Family physicians and general practitioners trained abroad

The MCC describes a Practice-Ready Assessment (PRA) as an accelerated route to a licence for internationally trained physicians (ITPs) who have completed their postgraduate medical training and have practised independently outside Canada. Nine provinces run one in family medicine. You apply to a provincial program, not to the MCC.

Which provinces run one

The MCC says nine provinces currently run independent PRA programs. Most of these are in family medicine, although a few provinces offer assessments in other specialties.

The nine provinces with a family medicine PRA are British Columbia, Alberta, Saskatchewan, Manitoba, Ontario, Quebec, New Brunswick, Nova Scotia, and Newfoundland and Labrador. Requirements differ between programs.

Prince Edward Island does not run one. According to the MCC, Prince Edward Island, Yukon, Nunavut and the Northwest Territories do not offer practice assessments within the NAC's pan-Canadian framework at this time.

What the assessment is

Each program offers a clinical workplace-based assessment lasting approximately 12 weeks. It is a supervised period of real practice in which trained physician assessors observe your work and decide on your readiness for independent practice. In family medicine, selection is competitive. The outcome is a provisional or conditional provincial licence and, in most provinces, a return of service.

Where to apply

IMGs apply to provincial PRA programs. The MCC says qualified ITPs who wish to apply to a PRA program should apply directly to their preferred or provincial PRA program.

Why the programs resemble each other (the NAC PRA framework)

The Medical Council of Canada (MCC) oversees a collaboration with the nine provincial programs to develop and maintain common guidelines, tools, research, and support materials through the National Assessment Collaboration Practice-Ready Assessment (NAC PRA) framework. As each provincial program is independently run, this pan-Canadian collaboration ensures comparable and transparent assessments, with portable results, for all candidates regardless of the assessment jurisdiction.

More on this site: Eligibility Screener

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This answer is my reading of the official source, not official or legal advice. It may be incomplete, out of date or wrong, and I take no responsibility for decisions made on it: confirm on the official page before you act. Disclaimer

PER eligibility is national and document-based, and the route leads to Royal College certification after passing the exam and completing 2 years of supervised practice in Canada. A PRA is provincial and workplace-based: a licensed physician observes your practice over a defined period, and the outcome is a provincial licence with a return of service. The PER carries no return of service. The two routes can suit different profiles, and some physicians qualify for both.

Official source: Medical Council of Canada: Practice-ready assessment Checked 2026-09-29

• Royal College: Practice Eligibility Route

More on this site: PER guide

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The MCC describes two resources.

Licensure Pathway Navigation Service

The MCC is launching the Licensure Pathway Navigation Service, a free and personalized service that helps internationally trained physicians (ITPs) understand the pathways to medical practice that may be available to them in Canada. The service is offered as a pilot in English and French, with limited availability.

Physician Licensing in Canada eBook

The Physician Licensing in Canada eBook is a practical guide to clinical assistant, associate physician and Practice-Ready Assessment pathways. It is a summary of information publicly available from the medical regulatory authorities and Practice-Ready Assessment programs, as compiled by Dr. Filipe Nadir Caparica Santos, IMG Consultant.

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This answer is my reading of the official source, not official or legal advice. It may be incomplete, out of date or wrong, and I take no responsibility for decisions made on it: confirm on the official page before you act. Disclaimer

It differs by province. The MCC says that to be eligible for any PRA program, a candidate must confirm language proficiency, currency of practice, scope of practice and credential verification. Some PRA programs also use additional selection or ranking tools.

Can an internship count as postgraduate training?

The MCC says postgraduate training may include either a completed residency program or an acceptable internship, depending on the eligibility requirements of the assessing jurisdiction. To be eligible, an internship must have lasted at least 12 months and include required clinical rotations, each meeting minimum duration requirements defined by the province. It must also have been completed at an educational institution acceptable to the provincial PRA program. All postgraduate training must be source verified through physiciansapply.ca by the MCC before it is considered.

