Residency: can you apply

Eligibility for entry into medical residency in Canada is set by each province's provincial medical regulatory authorities and postgraduate medical education offices. There are some common requirements across the country, but each province may have slight variations in its criteria. Requirements also vary by program, so check the program descriptions and the provincial eligibility criteria on the match pages to make sure you are eligible before you apply.

IMGs in the R-1 Main Residency Match

CaRMS lists these conditions for an international medical graduate (IMG) to be eligible for the R-1 match:

• You are attending, or have graduated from, a school listed in the World Directory of Medical Schools (https://search.wdoms.org/).
• You have written and passed the National Assessment Collaboration (NAC) Examination.
• You have written and passed the Medical Council of Canada Qualifying Exam.

Exam requirements are set by each province.

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 It may be incomplete, out of date or wrong, and I take no responsibility for decisions made on it: confirm on the official page before you act.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

Applicants can confirm that their medical school is recognized in Canada by accessing the World Directory of Medical Schools, locating their medical school, and then clicking on the Sponsor Notes tab. A note for “Canada” indicates that your medical school is recognized in Canada.

Official source: CaRMS help centre Updated by CaRMS 2026-01-28

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

If you graduate the same year as the match, e.g. you are a 2027 graduate applying to the 2027 Match, you will be allowed to remain in the match. If your date of graduation changes to a different year than the match year, you will be withdrawn from the match year.

Opening of the article; the full answer is on CaRMS.

Official source: CaRMS help centre Updated by CaRMS 2026-04-23

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

When going to participate in a match — under the “My Application – Match participation” section — it is possible you will see a message indicating you are not eligible to participate in a match.

Opening of the article; the full answer is on CaRMS.

Official source: CaRMS help centre Updated by CaRMS 2026-04-01

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

If you are an International Medical Graduate (IMG) looking to apply to the R-1 match, we recommend that you begin your match journey by reviewing the R-1 Match Overview for IMGs document and download a copy of it for your records.

Opening of the article; the full answer is on CaRMS.

Official source: CaRMS help centre Updated by CaRMS 2026-03-31

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

Your applicant type depends on where and when you completed your medical training. There are three main applicant types:

• Canadian Medical Graduates (CMGs): graduates of Canadian medical schools.
• U.S. Medical Graduates (USMGs): graduates of U.S. allopathic or osteopathic medical schools.
• International Medical Graduates (IMGs): graduates of medical schools outside Canada and the U.S.

Who counts as a CMG

A CMG is a Canadian citizen or permanent resident of Canada who received their medical degree from:

• a Canadian medical school accredited by the Committee on Accreditation of Canadian Medical Schools (CACMS); or
• a U.S. allopathic medical school accredited by the Liaison Committee on Medical Education (LCME), with an MD graduation date on or before June 30, 2025, or who meets the conditions of the combined degree exception under the LCME-CACMS agreement.

The combined degree exception

Students and graduates of a combined medical degree from a U.S. allopathic medical school, such as an MD-PhD, are considered CMGs in the residency application process under the LCME-CACMS agreement in effect before July 1, 2025, if they meet both conditions:

• they began the MD component of their program on or before December 31, 2020; and
• they complete the combined program before June 30, 2028.

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 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

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

Plan on both the MCCQE and the NAC Examination, and then check the criteria for the province you are applying to, because each province sets its own exam requirements.

What the MCC says

The MCC says passing the MCCQE is a requirement for international medical graduates applying for entry into a Canadian residency program. For the CaRMS R-1 Main Residency Match it says international medical graduates, graduates from a U.S. School of Osteopathic Medicine, and graduates from a U.S. School of Allopathic Medicine who graduated on or after July 1, 2025 need to provide results for both the MCCQE and the National Assessment Collaboration (NAC) Examination. For the 2027 R-1 match it says you can take the NAC Examination and the MCCQE in the order you prefer.

What CaRMS says

CaRMS says the MCC exams required for the R-1 match are set by each province. They can vary by province and from one year to the next, so what you need depends on where you wish to apply. For a future match, CaRMS can only go by the exam requirements for the current matches, because the provinces may change their requirements from one year to the next.

The last sessions that count for the 2027 R-1 match

CaRMS sets these out in a table, as an image in its article. For the first iteration: the MCCQE from the April 22 to May 30, 2026 session or the August 19 to October 21, 2026 session, and the NAC Examination of September 19 and 20, 2026. The January 19 to February 11, 2027 MCCQE session does not count for the first iteration. For the second iteration: any of those three MCCQE sessions, and the same September 2026 NAC Examination. CaRMS says some provinces may allow exceptions, and points to its R-1 Summary of MCC Examination Requirements.

