Orthopedic Surgery: the Practice Eligibility Route
Requirements as published by the Royal College. Last reviewed August 2026.
Orthopedic Surgery at a glance
- Required time in training
- 5 years (surgical specialty: Surgical Foundations required)STR: Five years of approved residency training in Orthopedic Surgery
- 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 Orthopedic 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 Orthopedic 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: 2015; Version 3.0 (applies to those beginning training on or after July 1st, 2015)
Required experiences6
Specific experiences the Royal College names for this discipline.
- 1.1 Minimum of (6) six blocks but no more than (18) eighteen blocks as a junior resident in Orthopedic Surgery
- 1.2 The foundational surgery training must include a minimum of (1) one block in each of: 1.2.1 critical care; 1.2.2 a service that provides initial trauma management (such as Emergency Medicine, General Surgery, trauma team, Orthopedic Surgery, or Plastic Surgery); 1.2.3 General Surgery and/or Vascular Surgery; 1.2.4 Internal Medicine or its relevant subspecialties
- 2.1 The equivalent of at least six (6) blocks in Pediatric Orthopedic Surgery
- 2.2 The equivalent of at least three (3) blocks in each of the following rotations: 2.2.1 Trauma; 2.2.2 Sports Medicine; 2.2.3 Spine Surgery; 2.2.4 Oncologic Orthopedic Surgery; 2.2.5 the equivalent of at least three (3) blocks of adult reconstruction/arthroplasty in each of 2.2.5.1 upper limb, 2.2.5.2 foot and ankle, and 2.2.5.3 hip and knee
- 2.3 The equivalent of at least two (2) blocks of training in Community Orthopedic Surgery
- 2.4 At least six (6) blocks of this period must be spent as a senior resident in Orthopedic Surgery
Flexible or selective components1
Where the requirements allow a choice.
- Not specified in this document (no explicit elective or selective blocks are listed; blocks beyond the stated minimums are at program discretion within the required periods)
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 Orthopedic 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 Orthopedic 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 Orthopedic Surgery?
The Specialty Training Requirements describe five years of approved residency training in Orthopedic Surgery. 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 Orthopedic Surgery requirements in one file.
The Orthopedic Surgery guide as one PDF
The seven PER steps, your document checklist, and the Orthopedic 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 Orthopedic Surgery are in the Fellowship Finder.
Adapted from the Royal College of Physicians and Surgeons of Canada Specialty Training Requirements for Orthopedic 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.