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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 medically 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.
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.
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.
The Medical Council of Canada defines an IMG as an individual who has graduated from a medical school not accredited in Canada or in the U.S.A (by the Committee on Accreditation of Canadian Medical Schools or by the Liaison Committee on Medical Education in the U.S.A). Graduates of a U.S. School of Osteopathic Medicine accredited by the American Osteopathic Association are 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
- postgraduate training or assessment
- return-of-service agreements (practising in an under serviced community for an agreed upon period of time).
The Medical Council of Canada outlines the route to licensure in Canada.
Registration to practise medicine in Canada
Undergraduate medical school
To practise medicine in Canada, you need an acceptable MD (medical doctor) degree granted by an approved university.
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.
In addition to an acceptable medical degree, you have to demonstrate equivalency of your medical knowledge by passing the MCCEE (Medical Council of Canada Evaluating Examination).
IMGs must provide proof of language proficiency. This may involve taking the TOEFL (Test of English as a Foreign Language) and the TSE (Test of Spoken English). In Québec, this involves taking the French examination of the Office Québécois de la langue française.
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. IMG-specific programs also offer assessments.
The Medical Council of Canada has produced a list of partner organisations.
In some cases, specialists can take the certification examinations without additional postgraduate training. This is done through special assessments of equivalency of training by the Royal College of Physicians and Surgeons of Canada.
Selection processes for IMG programs may include:
- written multiple choice or short answer examinations
- file review of training and experience
- objective structured clinical examinations
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 specialty
- in Québec, attestation in family medicine or certification in another specialty is provided through the Collège 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 programme in the province you would like to practise, if such a programme 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 LMCC is also one of the requirements to obtain an independent licence to practise medicine in most of the provinces or territories of Canada.
In addition to a pass standing on the MCCEE, you must have passed the Medical Council of Canada Qualifying Examination Part I (MCCQE Part I) and the Medical Council of Canada Qualifying Examination Part II (MCCQE Part II).
You must have completed a minimum of twelve months of acceptable postgraduate training to be eligible for the MCCQE Part II. Source verification of the medical degree or diploma is required for eligibility to take the MCCQE Part II.
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:
Visit the International Medical Education Directory (IMED) part of the Foundation for Advancement of International Medical Education and Research's (FAIMER) website.
Your medical school, the name of the medical degree and the year of your graduation must be listed on the FAIMER International Medical Education Directory to be accepted in Canada.
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. Fees should be checked at time of applying.
You can use the MCC's Physician Credentials Repository to establish a confidential professional electronic portfolio of their credentials before arriving in Canada. You can request that the Repository share their portfolio with provincial or territorial medical regulatory authorities, certifying and qualifying bodies.
The MCC requires IMGs who are applying for the first time to the MCCEE to open an application with the Physician Credentials Repository and send a certified copy of their final medical diploma. 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) Part II.
Fees should be checked at time of applying.
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 more than 70 countries. If IMGs have obtained Canadian or American board specialty certification, they may apply to the Medical Council of Canada for an exemption from the MCCEE. Fees should be checked at time of applying.
Note: The MCC requires all first-time MCCEE candidates to open an application with the MCC's Physician Credentials Repository and send a certified copy of their medical diploma.