By province

• British Columbia (PRA-BC): two years of postgraduate training leading to registration as a general or family physician, including 7 core rotations, plus a minimum of 2 years of independent practice, and 960 hours of clinical practice as a family physician in the preceding 3 years.
• Alberta (PRA-AB): completion of all postgraduate training required for the discipline. For family medicine, a university-affiliated program including 4 months of community-based primary care and 8 weeks in at least 3 of pediatrics, obstetrics and gynecology, surgery, and internal medicine, plus at least 1 year of recent practice or training within the last 3 years.
• Saskatchewan (SIPPA): a family medicine postgraduate program of at least 12 months with generalist rotations. If your program was under 24 months, SIPPA requires 3 years of full-scope practice as a family physician.
• Manitoba: a minimum of 3 years of independent clinical practice as a general or family practitioner within the 5 years immediately before the application deadline, plus either 2 years of accredited family medicine training or 1 year of training.
• Ontario (Practice Ready Ontario): a total of 48 months of training and practice experience as a general or family physician, 7 core rotations (practice experience can stand in for up to 3 missing rotations, with attestation), and 960 hours of recent clinical practice in the last 3 years, of which up to 25% may be virtual.
• New Brunswick (PRA-NB): two years of postgraduate training plus 1 year of independent practice, or 1 year of training plus 2 years of practice, with 7 core rotations, and a minimum of 450 hours of clinical practice in the last 3 years.
• Nova Scotia (NS PACE): twenty-four months of internship or postgraduate training plus 12 months of independent practice in family medicine or general practice, or 12 months of training plus 24 months of practice, with core rotations. The College of Physicians and Surgeons of Nova Scotia may accept practice in lieu of up to 3 missing rotations and can excuse psychiatry or obstetrics and gynecology with extra family medicine training.
• Newfoundland and Labrador (PRA-NL): CPSNL sets the training rule for the Provisional Licence in Family Medicine that PRA-NL leads to: at least two years of family medicine postgraduate training, or one to two years of training that is the accepted route to family or general medicine where you trained plus at least two years of independent unsupervised practice. For applications received on or after October 1, 2026, the one-year route also requires core rotations (8 weeks of family medicine and 4 weeks each of surgery, internal medicine, pediatrics, emergency medicine, obstetrics and gynecology, and psychiatry).

More on this site: PRA-BC Requirements for IMGs: Practice Ready Assessment BC

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Yes. PRA-NB allows no more than one unsuccessful attempt in a Canadian PRA program in the last 5 years.

Official source: CPSNB: PRA-NB eligibility criteria Checked 2026-09-29

More on this site: PRA-NB Requirements for IMGs: Practice Ready Assessment NB

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For residency through CaRMS, usually yes. For a family medicine practice-ready assessment (PRA), usually no: Practice Ready Ontario is the only one that requires it.

The CaRMS match

CaRMS requires Canadian citizenship or permanent residence, with a few exceptions. Its citizenship summary also accepts proof of protected person or convention refugee status for Nova Scotia, New Brunswick and PEI, Quebec, Ontario and Alberta. Quebec also accepts MD students already enrolled in a Quebec faculty of medicine with a valid visa.

A CaRMS help article for students at a Canadian medical school on a study or work visa (updated 2023) says that to obtain a licence to practise in residency, provincial rules require you to be a Canadian citizen or permanent resident, or to be in the process of obtaining Canadian citizenship or permanent residency.

For an IMG with none of these statuses, the one route since the 2025 R-1 match is Quebec's particular stream, in the second iteration only. You first need degree equivalence from the Collège des médecins du Québec. The particular stream is for IMGs without PR or citizenship, and for IMGs of any status who have already done accredited postgraduate training in Canada or the United States (a residency or a fellowship). Canadian citizens and PR holders without previous postgraduate training in Canada or the US are not eligible for it: they apply in the regular stream, in the first or second iteration. If you were already in a Quebec residency program, you are eligible for the particular stream only if 12 months have passed between the end of that training and the start of the new program. Residents currently training in Quebec cannot apply. New for the 2027 match, candidates who are neither citizens nor permanent residents are considered only in a limited number of programs, and only in specialties where positions remained unfilled after the first iteration.

Practice-ready assessment programs (family medicine)

• PRA-BC: no. Its pre-screening requirements do not include Canadian citizenship or permanent residence. Candidates who are selected and sponsored by a BC health authority are supported to apply for permanent residence through the BC Provincial Nominee Program Skills Immigration Health Authority stream.
• PRA Alberta (PRA-AB): no. Neither Canadian citizenship nor permanent residence is listed as a requirement.
• SIPPA (Saskatchewan): no current SIPPA or Health Careers Saskatchewan page lists Canadian citizenship or permanent residency as a requirement. If you are not a citizen or permanent resident, you are responsible for obtaining a work permit.
• PRA Manitoba (PRAMB-FP): no. Canadian citizenship or permanent residency is not a requirement. Separately, preference goes to people already living in Manitoba (established Manitoba residents). This is about where you live, not about permanent residence.
• Practice Ready Ontario (PRO): yes. Canadian citizenship or permanent residency is required at the time of application. This is the strictest immigration requirement of any PRA program in Canada.
• Quebec: candidates who do not hold permanent residency or Canadian citizenship must obtain a temporary work permit before starting the assessment period.

More on this site: PRA Programs in Canada Compared: All 9 Provinces

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Usually yes, unless you qualify for an exemption, most often based on where or in what language you studied medicine. The CaRMS match, the provincial and territorial programs and the provincial regulators (colleges) each set their own rules. They differ on which tests they accept, who is exempt and how long a result lasts.

The CaRMS match

For the R-1 match outside Quebec, CaRMS's summary of language proficiency requirements lists three tests: CELPIP-General 9, IELTS Academic 7.0, or OET Medicine grade B, in each of the four skills and in the same sitting. CaRMS sets no fixed validity window such as 24 months. For the 2027 match, results "must be valid until July 1, 2027, and must [be] submitted by the application deadline."

