A Practice-Ready Assessment (PRA) is a provincial route to a licence for family physicians and general practitioners trained abroad. Instead of repeating residency, you are assessed in clinical practice in the province, and a pass leads to a licence to practise there.
At a glance
Province by province
Abbreviations
- MCCQE
- Medical Council of Canada Qualifying Examination
- NAC
- National Assessment Collaboration
- TDM
- Therapeutics Decision-Making
- PR
- Permanent residency
- Recent practice (GAP)
- Currency of practice requirements
- Family medicine training (PGT)
- Postgraduate training requirements in family medicine rotations
- Independent practice (IPE)
- Independent practice experience as the most responsible physician
- IRCC
- Immigration, Refugees and Citizenship Canada
- CA
- Clinical assistant or associate physician licence
- N/A
- Information not clear or not available on the medical regulatory authority website
Provinces: AB: Alberta; BC: British Columbia; MB: Manitoba; NB: New Brunswick; NL: Newfoundland and Labrador; NS: Nova Scotia; ON: Ontario; QC: Quebec; SK: Saskatchewan.
| Province | MCCQE | NAC Examination |
TDM Examination |
Requires permanent residency | Return of service | Recent practice | Family medicine training | Independent practice |
|---|---|---|---|---|---|---|---|---|
| BC | No | No | Yes | No | 3 years | 960 hours in last 3 years |
2 years | 2 years |
| AB | Registration exam* | No | Yes | No | N/A | 1 year in last 3 years |
Required rotations | 1 year in the last 3 years if PGT is not recent |
| SK | Yes | Yes | Yes | No | 3 years | 6 months in last 3 years; licensed CA time may break gap |
1 year | If less than If 2 years of PGT → no IPE required |
| MB | No | Yes, or MCCQE Part II | Yes | No | Yes, length N/A |
3 years within 5 years immediately preceding the application deadline |
1 to 2 years | If less than If 2 years of PGT → no IPE required |
| ON | Yes | Yes | Yes | Yes | 3 years | 960 hours in last 3 years (720 hours in-person min.); licensed CA time may break gap |
1 to 2 years | If 1 year of PGT → If 2 years of PGT → 2 years of IPE |
| QC | Yes | No | N/A | No. Without PR or citizenship, a temporary work permit is needed before the assessment period. Must be proficient in French |
3 years | 1 year in last 3 years |
2 years | 1 year |
| NB | Yes | Suggested but not required | Yes | No | 3 years | 450 hours in last 3 years |
1 to 2 years | If 1 year of PGT → If 2 years of PGT → 1 year of IPE |
| NS | No | No | No | No | 3 years | 450 hours in last 5 years |
1 to 2 years | If 1 year of PGT → If 2 years of PGT → 1 year of IPE |
| NL | Yes | Yes | Yes | No | Negotiated length N/A |
450 hours in last 3 years |
1 to 2 years | If 1 to 2 years of PGT → If 2 years of PGT → no IPE required |
*CPSA policy: "Have successfully completed a nationally recognized standardized examination in Canada or an Approved Jurisdiction as approved by the Registrar, which evaluates the medical knowledge, clinical skills, and professional competencies required to practice medicine." The MCCQE fulfills this requirement
Common questions
What is a Practice-Ready Assessment (PRA) for IMG family physicians?
A PRA is a provincial route to a licence for family physicians and general practitioners trained abroad. Instead of repeating residency, you are assessed in clinical practice in the province, and a pass leads to a licence to practise there. Nine provinces run one: British Columbia, Alberta, Saskatchewan, Manitoba, Ontario, Quebec, New Brunswick, Nova Scotia, and Newfoundland and Labrador.
Which PRA programs do not require the MCCQE?
British Columbia, Manitoba and Nova Scotia do not list the MCCQE. Alberta asks for a nationally recognized standardized registration exam rather than naming the MCCQE.
Which PRA program requires permanent residency?
Only Practice Ready Ontario requires Canadian citizenship or permanent residence. In Quebec, a candidate without permanent residence or citizenship must obtain a temporary work permit before starting the assessment period.
Is there a PRA with no exam requirement at all?
Yes. NS PACE in Nova Scotia states that the NAC, MCCQE and TDM examinations are not mandatory.
Which PRA programs ask for the TDM?
British Columbia, Alberta, Saskatchewan, Ontario, and Newfoundland and Labrador list the TDM. New Brunswick's college still describes candidates being referred to sit it. Since September 2026 you apply for the TDM directly through the Medical Council of Canada, with no approval from a PRA program. Nova Scotia and Quebec do not list it.
Do all PRA programs have a return of service?