Outside the residency match

The MCC says the MCCQE is also used by some Practice-Ready Assessment programs as an eligibility criterion, to select internationally trained physicians into their programs.

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

Only in Canada, twice a year, at a limited number of exam centres. You cannot take it remotely and you cannot take it in another country.

It is a half-day objective structured clinical examination, offered in the spring and the fall, typically in May and September. The September 2026 exam is on September 19 and September 20, 2026, and those results are released in late November 2026. All dates are subject to change.

The centres for September 2026

Alberta: Edmonton, Calgary. Manitoba: Winnipeg. Ontario: Hamilton, London, Ottawa, Toronto, Windsor. Saskatchewan: Saskatoon. The exam is offered in English at all centres, and Ottawa also offers it in French. Centres are subject to change.

If you live outside Canada

The MCC notes that many candidates travel on a visitor visa for the exam and return to their country of residence afterward. Residency program directors accept results regardless of where you take the exam, so you do not have to take it in the province where you will apply for residency.

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

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

A stream is a block of residency positions a province sets aside for a particular group of applicants. Yes, the number of positions open to IMGs is capped, and the cap differs by province.

What a stream is

An application stream is a set of residency positions allocated according to who is eligible to apply. In the R-1 match it is a specific number of positions allocated by a province based on who is eligible to apply, in relation to their medical training, and the R-1 match has several streams. The subspecialty matches are also made up of streams, for example the Particular Stream, the Competitive Stream and the Competitive MOH Stream, each an allocation of positions based on eligibility and funding. Each province has criteria that applicants must meet to apply for positions in that province.

The limit on IMG positions

CaRMS says there are strict quotas on the number of IMGs accepted into residency positions each year, and the quotas vary by province. Where a quota is published, it is in the program descriptions for that match.

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. In these three provinces, IMGs must meet a provincial requirement before applying, and each year CaRMS receives a list of the applicants who are eligible to apply for the province's programs. To select these programs in CaRMS Online, you must be on that list.

• British Columbia: IMGs seeking a residency position must take part in the University of British Columbia's Clinical Assessment Program (BCIMG CAP). You must be on the BCIMG list to select BC programs.
• Alberta: IMGs must successfully complete the Alberta International Medical Graduate (AIMG) Program to be eligible for IMG-designated positions in the R-1 Main Residency Match. You must be on the AIMG list to select Alberta programs.
• Quebec: IMGs must have met the requirements of the Collège des médecins du Québec (CMQ) before applying to the CaRMS match. You must be on the QIMG list to select Quebec programs.

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 Family Medicine / Emergency Medicine (FM/EM) match has been renamed the Family Medicine / Enhanced Skills (FM/ES) match. The FM/EM match was introduced in 2006 for applicants who had completed, or were completing, postgraduate training in family medicine in Canada and wanted additional training in emergency medicine.

A CaRMS article last updated in 2021 says that to apply to the FM/ES match, you need to be in a family medicine program in Canada or the United States. If you did your family medicine residency outside Canada and the United States, you are not eligible for the FM/ES match.

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

CaRMS last updated this article in 2024. Check the current version before you rely on it.

The match process and policies does not allow CaRMS to provide one single year of training. We offer complete residency training programs. There are situations where applicants could do a something called a "Chief year" in the United States but that training must be approved by the Royal College of Canada.

Opening of the article; the full answer is on CaRMS.

Official source: CaRMS help centre Updated by CaRMS 2024-07-10

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

Some residency training positions require you to enter into a return of service (ROS) agreement with the provincial or territorial government. An ROS requires you to practise medicine in a specific area once you complete your residency training. For IMG positions, it depends on the province.

CaRMS says a program description always states when a position carries an ROS, and that a match to it is binding. The provincial rules below start from each province's CaRMS eligibility criteria for the first iteration; the British Columbia and Ontario details also come from each Ministry of Health's own pages, and the Quebec details from the Quebec criteria in both iterations. CaRMS still shows the 2026 match criteria on these pages and will post the 2027 text once each province has reviewed it.