Studying medicine in English is usually not enough for CaRMS. BC, Alberta, Saskatchewan, Manitoba, Nova Scotia, New Brunswick, PEI and Newfoundland and Labrador waive the test for IMGs who "completed their basic medical education and patient care experience" in one of 23 listed countries (among them the UK, Ireland, the US, Australia, New Zealand, South Africa, Singapore and most English-speaking Caribbean countries). Apart from Saskatchewan, these provinces do not accept an English-medium school elsewhere (India, Pakistan, Nigeria, the Philippines, Egypt) in place of a test score.

• Saskatchewan: also accepts a letter from your Dean confirming that the program was taught solely in English.
• Ontario: has no country exemption. It also accepts TOEFL iBT (93, with 24 in speaking). In place of a test score, it accepts a letter from your Dean attesting that your program "was completed solely in English", or the World Directory of Medical Schools (FAIMER) Program Details printout.
• Quebec: programs set their own French (and English) requirements, so check each program description. For a residency position, CaRMS lists several French tests (TCF, TCF Canada, TCF Québec, TEF, TFI, the OQLF exam). Université de Sherbrooke, for example, requires French at level C2.
• New Brunswick, Nova Scotia and PEI: CaRMS's criteria still list all three tests (2026 match text), although for a Nova Scotia licence the CPSNS will accept IELTS Academic and CELPIP-General only until January 1, 2027.
• Newfoundland and Labrador: allows the scores across up to two sittings of the same test.

CaRMS still labels these criteria as the 2026 match criteria and will post the 2027 criteria once each province has reviewed them. Check them again before you book a test.

Provincial regulators (MRAs)

For registration with the college, the rules on English-medium education are more generous in most provinces. A test result is valid for 24 months with most regulators, but they measure it from different points.

• British Columbia: accepts English as the primary language of medical education and patient care, from any country. The CPSBC counts the 24 months from the date the test was taken.
• Alberta: ties the education exemption to listed countries. The CPSA counts the 24 months before you submit your application.
• Manitoba: accepts more than half of medical education in English, from any country, with a World Directory English-program listing as evidence. The CPSM counts the 24 months at the time of application.
• Ontario: the regulation for the postgraduate education certificate accepts an MD taught in English, patient care included, from any country. The CPSO counts the 24 months at the time of application.
• Quebec: for a licence (permit) from the Collège des médecins du Québec, French is set by the Charter of the French language and the OQLF exam is the only test. The OQLF answers « Y a-t-il un autre examen équivalent à celui de l'Office? » with « Non. » (in English: is there another exam equivalent to the Office's? No.) You are deemed to know French after three years of full-time secondary or post-secondary education in French, among other routes. A graduate from outside Quebec can get a temporary permit valid one year, renewable at most three times, with the OQLF's authorization and an attempt at its exam each time. A Quebec restrictive permit also requires French, shown by a pass on the Office québécois de la langue française (OQLF) examination or accepted proof of knowledge of French.
• New Brunswick: the CPSNB counts the 24 months from the date on the results.
• Nova Scotia: the College of Physicians and Surgeons of Nova Scotia (CPSNS) "will only accept the IELTS-Academic and CELPIP-General until January 1, 2027". From that date it will no longer accept new IELTS Academic or CELPIP-General results, and OET Medicine (grade B) is the test; OET Medicine remains accepted. Results dated before January 1, 2027 are still considered, within their 24-month validity, counted from the date on the results. The same rule applies to clinical assistant applicants. The policy applies to applicants whose first language is not English. The CPSNS exempts an applicant who passed the MCCQE in English, holds an independent licence elsewhere in Canada, or completed medical school in English within the last 5 years and has been accepted into a Nova Scotia postgraduate program.
• PEI: accepts English-medium education only if completed within the last 5 years. The CPSPEI counts the 24 months from the date on the results.
• Newfoundland and Labrador: accepts more than half of medical education or patient care in English, from any country. It allows 36 months with a Chief of Staff attestation.

So in BC, Manitoba, Newfoundland and Labrador, Nova Scotia and PEI, the CaRMS rule is stricter than the college's. A test result expires; an exemption based on your education does not, except where a 5-year recency rule applies, as in Nova Scotia and PEI. Plan for a score that could lapse between your CaRMS application, the match and your licence.

Provincial and territorial programs (as the MCC describes them)

The MCC says that provincial or territorial programs define the final criteria, but most adhere to these minimum standards for English proficiency. It lists three acceptable tests, with the minimum score achieved within 24 months of your application to a provincial or territorial program:

• IELTS Academic: at least 7.0 in each of the four components, in one sitting.
• OET Medicine: at least grade B in each subset, in one sitting.
• CELPIP-General: at least 9 in each component, in one sitting.

