Specialists · Practice Eligibility Route

Anesthesiology: the Practice Eligibility Route

Requirements as published by the Royal College. Last reviewed August 2026.

Anesthesiology at a glance

Required time in training
5 yearsSTR: Five (5) years of approved residency training
2026 exam timing
Written in the Fall; Applied in the Spring (following year)
Apply for assessment of training
by August 31 of the year before your exam
Register for the exam
February 1 – April 15 of the exam year
Exam attempts
Maximum 4 attempts per component within a 5-year eligibility period

The Royal College reads your postgraduate training and practice record in Anesthesiology against the published Specialty Training Requirements. Those requirements are set out in full below, so you can see how your own training compares before you apply.

What licence can I get, and when?

Certification is national. Licensure is provincial. You do not need Royal College certification (FRCPC) to be licensed. Several provinces license you at an earlier PER stage, and the earliest any province accepts is the eligibility letter alone. The table applies to every specialty that reached exam eligibility through the PER.

Full province table: MCCQE, job offer and licence type
ProvinceMCCQERC writtenRC appliedLicence issuedJob offer
AlbertaRequiredRequiredRequiredFullNot required
British ColumbiaNot requiredRequiredRequiredProvisionalRequired
SaskatchewanRequiredRequiredRequiredProvisionalRequired
ManitobaNot requiredRequiredRequiredProvisionalRequired
OntarioNot requiredRequiredNot requiredProvisional, 3 yearsRequired
Nova Scotia (a)Not requiredNot requiredNot requiredDefined, 6 to 24 monthsRequired
Nova Scotia (b)Not requiredRequiredRequiredFullRequired
New BrunswickNot requiredNot requiredNot requiredSpecial, then DefinedRequired
Newfoundland & Labrador, PEIRequired*Not requiredNot requiredProvisionalRequired

* The MCCQE may be waived where the candidate has five or more years of independent practice abroad. Case by case, never guaranteed.

Educational only. Rules change, and each regulator decides on factors that may not be listed here; Filipe Santos MD does not make licensure decisions. Checked October 9, 2026 against each regulator's pages; Ontario confirmed with the CPSO in October 2026. Confirm with the regulator before you act.

Province notes (Alberta, Nova Scotia, New Brunswick, and the MCCQE) are in the PER guide.

How training is structured

The Royal College sets out the training for Anesthesiology in the blocks below. An internationally trained specialist is assessed on whether their own training and practice record is comparable in structure and content.

Requirements document: 2014, Version 1.0 (Revised May 2014); applies to those beginning training on or after July 1st, 2014

1. Basic clinical training
One (1) year
A minimum of 1 month and not more than 4 months in each of: Internal Medicine and/or its subspecialties; a surgical specialty; Pediatrics; and Obstetrics and Gynecology. No more than 4 months of Anesthesiology.
2. Anesthesiology
Four (4) years
Comprising sections 2.1, 2.2, and 2.3 below.
2.1 Approved residency in clinical Anesthesiology
Two (2) years
Eighteen (18) months, or longitudinal equivalent, of adult Anesthesiology, including general and regional anesthetic experience in outpatient surgical management, recognized general and subspecialty surgical procedures, and associated emergency conditions; plus pediatric Anesthesiology, obstetrical Anesthesiology, and chronic pain management (see required experiences).
2.2 Approved residency at the R2 level or above
One (1) year
Preferably after a year of clinical training in Anesthesiology: Cardiology or coronary care, Respirology, adult Critical Care Medicine, and 7 months of selectives.
2.3 One year selected from a defined list
One (1) year
Anesthesiology; Clinician Educator Program; Clinician Investigator Program; Clinical Pharmacology and Toxicology; Critical Care Medicine; Pain Medicine; Palliative Medicine; a graduate level program relevant to Anesthesiology; research experience in a clinical or basic science program; or up to 6 months of elective with approval of the program director.
Required experiences10

Specific experiences the Royal College names for this discipline.

  • 1.1 Basic clinical training: a minimum of 1 month and not more than 4 months in each of Internal Medicine and/or its subspecialties, a surgical specialty, Pediatrics, and Obstetrics and Gynecology
  • 1.2 No more than 4 months of Anesthesiology in the basic clinical year
  • 2.1.1 Eighteen (18) months, or longitudinal equivalent, of adult Anesthesiology, including general and regional anesthetic experience in outpatient surgical management, recognized general and subspecialty surgical procedures, and associated emergency conditions
  • 2.1.2 Three (3) months, or longitudinal equivalent, of pediatric Anesthesiology
  • 2.1.3 Two (2) months, or longitudinal equivalent, of obstetrical Anesthesiology
  • 2.1.4 One (1) month, or longitudinal equivalent, of chronic pain management, including long-term ambulatory patient management
  • 2.2.1 One (1) month of Cardiology or coronary care
  • 2.2.2 One (1) month of Respirology
  • 2.2.3 Three (3) months of adult Critical Care Medicine
  • 2.2.4 Seven (7) months of selectives: two or more of the listed medical specialties (maximum 2 months in any one area) and/or additional critical care experience (not to exceed 4 months in total, maximum 2 months per area)
Flexible or selective components2

Where the requirements allow a choice.

  • 2.3 One (1) year selected from: Anesthesiology; Clinician Educator Program; Clinician Investigator Program; Clinical Pharmacology and Toxicology; Critical Care Medicine; Pain Medicine; Palliative Medicine; a graduate level program relevant to Anesthesiology; research experience in a clinical or basic science program; or up to six (6) months of elective with approval of the program director
  • Overlap training: Anesthesiology training may overlap and allow for credit in the Clinician Investigator Program, Clinician Educator Program, master's programs, Clinical Pharmacology and Toxicology, Critical Care Medicine, Palliative Medicine, and Pain Medicine

Common questions

What is the Practice Eligibility Route in Anesthesiology?

The Practice Eligibility Route (PER) is the Royal College process by which an internationally trained specialist can be assessed for eligibility to sit the certification examination in Anesthesiology without repeating a Canadian residency. The Royal College reads your postgraduate training and practice record against the published Specialty Training Requirements for the discipline.

What training does the Royal College expect in Anesthesiology?

The Specialty Training Requirements describe five (5) years of approved residency training. The full block-by-block structure is set out on this page, taken from the Royal College document for this discipline.

Does meeting the training requirements guarantee eligibility?

No. Eligibility is a committee decision made on your individual file, and other factors are considered. This page reproduces the published requirements so you can see how your own training compares before you apply; it is not an eligibility ruling.

Where do I start?

Read the seven steps in the PER guide, then have your training mapped against the Specialty Training Requirements before you pay any fees. The free PDF for this specialty carries the steps, the document checklist, and the Anesthesiology requirements in one file.

The Anesthesiology guide as one PDF

The seven PER steps, your document checklist, and the Anesthesiology training requirements in a single file. Free. Not sure the PER is your route? The screener checks your file against every route in about two minutes.

or open the PER guide
Other specialties27

Canadian clinical fellowships in Anesthesiology are in the Fellowship Finder.

Adapted from the Royal College of Physicians and Surgeons of Canada Specialty Training Requirements for Anesthesiology. Not affiliated with or endorsed by the Royal College; every application is reviewed individually and final decisions rest solely with the Royal College. Verify current requirements at royalcollege.ca.