicians who have already completed their training and practiced independently abroad,” notes the CPSO.

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Through such a program, the regulatory body would:

  • rapidly assess the qualifications of foreign-trained physicians over a 12-week period through supervision and direct observation;
  • deploy successful candidates to underserviced communities, and;
  • provide a path to independent licensure for these foreign-trained physicians.

“With government funding and coordination among key system partners, a program could be implemented immediately and begin injecting a new supply of IEPs into the system as early as spring 2023 and onwards,” notes the CPSO in its submission.

It was presented to Ontario Health Minister Sylvia Jones in mid-August.

The regulatory body is also advocating for more residency positions for internationally-trained physicians.

“As only a small number of residency positions are accessible to internationally-educated physicians, Ontario is essentially limiting the opportunity to quickly grow our base of future physicians and support (them),” noted the CPSO.

“We ask government to immediately increase the number of residency positions available to internationally-educated physicians. 

“With consideration to how this increase in positions may impact other jurisdictions facing their own health human resource shortage, government should create targeted or additional spots for internationally-educated physicians already in the province, including Canadians who have studied abroad and are looking to complete their residency in Ontario.”

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Those who study medicine outside Canada, including both foreign nationals and Canadians who choose to study medicine in other countries, are often stymied in practicing medicine in Canada because of a lack of sufficient residency spots for them.

“The messaging for so long has been that it’s nearly impossible to get a bloody residency in Canada if you’re an international graduate,” Peter Nealon,  chief executive officer of the Atlantic Bridge Program, reportedly told The Globe and Mail national daily newspaper.

“These people are the cream of the crop and they’re simply going elsewhere because they’re in demand. You tell people to go away long enough, and eventually, they go away.”

CPSO Eyeing Faster Processes To Recognize Foreign Credentials Of Physicians

In Ontario, the CPSO wants to turn the tide and prevent that brain drain by putting in better ways to recognize foreign credentials of physicians.

“The Royal College of Physicians and Surgeons of Canada and the College of Family Physicians of Canada have training assessment programs to streamline credentialing for internationally-educated physicians from specific jurisdictions who have completed training in approved jurisdictions deemed equivalent to Canadian education standards,” notes the regulatory body in its submission to the Ontario government. 

“In turn, CPSO facilitates streamlined pathways to licensure for internationally-educated physicians who are undergoing these processes. In consultation with other regulators and system partners, CPSO is re-evaluating whether additional equivalencies and pathways could be explored in lieu of completing national examinations based on, for example, years of practice.”

The paucity of residency positions for internationally-educated physicians, though, remains a stumbling block – and the problem is getting worse, not better. 

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The number of residency spots for internationally-educated physicians has been dwindling since the late 1980s despite the growing shortage of healthcare professionals in Canada and Immigration, Refugees and Citizenship Canada’s (IRCC) efforts to open up immigration programs to healthcare workers, including physicians and nurses.

This year, only 13 per cent of the spots in residency programs in Canada, or 439 of the total 3,295, are filled by those who graduated from medical schools outside of the country, reports The Globe and Mail.

That’s down from 499 a decade ago and 700 residency spots for foreign-trained doctors in the late 1980s, reports the national newspaper.

And yet, foreign-educated doctors are widely-regarded as a possible fix for at least part of Canada’s healthcare labour shortage.

Across Canada, just under one in three doctors is already foreign-educated, and nowhere is that truer than among family physicians.

But fewer and fewer internationally-educated doctors are now even bothering to apply for Canada’s dwindling number of residency spots.

Additional Residencies For Foreign-Trained Doctors Vital To Resolving Labour Shortage

The Canadian Resident Matching Service (CaRMS), the national organization that matches medical school students with postgraduate training residencies, has reportedly said international applications for entry-level positions fell by 40 per cent, from 2,219 in 2013 to 1,322 in 2022.

Experts are increasingly in agreement that creating more residencies for international medical school graduates could help Canada resolve its physician labour shortage.

Those foreign nationals aspiring to practice medicine in Canada first have to complete a bachelor’s degree and then get a medical degree from a school accredited by Canada. That entire educational process usually takes seven years.

The newly-graduated applicants must then pass the Medical Council of Canada Qualifying Examination (MCCQE) Part 1 exam and the National Assessment Collaboration (NAC) Examination, the latter of which accesses their readiness for a Canadian residency program.

Once that’s done, the foreign national has to apply for a Canadian work permit with the IRCC and apply for a post-graduate residency spot through CaRMS.

Physicians can also apply for permanent residence through the Federal Skilled Worker Program or the Canadian Experience Class.

Under the Provincial Nominee Program, provinces and territories can also nominate physicians for permanent residence if they meet particular regional labour market needs and intend to settle in that province or territory. Provinces can recruit candidates from the Express Entry pool or they can nominate individuals under their non-Express Entry paper-based streams.

Medical Council Of Canada Sets National Standards For Physicians

Before a physician can practice in Canada, he or she needs to have his or her qualifications recognized.

The national organization that sets standards for physicians, including immigrating physicians, is the Ottawa-based Medical Council of Canada (MCC). It does not confer or issue licences to physicians. That responsibility belongs to the provincial and territorial medical regulatory authorities.

Those who are successful in obtaining one of the few residency spots for international grads will then be supervised by a Canadian medical school for at least two years before taking their certification exam in family medicine and getting their certification to join the College of Family Physicians of Canada (CFPC).

The last step is to apply for a license from a provincial or territorial medical regulator to practice family medicine there.

International medical graduates can see if their medical college will be readily acceptable to the licensing body, the medical college, in each province. It is the physician’s responsibility to check whether his or her medical school is listed in the World Directory of Medical Schools, something that can be done by visiting

Once a physician finds his or her college in that online directory, the next step is to check the “Sponsor Note” tab and see if it states “Canada Note”. This means medical degrees obtained from this medical school are acceptable to the provincial and territorial medical regulatory authorities in Canada and therefore acceptable to all medical organizations in Canada.

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