The Royal College exams

The Royal College offers its examinations in English and French. It says candidates whose first language is not English or French should ensure that they have reasonable fluency, written and oral, in either English or French.

More on this site: Clinical Assistant Nova Scotia: Requirements for IMGs

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Every program has a currency requirement. British Columbia, Ontario and Saskatchewan all require roughly six months of recent practice within the last three years.

By province

• British Columbia: 960 hours within the last three years.
• Saskatchewan: 26 weeks within the last three years.
• Manitoba: three years of practice within the last five.
• Ontario: 960 hours within the last three years.
• Quebec (restrictive permit): you must have practised competently in your field for 12 months during the 3 years before the application.
• New Brunswick: 450 hours in three years.
• Nova Scotia (NS PACE): a minimum of 450 hours of clinical practice in the last 5 years.
• Newfoundland and Labrador: PRA-NL does not publish its own currency rule; applicants must meet CPSNL's minimum, which for a provisional licence is 450 hours of clinical practice in the area within the previous three years. PRA-NL's selection criteria favour consistent practice as the most responsible physician in family medicine, and applicants with no currency beyond the CPSNL minimum are significantly less competitive.

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Not by itself. These are supervised roles, and a clinical assistant or associate physician licence is not a licensure pathway or a route to independent practice on its own. The MCC says these roles are not equivalent to independent clinical practice.

Supervision on each licence

• British Columbia: associate physicians practise under the direction and supervision of an attending physician, and may never be the most responsible physician.
• Saskatchewan: clinical assistants are licensed to provide limited medical services under supervision in specific settings approved for the role.
• Prince Edward Island: both classes practise only under a supervisor approved by the College of Physicians and Surgeons of Prince Edward Island.
• Newfoundland and Labrador: the clinical assistant licence is a supervised licence subject to oversight, tied to a Council-approved position. CPSNL does not describe it as a route to independent practice; confirm any future options directly with CPSNL.

Counting the time toward currency

Licensed time in these roles can still help you later, which is how candidates use them to close a practice gap. The MCC says that 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. It gives Saskatchewan and Ontario as examples that currently count time in such roles as recent clinical experience for their PRA family medicine pathways, and says other provinces and territories may not yet recognize this experience.

Ontario, Saskatchewan and New Brunswick all accept licensed clinical assistant or associate physician work done anywhere in Canada toward the currency requirement of their family medicine PRA programs. Unlicensed clinical assistant work does not count.

• British Columbia: associate physician work does not count toward currency for independent practice in BC.
• Saskatchewan: SIPPA accepts family practice as the most responsible physician, licensed clinical assistant or associate physician work, and relevant additional postgraduate training as currency of practice. This includes licensed clinical assistant work done in Manitoba, which, unlike the unlicensed role in Ontario, is practice under a provincial licence.
• Ontario: hours worked as a clinical assistant in Ontario are not recognized as Canadian practice hours by provincial regulators or by Practice-Ready Assessment programs.
• Nova Scotia: may consider associate physician experience from another province at its discretion.

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The MCC says clinical research positions in which 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, and positions such as medical assistant, are also considered gaps and are not recognized as maintaining clinical currency.

By contrast, completing an accredited internship year, or a clinical fellowship that includes direct patient care responsibilities, is typically not regarded as a gap, although rare exceptions may apply.

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It varies by province. The MCC says most provincial PRA programs use the MCCQE as a screening requirement, some use the National Assessment Collaboration (NAC) Examination, and most require a pass on the Therapeutics Decision-Making (TDM) Examination as part of their eligibility criteria.

British Columbia, Manitoba and Nova Scotia do not list the MCCQE as required. NS PACE in Nova Scotia is the only program with no MCCQE, NAC Examination or TDM Examination requirement.

By province

• British Columbia (PRA-BC): the MCCQE and the NAC Examination are not required, but you must have passed the TDM Examination within the previous three years before PRA-BC can refer you to health authorities for interviews.
• Alberta (PRA-AB): you need a registration exam: a nationally recognized standardized examination, such as the MCCQE, or one from an approved jurisdiction as approved by the Registrar. Family medicine applicants must also pass the TDM Examination.
• Saskatchewan (SIPPA): a pass on the MCCQE, plus the NAC Examination (or the MCCQE Part II taken in 2021 or before), plus the TDM Examination.
• Manitoba (PRAMB-FP): a pass on the NAC Examination or the MCCQE Part II, and the TDM Examination, which top-ranked candidates are nominated to sit. The MCCQE is not listed. Applicants first apply to CPSM through physiciansapply.ca; eligible applicants are referred to the University of Manitoba for shortlisting and interviews.
• Ontario (Practice Ready Ontario): a pass on the MCCQE with the Licentiate of the Medical Council of Canada (LMCC), plus the NAC Examination (or the MCCQE Part II taken in 2021 or before). Shortlisted candidates sit the TDM Examination.
• Quebec (restrictive permit): a pass on the MCCQE, the USMLE Step 2 CK, or the former MCC Evaluating Examination (taken before 2019). Quebec accepts the USMLE Step 2 CK on its own; other provinces that accept the USMLE ask for Steps 1, 2 and 3. Quebec does not use the TDM Examination.
• New Brunswick (PRA-NB): a pass on the MCCQE. Preference is given to candidates who have also passed the NAC Examination. The TDM Examination is required if not previously passed.
• Nova Scotia (NS PACE): no MCCQE, NAC Examination or TDM Examination requirement.
• Newfoundland and Labrador (PRA-NL): a pass on the MCCQE (needed for the CPSNL eligibility letter), plus the NAC Examination (or the MCCQE Part II taken in 2021 or before), plus the TDM Examination in phase 1.

