Practice-ready assessment and other routes for physicians trained abroad

If you finished postgraduate training and practised independently outside Canada, you may not need a Canadian residency. A practice-ready assessment (PRA) is a supervised, workplace-based assessment of about 12 weeks. After it, successful participants usually sign a return-of-service agreement to work in an area of need in that province. The Medical Council of Canada lists one program in each of 9 provinces, and most are for family physicians. U.S. board-certified physicians have a separate route, and licensing and immigration are separate processes.

Applying to residency through CaRMS instead? See IMG eligibility and return of service, province by province.

Independent, not affiliated with these programs, the MCC or any ministry. Last checked 9 Oct 2026: facts were read on the official pages linked in each chip; “not published” means that page doesn’t say. Programs change their rules without notice, so confirm with the program before you apply. This page doesn’t recommend a program and doesn’t list consultants, brokers or paid guides.

Practice-ready assessment programs compared

The Medical Council of Canada lists 9 PRA programs, one per row below. Each is run on its own terms.

Practice-ready assessment programs, one row per program: who runs it, disciplines, seats, eligibility, assessment, return of service and fees
Program and who runs it	Disciplines	Seats or intakes	Eligibility	Assessment length and setting	Return of service	Fees
PRA-BC British Columbia PRA-BC Program (B.C. Ministry of Health). Candidates apply through Health Match BC. Pre-screening criteria are set by PRA-BC and the College of Physicians and Surgeons of BC (CPSBC). Official page: prabc.ca for PRA-BC (opens in a new tab)	Family medicine only (“internationally-trained family physicians”).	“Up to 96 positions” a year from 2024.	Two years of postgraduate training and two years of independent practice as a general or family physician; seven core rotations; 24 weeks (at least 960 hours) of clinical practice in the past 3 years. English test required since 17 Apr 2026 (IELTS Academic 7, OET Medicine B, or CELPIP General 9 in each component, one sitting). Referral to health authorities needs a CPSBC eligibility letter and a pass on the MCC TDM exam within the previous 3 years. Citizenship or PR and MCCQE1 / NAC: not stated on the pre-screening page.	Centralized orientation in Vancouver, then a 12-week Clinical Field Assessment in a specified community, under trained physician assessors. The assessment community differs from the return-of-service community.	Three years, in a community in need. Health authorities choose communities. The contract “warrants independent legal advice”.	No program fee published. Sponsored candidates who complete the 12-week assessment are reimbursed for the TDM exam fee.
PRA-AB Alberta College of Physicians & Surgeons of Alberta (CPSA). Physicians don’t apply for a PRA: CPSA reviews each file, then sends it to the PRA program. Official page: cpsa.ca for PRA-AB (opens in a new tab)	Not stated on the CPSA page. Its TDM step is marked “Family Medicine only”.	Not published. A sponsor and a sponsored job (DoctorJobsAlberta) are required.	For IMGs from outside CPSA’s approved jurisdictions. CPSA decides eligibility case by case after a qualifications review on physiciansapply.ca. Sponsorship and a pass on the TDM exam (family medicine) come before the assessment. Citizenship or PR, training and practice months, MCCQE1 / NAC: not stated on this page.	Part A: 3 months under direct observation in an approved assessor’s practice (may be waived). Part B: 3 months of independent practice with a supervisor. Then the Provisional Register.	Not stated on the CPSA page.	Paid by the sponsor; applicants may be responsible after the sponsor is invoiced. 2026 maximum for Part A and B: $35,625 + GST (2027: $37,160 + GST), travel excluded.
SIPPA Saskatchewan Saskatchewan International Physician Practice Assessment (SIPPA). Requirements are set by the College of Physicians and Surgeons of Saskatchewan (CPSS) and SIPPA. Official page: saskdocs.ca for SIPPA (opens in a new tab)	Family medicine only (“international family physicians”).	Typically three iterations a year (spring, summer, fall); “the number of seats per iteration vary”.	Postgraduate training in family medicine of at least 12 months with set rotations; 26 weeks of full-time family medicine in the past 3 years (3 months before 1 June 2026). MCCQE1 plus the NAC OSCE (a past MCCQE2 pass is accepted); English test; TDM exam. For the independent-practice requirement, “observerships, and preceptorships” do not qualify. Citizenship or PR: not stated on the page.	About 3 weeks of online and 1 week of in-person orientation, then a 12-week Clinical Field Assessment in 2–3 communities other than the return-of-service one.	Three years in a specific underserved rural community, assigned by the Saskatchewan Health Authority and approved by the Ministry of Health.	Accommodation and an honorarium are provided during SIPPA. Fees apply for the CPSS review of qualifications; amounts are not on this page.
University of Manitoba IMG Program Manitoba Max Rady College of Medicine, University of Manitoba (IMG Program). The College of Physicians and Surgeons of Manitoba (CPSM) licenses. Official page: umanitoba.ca for University of Manitoba IMG Program (opens in a new tab)	Family practice (PRA MB-FP) and specialty practice (PRA MB-SP).	Not published. The specialty route needs an approved sponsor and a job offer in a specialty “deemed to be in high need”.	Family practice: a pass on the NAC OSCE or MCCQE2; at least 3 years of independent practice as a general or family practitioner within the 5 years before the deadline; CPSM provisional-registration requirements. Preference to established Manitoba residents. Specialty: you can’t apply to the program directly. Candidates apply to CPSM and for positions posted by sponsoring health authorities; a screening panel selects. Citizenship or PR for the PRA streams: not stated (it is for the separate MLPIMG training program).	Family practice: typically 12 weeks in three 4-week blocks at sites in Winnipeg and rural Manitoba, after a mandatory orientation (the page says both two and four weeks). Housing, a salary and a travel stipend are provided. Specialty: at least 3 months, usually not more than 6, in departments at University of Manitoba affiliated hospitals. A one-year mentorship follows.	Required under the sponsor’s agreement, in rural or underserviced Manitoba. Length: not published on this page.	Not published.
