Pathways for International Medical Graduates (IMGs) to Practise Medicine in Canada

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Quick Summary:

International Medical Graduates (IMGs) have multiple routes to practise medicine in Canada, ranging from the CaRMS residency match, to Practice-Ready Assessment (PRA) programmes, to specialist certification pathways for those trained abroad. Doctors from certain advanced jurisdictions may also have streamlined routes. Each option comes with unique requirements and opportunities depending on training background and province.


Canada has a growing need for physicians, yet many internationally trained doctors face challenges in joining the workforce. Fortunately, several structured pathways exist to help IMGs transition into medical practice. Here are the main routes available:

1. The CaRMS Route (Residency Training)

  • CaRMS (Canadian Resident Matching Service) is the most common pathway.

  • IMGs apply for residency positions alongside Canadian medical graduates.

  • Applicants must pass the Medical Council of Canada Qualifying Examination Part I (MCCQE1) and the National Assessment Collaboration (NAC OSCE).

  • Residency spots for IMGs are limited and highly competitive.

  • Once matched and residency is completed, physicians become eligible for full licensure after completing Royal College/CFPC certification exams.

2. Practice-Ready Assessment (PRA) Programmes

For IMGs who have already completed postgraduate training and have independent practice experience abroad, PRA programmes provide an alternative to residency. 

Housemanship is considered as postgraduate training in some provinces so technically, housemanship (at least 12 weeks in Paeds, Surgery, ObGyn, Int. Med and Pschy) + 3 months of independent practice in your home country can be considered as family medicine training. Great shortcut if you ask me. 

  • These programmes exist in provinces like Saskatchewan, Manitoba, British Columbia, Alberta, and Nova Scotia.

  • Doctors undergo a 12-week to 12-month supervised clinical assessment.

  • Successful candidates receive a provisional licence to practise in underserved areas (often rural or northern communities).

  • After fulfilling service requirements, many transition to full licensure.

3. Specialist Certification Route (Royal College of Physicians and Surgeons of Canada)

IMG specialists may be assessed directly by the Royal College of Physicians and Surgeons of Canada (RCPSC).

  • The RCPSC compares foreign training with Canadian residency standards.

  • If deemed equivalent, candidates may directly sit the Royal College exams.

  • If training is partially comparable, doctors may need to complete additional training in Canada.

  • Passing the Royal College exams leads to specialist certification and eligibility for licensure.

4. Family Medicine Certification (College of Family Physicians of Canada – CFPC)

  • Some IMGs can apply for recognition of training directly through the CFPC.

  • Doctors trained in approved jurisdictions (such as the US, UK, Ireland, Australia, New Zealand) may be eligible for exemption from residency and can challenge the CFPC exams directly.

  • Successful completion grants full family medicine certification.

5. Recognised Jurisdictions / Streamlined Pathways

Certain advanced training jurisdictions have streamlined recognition.

  • For example, graduates from the United States (ACGME-accredited programmes), the UK, Australia, New Zealand, and Ireland often have faster access to licensure.

  • Some provinces allow these doctors to bypass lengthy residency or PRA processes.

  • However, requirements still vary between provinces.

6.  Provisional and Restricted Licences

  • Some provinces issue restricted licences allowing IMGs to practise in specific settings (e.g., rural, hospitalist, or under supervision).

  • Over time, doctors may transition to broader practice rights.

  • These licences are often tied to service commitments.


While the road to medical practice in Canada as an IMG is complex, multiple options exist depending on one's training, country of origin, and career goals. CaRMS remains the main entry point, but PRA pathways and specialist certification routes offer viable alternatives, especially for experienced doctors. Physicians from certain advanced countries may benefit from streamlined recognition.


For IMGs, the key steps are to research provincial requirements, understand exam obligations, and prepare early for whichever route best matches their training background.



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