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Eligible candidates can apply for the exam through the MCC during the designated application period, without an invitation or approval from the Practice-Ready Assessment (PRA) programs. Before applying for the TDM Examination for admission to a PRA program, it is important to review the program's requirements to determine your eligibility.

Official source: Medical Council of Canada: Eligibility and application Checked 2026-09-29

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Quoted from the official source on the date shown, trimmed and selected by me. Rules change: confirm on the official page before you act. This is not official or legal advice, and I take no responsibility for decisions made on it. Disclaimer

The Therapeutics Decision-Making (TDM) Examination assesses therapeutic knowledge and clinical decision-making at the level expected of a family physician practising independently and safely in Canada.

Most Practice-Ready Assessment (PRA) programs use it to inform their applicant selection decisions for program admission. The TDM Examination helps PRA programs identify applicants who are most likely to succeed in supervised practice and safe independent family medicine practice in Canada.

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It differs by province.

• Alberta (PRA-AB): two parts that must be passed in succession: a Preliminary Clinical Assessment of about 3 months, then a Probationary Assessment of about 3 months, leading to the Provisional Register. CPSA may waive Part A based on your qualifications.
• Manitoba: twelve weeks, in three 4-week blocks at different assessment sites in Winnipeg and rural Manitoba, after a mandatory two-week orientation.
• Quebec (restrictive permit): on average 9 to 18 months for the whole process, including sponsorship through Travailler en santé au Québec (formerly Recrutement Santé Québec) and a 13-week assessment period (one week of observation, then 12 assessed weeks). Keep practising while you apply.
• Nova Scotia (NS PACE): typically about 12 weeks, with a maximum of 20, in the PACE clinic under a competency-based model with rolling entry.

More on this site: PRA Alberta (PRA-AB): Family Medicine Requirements for IMGs

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The MCC says most physicians who graduate from a Practice-Ready Assessment (PRA) program obtain a full licence within two years.

In Newfoundland and Labrador, passing the 12-week PRA-NL clinical field assessment does not guarantee full licensure in Newfoundland and Labrador or elsewhere in Canada.

More on this site: PRA-NL Requirements for IMGs: Newfoundland and Labrador

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Usually. The MCC says that after completing a practice-ready assessment, successful participants enter a return of service agreement to work in areas of high need within the province of assessment for a determined time.

Family medicine PRA

Most programs require one, served in the province that assessed you, often in a community the province designates. Treat the return of service as part of the deal, not a footnote.

• British Columbia: yes. Candidates who complete the program fulfil a 3-year return of service in a BC community of need.
• Alberta: the college does not state a return of service for PRA-AB.
• Saskatchewan: 3 years.
• Manitoba: candidates are placed in rural, underserviced communities under a return of service agreement with the sponsor. No length is stated.
• Ontario: yes. A 3-year return of service agreement with the Ontario Ministry of Health must be signed before the 12-week clinical field assessment begins.
• Quebec: 3 years.
• New Brunswick: yes. Candidates who complete the clinical field assessment enter a 3-year agreement with the Department of Health.
• Nova Scotia: 3 years.
• Newfoundland and Labrador: the term is negotiated with NL Health Services; the program does not publish its terms, and no length is stated.

Specialist PRA

Specialist PRA positions commonly carry a return of service in the sponsoring province, often in an area of need. Read the contract before you commit.

• Alberta: the college does not state one.
• Manitoba: tied to your funding or sponsorship agreement, with no published length.
• Quebec: the sponsorship agreement commits you to three years in the sponsoring institution's territory.
• Nova Scotia: tied to your funding or sponsorship agreement, with no published length.

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A licence comes from the medical regulatory authority (MRA) of the province or territory where you want to practise. The MCC says each jurisdiction's MRA defines its own requirements, and that it is essential to check the requirements of the MRA where you want to practise.

What a full licence requires (the Canadian Standard)

The MCC says the Canadian Standard sets out the academic qualifications that make an applicant eligible for full licensure. Physicians must have:

• an acceptable medical degree from an acceptable medical school that, at the time they completed the program, was listed in the World Directory of Medical Schools;
• an LMCC;
• satisfactorily completed a discipline-appropriate postgraduate training program in medicine and an evaluation by a recognized authority;
• certification from the College of Family Physicians of Canada, the Royal College of Physicians and Surgeons of Canada, or the Collège des médecins du Québec.