Practice Ready Ontario (PRO) Ontario Touchstone Institute, with the Government of Ontario, Ontario Health and the College of Physicians and Surgeons of Ontario (CPSO). Official page: touchstoneinstitute.ca for Practice Ready Ontario (PRO) (opens in a new tab)	Family medicine only (“internationally educated family physicians”).	Number not published. “Due to limited spaces”, some eligible applicants are invited to a later assessment or intake. Applications are open year-round and processed first come, first served.	Canadian citizen or permanent resident; LMCC; NAC Examination (March 2013 or later) or MCCQE Part 2 (before 2021); TDM exam. 48 months of postgraduate training and independent practice as a family physician; 960 hours of family medicine in the past 3 years, 720 in person; seven core rotations. “Community experience or observerships do not count towards postgraduate training.”	Orientation, then a 12-week Clinical Field Assessment in a designated community, with a stipend. From application to starting return of service, the process “may take up to one year”.	Three years, under an agreement with the Ontario Ministry of Health. Eligible communities have a Rurality Index of Ontario score of 40 or more, are one of five Northern Urban Referral Centres, or have high rates of unattachment to primary care.	No application fee; the assessment and orientation are covered. Candidates pay exam and licensing fees (TDM exam CAN$2,910 as of June 2026).
CMQ PRA (restrictive permit, clinician) Quebec Collège des médecins du Québec (CMQ). A health institution sponsors the candidate through Recrutement Santé Québec (RSQ), a Ministry of Health service. Official page: cmq.org for CMQ PRA (restrictive permit, clinician) (opens in a new tab)	Not limited to family medicine: the permit is for the specialty or discipline you apply in.	Not published. Sponsorship by an institution is required first.	Pass the MCCQE (EACMC), the MCC Evaluating Examination (EECMC, passed before 2019) or USMLE Step 2 CK; postgraduate training broadly equivalent to Quebec’s; a specialist certificate (or equivalent) in the discipline. 12 months of practice in the past 3 years in the field; proof of French (OQLF exam or exemption); the ALDO-Québec course. Citizenship or PR: not stated on the page.	12 consecutive weeks, preceded by one week of observation, in an accredited university clinical setting or another site the CMQ designates. The whole process averages 9–18 months.	Not stated on this page. The permit is restricted to an institution, valid 1 year and renewable.	RSQ sponsorship includes financial support for the file review and the assessment (a fee schedule is linked on the page). Permit issuance fees apply.
PRA-NB New Brunswick College of Physicians and Surgeons of New Brunswick (CPSNB), with the Government of New Brunswick. Offered in English and French. Official page: cpsnb.org for PRA-NB (opens in a new tab)	Family medicine only.	Not published. Selection depends on “assessment capacity”.	Canadian citizen, PR, or legally entitled to live and work in New Brunswick; MCCQE1 (NAC preferred); TDM exam. Two years of postgraduate training plus 1 year of independent practice, or 1 year plus 2 years; seven core rotations; 450 hours of practice in the 3 years before applying.	A clinical field assessment over 12 weeks. Assessment process details: “under development” on the program page.	Not yet published (“will be made available soon”).	$450 non-refundable application fee, plus the MCC application-for-registration fee.
Nova Scotia PACE Nova Scotia Physician Assessment Centre of Excellence (PACE), funded by the Government of Nova Scotia; selection by Nova Scotia Health. The College of Physicians and Surgeons of Nova Scotia sets eligibility. Official page: nspace.ca for Nova Scotia PACE (opens in a new tab)	Office-based primary care and hospitalist medicine (two separate programs).	Number not published. The page says there is “limited space”. Rolling entry: candidates start at various points through the year.	24 months of postgraduate training plus 12 months of independent practice, or 12 months plus 24; 450 hours of practice in scope within the past 5 years. NAC OSCE, MCCQE1 and TDM exams “are not mandatory”, and PACE does not reimburse them, but passing them is favourable in selection. Citizenship or PR: not stated on the pages read.	About 12 weeks on average, 20 at most, competency-based. At two PACE clinics in Halifax, or at Dartmouth General or Colchester East Hants hospitals.	Three years in Nova Scotia, under an agreement with the Department of Health and Wellness.	No program fee published.
PRA-NL Newfoundland and Labrador PRA-NL, Memorial University Faculty of Medicine (OPED). The College of Physicians and Surgeons of Newfoundland and Labrador (CPSNL) licenses; Newfoundland and Labrador Health Services sponsors. Official page: med.mun.ca for PRA-NL (opens in a new tab)	Family medicine, in two pathways: full-scope primary care, or office/community-clinic primary care only.	Not published.	A CPSNL letter of eligibility for a provisional licence first. MCCQE Part I (or USMLE); NAC Examination (March 2013 onward) or MCCQE2; TDM exam. 450 hours of family medicine practice in the previous 3 years; fewer than two prior failed Canadian PRA attempts. Citizenship or PR: not stated, beyond “continuation of eligibility to work in Canada” at assessment entry.	A 12-week clinical field assessment with after-hours and on-call duties; settings depend on the pathway (office, hospital, emergency, nursing homes, home visits).	Not stated on the PRA-NL pages read. Sponsorship by Newfoundland and Labrador Health Services is required to take part.	No program fee published. Candidates pay for interview, orientation and background checks.

