Licensing in Canada for internationally trained physicians

Nine provinces run a Practice-Ready Assessment (PRA) for family physicians. You practise under observation for a period, typically around 12 weeks, and a pass leads to a conditional licence with a return of service. Selection is competitive, and each province sets its own exam and currency rules.

Two routes lead to specialist practice. The Practice Eligibility Route (PER) is national and run by the Royal College; its eligibility step is document based and can be started from abroad, and certification follows the exam and two years of supervised practice in Canada. The specialist PRA is provincial and workplace based. Four provinces run one, Alberta, Manitoba, Quebec, and Nova Scotia, each for the disciplines it is currently assessing, and each asks for a job offer first.

Clinical assistant and associate physician roles let you work under a licensed physician's supervision. You are never the most responsible physician. The role is not a licensure pathway on its own, but licensed time in it counts toward the currency requirement of some PRA programs.

Residency positions are filled through the CaRMS match. You apply to programs, interview, rank them, and the algorithm matches you. Most programs ask for the MCCQE and the NAC, and most program descriptions say what they want in your CV and personal letter.

The Medical Council of Canada (MCC) runs the MCCQE, the NAC Examination, and the TDM Examination. Which ones you need depends on the route and the province. Start with the format of each exam, then build a study plan around it.