The Royal College

Royal College certification is recognition of your specialist training and qualifications by the Royal College. It is not a licence: medical licences are granted by a provincial or territorial MRA, not the Royal College, and allow you to practise medicine in that specific jurisdiction. The Royal College does not have the authority to issue licences to practise in Canada and cannot guarantee that success at an exam component will lead to licensure from an MRA. MRAs may consider exam success in the licensure application process.

The CFPC

The CCFP does not give you a licence to practise. The CFPC says registration or licensure to practise family medicine in Canada is a provincial responsibility and involves a number of different criteria; for licensing information, contact the local medical regulatory authority.

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Certification in the College of Family Physicians of Canada (CCFP) is a Special Designation of membership from the CFPC. Once eligible, candidates may be granted certification either by successfully completing the Certification Examination in Family Medicine or through one of the alternative pathways.

Official source: College of Family Physicians of Canada: Alternative Pathways to Certification in Family Medicine Checked 2026-09-29

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Quoted from the official source on the date shown, trimmed and selected by me. Rules change: confirm on the official page before you act. This is not official or legal advice, and I take no responsibility for decisions made on it. Disclaimer

You must provide evidence from a medical regulatory authority (MRA) in Canada that you meet all the requirements for licensure or registration in a province or territory, pending CCFP, and that you have been granted a provisional or restricted licence to practise. All applications are reviewed by the CFPC's Board of Examinations and Certification, which makes final rulings on all questions of eligibility for certification.

If you already hold a Canadian licence

The requirement that your licence or registration be active at the time of application and throughout your entire career is waived if you are currently licensed or registered by a provincial or territorial MRA to practise in Canada under a full or provisional/restricted licence. If you were granted a provisional or restricted licence more than one year before applying, you are expected to meet the annual continuing professional development requirements for each full year.

Ontario

For Ontario, applicants must have been granted the approval under the College of Physicians and Surgeons of Ontario Registration Committee's policy for Recognition of Certification without Examination, issued by the CFPC.

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This answer is my reading of the official source, not official or legal advice. It may be incomplete, out of date or wrong, and I take no responsibility for decisions made on it: confirm on the official page before you act. Disclaimer

The CFPC deems an applicant ineligible if any of the following apply:

• any involuntary loss, suspension or removal of licensure or registration to practise;
• any previously denied licensure or registration in Canada or abroad;
• any disciplinary or regulatory action imposed by a medical regulatory authority (MRA) in Canada or abroad, including any limitation, restriction or condition imposed on the licence or registration, any undertaking restricting the applicant's practice, or any voluntary relinquishment of licensure or registration in connection with a regulatory matter.

Any warning, caution or other non-restrictive regulatory disposition issued by an MRA is reviewed case by case and may result in ineligibility.

Missing training records

If a candidate's training through a formal accredited program and its approved sites cannot be confirmed because records are unavailable, the candidate is deemed ineligible for this route. Physicians with a Certificate of Prescribed/Equivalent or Certificate of Equivalent Experience (UK general practice) will be asked to source verify the Confirmation of UK Training Posts issued by the GMC.

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This answer is my reading of the official source, not official or legal advice. It may be incomplete, out of date or wrong, and I take no responsibility for decisions made on it: confirm on the official page before you act. Disclaimer

Steps

• Complete the online self-assessment questionnaire.
• Apply to become a member of the CFPC.
• Complete the online application and pay the $533 non-refundable fee.
• Register your credentials with the Medical Council of Canada's Physician Credentials Repository and share them with the CFPC.

Fees

Effective March 1, 2026, the CFPC's Board of Directors approved an increase of the non-refundable application fee to $533 and the certification fee to $3,518. The application steps say to "Pay the processing fee of $3,518 once all the requirements are met."

Source verification

The CFPC requires source verification of:

• the medical degree;
• postgraduate family medicine training;
• certification in family medicine;
• a Certificate or Letter of Good Standing from the licensing body, not older than six months;
• a Letter of Good Standing from the certifying body, not older than six months.

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This answer is my reading of the official source, not official or legal advice. It may be incomplete, out of date or wrong, and I take no responsibility for decisions made on it: confirm on the official page before you act. Disclaimer

Both certifying colleges describe a route to certification without examination.

Family medicine: the CFPC

The Equivalent Jurisdictional Pathway is a credentials-based route to certification in the CFPC without examination, based on recognition of training and certification obtained in international jurisdictions.