PRA-BC (British Columbia)

Disciplines: Family medicine · Return of service: 3 years · Fees: No program fee published

Run by: PRA-BC Program (B.C. Ministry of Health). Candidates apply through Health Match BC.
Pre-screening criteria are set by PRA-BC and the College of Physicians and Surgeons of BC (CPSBC).
Disciplines: Family medicine only (“internationally-trained family physicians”).
Seats or intakes: “Up to 96 positions” a year from 2024.
Eligibility: Two years of postgraduate training and two years of independent practice as a general or family physician; seven core rotations; 24 weeks (at least 960 hours) of clinical practice in the past 3 years.
English test required since 17 Apr 2026 (IELTS Academic 7, OET Medicine B, or CELPIP General 9 in each component, one sitting).
Referral to health authorities needs a CPSBC eligibility letter and a pass on the MCC TDM exam within the previous 3 years.
Citizenship or PR and MCCQE1 / NAC: not stated on the pre-screening page.
Assessment length and setting: Centralized orientation in Vancouver, then a 12-week Clinical Field Assessment in a specified community, under trained physician assessors. The assessment community differs from the return-of-service community.
Return of service: Three years, in a community in need. Health authorities choose communities. The contract “warrants independent legal advice”.
Fees: No program fee published.
Sponsored candidates who complete the 12-week assessment are reimbursed for the TDM exam fee.

