Practice gaps and recent practice

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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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 It may be incomplete, out of date or wrong, and I take no responsibility for decisions made on it: confirm on the official page before you act.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

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

Not sure how your own gap or training will be read? In a 60-minute call I review it with you. Book a consultation

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 IMG-L framework includes four essential requirements to prepare for relocating to Canada: I – Immigration; M – Medical licensing; G – Gap or currency of practice; L – Language requirements.

Official source: Medical Council of Canada: Supporting internationally trained physicians before arrival in Canada Checked 2026-09-29

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

Not sure how your own gap or training will be read? In a 60-minute call I review it with you. Book a consultation

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

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.

More on this site: Eligibility Screener

Not sure how your own gap or training will be read? In a 60-minute call I review it with you. Book a consultation

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. Manitoba has the lightest requirements: it lists no postgraduate training, independent practice or currency requirement, and requires either a pass on the MCCQE (which grants the LMCC) or a pass on the NAC Examination.

Postgraduate training and practice

• British Columbia (associate physician): a minimum of 1 year of accredited postgraduate training appropriate to the setting: as a medical or surgical specialist for acute care, as a general practitioner for community primary care, or either with 4 weeks of surgical training (not counting obstetrics and gynecology) for surgical assisting. CPSBC is currently not accepting applications for community primary care associate physicians.
• Alberta (associate physician): a minimum of 1 year of postgraduate training that is hospital-based, in clinical services providing direct patient care in the acute care setting. Research, administrative work, and instruction that does not contribute to direct patient care do not qualify.
• Manitoba (clinical assistant): CPSM lists no postgraduate training or independent practice requirement. You still need a medical degree (or another listed qualification), the NAC Examination or the LMCC, and English proficiency.
• New Brunswick (clinical assistant): two years of postgraduate training plus 1 year of independent practice experience, or 1 year of training plus 2 years of practice.
• Nova Scotia (clinical assistant): two years of postgraduate training plus 1 year of licensed independent practice, or 1 year of training plus 2 years of practice.
• Newfoundland and Labrador (clinical assistant): a discipline-appropriate postgraduate program of at least 12 months plus 2 years of institutional acute care practice experience, or a completed program of 2 years or more with no practice experience required.

Recent practice (currency)

• British Columbia (associate physician): a minimum of 960 hours (24 weeks full time) of clinical practice within the preceding 3 years. Candidates with health authority employment may be eligible to retrain to regain currency.
• Alberta (associate physician): within the last 3 years, at least 6 months in postgraduate training or independent practice.
• Saskatchewan (clinical assistant): five months of clinical practice within the past 5 years, or an assessment and retraining satisfactory to CPSS at the physician's expense.
• Manitoba (clinical assistant): CPSM lists no currency requirement.
• New Brunswick (clinical assistant): at least 450 hours of clinical practice within the 5 years before the application.
• Nova Scotia (clinical assistant): 450 hours of clinical practice in the intended scope within the last 5 years, and no more than 5 years out of independent practice.
• Prince Edward Island (associate physician and clinical assistant): the PEI regulation requires active practice (or training or a refresher program) within the five years before you apply; the College applies this as at least 450 hours of clinical practice in the last 5 years.
• Newfoundland and Labrador (clinical assistant): 6 continuous months of practice within the last 4 years. CPSNL counts clinical practice where you were not the most responsible physician, so supervised licensed roles, for example a registrar post in a non-training program in the United Kingdom or Australia, may count, provided all other requirements are met. Confirm directly with CPSNL.

More on this site: Clinical Assistant Licences Compared Across Canada

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

Not sure how your own gap or training will be read? In a 60-minute call I review it with you. Book a consultation

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

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.

More on this site: Eligibility Screener

Not sure how your own gap or training will be read? In a 60-minute call I review it with you. Book a consultation

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

For certification, in addition to passing the Royal College specialty exam, the Royal College requires a minimum of two (2) years of supervised practice in a continuous practice location in Canada within the primary specialty. The two years must be the equivalent of two full-time years in practice, and at least 50% of practice must be in the primary specialty.

Licence and role

You must hold a licence from a Canadian medical regulatory authority (MRA) for the full two years, and it is your responsibility to obtain a non-educational licence. You must demonstrate professional competence in the full scope of the primary specialty, acting as the most responsible physician on clinical cases.

Practice you already have in Canada

If you are already practising in Canada when you apply to the PER, you may have already met the minimum time in practice requirement. If you already have a total of two (2) years of practice in Canada, you may apply for an assessment of practice immediately.

Practice completed before you receive a ruling letter may be assessed only if it was completed within the five (5) years before the date on the exam eligibility ruling letter. Any practice completed after you receive the ruling letter may be assessed.

Clinical fellowship in Canada

In some specific cases, one (1) year of clinical fellowship training in Canada may be counted toward the two-year practice requirement, if the fellowship had significant overlap with the primary specialty. Fellowship time counted toward the training requirements cannot be counted toward the practice time requirement.

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

Not sure how your own gap or training will be read? In a 60-minute call I review it with you. Book a consultation

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 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.

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

Not sure how your own gap or training will be read? In a 60-minute call I review it with you. Book a consultation

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

Postgraduate training in family medicine, emergency medicine, obstetrics and gynecology, pediatrics, surgery, internal medicine or psychiatry over and above the 12-month requirement may receive not more than three years of credit. For a CFPC- or ACGME-accredited family medicine residency, "each full year of additional training is equivalent to two years in full-time active practice with no maximum." For a family medicine residency not accredited by the CFPC or the ACGME, each full year is equivalent to one year in full-time active practice up to a maximum of two years. For emergency medicine, obstetrics and gynecology, pediatrics, surgery, internal medicine or psychiatry, "each full year of additional training is equivalent to one year of full-time active practice up to a maximum of two years." "No credit will be granted for any additional training that is incomplete, unsuccessful, or less than a full year in duration."

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

Not sure how your own gap or training will be read? In a 60-minute call I review it with you. Book a consultation

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