How Internationally Trained Doctors Get Licensed in Canada

Who qualifies as an IMG in Canada

An International Medical Graduate (IMG) is anyone who completed their medical degree outside Canada or the United States. Eligibility for licensing routes generally depends on your medical degree being listed in the World Directory of Medical Schools, your postgraduate training and years of independent clinical practice, and — for the Practice-Ready Assessment route specifically — a minimum of recent, verifiable clinical experience, often around three to five years, though exact thresholds vary by province and change periodically.

Family doctors and generalists tend to have the most PRA options, while some specialists find the CaRMS residency route more realistic simply because dedicated specialty PRA seats are scarce. It is worth mapping your specialty against current provincial programmes before deciding which route to pursue, since this single decision shapes your entire timeline.

The two main routes into practice

1. CaRMS residency route — you compete through the Canadian Resident Matching Service (CaRMS) for a Canadian residency position, the same system used by Canadian medical graduates, with a defined number of IMG-designated positions each year. After matching, you complete a full residency (typically two to six years depending on specialty), then sit certification exams with the College of Family Physicians of Canada (CFPC) or the Royal College of Physicians and Surgeons of Canada (RCPSC).

2. Practice-Ready Assessment (PRA) route — designed for IMGs who already have substantial independent practice experience. Instead of full residency, you complete a supervised clinical assessment, typically around 8–12 weeks, evaluated by an assessor. Provinces run their own PRA-style programmes under different names, for example Practice Ready Ontario, PRA-BC in British Columbia, PRA-NB in New Brunswick, and the Saskatchewan International Physician Practice Assessment (SIPPA).

The exams, named and explained

• MCCQE Part I (Medical Council of Canada Qualifying Examination Part I) — a computer-based exam testing clinical knowledge, clinical decision-making and problem solving, delivered at Prometric test centres. Most licensing and CaRMS routes require it.
• NAC Examination (National Assessment Collaboration Examination) — an OSCE-style clinical skills exam specifically for IMGs, assessing history-taking, physical examination and clinical reasoning against Canadian standards. A strong NAC result is typically required before entering a PRA programme or applying through CaRMS as an IMG.
• MCCQE Part II — taken during residency, assessing clinical skills in a Canadian training context; required for full certification via CFPC or RCPSC.

Document verification: physiciansapply.ca

The Medical Council of Canada operates physiciansapply.ca, the centralised portal IMGs use to have their medical degree, postgraduate training and identity documents source-verified. Most provincial colleges and CaRMS require a completed physiciansapply.ca profile before they will process your application, so this is usually the first practical step once you decide to pursue licensing in Canada.

Provincial colleges you'll deal with

Medical licensing in Canada is provincial, not national. You will ultimately register with the college in the province where you plan to practise, such as:

• College of Physicians and Surgeons of Ontario (CPSO)
• College of Physicians and Surgeons of Alberta (CPSA)
• College of Physicians and Surgeons of British Columbia (CPSBC)
• Equivalent colleges in Manitoba, Saskatchewan, the Atlantic provinces and the territories.

Each college sets its own PRA eligibility criteria, provisional/conditional licensure terms, and supervision requirements, so the easiest province to choose depends heavily on your specialty and experience profile — this is worth researching carefully before applying.

Provisional and conditional licensure

Many provinces offer a provisional or conditional licence that allows a physician to practise under defined supervision while completing a PRA or the early stages of the assessment process. This is not the same as full, unrestricted licensure — conditions typically lift once you pass your assessment and meet any outstanding requirements set by the college. In practice, this means you can often start earning a Canadian salary and building local references well before your final certification is complete, provided you remain within your supervisor's defined scope of practice.

Timelines and indicative costs

The PRA route is considerably faster: allow roughly 18 months to 3 years from starting document verification to full licensure, depending on exam scheduling, PRA availability (places are limited and competitive) and the college's own processing times. The CaRMS residency route is longer, typically 4–7 years once residency and certification exams are included.

Indicative costs (confirm current fees on mcc.ca, cic.gc.ca-linked college sites and physiciansapply.ca): MCCQE Part I and NAC exam fees each run into the low thousands of Canadian dollars, plus physiciansapply.ca verification fees, provincial registration fees, and PRA programme fees where applicable. Budget for exam retakes, travel to test centres, and living costs during any supervised assessment period.

Pitfalls to avoid

The biggest mistakes are applying to a PRA programme before checking its specific experience thresholds, underestimating how competitive PRA seats are in popular provinces, and delaying physiciansapply.ca verification — which can itself take months. Specialty matters too: PRA availability is often concentrated in family medicine, so specialists may find the CaRMS route more realistic despite the longer timeline.

How Ava Medical helps

Ava Medical is free for doctors, always. We help you assess which province and route — PRA or CaRMS — fits your specialty and experience, keep your physiciansapply.ca and college applications on track, and connect you with Canadian health authorities actively recruiting IMGs. Speak to Ava Medical to map out the fastest realistic route to practising medicine in Canada.

Frequently asked questions