CPSO Removes Barriers for Internationally Educated Physicians

4/4/2023

The College of Physicians and Surgeons of Ontario (CPSO) is pleased to share another significant step it has taken to address the physician shortage in Ontario. This morning, CPSO’s Executive Committee of Council approved amendments to our registration policies that will remove barriers making it easier for physicians trained outside of Canada to practice in Ontario.

CPSO Council removed supervision and assessment requirements for physicians who are trained and Board Certified in the U.S., allowing them to begin independent practise in Ontario immediately. The changes were possible due to the similarities in training programs between the U.S. and Canada, and the historical experience with existing assessment process. CPSO is also introducing a new pathway for U.S. physicians who completed their residency training within the last five years and are eligible for their board examinations. Physicians in these circumstances can come to Ontario and practise under supervision while they complete their U.S. Board Exams.

“We have been working diligently since the start of the pandemic to identify opportunities and leverage every mechanism available to us within the constructs of the current legislation,” said CEO and Registrar Dr. Nancy Whitmore. “We will continue to find innovative ways to reduce barriers to practice while ensuring all Ontario physicians are providing high quality care.”

CPSO also approved changes to make it easier for family physicians from Australia, Ireland, the United Kingdom and the United States to practice in Ontario. The changes remove supervision and assessment requirements for physicians who obtain certification from the College of Family Physicians of Canada (CFPC) without further examination allowing these physicians to immediately start independent practice.

These changes are the result of CPSO’s continued efforts to streamline its registration policies in order to improve access for qualified, internationally-educated physicians who can immediately begin providing quality care to patients in Ontario.

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Shae A. Greenfield
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Background

The new Recognition of Certification Without Examination Issued by CFPC policy grants eligible physicians a scope-limited restricted certificate of registration to practise independently in Ontario.

Physician Category	Previous Route and License	New Route and License
Physicians with CFPC certification without examination	Scenario 1: Physicians who have CFPC certification without examination and have completed an acceptable qualifying examination are granted a restricted certificate to practise with a supervisor and/or mentor until the completion of an assessment after a minimum of one year of practice.	Scenario 1: Physicians who have CFPC certification without examination are granted a restricted certificate to practise independently without supervision and assessment, limited to scope of practice.
Physicians with CFPC certification without examination	Scenario 2: Physicians who have CFPC certification without examination and have completed MCCQE1&2 or obtained the LMCC are granted an independent practice certificate.	Scenario 2: Physicians who have CFPC certification without examination and have completed MCCQE1 or obtained the LMCC are granted an independent practice certificate.

The Alternative Pathways to Registration for Physicians Trained in the United States policy has been amended to remove existing supervision and assessment requirements for physicians who are Board Certified in the U.S., enabling them to begin practising in Ontario to their full scope immediately. This removes a barrier and helps increase mobility from the U.S. Given the broad similarities in training programs between the U.S. and Canada, and the historical experience with current assessment processes, Council believed the current supervision and assessment requirements were unnecessarily burdensome.

The policy also introduces a new pathway for U.S. physicians who completed their residency training and are eligible for their relevant board examinations. It considers enabling those physicians to come to Ontario and practise under supervision, while they complete their U.S. Exams.

Physician Category	Previous Route and License	New Route and License
U.S. board-certified physicians	Pathway A: Restricted certificate to practise independently after a minimum of one-year supervision and assessment, limited to scope of practice.	Pathway A: Restricted certificate to practise independently without supervision and assessment, limited to scope of practice.
U.S. board-eligible physicians	N/A	Pathway C: Time-restricted (three years) certificate to practise under supervision until completion of U.S. Specialty Board examination.