Pathways to practice medicine in Canada

How to get a residency in Canada? How to practice medicine in Canada? what to do after passing all required Canadian exams? what are the pathways to practice medicine in Canada? these are some questions every IMG has on his mind considering the country they want residency in or want to practice medicine in. This article will answer these questions in Canada’s language.

Before we start, know that if you want to know information about any specific statement, see if it is highlighted and click it. It will link you to a separate article for the specific word

Some Harsh Facts

Basically, it is very difficult for IMGs to get a permanent or even temporary residency in Canada. This is because there are relatively very fewer spots for IMGs to fill in.

pathways to practice medicine in Canada

Pathways to Practice Medicine in Canada

Medical school in Canada

The best way at first would be if you could get your medical degree from a Canadian medical school, that’s your best option but considering that they are highly costly and require much higher competition as you have to pass the MCAT with high scores and there are only around 20 medical schools in Canada. If you seriously want to consider this option then there is another option, you can apply for a clinical clerkship in a medical school for 2 years, upon passing which you will be a Canadian medical graduate. The programs are listed below

After Post-graduation

come to Canada after post graduation or after training some time (usually 2 years) as a general practitioner. This increases your chances of practising medicine in Canada and you may be eligible for the three exams that form your core CV.

  1. The Royal College of Physicians and Surgeons of Canada exam
  2. Medical Council of Canada’s Therapeutics Decision Making (TDM)
  3. Practice Readiness Assessment (PRA)

TDM is only for those IMGs interested in family medicine. The TDM exam standardizes the selection process into the PRA. All info regarding TDM can be found by clicking it. TDM is solely for those who want to practice family medicine. The following steps must take place after your TDM exams to get a membership with the College of Physicians and surgeons of Alberta (Canada)

pathways to practice medicine in canada

The Royal College exams are for all other specialties (not including family medicine). This Pathway is called the Practice Eligibility Route to certification for specialists (PER).

You first have to go through the (PRA) exams and then take your Royal College exams. Specialists that don’t get to work in their respective areas may occasionally be allowed to practice as primary care physicians after they pass the PRA and Royal College exams. Depending on the province where you receive your post-graduate training you may get a permanent or temporary license.

The sites listed below provide more info regarding the PRA exams

IMGs (International medical graduates)

pathways to practice medicine in Canada

This is the most difficult and stressful of options for an IMG. If you are not a Canadian medical school graduate or do not have 24 months post-graduate training or have not worked as a general practitioner and are a fresh candidate wanting to get to Canada (Passing just your MBBS or equivalent undergraduate degree), This is your only way, and believe me it is a hard way to take. Do not demotivate yourself you can still do it. This Pathway is the famous Medical Council of Canada exams pathway. it includes the following three tests:

  1. MCCEE (Medical Council of Canada Evaluating Examination)Before 2018 this was to be taken necessarily before all the other exams but now it can be taken in any order but is still a necessity. They are phasing this MCCEE examination out after 2018 because the MCCQE exam will be available worldwide and IMGs will not have to take the MCCEE exam after that.
  2. NAC-OSCE (National Assessment Collaboration Examination)It is an Objective structured clinical examination (OSCE). This and MCCEE is only taken by IMGs.

  3. MCCQE Part 1 (Medical Council of Canada Qualifying Examination)This exam has two component, an MCQs component, and Clinical decision making.
  4. MCCQE Part 2Not compulsory for residency, you can take this during your stay or residency.

The idea here is that after you pass your NAC-OSCE and MCCEE exams, You are eligible to apply for a residency but you must pass your IELTS exam too, with 7-7.5 bands overall in all subjects.

Note: IELTS nowadays is essential for any foreign residency or examination.

Once you have NAC-OSCE, MCCEE, and IELTS. You can now apply for residency through Canadian Residency Matching Services (CaRMS). Even though you are applying through it, still, each province has their own criteria, described here CaRMS provincial criteria.

Now, If your residency application gets accepted by a program, You are called upon for an interview, The more programs you apply for the higher the chances of getting an interview and success. After the interview, you are asked to rank all you interviewed programs in order of preference. Then they match your preferences to your programs and the one that matched to your program, you get it. After getting matched the program may assess you for usually 4-6 weeks and if you pass that your residency is confirmed.

Clinical Assistant Pathway

There is another way you can work in Canada is by applying for a clinical assistant. This way you will always be under supervision but will be well enumerated and respected. If you wish to work independently then this option is not for you, but if you have tried everything and are still desperate to get to Canada then this is definitely for you.

To summarize the article look at the diagram below, This would recall you whatever you just read

pathways to practice medicine in Canada

This was all about pathways to practice medicine in Canada. Here is an article on tips and tricks for MCC exams for IMGs. Leave your queries or questions in the comments below and they will surely be answered. Thankyou


    • That is the toughest question one can ask anyone but in my opinion, Australia is easier to get residency. If you can do your undergraduate course at a Canadian medical school then Canada is much easier but else than that I would prefer Australia.

  1. Hi , i m Dr Maryam , IMG from Pakistan, i did my mbbs from Pak n having 6 yrs of work experience as general physician in Pak. Can i appear in PRA or i hv to go through all mccee, mccqe etc?

    • hello Dr. Maryam. If you are a Post-graduate having 2 years of experience then yes you can go for PRA through the Second Pathway that is for post-graduates mentioned above.

