RETURNING TO CANADA
PATHWAY 1: US ACGME RESIDENCY
After completing an ACGME residency in the US, you will be eligible to apply for medical licensure in Canada. To obtain licensure, you must meet the four requirements of the Canadian Standard - the set of qualifications that makes a candidate eligible for full licensure in every province and territory. Once this has been met, the process of applying for and obtaining a Canadian medical license varies from province to province.
THE CANADIAN STANDARD
The Canadian Standard was established by the Federation of Medical Regulatory Authorities of Canada (FMRAC). It is a combination of qualifications from different regulatory bodies in Canada which, when met, make a candidate eligible for licensure in their medical specialty in all provinces and territories. From the MCC website:
Physicians applying for the first time to become licensed to practice medicine in a Canadian jurisdiction may achieve full licensure only if they:
1. Have a medical degree [from a medical school that, at the time the candidate completed the program, was listed in the FAIMER’s International Medical Education Directory (IMED) or the WHO’s World Directory of Medical Schools (WDMS) Seventh Edition (2000)], or a Doctor of Osteopathic Medicine degree from a school in the United States accredited by the American Osteopathic Association Commission on Osteopathic College Accreditation; and
2. Are a Licentiate of the Medical Council of Canada; and
3. Have satisfactorily completed a discipline-appropriate postgraduate training program in allopathic medicine and an evaluation by a recognized authority; and
4. Have achieved certification from the College of Family Physicians of Canada or the Royal College of Physicians and Surgeons of Canada or the Collège des médecins du Québec.
The Canadian Standard does not grant a medical license, only eligibility to become licensed. It is a federal set of qualifications, whereas the ability to grant a medical license is held by the provinces. Once the above qualifications have been met, you will then be able to apply for a medical license through provincial regulatory bodies.
BREAKING DOWN THE CANADIAN STANDARD
1 AND 3: Obtain an acceptable medical license, and have complete graduate medical training in an allopathic program - have already been met! You have your DO degree and have completed an ACGME residency. Congratulations, you are half way there.
2 - BECOMING A LICENCIATE OF THE MCC: Becoming a Licentiate of the Medical Council of Canada (LMCC) is achieved by completing the Canadian Board Exams, which are administered by the MCC. As IMGs, obtaining licensure will require DOs to take theCanadian medical boards - the MCCEE, MCCQE, and NAC OSCE. The process is therefore very expensive. You may have taken the MCCEE and NAC OSCE in medical school, which puts you ahead of the game. Either way there are several steps that must be taken to take the rest of the Canadian boards and apply for licensure.The following steps are outlined on the MCC website.
BEFORE YOU RETURN TO CANADA
STEP 1. Confirm that your medical degree is from a recognized medical school - US DO schools are all recognized medical schools.
STEP 2. Take an online self-assessment exam ONLY IF the MCC will not grant an exemption (see STEP 4). This will be important particularly for those finishing residency, as the US board exams will be ancient history at this point. IMGs can test their readiness for the Medical Council of Canada Evaluating Examination (MCCEE) through the Medical Council of Canada Self Administered Evaluating Examination (SAE – EE). IMGs who take the SAE – EE will receive the number of questions correctly answered as well as a percentile table that compares their performance to the results achieved by other MCCEE candidates.
STEP 3. Submit your credentials with the Medical Council of Canada (MCC) Physician Credentials Repository. IMGs can use the MCC Physician Credentials Repository to establish a confidential professional electronic portfolio of their credentials prior to arriving in Canada. IMGs can share their portfolio with provincial/territorial medical regulatory authorities, certifying and qualifying bodies. The MCC requires that IMGs who are applying for the first time to the MCCEE send a copy of their final medical diploma to the MCC Physician Credentials Repository. The diploma must be successfully source verified through the Repository for the candidate to be eligible to the Medical Council of Canada Qualifying Examination (MCCQE).
Fees: To access Repository services, IMGs must open a physiciansapply.ca account. A one-time account fee is involved with the creation of an account. Additional document fees are also charged for each medical document submitted for source verification.
STEP 4. Take the Medical Council of Canada Evaluating Examination (MCCEE). IMGs must pass the MCCEE to apply for a residency position through the Canadian Resident Matching Service. The MCCEE is offered in 500 sites in 80 countries.If IMGs have obtained Canadian or American board specialty certification, they may apply to the MCC for an exemption from the MCCEE.