Official page: prabc.ca for PRA-BC (opens in a new tab)

PRA-AB (Alberta)

Disciplines: Not stated · Return of service: Not stated · Fees: Paid by the sponsor, up to $35,625 + GST (2026)

Run by: College of Physicians & Surgeons of Alberta (CPSA). Physicians don’t apply for a PRA: CPSA reviews each file, then sends it to the PRA program.
Disciplines: Not stated on the CPSA page. Its TDM step is marked “Family Medicine only”.
Seats or intakes: Not published. A sponsor and a sponsored job (DoctorJobsAlberta) are required.
Eligibility: For IMGs from outside CPSA’s approved jurisdictions. CPSA decides eligibility case by case after a qualifications review on physiciansapply.ca.
Sponsorship and a pass on the TDM exam (family medicine) come before the assessment.
Citizenship or PR, training and practice months, MCCQE1 / NAC: not stated on this page.
Assessment length and setting: Part A: 3 months under direct observation in an approved assessor’s practice (may be waived). Part B: 3 months of independent practice with a supervisor. Then the Provisional Register.
Return of service: Not stated on the CPSA page.
Fees: Paid by the sponsor; applicants may be responsible after the sponsor is invoiced. 2026 maximum for Part A and B: $35,625 + GST (2027: $37,160 + GST), travel excluded.

Official page: cpsa.ca for PRA-AB (opens in a new tab)

SIPPA (Saskatchewan)

Disciplines: Family medicine · Return of service: 3 years, rural community · Fees: Fees apply for the qualifications review; amounts not published

Run by: Saskatchewan International Physician Practice Assessment (SIPPA). Requirements are set by the College of Physicians and Surgeons of Saskatchewan (CPSS) and SIPPA.
Disciplines: Family medicine only (“international family physicians”).
Seats or intakes: Typically three iterations a year (spring, summer, fall); “the number of seats per iteration vary”.
Eligibility: Postgraduate training in family medicine of at least 12 months with set rotations; 26 weeks of full-time family medicine in the past 3 years (3 months before 1 June 2026).
MCCQE1 plus the NAC OSCE (a past MCCQE2 pass is accepted); English test; TDM exam.
For the independent-practice requirement, “observerships, and preceptorships” do not qualify.
Citizenship or PR: not stated on the page.
Assessment length and setting: About 3 weeks of online and 1 week of in-person orientation, then a 12-week Clinical Field Assessment in 2–3 communities other than the return-of-service one.
Return of service: Three years in a specific underserved rural community, assigned by the Saskatchewan Health Authority and approved by the Ministry of Health.
Fees: Accommodation and an honorarium are provided during SIPPA. Fees apply for the CPSS review of qualifications; amounts are not on this page.

Official page: saskdocs.ca for SIPPA (opens in a new tab)

University of Manitoba IMG Program (Manitoba)

Disciplines: Family and specialty practice · Return of service: Required; length not published · Fees: Not published

Run by: Max Rady College of Medicine, University of Manitoba (IMG Program). The College of Physicians and Surgeons of Manitoba (CPSM) licenses.
Disciplines: Family practice (PRA MB-FP) and specialty practice (PRA MB-SP).
Seats or intakes: Not published. The specialty route needs an approved sponsor and a job offer in a specialty “deemed to be in high need”.
Eligibility: Family practice: a pass on the NAC OSCE or MCCQE2; at least 3 years of independent practice as a general or family practitioner within the 5 years before the deadline; CPSM provisional-registration requirements. Preference to established Manitoba residents.
Specialty: you can’t apply to the program directly. Candidates apply to CPSM and for positions posted by sponsoring health authorities; a screening panel selects.
Citizenship or PR for the PRA streams: not stated (it is for the separate MLPIMG training program).
Assessment length and setting: Family practice: typically 12 weeks in three 4-week blocks at sites in Winnipeg and rural Manitoba, after a mandatory orientation (the page says both two and four weeks). Housing, a salary and a travel stipend are provided.
Specialty: at least 3 months, usually not more than 6, in departments at University of Manitoba affiliated hospitals. A one-year mentorship follows.
Return of service: Required under the sponsor’s agreement, in rural or underserviced Manitoba. Length: not published on this page.
Fees: Not published.

