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How to obtain Residency in Canada

By Unknown - Wednesday, May 18, 2011 6 Comments
(information from a sjsm graduate)

Pathway Summary: Basic Sciences > USMLE Step 1 > Clerkships > MD > MCCEE > +/-
Assessment > CARMS > Residency, MCCQE1 & 2 > Family/Specialty Exam > Able to Practice in

Returning to Canada
1. After clerkships are done and you receive the M.D. designation from your school you can
now apply for residency in Canada (for Residency in the US, you will need to write USMLE
Step 2).
2. Your first step is to arrange to write the MCCEE (Evaluation Exam) from the Medical Council
of Canada: http://www.mcc.ca/en/exams/ee/ (This is the minimum requirement to begin a
residency in Canada; it establishes your basic medical knowledge). This is the MOST
important exam you will write to get into a Canadian residency. To prepare for it, you
will need to study the content that is tested on USMLE Step 2CK, CanadaQbank, and the
material in the Toronto Notes.
a. www.canadaqbank.com
b. http://www.usmle.org/examinations/step2/ck/2010step2ck.pdf
c. http://www.torontonotes.ca/index.php
d. MCCEE online practice exams: https://www.mcc.ca/SelfAdministered/Login.aspx
*I suggest you apply for a Clinical Trainee License which will allow you to do electives in Canada
(as an M.D.) while you wait for CARMs to gain Canadian experience and get some reference
letters. This is arranged through the Province you come back to or live in, e.g. the College of
Physicians and Surgeons of Ontario.

(The most confusing aspect of this process!)
1. Once you pass the exam, you will apply to CARMS (The Canadian Resident Matching
Service) for a residency match; eligibility is listed at:
i. As of 2007, all International Medical Graduates-IMG’s, can apply to 1st iteration
matches, just like any Canadian medical school graduate—Great News!!!
ii. Each year, more money is poured into IMG programs in Canada creating more
residency spots and opportunities!
2. Terminology
i. CARMs 1st iteration: is the first round of applications and placements for Canadian
and international M.D.s. into postgraduate positions (within one of the 17 Canadian
medical school programs).
ii. 2nd iteration: is offered for positions and applicants that were not matched in the first
3. Generally, 1st iteration CARMs spots for IMG’s have a return of service (ROS) attached to the
residency position; i.e. for every year the province pays for your residency training, you owe
them a year of practice after you finish residency. This is generally in an underserviced area
(e.g. Barrie, Newmarket, St. Catherines, Thunder Bay …etc). Ontario is the only province
that attaches a 5 year ROS to your residency no matter how long it is. I.e. whether you do a
2 year family med residency or a 5 year surgery residency, you owe Ontario 5 years in an
underserviced area!
i. There are some 1st iteration CARMs spots that don’t have any ROS (e.g. Manitoba,
ii. CARMs 2nd iteration spots, if left over, have no ROS.
iii. These rules and regulations change yearly, so you will have to keep up to date on
the latest info for each province.
4. For the latest available statistics regarding IMGs and Canada please refer to:
i. http://www.caper.ca/docs/pdf_2005_2009%281%29_img_dbase_report.pdf
ii. http://www.caper.ca/docs/pdf_2009-10_CAPER_Census.pdf
5. Some provinces (e.g. AB, BC, ON) require IMGs to go through assessments before they can
apply to their programs via CARMS, for details see:
a. Ontario: http://www.cehpea.ca/
b. BC: http://www.imgbc.med.ubc.ca/Home.htm
c. AB: http://www.aimg.ca/
6. The competition is fierce in Canada. Many international applicants (like you and I) are
Canadians with full command of the language, who entered as mature students and who
have very impressive resumes. E.g. there were 500+ applicants for 18 positions in the
Winnipeg family medicine program!
i. To stay ahead of the bunch, you will need an excellent MCCEE score, a good
IMG assessment in the province you are interested in, great references, an
impressive and well-prepared interview and sheer determination. It is doable
and every year, hundreds of IMGs match.
ii. If a Canadian citizen with English fluency, you will have a distinct advantage over the
IMG’s that are not.

Residency and Beyond
1. Once accepted into a program (or before if you like), you will write the other Canadian
Licensing Exams:
i. At some point during your residency, the LMCCI:
ii. and (after at least 12 months of residency training) the LMCCII:
2. Once you have finished residency, you will then write either:
i. For family physicians: the College of Family Physicians of Canada Certification
ii. Or for specialists:

Information provided by: David Klein , m.d. 
Our deep thanks and Appreciation to the doctor for taking the time to provide us with this information

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