Return of service

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.

Want this read against your own training and practice history? 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 provinces answer this differently, so read the second-iteration criteria for the province and the program description of the exact position.

Tied to the person (any IMG who matches owes ROS): Ontario and Manitoba. Nova Scotia, New Brunswick and PEI say so explicitly: "Unfilled CMG positions in the first iteration require an ROS in the second iteration if filled by an IMG candidate."

Tied to the position: in British Columbia all unfilled positions blend into one stream, and "Second iteration program descriptions will indicate whether a position requires a Return of Service commitment." BC links ROS to the stream a participant matches to and has no ROS on CMG stream positions, but no official text states outright that a former CMG position filled by an IMG is ROS-free, so the program description is the document to check. In Newfoundland and Labrador, ROS follows positions that came from the IMG family medicine or internal medicine streams, whoever fills them. In Saskatchewan, only IMGs who match to family medicine, internal medicine or psychiatry in the second iteration sign an agreement.

Alberta has no provincial ROS in either iteration. In Quebec only the New Brunswick-funded positions carry one.

Official source: CaRMS: British Columbia, second iteration Checked 2026-09-29

• CaRMS: Ontario, second iteration
• CaRMS: Nova Scotia, New Brunswick and PEI, second iteration
• CaRMS: Newfoundland and Labrador, second iteration
• CaRMS: Saskatchewan, second iteration
• CaRMS: What is a return of service (ROS) agreement?
• CaRMS: Manitoba, second iteration
• CaRMS: Alberta, second iteration
• CaRMS: Quebec, second iteration

Want this read against your own training and practice history? 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

If you have a return of service contract, you must declare it in the declaration section of your application. We recommend you contact the provincial body to verify your eligibility on other provinces.

Official source: CaRMS help centre Updated by CaRMS 2025-05-06

Want this read against your own training and practice history? 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

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.

More on this site: Eligibility Screener

Want this read against your own training and practice history? 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