Cardiac Surgery: the Practice Eligibility Route
Requirements as published by the Royal College. Last reviewed August 2026.
Cardiac Surgery at a glance
- Required time in training
- 6 years (surgical specialty: Surgical Foundations required)STR: Pathway 1: Six (6) years of approved residency training made up of rotations equivalent to 78 4-week blocks (Pathways 2 and 3 build on General Surgery or Thoracic Surgery certification eligibility)
- 2026 exam timing
- Written in the Spring; Applied in the Fall (same year)
- Apply for assessment of training
- by April 30 of the year before your exam
- Register for the exam
- September 1 – November 4 of the year before
- Exam attempts
- Maximum 4 attempts per component within a 5-year eligibility period
The Royal College reads your postgraduate training and practice record in Cardiac Surgery 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
| Province | MCCQE | RC written | RC applied | Licence issued | Job offer |
|---|---|---|---|---|---|
| Alberta | Required | Required | Required | Full | Not required |
| British Columbia | Not required | Required | Required | Provisional | Required |
| Saskatchewan | Required | Required | Required | Provisional | Required |
| Manitoba | Not required | Required | Required | Provisional | Required |
| Ontario | Not required | Required | Not required | Provisional, 3 years | Required |
| Nova Scotia (a) | Not required | Not required | Not required | Defined, 6 to 24 months | Required |
| Nova Scotia (b) | Not required | Required | Required | Full | Required |
| New Brunswick | Not required | Not required | Not required | Special, then Defined | Required |
| Newfoundland & Labrador, PEI | Required* | Not required | Not required | Provisional | Required |
* 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 Cardiac Surgery 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: 2013, Version 1.2 (Revised June 2013; Editorial Revisions January 2014, May 2015); applies to those who begin training on or after July 1st, 2013
Required experiences12
Specific experiences the Royal College names for this discipline.
- 1.1 Three (3) blocks of Cardiac Surgery
- 1.2 Three (3) blocks of critical care medicine
- 1.3 One (1) block of anesthesia
- 1.4 Two (2) blocks of general surgery
- 1.5 One (1) block on a trauma service
- 1.6 Six (6) blocks of Cardiology, which must include one (1) block of each of: 1.6.1 coronary care unit; 1.6.2 ward cardiology; 1.6.3 adult cardiac electrophysiology; 1.6.4 interventional cardiology; 1.6.5 adult echocardiography; 1.6.6 cardiac imaging
- 1.7 One (1) block of emergency medicine
- 1.8 Four (4) blocks of vascular surgery and/or thoracic surgery
- 2.1 Six (6) blocks as chief resident in Cardiac Surgery
- 3.1 A minimum of three (3) blocks at senior resident level in Thoracic Surgery
- 3.2 A minimum of six (6) blocks at senior resident level in Vascular Surgery
- 4.1 Minimum of three (3) blocks on a pediatric cardiac surgery service
Flexible or selective components4
Where the requirements allow a choice.
- 1.9 Five (5) blocks of selectives chosen from: 1.9.1 Cardiac Surgery; 1.9.2 general surgery; 1.9.3 Pathology; 1.9.4 plastic surgery; 1.9.5 ambulatory cardiology; 1.9.6 cardiology consultation; 1.9.7 coronary care unit; 1.9.8 cardiac imaging; 1.9.9 echocardiography; 1.9.10 critical care medicine; 1.9.11 geriatrics; 1.9.12 infectious diseases; 1.9.13 nephrology; 1.9.14 neurology; 1.9.15 other training as approved by the program director to a maximum of 2 blocks
- 5. Thirteen (13) blocks of academic/clinical enrichment, flexible in content and location within the six (6) years
- Pathway 2 (eligible for Royal College Certification in General Surgery) plus: (1) 6 blocks dedicated congenital cardiac surgery service (min 3 pediatric); (2) 6 blocks Cardiac Surgery if not completed during General Surgery training; (3) 6 blocks senior residency (min 3 Thoracic, 3 Vascular) if not completed; (4) 13 blocks academic enrichment as under Pathway 1 if not completed; (5) 13 blocks senior residency in Cardiac Surgery
- Pathway 3 (eligible for Royal College Certification in Thoracic Surgery) plus: (1) 6 blocks dedicated congenital cardiac surgery service (min 3 pediatric); (2) 6 blocks Cardiac Surgery if not completed; (3) 6 blocks senior residency (min 3 Vascular) if not completed during General Surgery training; (4) 13 blocks senior residency in Cardiac Surgery
Common questions
More questions about specialists trained abroad, each answered once with its official source, are in the IMG FAQ Center.
What is the Practice Eligibility Route in Cardiac Surgery?
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 Cardiac Surgery 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 Cardiac Surgery?
The Specialty Training Requirements describe pathway 1: Six (6) years of approved residency training made up of rotations equivalent to 78 4-week blocks (Pathways 2 and 3 build on General Surgery or Thoracic Surgery certification eligibility). 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 Cardiac Surgery requirements in one file.
The Cardiac Surgery guide as one PDF
The seven PER steps, your document checklist, and the Cardiac Surgery 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.
Other specialties27
Canadian clinical fellowships in Cardiac Surgery are in the Fellowship Finder.
Adapted from the Royal College of Physicians and Surgeons of Canada Specialty Training Requirements for Cardiac Surgery. 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.