Most do. British Columbia, Saskatchewan, Ontario, Quebec and Nova Scotia require a 3-year return of service. Manitoba's sponsor offer includes a return of service agreement in a rural, underserviced community, with no length stated. New Brunswick's college says its return of service details will be made available soon. Alberta's college does not state one, and the Newfoundland and Labrador program pages do not describe one.
Sources (27), checked October 9, 2026
- Medical Council of Canada, Practice-Ready Assessment. Checked 2026-10-09. Supports: nine provinces run PRA programs.
- PRA-BC, Pre-screening requirements. Checked 2026-10-09. Supports: BC exams, 960 hours in 3 years, 2 years of training, 2 years of independent practice.
- PRA-BC, Referral and selection. Checked 2026-10-09. Supports: the BC TDM requirement.
- PRA-BC, Immigration. Checked 2026-10-09. Supports: BC permanent residence not required at application.
- PRA-BC, Know your ROS community. Checked 2026-10-09. Supports: the BC 3-year return of service.
- CPSA, Apply for independent practice. Checked 2026-10-09. Supports: the Alberta registration exam and recent practice.
- CPSA, Provisional Register, specialty discipline policy (September 2025, PDF). Checked 2026-10-09. Supports: the Alberta exam wording, TDM, rotations, one year in the last three.
- CPSA, Sponsorship. Checked 2026-10-09. Supports: no return of service stated for PRA-AB.
- Health Careers Saskatchewan, SIPPA. Checked 2026-10-09. Supports: the Saskatchewan exams, 6 months in 3 years, training, independent practice, 3-year return of service.
- University of Saskatchewan, SIPPA important updates. Checked 2026-10-09. Supports: the Saskatchewan TDM requirement.
- University of Manitoba, International Medical Graduate (IMG) programs. Checked 2026-10-09. Supports: the Manitoba exams, recent practice, rural return of service, preference for Manitoba residents.
- CPSM, International medical graduates. Checked 2026-10-09. Supports: the Manitoba training and practice options, immigration status.
- Touchstone Institute, Practice Ready Ontario requirements. Checked 2026-10-09. Supports: Ontario LMCC, 960 hours, training and independent practice.
- Touchstone Institute, Practice Ready Ontario. Checked 2026-10-09. Supports: the Ontario NAC, TDM, citizenship or permanent residence, 3-year return of service.
- Collège des médecins du Québec, Permis restrictif clinicien, évaluation de la capacité à exercer. Checked 2026-10-09. Supports: the Quebec exams, 12 months of practice in 3 years, equivalent training, specialist certificate.
- Gouvernement du Québec, Permis restrictif clinicien. Checked 2026-10-09. Supports: the Quebec work permit, French, 3-year return of service.
- CPSNB, PRA-NB eligibility criteria. Checked 2026-10-09. Supports: the New Brunswick MCCQE, NAC preference, status, 450 hours, training and practice.
- CPSNB, PRA-NB process overview. Checked 2026-10-09. Supports: the TDM referral and the return of service details still to come.
- NS PACE, Selection and review. Checked 2026-10-09. Supports: no mandatory exam, legal authority to work, return of service.
- NS PACE, Overview. Checked 2026-10-09. Supports: the Nova Scotia 3-year return of service.
- CPSNS, Currency of practice experience. Checked 2026-10-09. Supports: 450 hours in 5 years.
- CPSNS, Pathway to licensure via a practice-ready assessment, family medicine. Checked 2026-10-09. Supports: the Nova Scotia training and practice options.
- Memorial University, PRA-NL, How to apply. Checked 2026-10-09. Supports: the NL exams (MCCQE, NAC), 450 hours in 3 years.
- Memorial University, PRA-NL, Important dates and deadlines. Checked 2026-10-09. Supports: no application accepted without a TDM pass.
- Memorial University, PRA-NL, Screening and selection. Checked 2026-10-09. Supports: eligibility to work in Canada, NLHS sponsorship.
- CPSNL, Provisional licence, family medicine policy (live October 1, 2026, PDF). Checked 2026-10-09. Supports: the NL training and practice options.
- Medical Council of Canada, New application model and eligibility criteria for the TDM Examination (news, April 15, 2026). Checked 2026-10-09. Supports: direct TDM applications without PRA approval.
Check if you qualify
Open the Eligibility ScreenerFrom the Path to Practice Series
Adapted with attribution from "Physician Licensing in Canada", written by Dr. Filipe Santos and published by the Medical Council of Canada; copyright in the e-book belongs to the MCC, and this site is not affiliated with or endorsed by the MCC. For education only: rules, fees and requirements change, the regulator and the program make every eligibility and licensing decision, and Dr. Santos makes none. Confirm with the program before acting. Full disclaimer.