Medical Council of Canada
1021 Thomas Spratt Place
Ottawa, ON Canada, K1G 5L5
T : 1-613-521-6012
F : 1-613-248-5234
E : [email protected]
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The Medical Council of Canada (MCC) recognizes the importance of clear information for internationally trained physicians (ITPs) who are considering a future in Canada’s health care system. That is why we have developed practical guidance to help you understand what steps to take before arriving in Canada.
The steps outlined below may be completed outside Canada, allowing you to maintain your clinical practice and professional networks while progressing toward licensure in Canada.
The IMG-L framework includes four essential requirements to prepare for relocating to Canada:
It is essential to hold a valid immigration status—such as a work permit, permanent resident status, or Canadian citizenship—to work in Canada. A valid immigration status is required for the Canadian Residency Matching Service (CaRMS) and some Practice-Ready Assessment (PRA) routes.
As an ITP, you may be eligible to apply for permanent residence in Canada before arrival through the Express Entry system, which is the Canadian government’s online platform for managing applications under three immigration programs:
To become an Express Entry candidate, you must first meet the eligibility requirements of at least one of these three programs. Once your profile is submitted, you are assigned a Comprehensive Ranking System (CRS) score—a standardized point-based assessment of core human capital factors, which are key attributes that include age, education, language proficiency in English and/or French, skilled work experience, and others. Candidates with the highest scores are invited to apply for permanent residence during scheduled rounds of invitations by Immigration, Refugees and Citizenship Canada (IRCC).
IRCC conducts three types of invitation rounds throughout the year. Understanding the structure and purpose of each type can help you better understand your likelihood of receiving an invitation:
In the category-based rounds of invitation, there are two categories that are particularly relevant to ITPs:
To know whether you are ready to apply and if you are likely to receive an invitation, it is important to compare your CRS score with the minimum scores in recent invitation rounds. IRCC publishes detailed information about each Express Entry round, including:
You can view the full history of Express Entry invitations and IRCC ministerial instructions on the Government of Canada website.
To estimate your CRS score and explore how changes to your profile might affect the likeliness of receiving an invitation, you can use the official CRS calculator.
A number of Canadian provinces and territories offer immigration pathways for ITPs, often in partnership with public health authorities. Below is an overview of provinces that have a nominee program.
The BC Provincial Nominee Program offers pathways through Skills Immigration, Express Entry BC, and the Health Authority stream. If you have a job offer from a public health authority, or if you have been endorsed by a health authority even without direct employment, you may be eligible to apply.
The Alberta Advantage Immigration Program offers a Dedicated Health Care Pathway if you have a valid job offer from an Alberta health sector employer to work as a physician and you meet licensure requirements.
The Saskatchewan Immigrant Nominee Program offers the Health Talent Pathway if you have a valid job offer to work as a physician in Saskatchewan. You may also register with the International Healthcare Worker EOI Pool to be connected with potential employers in Saskatchewan.
The Ontario Immigrant Nominee Program offers several immigration pathways for ITPs. The following three program streams are relevant to physicians:
Under the Nova Scotia Nominee Program, general practitioners, family physicians, and specialist physicians with approved job offers from the Nova Scotia Health Authority or the IWK Health Centre can be nominated. This simplifies the immigration process by reducing paperwork and speeding up the application process.
Processing times can vary based on application type, country of residence, and current immigration volumes. To view the estimated processing time for your application, visit IRCC’s Check processing times.
Candidates are encouraged to visit the Immigration, Refugees and Citizenship Canada website to explore pathways such as Express Entry and Provincial Nominee Programs. When seeking support, ensure that any immigration consultant or lawyer you engage is accredited by a recognized regulatory body by verifying their licensing and membership.
For consultants, you can check the College of Immigration and Citizenship Consultants (CICC) Public Register to confirm their status as one of the following:
For lawyers, you can consult the following:
Before you arrive in Canada, you can take these important steps towards licensure:
Most licensing pathways require an active physiciansapply.ca account with the MCC. Through this portal, you can upload identity documents and the MCC can begin source verification of your medical credentials. Source verification is also a prerequisite for obtaining an Educational Credential Assessment, a common requirement for Express Entry and other immigration programs.
The Medical Council of Canada Qualifying Examination (MCCQE) Part I is offered internationally in test centres and through remote proctoring. This lets you complete this step while maintaining clinical responsibilities in your country of residence.