Note: The MCC requires all first-time MCCEE candidates to open a physiciansapply.ca account and send a student attestation or a copy of their medical diploma to the MCC Physician Credentials Repository for source verification.
AFTER ARRIVING IN CANADA
All provinces have the right to request additional assessments to qualify for residency positions in their province. These assessments may include the National Assessment Collaboration (NAC) examination, which is only administered in Canada. Candidates must take the MCCEE before being eligible to take the NAC examination, and certain jurisdictions may add region-specific eligibility criteria for certain provincially funded training positions.IMGs may be required to pass the Medical Council of Canada Qualifying Examination (MCCQE) Part I and Part II (additional fees apply). Candidates may also take a self-assessment exam to help prepare for the multiple-choice component of the MCCQE Part I. This self-assessment is offered over the Internet and can be completed before arriving in Canada. The MCCQE Part I and the MCCQE Part II are administered in Canada and are also required for graduates from Canadian faculties of medicine. All jurisdictions also require a minimum of two years of postgraduate training for licensure. When IMGs pass the MCCQE Part II or the new Certification Examination in Family Medicine, they are awarded the Licentiate of the Medical Council of Canada. The Licentiate is required for candidates to meet the Canadian Standard for full licensure, as defined through the Federation of Medical Regulatory Authorities of Canada. IMGs who are considering practicing or completing their medical training in Canada should be aware of the requirements for medical liability protection in Canada. For more information, please contact the Canadian Medical Protective Association.
4 - CERTIFICATION FROM RCPSC: Certification from the Royal College of Physicians and Surgeons of Canada (RCPSC) has two steps - credentialing, and examination.
CREDENTIALING: Credentialing is the process of verifying that a physician has met all the requirements necessary for Royal College certification. To become eligible for the next stage of assessment - examination - physicians must meet an array of credentialing requirements set by the Credentials Committee and a designated specialty committee of the Royal College. Applicants who have completed some or all residency training in an Accreditation Council for Graduate Medical Education (ACGME) accredited training program in the United States must apply for an assessment of training to ensure that your training satisfactorily meets the Canadian specialty specific training requirements. The Application for Assessment of Training is available on the RSCPC WEBSITE. Many ACGME accredited programs are shorter than Royal College accredited programs. In order for your Application for Assessment of Training to be successful, you must ensure that your residency training meets the Canadian requirements. You are encouraged to review the Canadian Specialty Training Requirements of your specialty to see whether your training is adequate in duration and content to fulfill Canadian requirements for eligibility to certification.
EXAMINATION: Once your Application for Assessment of Training has been successful, you can apply to sit for the certification examination administered by the College. Information on registering for and taking specialty examinations can be found HERE.
Each province and territory has its own regulatory body for granting medical licenses. The processes vary from province to province, and a thorough review of each is beyond the scope of this website. Once you have completed the requirements for the Canadian Standard, access your province's procedures and requirements for medical licensure.
Medical regulatory authorities:
Collège des médecins du Québec
College of Physicians and Surgeons of Alberta
College of Physicians and Surgeons of British Columbia
College of Physicians and Surgeons of Manitoba
College of Physicians and Surgeons of New Brunswick
College of Physicians and Surgeons of Newfoundland & Labrador
College of Physicians and Surgeons of Nova Scotia
College of Physicians and Surgeons of Ontario
College of Physicians and Surgeons of Prince Edward Island
College of Physicians and Surgeons of Saskatchewan
Government of the Northwest Territories
Nunavut Department of Health and Social Services, Medical Registration Committee
Yukon Medical Council
Provincial IMG programs
Alberta Clinical and Surgical Assistant Program
Alberta International Medical Graduate Program
Centre for the Evaluation of Health Professionals Educated Abroad (Ontario)
Clinical Skills Assessment and Training Program (Newfoundland and Labrador)
Clinician Assessment for Practice Program (Nova Scotia)
HealthForceOntario Access Centre
Medical Licensure Program for International Medical Graduates (Manitoba)
Collège des médecins du Québec
Saskatchewan International Physician Practice Assessment (SIPPA)