How to Practice Medicine in Ontario, Canada

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.

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 restricted 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:

  1. Cold email or cold call all the hospitals and or clinics in your desired area to find openings in your specialty
  2. Search province-specific job boards like Health Force Ontario or Canada-wide job boards like MDwork, drcareers
  3. Use a recruiting agency. They’ll connect you with a position, and help with the registration paperwork and immigration. Typically, the recruiting agency’s fees are paid by the hospital or clinic.

Below you’ll find our partner clinics and recruitment organizations. If inquiring with the organization, mention that you’re with Hippocratic Adventures. You’ll help support our community and website.

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. Our diverse team of general pediatricians, pediatric subspecialists, mental health practitioners and allied health care providers work together to provide comprehensive and collaborative care. Apply for pediatric positions here.

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.

Sentry Health is a forward-thinking healthcare institution leveraging cutting-edge technology to pioneer a preventative and multidisciplinary approach to patient care. By prioritizing physician training, Sentry Health not only ensures the continuous professional development of healthcare providers but also plays a pivotal role in facilitating the attainment of medical licenses. In addition to training, the clinic goes beyond conventional healthcare models by providing comprehensive support in practice administration, empowering physicians to focus on delivering optimal patient outcomes efficiently and streamlined. With locations throughout Ontario, apply for a position here

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. 

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