By province

• British Columbia: BC runs three streams in the first iteration. The IMG stream carries a return of service of 2 years for family medicine (in the same health authority as the training site) and 3 years for Royal College specialties (for the 2027 cohort, psychiatry, internal medicine and pediatrics in Northern Health). The Competitive ROS stream, open to CMGs and IMGs, carries 3 years anywhere in BC outside the City of Vancouver. CMG stream positions carry none. The 2027 family medicine contract sets repayment at up to $660,000 plus compound interest, not pro-rated. See the court decision below.
• Alberta: no. "There is no provincial return of service requirement."
• Saskatchewan: yes for IMGs who match to family medicine or Royal College positions. The agreement template linked from the CaRMS page is year for year (2 years of training, 2 years of service). Royal College and distributed family medicine participants serve outside Saskatoon, Regina and listed bedroom communities; Regina and Saskatoon family medicine participants serve in an area of need approved by the Minister.
• Manitoba: yes for all IMGs, "commensurate with the length of the training program". CaRMS gives no number of years.
• Ontario: yes for all IMGs in a ministry-funded position, who sign a Return of Service Agreement with the Ministry of Health. The ministry's web page still says "5-year Return of Service (ROS) Agreement"; its IMG ROS Guidelines (October 2025) say that beginning in 2026 the commitment is 7,200 hours of clinical practice, at least 120 hours a month, which "is a change from the prior 5 years". Check which one your own agreement uses. You may serve in any Ontario community except the City of Ottawa and the Toronto area (Toronto, Mississauga, Brampton, Vaughan, Markham and Pickering). A breach means repaying training and administrative costs with interest, and the ministry says this includes residents who do not complete training or do not pass the Assessment Verification Period.
• Quebec: no Quebec return of service on Quebec's own CaRMS positions. The return of service section of the Quebec criteria, in both iterations, lists only New Brunswick-funded positions: "Eight positions are available for candidates who will commit to practicing medicine in New Brunswick for at least five years." A resident who decides not to practise in New Brunswick faces "a penalty of $400,000 with interest", and positions in the Vitalité network need French. Quebec's Bill 83 (assented to April 24, 2025) requires any new physician to participate in the public plan for five years before being allowed to leave it, and lets the government require residents it designates to sign an undertaking to practise in Quebec for up to five years after training. No designation of residents under that power appeared on the CaRMS Quebec pages when this was checked. The particular stream carries no service obligation in any source found.
• New Brunswick, Nova Scotia and PEI (Dalhousie): yes for every IMG-stream position, under a contract with the province that sponsors it (Nova Scotia, New Brunswick or PEI).
• Newfoundland and Labrador: yes for the IMG family medicine stream (2 years in Labrador-Grenfell or 5 years elsewhere in the province) and the IMG internal medicine stream (5 years).

The BC court decision (September 2026)

On September 10, 2026 the Supreme Court of British Columbia (Society for Canadians Studying Medicine Abroad v. College of Physicians and Surgeons of British Columbia, 2026 BCSC 1723) held that the Minister's imposition of ROS on IMGs who match to an IMG residency position requires statutory authorization, "for which there is none", and that it may engage their liberty interest in deciding where to live. The remedy was a declaration, suspended for 60 days. The court did not set aside existing contracts and did not strike down the separate IMG and CMG streams. The Ministry of Health's IMG-BC page (updated September 18, 2026) says: "All existing ROS agreements remain in effect", "There are no immediate changes to residency training pathways", and "Prospective applicants can continue to apply through normal processes." The court asked the parties for submissions on whether a longer suspension is needed. What happens after the suspension (new legislation, an appeal, a longer suspension) had not been announced when this was checked.

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

Quebec divides its residency positions into two main streams. The regular stream is where Canadian citizens, permanent residents, people with Indian status and refugees apply. The particular stream, filled in the second iteration, is for IMGs without one of those statuses, and for IMGs of any status who have already done accredited postgraduate training in Canada or the United States.

Before either stream, an IMG first needs degree equivalence from the Collège des médecins du Québec (CMQ).

The two streams

The Government of Quebec defines several streams (contingents) for admission to postgraduate medical education, and the two main ones are the regular stream and the particular stream. In the R-1 match, particular stream positions are offered in the second iteration, and have been filled there since the 2025 R-1 match. In the subspecialty matches Quebec programs also run a regular and a particular stream, and there the regular positions are available to applicants who are currently doing their residency at a program in Quebec.

Who applies where in the R-1 match

• IMGs with no previous accredited postgraduate training: citizens, permanent residents, people with Indian status and refugees apply in the regular stream, first or second iteration. People with any other status, or no status, apply in the particular stream, second iteration.
• IMGs with previous accredited postgraduate training in Canada or the United States: whatever their status, or with no status, they apply in the particular stream, second iteration.
• Canadian citizens and permanent residents without that previous training are not eligible for the particular stream.
• Residents now training in Quebec cannot apply to the particular stream.

Fellowships

In Quebec only, fellowship experience that took place in Canada or the United States counts as postgraduate training. CaRMS defines fellowships as non-accredited specialized training offered by a postgraduate training institution, with supervised patient contact, that does not lead to certification or licensure. CaRMS gives this in answer to applicants who cannot apply to Quebec's regular stream because they have a fellowship.

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