Official page: umanitoba.ca for University of Manitoba IMG Program (opens in a new tab)

Practice Ready Ontario (PRO), Ontario

Disciplines: Family medicine · Return of service: 3 years · Fees: No application fee; exam and licensing fees are yours

Run by: Touchstone Institute, with the Government of Ontario, Ontario Health and the College of Physicians and Surgeons of Ontario (CPSO).
Disciplines: Family medicine only (“internationally educated family physicians”).
Seats or intakes: Number not published.
“Due to limited spaces”, some eligible applicants are invited to a later assessment or intake.
Applications are open year-round and processed first come, first served.
Eligibility: Canadian citizen or permanent resident; LMCC; NAC Examination (March 2013 or later) or MCCQE Part 2 (before 2021); TDM exam.
48 months of postgraduate training and independent practice as a family physician; 960 hours of family medicine in the past 3 years, 720 in person; seven core rotations.
“Community experience or observerships do not count towards postgraduate training.”
Assessment length and setting: Orientation, then a 12-week Clinical Field Assessment in a designated community, with a stipend.
From application to starting return of service, the process “may take up to one year”.
Return of service: Three years, under an agreement with the Ontario Ministry of Health.
Eligible communities have a Rurality Index of Ontario score of 40 or more, are one of five Northern Urban Referral Centres, or have high rates of unattachment to primary care.
Fees: No application fee; the assessment and orientation are covered. Candidates pay exam and licensing fees (TDM exam CAN$2,910 as of June 2026).

Official page: touchstoneinstitute.ca for Practice Ready Ontario (PRO) (opens in a new tab)

CMQ PRA (restrictive permit, clinician), Quebec

Disciplines: Any discipline you apply in · Return of service: Not stated · Fees: Sponsorship helps with file review and assessment; permit fees apply

Run by: Collège des médecins du Québec (CMQ). A health institution sponsors the candidate through Recrutement Santé Québec (RSQ), a Ministry of Health service.
Disciplines: Not limited to family medicine: the permit is for the specialty or discipline you apply in.
Seats or intakes: Not published. Sponsorship by an institution is required first.
Eligibility: Pass the MCCQE (EACMC), the MCC Evaluating Examination (EECMC, passed before 2019) or USMLE Step 2 CK; postgraduate training broadly equivalent to Quebec’s; a specialist certificate (or equivalent) in the discipline.
12 months of practice in the past 3 years in the field; proof of French (OQLF exam or exemption); the ALDO-Québec course.
Citizenship or PR: not stated on the page.
Assessment length and setting: 12 consecutive weeks, preceded by one week of observation, in an accredited university clinical setting or another site the CMQ designates. The whole process averages 9–18 months.
Return of service: Not stated on this page. The permit is restricted to an institution, valid 1 year and renewable.
Fees: RSQ sponsorship includes financial support for the file review and the assessment (a fee schedule is linked on the page). Permit issuance fees apply.

Official page: cmq.org for CMQ PRA (restrictive permit, clinician) (opens in a new tab)

PRA-NB (New Brunswick)

Disciplines: Family medicine · Return of service: Not yet published · Fees: $450 application fee plus the MCC registration fee

Run by: College of Physicians and Surgeons of New Brunswick (CPSNB), with the Government of New Brunswick. Offered in English and French.
Disciplines: Family medicine only.
Seats or intakes: Not published. Selection depends on “assessment capacity”.
Eligibility: Canadian citizen, PR, or legally entitled to live and work in New Brunswick; MCCQE1 (NAC preferred); TDM exam.
Two years of postgraduate training plus 1 year of independent practice, or 1 year plus 2 years; seven core rotations; 450 hours of practice in the 3 years before applying.
Assessment length and setting: A clinical field assessment over 12 weeks.
Assessment process details: “under development” on the program page.
Return of service: Not yet published (“will be made available soon”).
Fees: $450 non-refundable application fee, plus the MCC application-for-registration fee.