The National Assessment Collaboration (NAC) Examination is an objective structured clinical examination that is only delivered in Canada. It cannot be completed remotely. However, many candidates travel on a visitor visa for the exam and return to their country of residence afterward. You should plan for exam dates, travel, and results timelines when making your preparations.
In many provinces and territories, you may begin an application for licence eligibility before moving to Canada. Roles such as clinical assistant, associate physician, or family/general practitioner often have distinct licensing routes, some of which may not require an examination if the candidate meets certain independent practice thresholds. More details are available in the MCC’s Physician Licensing in Canada eBook. Use this eBook to understand the requirements for applying to each province and territory in these roles. It can help you decide which province or territory and program best match your qualifications and experience.
If you are an internationally trained specialist, you may be able to pursue Canadian certification in your field by applying for the Royal College of Physicians and Surgeons of Canada (Royal College) for exam eligibility through the Practice Eligibility Route. This pathway is for physicians who have completed their specialty postgraduate training abroad. This route allows you to be assessed for comparability to Canadian standards and, if approved, to take the Royal College certification examination in your specialty. You must meet specific criteria related to your training, and the requirements vary among each specialty. You should also apply well in advance, as the assessment process can take several months, and most specialty examinations are offered only once a year.
For complete eligibility requirements and application guidance, visit the Royal College website.
Maintaining recent clinical practice is a common requirement for licensure across various pathways. While specific allowances vary by jurisdiction, a prolonged interruption—often referred to as a “practice gap”— makes it more difficult to meet eligibility criteria for programs such as CaRMS and PRA pathways. Whenever possible, you are encouraged to remain in active clinical practice until the transition to licensure in Canada is well underway. One way to reduce the impact of a practice gap is to start the licensing process as early as possible while continuing to practise independently in your country of residence or in another jurisdiction where you hold independent licensure.
Note that certain activities do not constitute a practice gap. Full-time enrolment in a medical school program or participation in a postgraduate residency program that is accredited according to the national accreditation standards of your country of residence is generally not considered a practice gap. Similarly, completion of an accredited internship year or participation in a clinical fellowship—where the fellowship includes direct patient care responsibilities—is typically not regarded as a gap, although rare exceptions may apply.
By contrast, clinical research positions where the physician does not hold a medical licence to practise (whether or not the research is educationally focused) are generally considered a gap in practice. Volunteer roles without an active medical licence, as well as positions such as medical assistant, are also considered gaps and are not recognized as maintaining clinical currency.
Clinical assistant or associate physician roles are not equivalent to independent clinical practice. However, in some jurisdictions and under certain PRA programs, time worked as a licensed clinical assistant or associate physician in Canada may be recognized as current clinical practice for the purposes of bridging a gap. For example, Saskatchewan and Ontario currently allow time in such roles to be counted as recent clinical experience to meet the requirements of their PRA – Family Medicine pathways. Other provinces and territories may not yet recognize this type of experience to meet currency-of-practice requirements.
The MCC acknowledges that physicians may experience unavoidable interruptions in their practice because of displacement, family emergencies, or other personal or systemic hardships. Nonetheless, it is important to anticipate potential delays—such as those associated with credential verification or examination scheduling—and to plan proactively to minimize practice gaps. These efforts will support a smoother transition to medical practice in Canada.
Every province or territory requires proficiency in the language of practice. This is typically English, except in New Brunswick, where either English or French is accepted, and in Quebec, where French is required. While provincial or territorial programs define the final criteria, most adhere to the following minimum standards:
To demonstrate English proficiency there are three acceptable tests and the minimum score (achieved within 24 months of your application to a provincial or territorial program) for each is as follows:
To demonstrate proficiency in French in Quebec, you must achieve a pass result on the Office québécois de la langue française (OQLF) examination.
Exemptions to language requirements may apply if you have completed undergraduate or postgraduate training in an English- or French-speaking country or if you can demonstrate that most of your education or patient care has been in English or French. Individual provincial and territorial programs determine if you are eligible for an exemption. Please refer to their respective websites for full criteria.
The journey to licensure in Canada is complex, but it can be more manageable if you have the right information and prepare accordingly. The MCC is committed to assisting you in this journey with reliable, centralized resources. We are also committed to working with regulatory bodies and PRA programs to ensure that licensure pathways are clear, efficient, and equitable.
Explore MCC’s eBook for more details on licensing requirements and pathways across Canada:
1021 Thomas Spratt Place
Ottawa, ON Canada, K1G 5L5
T : 1-613-521-6012
F : 1-613-248-5234
E : [email protected]