Interested in practicing medicine in Ontario? Here’s a province-specific spotlight. We’ll review medical registration/licensure, finding a job, and immigration. For general information, read Practicing in Canada: A General Fact Sheet. For more personalized support in moving to Ontario, Canada learn more about out Guidance Service here.
Registration Overview
The College of Physicians & Surgeons of Ontario (CPSO) oversees the certificate of registration – the provincial medical license akin to a state medical license in the US.
In April 2023, they updated their policies making it easier for US-trained physicians to practice in Ontario. They took this step to address Ontario’s physician shortage and make it easier for US-trained doctors to work in Ontario.
Now, physicians Board Certified in the U.S. no longer need supervision or exams. This means US-trained physicians can begin practicing in Ontario to their full scope once they register with the CPSO.
The regulations are evolving, and some application details are being modified and adapted. I’ll share updates as the process becomes more streamlined.
Registration Pathways
There are several pathways to registration but the most relevant ones for US-trained physicians are:
1.Pathway A is for US Board-certified physicians, including American DOs. It is the best and easiest pathway if you work as an independent physician in the US.
You must have an acceptable medical degree from the World Directory of Medical Schools, completed ACGME residency training, have passed the USMLEs, and hold a full license to practice in the US or are eligible for one.
Registration through this pathway results in a unrestricted license enabling you to practice independently, without supervision or additional exams, within your particular “scope of practice”. You can renew this license indefinitely.
2. Pathway C is for US-Board-eligible physicians. Registration through this pathway results in a time-limited, restricted certificate of registration to practice under supervision. Your initial certificate automatically expires within three years from the date of issuance. You must practice with supervision and need to take your US board exams during this time.
Once candidates have been certified by a US Specialty Board, they will be eligible for a restricted certificate of registration under Pathway A.
3. Academic Registration is for physicians recruited by medical schools in Ontario for an academic position as an assistant, associate, or full professor. To qualify you must hold a degree in medicine, US board certification, have a full-time clinical academic appointment offer, and the medical school must be able to assess the physician’s clinical and academic performance.
None of these pathways require Canadian examinations or repeating training! Phew!
Supervision for Pathway C
Finding a supervisor can be a challenging and lengthy process. Many institutions do not have the appropriate staffing to accommodate supervision. It is unlikely you will find a supervisor in a major city. Some supervisors may ask for a percentage of your billings. This is common. It can take 6 months to a year to find a position and a supervisor.
If you require a supervisor, you can approach this in different ways. You can apply directly to jobs and indicate you need a supervisor. You will be a less competitive candidate in academic settings and large cities. In rural areas or underserved areas, it will depend on if they have an appropriate supervisor.
For example, a family physician cannot supervise a general internal medicine physician. Alternatively, the preferred method is to have a supervisor who has agreed to supervise your practice and then apply for a position. Using your professional connections, finding other physicians with similar interests (publications), and networking are ways to find a supervisor.
Registration with CPSO can take 4-5 months to complete. Apply for registration here. Have questions? Email inquiries@cpso.on.ca.
Application Process
You can apply through this CPSO portal.
The CPSO will reply to messages on the portal. They may respond slower via email. In general, they will not make committal statements in writing, especially since this is a new process and things are fluid. It’s easier to reach them via phone, however, they may request you send a message through your applicant portal.
The process can still take up to a year. Plan ahead and expect delays. It’s common for physicians to start later than expected due to credentialling delays.
Finding a Job
There are several ways to find a job. You can:
- Browse the Hippocratic Adventures Job Board for current openings in Ontario.
- Cold email or cold call all the hospitals and or clinics in your desired area to find openings in your specialty
- Search province-specific job boards like Health Force Ontario or Canada-wide job boards like MDwork, drcareers
- Use a recruiting agency. Many U.S.-trained physicians relocating to Canada choose to work with an international medical recruitment agency or directly with health systems or clinics recruiting physicians internationally. These organizations often help coordinate job placement, licensing support, immigration guidance, and relocation logistics. Importantly, reputable recruiters do not charge physicians fees for their services.For example:
For example:
Head Medical is an international physician recruitment agency that has helped thousands of doctors relocate to destinations including Canada, the UK, Australia, New Zealand, the Gulf, and the Caribbean. Their team works closely with hospitals and health authorities and can guide physicians through licensing, immigration, and relocation.
KidCrew is an award-winning multidisciplinary pediatric practice in Toronto, Ontario. The clinics are bright and welcoming, with state-of-the-art technology to improve efficiency and communication between team members. Their diverse team of general pediatricians, pediatric subspecialists, mental health practitioners and allied health care providers work together to provide comprehensive and collaborative care.
Immigration
To finalize the certificate of registration in Ontario before practicing, you must obtain authorization from the Immigration, Refugee, and Citizenship of Canada (IRCC) to live and work in Canada.
If your spouse or parent is a Canadian citizen or permanent resident, they can sponsor you for permanent residency without you having a job offer via Permanent Residency – Family Class. The sponsoring individual must be able to financially support their spouse or child and ensure they won’t need social assistance from the government.
Physicians who do not have family to sponsor them and who are not Canadian citizens or permanent residents need a job offer in hand to apply for immigration via the Temporary Foreign Worker Program work permits or the Federal Skilled Worker Program for permanent residence.
Temporary Foreign Worker Program Work Permit fills temporary labor and skills shortages. This work permit requires:
- A job offer from an organization that received a “Labor Market Impact Assessment” – a document from an employer stating that there is no Canadian Citizen or permanent resident available for this job, hence there is a need to hire a foreign worker.
- A letter confirming approval for a certificate of registration from CPSO
- A IRCC medical examination
- Other IRCC general eligibility requirements
Federal Skilled Worker Program – Express Entry is for skilled workers, like physicians, with foreign work experience who want to immigrate to Canada permanently. It is a point-based system that considers English and/or French language skills (requires a language test), education, work experience, age, a job offer, and adaptability. Check your eligibility then apply.
Bottom Line
If you’re excited to root for the Toronto Maple Leafs or the Ottawa Senators, enjoy the Great Lakes, and be near a large multicultural city like Toronto, transitioning your practice to Ontario is doable and does not require extra training!
Feeling overwhelmed or stuck and wanting 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!
👉 Ready to start your adventure? Grab your FREE e-book and learn the 3 steps to kick start your adventure!
Dr. 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. She also provides personalized guidance to physicians looking to move to Ontario, Canada. Learn more and sign up here.
Last Updated November 14, 2024