Official page: cpsnb.org for PRA-NB (opens in a new tab)

Nova Scotia PACE (Nova Scotia)

Disciplines: Primary care and hospitalist medicine · Return of service: 3 years · Fees: No program fee published

Run by: Physician Assessment Centre of Excellence (PACE), funded by the Government of Nova Scotia; selection by Nova Scotia Health. The College of Physicians and Surgeons of Nova Scotia sets eligibility.
Disciplines: Office-based primary care and hospitalist medicine (two separate programs).
Seats or intakes: Number not published. The page says there is “limited space”.
Rolling entry: candidates start at various points through the year.
Eligibility: 24 months of postgraduate training plus 12 months of independent practice, or 12 months plus 24; 450 hours of practice in scope within the past 5 years.
NAC OSCE, MCCQE1 and TDM exams “are not mandatory”, and PACE does not reimburse them, but passing them is favourable in selection.
Citizenship or PR: not stated on the pages read.
Assessment length and setting: About 12 weeks on average, 20 at most, competency-based. At two PACE clinics in Halifax, or at Dartmouth General or Colchester East Hants hospitals.
Return of service: Three years in Nova Scotia, under an agreement with the Department of Health and Wellness.
Fees: No program fee published.

Official page: nspace.ca for Nova Scotia PACE (opens in a new tab)

PRA-NL (Newfoundland and Labrador)

Disciplines: Family medicine · Return of service: Not stated · Fees: No program fee published

Run by: PRA-NL, Memorial University Faculty of Medicine (OPED). The College of Physicians and Surgeons of Newfoundland and Labrador (CPSNL) licenses; Newfoundland and Labrador Health Services sponsors.
Disciplines: Family medicine, in two pathways: full-scope primary care, or office/community-clinic primary care only.
Seats or intakes: Not published.
Eligibility: A CPSNL letter of eligibility for a provisional licence first. MCCQE Part I (or USMLE); NAC Examination (March 2013 onward) or MCCQE2; TDM exam.
450 hours of family medicine practice in the previous 3 years; fewer than two prior failed Canadian PRA attempts.
Citizenship or PR: not stated, beyond “continuation of eligibility to work in Canada” at assessment entry.
Assessment length and setting: A 12-week clinical field assessment with after-hours and on-call duties; settings depend on the pathway (office, hospital, emergency, nursing homes, home visits).
Return of service: Not stated on the PRA-NL pages read. Sponsorship by Newfoundland and Labrador Health Services is required to take part.
Fees: No program fee published. Candidates pay for interview, orientation and background checks.

Official page: med.mun.ca for PRA-NL (opens in a new tab)

Prince Edward Island, Yukon, Nunavut and the Northwest Territories do not offer a practice assessment within the NAC’s pan-Canadian framework at this time.

U.S.-certified physicians

Physicians certified by the American Board of Medical Specialties (ABMS) or the American Board of Family Medicine (ABFM) have a separate route and do not take a PRA. The Medical Council of Canada says they can get full independent licensure at once in British Columbia, Alberta, Saskatchewan, Manitoba, Nova Scotia, New Brunswick, Prince Edward Island; Ontario and Newfoundland and Labrador give restricted or provisional licences first.

Each college’s own page (checked 9 Oct 2026). For Saskatchewan, use the link on the MCC page:

Each province or territory sets its own requirements and can change them. Confirm on the MCC page and the college’s page before you apply.

Immigration

Licensing and immigration are separate processes. IRCC runs an Express Entry category for physicians with at least one year of full-time work experience in Canada in the last 3 years, and it reserves up to 5,000 federal spaces for provinces and territories to nominate doctors who have job offers or letters of support.

Provincial nominee programs:

Links only, checked 9 Oct 2026. Eligibility, draws and streams change; read the current rules on IRCC and the province’s own page.

Observerships

An observership is a short placement in which you observe clinical care. They cost money, and each hospital sets its own application and fee. UHN lists $150 for 1–6 days, $275 for 7–30 days, $400 for 31–90 days. SickKids lists a $275 application fee and, for physicians, a $175 credentialing fee, plus a learning-experience fee by the week. Women’s College Hospital lists application fees of $125 for citizens and permanent residents and $525 for international learners (the page says these are planned). Two programs say on their own pages that observerships don’t count. Practice Ready Ontario: observerships “do not count towards postgraduate training”. SIPPA: observerships are not independent practice. Other programs’ pages may differ, so check each program’s own page before you pay for a placement.

Fees are as published on the pages above and can change. residency.fyi doesn’t list observership or clinical-assistant openings.