The CPSO issues certificates of registration to physicians, allowing them to practise medicine or engage in postgraduate medical training in Ontario, as set out in the Ontario Regulation 865/93: Registration.

Medical degree

The first qualification for any class of certificate is a medical degree. This can come from either an accredited medical school or an acceptable unaccredited medical school.

An accredited medical school means one accredited by the Committee on Accreditation of Canadian Medical Schools or by the Liaison Committee on Medical Education of the United States of America.

It is based upon successful completion of an undergraduate program of medical education that included a clerkship that complies with the regulation made under the Medicine Act, 1991.

A graduate from an acceptable unaccredited school means a person holding an M.D. or equivalent M.D., based upon successful completion of a conventional undergraduate program of education in allopathic medicine that:

1. teaches medical principles, knowledge and skills similar to those taught in undergraduate programs at accredited medical schools in Canada or the US;
2. includes at least 130 weeks of instruction over a minimum of thirty-six months, and was, at the time of graduation, listed in the World Directory of Medical Schools published by the World Health Organization (WHO).

Non-exemptible requirements

As you can see in section 2 of the regulation, every applicant must also meet the following criteria:

• is mentally competent to practise medicine;
• will practise medicine with decency, integrity and honesty and in accordance with the law;
• has sufficient knowledge, skill and judgment to engage in medical practice; and
• can communicate effectively and will display an appropriately professional attitude.

If we identify any issues with your application, we will forward it to our registration committee for review.

Specific types of registration

• Postgraduate Education Certificate of Registration

  You will need a postgraduate education certificate to undertake postgraduate medical training at an Ontario medical school. We renew this certificate annually. 

  Requirements for obtaining this certificate include: 

  • A medical degree from an accredited Canadian or US medical school or from an acceptable international medical school. 
  • An appointment in training at an Ontario medical school. 

  International Medical Graduates are also required to pass the Medical Council of Canada Evaluating Examination (or Part 1 of the Medical Council of Canada Qualifying Examination). 

  The holder of this certificate may practise medicine: 

  • Only as required by the postgraduate program. 
  • Only in clinical teaching units or settings affiliated with a postgraduate program. 

  The holder may not charge fees for services. 

  Medical school graduates seeking postgraduate training in Ontario may apply for entry to an Ontario residency program through the Canadian Resident Matching Service (CaRMS), provided they meet CaRMS eligibility requirements for Ontario. 

  We caution those medical students who wish to take postgraduate training outside Canada, and who wish to return and obtain an Ontario certificate of registration, to seek confirmation from either the Royal College of Physicians and Surgeons of Canada (RCPSC) or the College of Family Physicians of Canada (CFPC) that such training will allow them to be eligible for the certification exams of either of those bodies. You are required to have certification by the RCPSC or CFPC to qualify for independent practice in Ontario. 

• Independent Practice Certificate of Registration

  This certificate authorizes the holder to engage in independent, unsupervised medical practice in Ontario.

  The holder of an Independent Practice certificate is entitled to all the rights and responsibilities of a physician in Ontario and must meet the annual renewal requirements set by the CPSO to maintain the Independent Practice certificate. 

  General Requirements

  1. A medical degree from an accredited Canadian or US medical school or from an acceptable international medical school.
  2. Successful completion of Parts 1 and 2 of the Medical Council of Canada Qualifying Examination (MCCQE) or an acceptable alternative examination. Under the CPSO’s current regulation, acceptable alternative examinations to Parts 1 and 2 of the MCCQE are:
     • If completed successfully before December 31, 1991, the MCCQE (before the introduction of Parts 1 and 2), or 
     • If completed successfully before December 31, 1991, the examinations for the diploma of the National Board of Medical Examiners (NBME) of the United States of America, or 
     • If obtained before December 31, 1991, a score of 75 on each of Component 1 and Component 2 of the Licensing Examination of the Federation of State Medical Boards of the United States of America (FLEX). If FLEX was taken before July 1, 1985, a weighted score average of 75 on all components is required. 
  3. Certification by examination by either the Royal College of Physicians and Surgeons of Canada (RCPSC) or the College of Family Physicians of Canada (CFPC).
  4. Completion in Canada of one year of postgraduate training or active medical practice, or completion of a full clinical clerkship at an accredited Canadian medical school. 
  5. Canadian Citizenship or permanent resident status. 

  The holder of the certificate may only practise in the areas in which he or she is educated and experienced.

