Emergency Medicine: the Practice Eligibility Route
Requirements as published by the Royal College. Last reviewed August 2026.
Emergency Medicine at a glance
- Required time in training
- 5 yearsSTR: Five (5) years of approved residency training
- 2026 exam timing
- Written in the Spring; Applied in the Spring (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 Emergency Medicine 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 Emergency Medicine 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: 2010, Reviewed and Approved 2014, Version 1.1 (applies to those beginning training on or after July 1, 2010)
Required experiences4
Specific experiences the Royal College names for this discipline.
- 1.1 A minimum of twenty-four (24) months as a resident in the emergency department, which includes: 1.1.1 a minimum of six (6) months as a senior resident; 1.1.2 a minimum of four (4) months with a pediatric clinical emphasis, a portion of which is as a senior resident; 1.1.3 a minimum of one (1) month in a community or non-tertiary care hospital setting
- 1.2 A minimum of four (4) months or equivalent devoted to objectives in areas of particular importance to Emergency Medicine: emergency medical services (EMS), including pre-hospital care and disaster management; the administrative aspects of Emergency Medicine; educational skills; research skills
- 1.4 A minimum of six (6) months on critical care rotations, including at least one (1) month or equivalent in each of: 1.4.1 Anesthesiology; 1.4.2 Adult Critical Care; 1.4.3 Pediatric Critical Care; 1.4.4 Cardiac Care
- 1.5 A minimum of eight (8) months on rotations in other disciplines, selected from the following without a specific requirement for any one: 1.5.1 Family Medicine; 1.5.2 General Surgery; 1.5.3 Internal Medicine; 1.5.4 Neurosciences; 1.5.5 Orthopedics; 1.5.6 Psychiatry (including crisis intervention); 1.5.7 Obstetrics/Gynecology; 1.5.8 Pediatrics; 1.5.9 Plastic Surgery; 1.5.10 Traumatology; 1.5.11 Toxicology
Flexible or selective components3
Where the requirements allow a choice.
- 1.3 A minimum of six (6) months devoted to achieving particular expertise in a scholarly activity or clinical area pertinent to Emergency Medicine; clearly identifiable and structured, with specific activities, objectives, and measurable goals, formally approved by the program. Examples: education, clinical research, health care management, pre-hospital care, pediatrics, toxicology, and critical care
- 1.6 A maximum of months on selective activities approved by the program: 1.6.1 eight (8) months of further training in any of the above activities (sections 1.1, 1.2, 1.3, 1.4, 1.5)
- 1.7 Four (4) months of elective activities
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 Emergency Medicine?
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 Emergency Medicine 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 Emergency Medicine?
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 Emergency Medicine requirements in one file.
The Emergency Medicine guide as one PDF
The seven PER steps, your document checklist, and the Emergency Medicine 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 Emergency Medicine are in the Fellowship Finder; start with Emergency Medicine fellowships in Canada.
Adapted from the Royal College of Physicians and Surgeons of Canada Specialty Training Requirements for Emergency Medicine. 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.