Only physicians who obtained certification in family medicine through an accredited postgraduate training program in a jurisdiction acceptable to the CFPC are eligible. They must also have maintained a valid and unrestricted licence or registration and an active practice in family medicine in an approved jurisdiction, and show evidence of maintaining ongoing active certification in family medicine in that jurisdiction. Approved jurisdictions include:

• Australia (FRACGP or FACRRM)
• Ireland (MICGP)
• the United Kingdom (MRCGP)
• the United States (ACGME-accredited family medicine residency with DABFM)

Specialties: the Royal College

Under certification without examination, Deans of Medicine may apply for Academic Certification on behalf of their non-certified full-time clinical faculty at the rank of full or associate professor, with five years' experience. Academic Certification remains in effect only for as long as the Certificant maintains a full-time academic appointment in the same specialty practice, at the same medical school and its affiliated institutions.

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It depends on the CFPC route.

Equivalent Jurisdictional Pathway (certification without examination)

There can be no voluntary gaps in licensure or active practice longer than two years, either continuously or in total, over the past three years of practice from the date of application. The CFPC defines active practice as "working as the physician who has the overall responsibility for directing and coordinating the care and management of an individual patient." Physicians who provide virtual care exclusively do not meet this requirement.

Practice-eligible route

Physicians who have had interruptions in their practice during the five-year period may still qualify, as long as the interruption does not occur during the two years immediately before the date of application. Additional time in practice may be required.

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You may qualify as a practice-eligible candidate. The CFPC says practising physicians may qualify under Category A or B. Category B applies to graduates of medical schools not accredited by the organizations in Category A who are currently in full-time active family practice in Canada.

Category B requirements

Category B candidates must:

• possess a licence in good standing to practise family medicine independently in a province or territory of Canada;
• be an Active member in good standing with the CFPC;
• have completed 12 months of relevant postgraduate training;
• have completed a minimum of five years of full-time active family practice;
• have been in continuous full-time active family practice in Canada for a minimum of two years immediately before the date of application;
• "Remain in continuous full-time active practice in Canada and maintain their licensure until they take the Examination";
• have credentials obtained outside Canada "successfully source-verified by the Medical Council of Canada (MCC) Physician Credentials Repository ... at least eight weeks prior to the Examination date".

What else Category B candidates submit

• References from two colleagues who are licensed and in good standing in the same jurisdiction as you and have known you for at least two years. At least one letter of support must be from a CFPC member who holds Certification in the College of Family Physicians of Canada (CCFP).
• Completion of the CLASS Program within the two years of taking the Examination.
• Verification of registration or licensure.
• Registration with the MCC Physician Credentials Repository to have overseas credentials source verified.

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This answer is my reading of the official source, not official or legal advice. It may be incomplete, out of date or wrong, and I take no responsibility for decisions made on it: confirm on the official page before you act. Disclaimer

Yes. The CFPC says practising physicians who, from January 1, 2017 on, successfully completed a provincial or territorial practice-ready assessment (PRA) program that meets the National Assessment Collaboration (NAC)-PRA standards, and who meet all other Category B practice-eligibility criteria, may apply to take the Examination after completing a minimum of four years of full-time active family practice that includes one year of continuous, full-time active family practice in Canada immediately before the date of application.

To qualify for this credit, you must provide an official letter confirming successful completion, issued by the program. This official confirmation replaces the requirement to provide references from two colleagues.

Programs that meet the standards

• British Columbia: Practice-Ready Assessment, Physicians for BC (PRA-BC).
• Alberta: Practice Readiness Assessment Alberta (PRA-AB).
• Saskatchewan: Saskatchewan International Physician Practice Assessment (SIPPA).
• Manitoba: University of Manitoba International Medical Graduate Program (PRA MB, Family Practice, and PRA MB, Specialty Practice).
• Ontario: Practice Ready Ontario (PRO).
• Quebec: Collège des médecins du Québec (CMQ) Practice Ready Assessment (PRA).
• New Brunswick: Practice Ready Assessment New Brunswick (PRA-NB).
• Nova Scotia: Nova Scotia Practice Ready Assessment Program (NSPRAP), and Nova Scotia Physician Assessment Centre of Excellence (PACE).
• Newfoundland and Labrador: Practice Ready Assessment, Newfoundland and Labrador (PRA-NL).

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This answer is my reading of the official source, not official or legal advice. It may be incomplete, out of date or wrong, and I take no responsibility for decisions made on it: confirm on the official page before you act. Disclaimer

Residency eligibility applies to successful graduates of postgraduate family medicine training programs in jurisdictions where the standards for accreditation of postgraduate family medicine training are judged comparable and acceptable to the CFPC, which include the United States (ACGME), Australia (AMC/RACGP), Ireland (ICGP) and the United Kingdom (GMC/RCGP). "In order to be considered for residency eligibility all candidates must: Be registered with the CFPC as a Resident member" and "Be residents who are recommended to the CFPC by the dean for postgraduate medical education and the postgraduate director of the department of family medicine or by the institution's equivalent officers".

