Ultimate Guide to Practicing Medicine in Canadaby Dr. Kayla Wolofsky
Here’s a big picture overview of how to practice medicine abroad in Canada. Our later posts detail province-specific information for Ontario, British Columbia, and Quebec.
The criteria for medical licensure/registration in Canada is unique to each province, specialty or subspecialty, and location.
In Ontario you can obtain a restricted license without repeating examinations or training as long as you’re a board certified or board-eligible US physician. The restricted license can be renewed indefinitely. As of April 2023, the College of Physicians & Surgeons Ontario no longer requires US board-certified physicians to undergo a period of supervision. This makes it much easier for US trained physicians to practice in Ontario.
In March 2023, Nova Scotia changed it’s policy as well. US-board certified physicians are now eligible for Full licensure without the need to take additional exams.
British Columbia has similar criteria as Ontario for obtaining a provisional license, though they do expect you to take the Canadian boards, known as the Royal College exams, and advance to a full medical license within a specific period of time.
Some provinces require the total length of postgraduate training to be equivalent to that in Canada. For example, Internal Medicine Residency in Canada is 4 years, compared to 3 years in the US. Emergency Medicine training in Canada is 5 years, compared to 4 years in the US. For a US-trained physician, fellowship training contributes to this requirement. For example, three years of internal medicine residency and a one-year fellowship in palliative care meets the 4-year requirement for postgraduate training in internal medicine. This may also be considered on a case-by-case basis based on your training and years of experience.
Notably, Family Medicine physicians boarded through the American Board of Family Medicine (ABFM) can benefit from reciprocity agreements with Canada. This agreement allows an ABFM diplomate to directly seek certification in Canada without additional examinations.
Depending on the province, US trained physicians may need to obtain a provisional license allowing them to practice medicine in their specialty with clinical supervision for 12-18 months. The supervisor should hold a full license in your specialty and will review a handful of your clinical cases on a monthly basis. They will serve as a mentor to educate you on local resources and practices. In general, supervision is more helpful than onerous.
Finding a Job
There are several approaches to finding a job. One approach is to make a list of all the hospitals and or clinics in the province and to cold email/call them to find out if they have openings in your specialty and if there is a local supervisor available. You can search Canada-wide job boards like MDwork and drcareers, province-specific job boards like Health Force Ontario or Health Match BC, or utilize an international recruitment agency.
If you work in an underserved field like psychiatry or family medicine, you will have an easier time finding a job. A highly specialized individual’s job prospects may be limited to the urban areas. That being said, if the province or hospital needs you, it may be possible to practice without completing medical licensing exams or boards.
Below you will find our partner recruitment organizations. If inquiring with the organization, mention that you are with Hippocratic Adventures. You will support our community and website.
Head Medical is a leading specialist in international medical recruitment, having helped 1,000s of physicians find new roles in amazing locations including UK, Australia, New Zealand, Singapore, China, the Gulf, Canada and Caribbean. So, if you think you might be interested in a new challenge and a change of scene, please get in touch for a chat with one of their recruitment specialists. Their expert team will support you with your licensing and immigration paperwork and provide practical advice to ensure your relocation goes as smoothly as possible.
Nova Scotia Health Authority is a provincial health authority serving Nova Scotia Canada. They are currently looking for physicians to fill job postings in Nova Scotia, Canada.
Work Culture & Salary
Canadian Medicare is Canada’s universal, decentralized, publicly funded health system. Canadians are provided a basic level of coverage under Canadian Medicare, and 2/3 of Canadians purchase private insurance to cover other services.
Most physicians are independent contractors – they buy their own health insurance, their own malpractice insurance, and contribute to their own retirement plan. Malpractice insurance premiums depend on the specialty, but as a ballpark for palliative care is around 250 CDN per month. Physician services are reimbursed through a fee-for-service model, though there has been movement to alternative payment models. Salaries depend on the specialty, with Family physicians making around 271,000 CAD, medical specialists making around 338,000 CAD, and surgical specialists earning 446,000 CAD.
Planning your move?
Step 1: Choose a Province: Decide on the province you want to move to – the process is province specific.
Step 2: Apply for Licensure & Find a Job: Apply for provincial medical registration/licensure and find a job with supervision simultaneously. You can submit credentials for provincial medical licensure at physiciansapply.ca.
Step 3: Immigration: Immigration policies are province dependent. Physicians qualify for Express Entry as a Federal Skilled Worker, and when approved, are invited to apply for permanent residency. You will need to take an English or French Language test.
Transitioning to Canada can take 6 months of longer, so if you are committed to moving, start this process early.
Moving to Canada and practicing medicine is doable and does not require repeating training. Depending on the province you may have to undergo a period of supervision or take the Canadian Boards.
Feeling overwhelmed or stuck and want to talk to someone who’s relocated from the US to Canada? Check out our Guidance Service where we offer one-on-one personalized guidance to help you move to Canada!
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Here’s a glossary of terms to know as you navigate a transition to Canada.
Medical Council of Canada Qualifying Exam (MCCQE) Part 1&2: This is the Canadian Equivalent of the USMLEs. The MCCQE1 is a one-day, computer-based test typically taken in the final year of medical school. The MCCQE2 is a clinical test using standardized patients, typically taken in the first or second year of residency. When a physician has passed both parts of the MCCQE, they are awarded a designation called the Licentiate of the Medical Council of Canada (LMCC). Some provinces require these exams.
Royal College of Physicians & Surgeons of Canada Board Exam: This is equivalent to the American Board of Medical Specialties and its board certification. This organization administers the Canadian boards for specialties and subspecialties, testing a physician’s skills and knowledge in their area of post-graduate training (residency/fellowship). For more information on how to study for these exams check out 5 Tips for Passing the Canadian Royal College Exams and 6 Study Tools to Pass the Canadian Royal College Exams. The family medicine boards are administered by the College of Family Physicians of Canada. Some provinces require these exams.
Provincial Medical License: this is similar to having a state’s medical license. This is provided by each province, often by the College of Physician & Surgeons of [insert province].
Clinical Supervision: Depending on the province, this may be required for physicians coming from the US and working in Canada. This helps a US trained physician learn about and navigate the Canadian healthcare system successfully. A physician certified by the Royal College of Physicians & Surgeons receives a small stipend to supervise a foreign physician for a period of 12-18 months.
The period of supervision involves reviewing together a handful of patient charts and sending summary reports to the provincial College of physicians and surgeons. The frequency of supervision varies, may be more frequent initially, then monthly. At the end of the supervision period, the foreign physician is required to pay the fees for an observer (10,000-15,000 CND), to assess your clinical competence. It can be challenging to find a hospital willing to hire you if you need supervision, though this would depend on the local needs. Having heard from peers who have gone through supervision, this process is not onerous, is helpful, albeit costly
Dr. Kayla Wolofsky is from Toronto, Canada and completed medical school at the University of Queensland in Brisbane Australia. She completed her Internal Medicine residency at Emory University in Atlanta and did a fellowship in palliative care at Harvard University. She is currently a palliative care physician in Toronto and holds an academic position at the University of Toronto.
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