Canada's healthcare system

Canada has a comprehensive healthcare service for the entire population, called Medicare. It is publicly funded.

The service provides universal coverage for medical hospital services based on need rather than the ability to pay.

Primary care is the foundation of the healthcare system. Patients do not pay for medical consultations or treatment and can have direct access to specialists without needing a GP referral.

Immigration

Before leaving the UK, you will need to apply to the Canadian High Commission for a work permit. This is only issued on the basis of a temporary offer of employment endorsed by the government.

Following that, the Canada Employment Centre must certify that there are no qualified Canadian citizens/permanent residents who are available to undertake the position offered.

The province of Quebec has a similar, but separate immigration procedure.

You will also need a medical examination carried out by an approved GP.  

For further details on immigration requirements, contact the Canadian High Commission in London.

International medical graduates

Most healthcare organisations refer to physicians who have received their medical education abroad as IMGs (international medical graduates).

This can include physicians coming from a wide range of backgrounds:

• may have several years of independent practice experience in his/her country
• may have just recently completed medical school
• may have completed a residency training program
• may have gone directly into practice with no requirement for a residency
• may be from a country with a medical education system similar to Canada's
• may be from a country whose medical education system is very different from Canada's
• may be from a country whose medical education system is different from Canada's.

The Medical Council of Canada (MCC) defines an IMG as an individual who has graduated from an international medical school listed in the World Directory of Medical Schools. Graduates of a U.S. School of Osteopathic Medicine accredited by the American Osteopathic Association are also considered IMGs.

What to consider as an IMG 

Before starting the licensure process in Canada, you will need to consider that:

• there is no guarantee of obtaining a licence to practise in Canada
• the licensure process has many stages and can seem complex to those not familiar with the Canadian approach
• there are differences in the registration processes between provinces and territories
• there is a significant financial and personal commitment required to pursue licensure.

Depending on the province or territory, licensure may involve:

• a series of examinations (eligibility, program selection, qualifying, certification)
• language proficiency tests
• credentialing
• postgraduate training or assessment
• return-of-service agreements (practising in an under serviced community for an agreed upon period of time).

The MCC outlines the pathways to licensure. This video provides an overview of the route to Canadian licensure.

Registration to practise medicine in Canada

Language

All practising physicians in Canada need to be able to communicate clearly with their patients in English or French. For IMGs whose medical degree is from a country where the first language is neither English nor French, demonstrating language proficiency in one of the two official languages is part of the pathway to licensure set by medical regulatory authorities (MRAs).

Several language testing options are available, and the one(s) you choose may depend on your goals, skill level, or the timeline of your planned immigration. For example, candidates may elect to take a language test prior to taking the MCC exams to prepare for success.

Undergraduate medical school

To practise medicine in Canada, you need an acceptable MD (medical doctor) degree granted by an approved university.

A physiciansapply.ca account will give you access to important services, including submitting documentation verification requests, applying for MCC examinations.

Your acceptable medical degree can be source verified by the MCC through your physiciansapply.ca account. 

Source verification is the process by which the MCC sends your credential to the issuing institution (the source) and requests that they confirm that they issued the credential and that it is authentic, accurate, and valid (verification). This process is completed in collaboration with the Educational Commission for Foreign Medical Graduates (ECFMG), a member of Intealth.

The Medical Council of Canada's Physician Credentials Repository (PCRC)

Your acceptable medical degree must be source verified by the Medical Council of Canada's PCRC (Physician Credentials Repository).

You must check with the organisation with whom you are applying which documents need to be sent to the repository. Once verified, the documents are stored for life in the repository, and can be shared with many organisations.

Medical knowledge

Pass the MCC Qualifying Examination (MCCQE) Part I

The MCCQE Part I is a Canadian national standardized examination that assesses the critical medical knowledge and clinical decision-making ability of a candidate at a level expected of a student about to graduate with a medical degree in Canada.

Pass the National Assessment Collaboration (NAC) Examination

The NAC Examination is a Canadian national standardized examination that assesses international medical students’ and IMGs’ readiness to enter supervised training in Canada. For example, this exam is required for those looking to apply  to the Canadian Resident Matching Service (CaRMS) for entry into a postgraduate training program, as well as a screening tool for some provincial Practice-Ready Assessment (PRA) programs.

Postgraduate training

All Canadian medical graduates must complete an accredited postgraduate training program (often referred to as "residency training") to be eligible to take the certification examinations.

The length of postgraduate medical training undertaken through a Canadian-accredited medical school is:

• two years for family medicine
• four to five years for other specialties.

Postgraduate trainees, called "residents", practise under an educational licence and cannot practise without supervision.

As an IMG, you must complete supervised clinical training or assessment to meet licensure educational requirements. The number of places in the assessment programs and postgraduate training system are limited.

CaRMS and IMG-specific programs ( are the main points of access to postgraduate training. The Practice-Ready Assessment (PRA) programs provide an accelerated pathway to licensure for IMGs who have already completed their residency and practised independently abroad.

International residency programs are also available to internationally trained physicians who graduated from accredited postgraduate training, meet the eligibility requirements, and may or may not have started practice. This is done through special assessments of equivalency of training by the Royal College of Physicians and Surgeons of Canada, the College of Family Physicians of Canada, and the Collège des Médecins du Québec.

Selection processes for IMG programs may include:

• written multiple choice or short answer examinations
• file review of training and experience
• objective structured clinical examinations
• interviews.

Upon completion of residency training, you must pass the following certification examinations:

• the College of Family Physicians of Canada Certification Examination for family medicine
• the Royal College of Physicians and Surgeons of Canada Certification Examination specific to your speciality
• in Quebec, attestation in family medicine or certification in another specialty is provided through the College des médecins du Québec.

Provincial or territorial registration and licensure

Each province or territory is responsible for the regulation of the practice of medicine in their respective jurisdiction. For the most current licensure information and provisions, you should:

• contact the medical regulatory authority in the province or territory in which you would like to practise
• contact the international medical graduate program in the province you would like to practise, if such a program exists.

All provinces and territories accept the LMCC (Licentiate of the Medical Council of Canada) and certifications from the College of Family Physicians of Canada and the Royal College of Physicians and Surgeons of Canada. Provinces and territories also accept other qualifications for licensure on an individual basis.

Licentiate of the Medical Council of Canada (LMCC)

The Licentiate of the Medical Council of Canada (LMCC) is granted by the MCC and is part of the requirements set by the provincial and territorial medical regulatory authorities (MRAs) to be granted license to practise medicine in their respective jurisdictions.

How to get started

There are general steps that you should take before arriving in Canada, and steps you should take after your arrival.

In support of the requirements outlined in this guidance, follow these steps to start the licensure process: