Whether you’re chasing a better work-life balance, lucrative opportunities, scenic landscapes or a new clinical challenge, Canada is becoming an increasingly attractive destination for international medical graduates (IMGs), especially UK doctors. Canada offers multiple pathways for to work in Canada either as an attending (consultant) doctor or entering into a residency (training) program. Below we have provided you an overview of this process:

Why Consider Canada?

• Work-life balance: Less burnout, more time outdoors.
• Better pay with less stress: Physicians often report a more manageable workload with high earning potential.
• High demand: Many provinces are actively recruiting doctors, whether it is in rural or urban areas. 
• Streamlined immigration with pathways to permanent residency (PR) and citizenship: Multiple immigration streams ( including category-based Express Entry for healthcare workers)
• Cultural diversity: Cities such as Toronto and Vancouver are among the most multicultural in the world
• Universal healthcare system: Free health-care services to all Canadian residents (funded by taxes) regardless of their financial status. 

Timeline at a Glance

Immigration: Do You Need PR or a Work Visa?

Immigration route depends on whether you’re applying for residency training or direct licensure.

Permanent Residency (PR)

Required if you plan to enter Canada’s national residency match system (CaRMS). Only individuals with a PR or Canadian citizenship can apply for a residency (training) program in Canada. PR can be applied through the following options:

• Express Entry (e.g., Federal Skilled Worker, Canadian Experience Class)
• Provincial Nominee Programs (PNPs)
• Spousal sponsorship

Employer-Sponsored Work Visa

If you qualify for direct licensure, you may bypass PR and work under a temporary visa sponsored by a hospital or health authority. This is common for UK-trained doctors.

Pathways to Licensure in Canada

1. Direct Licensure (Approved Jurisdictions)

Canada recognizes the medical training systems of certain countries as equivalent—these are known as “approved jurisdictions.” This includes the UK, Australia, New Zealand, Ireland and the USA. Doctors from these countries may be eligible for provisional or full licensure depending on the province, without the need to do further residency training or the NAC OSCE (clinical) examination. All that is required is passing the Medical Council of Canada Qualifying Examination (MCCQE) Part I (written) exam. This is the most common pathway for doctors trained in an approved jurisdiction due to the high success rate. 

This pathway is deal for doctors who have:

• Completed a residency training in a country on the approved jurisdiction list
• Passed the MCCQE Part I exam

The following are the steps required when applying for the direct licensure route:

• Study and pass the MCCQE1 exam
• Set up a PhysiciansApply.ca account
• Submit credential verification and MCCQE1 results
• Apply for training assessment via the Royal College of Physicians and Surgeons of Canada (for specialists) or College of Family Physicians of Canada (CFPC)
• Obtain a letter of eligibility and apply for a provisional or full license via the provincial College of Physicians and Surgeons
• Secure a job offer and apply for a work visa (unless you have PR)

2. Practice Ready Assessment (PRA)

If you’ve completed residency abroad (but not in an approved country), you may qualify for a supervised 12-week clinical assessment followed by a return-of-service (ROS) agreement. ROS requires physicians to work in an underserved area on completion of program for 3-5 years. Currently PRA is offered in the following provinces: BC, Alberta, Saskatchewan, Manitoba, New Brunswick and Nova Scotia

Requirements:

• Language proficiency (assessed by IELTS/OET)
• Recent clinical practice
• MCCQE1 (and sometimes NAC OSCE or Therapeutics Decision-Making exam based on province)

3. Applying for a Canadian Residency Program via CaRMS

This route is ideal for IMGs that have not completed of a post-graduate training/residency program in an approved jurisdiction or for those doctors wanting to retrain in Canada. This pathway is difficult for international medical graduates as there is a preference for Canadian graduates. However, according to latest CARMS data, each year about 30% of IMG get into a Canadian residency program and from the IMG that did medical school in Europe about 66% get into Canadian residency program. The application is made through the Canada’s national residency match system (CaRMS).

The key requirements may require:

• Must have PR or Canadian citizenship
• Pass MCCQE1 exam and NAC OSCE exam
• Apply through CaRMS (competitive)
• ROS (Return-of-Service) may apply post-residency

The application timeline for Canadian residency programs:

• July: Register
• Sept–Dec: Submit applications
• Jan–Feb: Interviews
• March: Match Day

4. Fellowships in Canada

UK-trained specialists may apply for post-residency fellowships in Canada to pursue subspecialty training. These do not require repeating a full residency program in Canada.

Key considerations:

• May require MCCQE1 and credential verification
• Competitive entry with interview and proof of prior training
• Completing fellowships can enhance skills, open career opportunities and build Canadian experience
• Some fellowships are self-funded; others are salaried and funded by institutions

Canadian Medical Licensing Exams 

MCCQE1 

Medical Council of Canada Qualifying Examination Part I (MCCQE1) is a written exam that compromises of multiple choice questions (MCQ). Prior to the recent update in 2025 there was a clinical decision making (CDM) section of exam, but that has now been removed from the exam. This exam tests medical knowledge across key disciplines like internal medicine, surgery, psychiatry and biostatistics. There is also more Canadian specific subjects such as ethics and public health. For IMG

The updated MCCQE1 exam will be about 6.5 hours long. The first MCQ section will be 2 hours and 40 minutes and the second MCQ section will be 2 hours and 40 minutes. There will also be an optional 45 minute break. This computer-based written exam can be done in many countries around the world and does not require doctors to do the exam in Canada. 

Completion of the MCCQE1 is essential for progressing toward full licensure and applying to residency programs. For doctors applying for the direct licensure route (via approved jurisdiction) only require a pass on the MCCQE1 exam. However, when applying for a Canadian residency program, a high MCCQE1 score is required to be competitive. 

NAC OSCE

The National Assessment Collaboration Objective Structured Clinical Examination (NAC OSCE) is a 1-day clinical exam that evaluates how well you perform in patient encounters. Through a series of timed stations with standardized patients, you’ll be assessed on history taking, physical exams, communication and clinical reasoning. The clinical cases cover a variety of topics. The exam is held in multiple cities in Canada and is either in English or French. The NAC OSCE is comprised of 10 stations, each 11 minutes in length with 2-minute breaks between stations to prepare for the next station. NAC OSCE is a vital part of the CaRMS application process for IMGs as the score is vital to determine whether you are offered an interview.

Study Resource Spotlight: PracticeMed

PracticeMed is one of the most widely used platforms among Canadian medical students and international medical graduates preparing for the MCCQE Part I exam. Their platform offers:

• High-quality exam-style MCQ which are closest to the actual exam
• Detailed explanations mapped to MCC objectives and Canadian guidelines
• A performance tracker to monitor progress
• A concise, high-yield textbook covering all exam domains
• Study resources offered in both English and French

Learn more at www.practicemed.ca

Expected Fees 

*Up to 4 MCCQE1 attempts are allowed.

*Fees and exam requirements may vary by pathway: