Language tests

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

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

Record any language examinations you have taken, to show your proficiency in English or French, in the "Examinations - Language" section of your CaRMS Online account. If your language of instruction during medical school was not English or French, some provincial or program criteria may require you to take a language assessment exam and provide the results.

You can upload your TOEFL or IELTS results directly in your account in CaRMS Online.

OET results include a grade (E to A) and a score on a scale from 0 to 500. In the Language Proficiency Examinations section, enter only the numerical score for each subsection.

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

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 MCCQE and the TDM Examination can be booked in English or French, and the NAC Examination can be taken in English or French at designated centres.

The MCCQE

You choose English or French when you book: go to the MCCQE Prometric landing page and find the section for the language you want for your appointment.

The TDM Examination

The TDM Examination is offered in English and French. You book it the same way, through the section for your language on the TDM Examination Prometric landing page.

The NAC Examination

The NAC Examination can be taken in English or French at designated centres.

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