  2. Asalam o alekum. I’m Dr Shazia azim I have done my mbbs from Pakistan .I have done DCH .and MCPS 2 YEARS , training I have 13 years research experience so can I apply for Canada? If I am eligible then plz send me completely information plz

    • Walaikum as salaam Dr Shazia. I’m happy to tell you that yes you can apply for Canadian residency and you have a very clear chance of getting it too. But the process will take you long and you will most probably start from a lower post. there is no complete information you have to contact the Canadian residency program at they will guide you through the process. Wishing you best of luck

  3. Hi , they said that they are phasing out MCCEE in 2019, then NAC OSCE is the only exam IMG’s have to take?
    and whats the role of MCCQE1 for an IMG ?

    • Hello, Dr Kiran. Yes, they are phasing out MCCEE for international medical graduates because they plan to make MCCCQE part 1 exam conduction internationally. Currently, the MCCEE is only for IMGs and not Canadian residents but after 2018 MCCEE will be phased out worldwide. Secondly, MCCQE part 1 is an essential exam for every IMG else than NAC-OSCE to pass before they can apply for residency through the Standard Pathway mentioned, So NAC-OSCE and MCCQE part 1 are necessary. Thankyou

  4. Hello,
    I’m Dr. Masood, completed MD (6 years basic medical graduation from Ukraine), MPH (non clinical master in public health from Finland) and having 9 years of clinical working experience as as general physician in India and Oman. Currently working in Oman. Which pathway would be suitable for me? Kindly reply me. Thanks

  5. Hello again,
    Thanks for information and suggestions. It’s Dr Masood again. But I’m not specialist, I’m looking for residency in Canada. As I said that I’m general physician (not specialist). Still I need to follow the same pathway as you suggested in your last message?

    • Sorry for having mistaken your qualification, Dr Masood. You will have to take the standard MCC exam pathway. The only advantage you have is you already have some experience so that might match you for a residency program but the path still remains tough for you.

  6. Hi ,I m gynecologist ,I did my FCPS,having 9 years of post FCPS experience,I have to appear in practice readiness assessment ,kindly tel me exact site and procedure how to apply

  7. Hello Hamad, thanks for helping out for IMG.
    My name is Dr Gabriel, I did MBBS in Nigeria and also had an MPH in England. I am a resident Doctor in Obstetrics and Gynaecology with a 6 years active clinical practice. What is the best route for me?

  8. Hello…
    I m dr.punam
    and hv done MBBS and DGO from bangladesh with 6yrs clinical experiences.
    I m here in Montreal as New IMG.
    should I go through all MCCE steps or any other option?
    Another ques is USMLE or MCCE which will be easier for me?

  9. Hi
    I’m Dr Adeyeye. Had my MBBS in Nigeria with 8yrs clinical experience. I intend to do residency in Canada. However, Obs/Gynae is my preferred area of specialisation. I want to know how possible to get O & G residency & what to do (as I don’t feel fulfilled practising any other specialty.
    Also, I want to know if there’s any concession for those that have passed the PLAB exam

    • Hello Dr, Adeyeye. You will have to Pass the MCC exams and then get yourself a residency which is quite a difficult task in Canada. You can read this article on chances to get a residency in Australia, Canada and the USA.
      About Plab, it does not help in any way for a residency in Canada. For O&G residency, you have to go through the MCC exams or the Royal college and PRA pathway. Thankyou

  10. Hello Hamad i want to know about 24 months training. What they expect in it. I have 12 months internship training( 2 months in internal medicine, 3 months in preventive and social medicine, 2 months in surgery and rest in other specialities).and 12 months house job in obs and gynae. 6 months house job in anaesthesia. I have done post graduation in ENT surgery from india and have 8 year of exp after that. Pls let me know which path i should go.

    • Hello sir, You can apply through the Royal College exams and the practice readiness assessment pathway I have described. Click the words to know more about them in detail

  11. Hi brother
    I am Family Physician working in KSA
    I have MCPS and MRCGP INT degrees and four year structured family medicine training from Aga Khan University Hospital Karachi Pakistan
    How should I start my licencing process brother

    • I will update the post on family medicine pathway in 5-6 hours and then you can read it again to know what you should do next Dr Muhammad mataro

  12. asalamualaikm.
    iam doing my internship now…. i just need to move to canada for my postgraduation.. will i get any scholarship for that.. or what are the needs for that. so can you please guide .. thankyou.

    • walaikum as salaam .I do not think there are any scholarship programs available in this case. I do not have much info regarding this Doctor.

  13. Hi , i’m a medical student from Tunisia we study in French , is there anyway please to switch my diploma and studies into an english diploma , and what are the chances please to work in Canada

    • I am afraid you can not do that sir. The chances of getting to practice medicine in Canada are good only if you have graduated from a Canadian medical College. Otherwise there are extremely sleek chances.

  14. Hello Sir! I am a general surgeon from Ukraine with 14 years experience. I going to move Canada with my wife next year , she has PR in Canada. Can you advice me the medical pathway in my situation? I am ready even to be a family physician in Canada. Thank you very much in advance!!!

  15. Assalam Aleikum Hamad,

    I am Iraqi Physician(GP and Ocuupational health practice) with experience of 14 years, I want to migrate to Canada under skilled workers prog. I need your advice regarding which pathway I need to follow?


  16. Thank You Mr. Hamad, You are doing a wonderful job.

    Can I ask you that if a person is a specialist CCT Consultant in Medicine from UK, What’s his procedure for Canada?
    Which place will be better for him
    Canada, Australia, Gulf?

  17. Hello, I am Dr Amber I have done MBBS and a postgraduate diploma in public health from the Canada University of Ottawa. I would like to pursue my clinical career at present I am in Pakistan planning to immigrate to Canada. I would like to ask what will be the best option for me?
    Secondly, is MCPS family medicine valid in Canada?

    Thank you

  18. If I have a canadian PR but I have graduated from Pakistan with 12 months of housejob and 8 months of RMO ship only. What are the possibilities of becoming a surgeon in Canada?


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