• Out of Province Licence Holders

  Physicians practising in another Canadian province or territory may apply for an equivalent certificate of registration in Ontario. We assess these applications under the labour mobility provisions in Ontario's Regulated Health Professions Act relating to the Canadian Free Trade Agreement (CFTA). 

  This allows you to apply on the basis of holding a current Canadian out-of-province licence, rather than on holding the specific postgraduate Canadian qualifications that we would otherwise require. Note, however, that the usual credentialing requirements and fees still apply.

• Academic Practice Certificate of Registration

  General Requirements 

  1. A medical degree from an accredited Canadian or US medical school or from an acceptable international medical school. 
  2. A geographical full-time teaching appointment or a geographical full-time research appointment to the academic staff of an accredited medical school in Ontario at the rank of full or associate professor. 
  3. Certification by the Royal College of Physicians and Surgeons of Canada or by the College of Family Physicians of Canada. 

  Terms, Conditions and Limitations  

  The holder of this certificate of registration may practise medicine only to the extent required by the teaching or research requirements of the academic appointment, and only in a clinical teaching unit formally affiliated with the department of the medical school where the holder has an academic appointment.

  If a medical school in Ontario is recruiting an applicant who does not meet the above qualifications for an academic position, the applicant may be eligible to apply to the CPSO’s registration committee for consideration under Academic Registration policy. 

• Supervised Short Duration Certificate of Registration

  The CPSO may issue this certificate for an appointment solely for one of the following purposes: 

  1. providing assistance that would otherwise be unavailable on an urgent basis relating to a person's medical problem that requires prompt remedy; 
  2. providing, on an interim basis, medical services that would otherwise be unavailable because of a lack of persons able to provide them; or 
  3. providing a brief program of continuing medical education that is primarily for the benefit of members of this College holding certificates of registration authorizing independent practice or academic practice. 

  The supervised short duration appointment must not exceed thirty days in duration, and must be at one of the following: 

  1. an accredited medical school in Ontario; 
  2. a public hospital in Ontario within the meaning of the Public Hospitals Act; 
  3. a psychiatric facility in Ontario within the meaning of the Mental Health Act; or 
  4. an agency of the Crown in right of Ontario or Canada. 

  Terms, Conditions and Limitations

  The holder of a Supervised Short Duration certificate may practise medicine only to the extent required by the holder’s appointment and under the supervision of the member who gave the undertaking and the certificate expires on the earliest of the following days: 

  1. the day of the expiry of the holder’s appointment, 
  2. the day when the holder leaves Ontario, or 
  3. the thirtieth day after the certificate is issued.

  *Note: A physician is not eligible to apply for a supervised short duration certificate if they have not engaged in clinical practice for the preceding two years or more at the time of application, or have had a significantly reduced practice, as they would be subject to the Ensuring Competence: Changing Scope of Practice and/or Re-entering Practice policy.

• Temporary Independent Practice Certificate of Registration

  This certificate authorizes the holder to engage in independent, unsupervised medical practice in Ontario on a temporary basis.  

  General Requirements:

  1. The applicant must hold a full, unrestricted licence or a certificate of practice authorizing independent practice in a Canadian jurisdiction other than Ontario, which may include an indication of the specific areas of practice in which the applicant is authorized to practice independently, based on education, qualifications and experience.
  2. The applicant must have an agreement with, hold an appointment by, or have an offer from a sponsor, including a sponsor listed in paragraph 4, that is approved by the Registrar.
  3. The agreement, appointment or offer must be approved by the Registrar and be solely for the purpose of providing medical services on a temporary basis.
  4. The sponsors referred to in paragraph 2 are:
     1. A hospital within the meaning of the Public Hospitals Actor a private hospital within the meaning of the Private Hospitals Act.
     2. An organization, other than a hospital or private hospital referred to in subparagraph i, that facilitates the provision of medical services.
     3. A member. O. Reg. 510/22, s. 1.

  Terms, Conditions and Limitations

  The holder of a Temporary Independent Practice certificate may practise medicine only to the extent required by the holder’s agreement, appointment or offer and the certificate expires on the earliest of the following days:

  1. the day after the holder’s agreement, appointment or offer expires, or
  2. the ninetieth day after the certificate is issued.

Please send any questions about CPSO certificates of registration via the Member Portal message center. Alternatively, you can call 416-967-2617 or 1-800-268-7096, ext. 617.