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Alternative Pathways to Registration

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We are committed to improving access for qualified doctors looking to practice medicine in Ontario.

The CPSO offers two alternative pathways for physicians looking to gain licensure in the province of Ontario but who are applying outside of our regular registration requirements.

If you gain licensure under one of these pathways, you will undergo an assessment after completing a minimum of one year of supervised practice in Ontario.  Upon satisfactory completion of the assessment, you will be issued a certificate of registration to practice independently in the area that was assessed. Your initial certificate automatically expires 18 months from the date of issuance, but the Registration Committee may renew it with or without terms, conditions and limitations.

Pathway A

We may issue you a certificate if you have:

  • One of the following degrees:
    • an acceptable medical degree as defined in Ontario Regulation 865/93 under the Medicine Act, 1991; or
    • a “doctor of osteopathy” degree granted by an osteopathic medical school in the US that was accredited by the American Osteopathic Association at the time it granted you your degree;
  • successfully completed a residency program accredited by the ACGME;
  • been certified by a US Specialty Board;
  • successfully completed the US Medical Licensing Examination or successfully completed an acceptable qualifying exam; and
  • an independent or full licence to practise without restrictions in the US or are eligible to apply for such a licence.

How we’ve reduced barriers

This adds another pathway to licensure if you are not certified by the RCPSC or CFPC. Under this policy, you now have a route to a certificate of registration to practice medicine independently, limited to your scope of practice.

Unlike our previous policy for ACGME-trained specialists, this pathway does not require that the ACGME residency be comparable in content and duration to a Canadian training program in the same discipline.

Pathway B

The CPSO may issue you a certificate if you have a medical degree from a medical school in Canada accredited by the Council on Accreditation of Canadian Medical Schools, or an acceptable international medical degree. To qualify, you must have: 

  • successfully completed a Canadian residency program or acceptable pre-1993 training;
  • successfully completed the Medical Council of Canada Qualifying Examinations or an acceptable qualifying exam;
  • practised for five or more continuous years in Canada or the United States (US) while holding an independent or full license or certificate of registration without restrictions but does not currently hold a certificate in a Canadian jurisdiction.

How we’ve reduced barriers

This adds another pathway if you are not certified by the RCPSC or CFPC and do not currently hold a certificate in a Canadian jurisdiction. You now have a route to practice medicine independently, limited to your scope of practice.