Official source: College of Family Physicians of Canada: Eligibility and Application Checked 2026-09-29

Check your own training and practice history against each program: Eligibility Screener

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Quoted from the official source on the date shown, trimmed and selected by me. Rules change: confirm on the official page before you act. This is not official or legal advice, and I take no responsibility for decisions made on it. Disclaimer

Potential candidates who hold a temporary or restricted licence to practise medicine independently and who meet all other criteria in Category A or B may request special consideration for eligibility from the CFPC. Individuals who are registered in a residency training program and who provide clinical services outside the context of the residency program (i.e., moonlighting) cannot claim this experience as independent practice for purposes of examination eligibility for the practice-eligible route.

Official source: College of Family Physicians of Canada: Eligibility and Application Checked 2026-09-29

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Quoted from the official source on the date shown, trimmed and selected by me. Rules change: confirm on the official page before you act. This is not official or legal advice, and I take no responsibility for decisions made on it. Disclaimer

The CFPC asks you to submit only the documents relevant to confirming your eligibility:

• your medical school diploma, if you obtained your undergraduate medical degree outside Canada;
• only the certificate that proves completion of 12 months of postgraduate training;
• certificates confirming registration or licensure for up to three years of practice only, as the most recent two years must have been in Canada;
• if you intend to claim additional postgraduate training obtained outside Canada for credit toward the five-year full-time active practice requirement, the relevant certificates.

Deadline

All documents submitted to physiciansapply.ca must reach the verification stage returned with a pass no later than eight weeks before the examination date. If your documentation has not been fully verified by then, your application will be withdrawn from the examination, and the examination fees you already paid will be refunded to the credit card used at the time of application. This process can take several months, so the CFPC recommends starting it as soon as possible.

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This answer is my reading of the official source, not official or legal advice. It may be incomplete, out of date or wrong, and I take no responsibility for decisions made on it: confirm on the official page before you act. Disclaimer

The Certification Examination in Family Medicine has two components: a written examination of short-answer management problems (SAMPs) and select-answer questions, and an oral component of five virtual 15-minute simulated office oral (SOO) stations.

Changes to the SAMP

Starting April 2026, SAMP cases are transitioning from questions requiring a write-in answer to multiple-choice questions (MCQs) and short-menu questions. The 2026 exam will have up to 25 per cent of the cases in either an MCQ or a short-menu format, and in 2027 all the exam cases will use multiple-choice and short-menu questions.

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Yes. Only CFPC members in good standing may take the examination, and first-time practice-eligible candidates need full membership with the CFPC.

An international medical graduate (IMG) enrolled in a Canadian provincial ministry of health- and/or university-approved assessment or training program leading to a licence to practise in Canada can be a Learner member. Learner members are not required to pay annual Corporation or Chapter fees.

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This answer is my reading of the official source, not official or legal advice. It may be incomplete, out of date or wrong, and I take no responsibility for decisions made on it: confirm on the official page before you act. Disclaimer

The CFPC holds the Certification Examination in Family Medicine twice a year, in the spring and fall, in multiple centres across Canada, in both official languages.

Exam dates

• Fall 2026: SAMPs October 13 to 14, 2026; SOOs October 17 to 18, 2026.
• Spring 2027: SAMPs April 5 to 7, 2027; SOOs April 17 to 18, 2027, and April 24 to 25, 2027.

Application windows for first-time practice-eligible candidates

• Fall 2026 exam: January 1, 2026 to April 1, 2026.
• Spring 2027 exam: July 1, 2026 to October 1, 2026.
• Fall 2027 exam: January 1, 2027 to April 1, 2027.

Dates are subject to change.

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The practice-eligible fee is $5,972 CAD for Fall 2026 and $6,091 CAD for Spring 2027 and Fall 2027 (residency eligible: $4,478 and $4,568). A tuition tax credit is available to each candidate who attempts the examination.

Non-refundable component

Beginning July 1, 2025, a non-refundable component of the application fee of $500 applies to all new practice-eligible applicants. It is part of the exam fee, not an additional cost. The CFPC states: "This component of the exam fee is non-refundable and retained only when an application is submitted and rejected due to incomplete application information or the absence of supporting documentation".

Cancellation

Withdrawal more than 60 days before the exam is refunded less a non-refundable $500 administration fee. Within 30 to 60 days, a penalty of 50 per cent applies. There is no refund within 30 days. Fees paid for a previous attempt are not transferable to a later session.

Check your own training and practice history against each program: Eligibility Screener

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This answer is my reading of the official source, not official or legal advice. It may be incomplete, out of date or wrong, and I take no responsibility for decisions made on it: confirm on the official page before you act. Disclaimer

No. The CFPC does not hold or endorse any examination preparation courses or workshops.

Official source: College of Family Physicians of Canada: FAQs for the Certification Examination in Family Medicine Checked 2026-09-29

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Quoted from the official source on the date shown, trimmed and selected by me. Rules change: confirm on the official page before you act. This is not official or legal advice, and I take no responsibility for decisions made on it. Disclaimer