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Future MD Canada

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...thinking about applying to medical school in Canada?

...a current medical student or resident in a Canadian faculty of medicine?

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If you answered ‘yes’ to one of the above questions, the Future MD Canada web tool will be of interest to you. This comprehensive tool features a Q&A format, glossary, and cross-referencing to provide factual responses to all of your questions. A broad range of topics address questions related to admissions, costs and funding, international medical graduates, earnings and residency and practice. Click on the link below to enter and start researching!

I'm An Applicant

How do I apply to Canadian medical schools?

Before you apply, Applicants should review the information about the Essential Skills and Abilities Required for ​Entry to a Medical Degree Program at  Canadian Faculties of Medicine of Admission Requirement to ensure you meet the minimum academic requirements.

  1. Applicants should schedule their MCAT if needed (must be done prior to, and within five years of the year of application). For more information on the MCAT  click here

Students interested in the MCAT Fee Assistance Program for Canadians can learn more about the eligibility criteria, application process, and deadlines by visiting AFMC's website at AFMC MCAT Fee Assistance Program. AFMC will review applications, determine eligibility for financial assistance and notify awardees.

  1. Applicants should obtain a copy of their Undergraduate transcript(s) which will be needed to complete the on-line application.
  2. Prepare autobiographical sketch/essay and reference Letters and any additional materials required for submitting.
  3. Application to the medical school is completed on-line. We recommend that you review the online verification report provided to you by schools to ensure that you have submitted all required application materials before the stated deadline.

All applications are completed on line. See the admission requirements guide for details.

How many entry positions and applicants are there for Canadian medical school?
There are 17 accredited faculties of medicine in Canada, distributed geographically across the country. In 2017/18 Faculties received 38,408 applications from 13,929 applicants to fill the 2916 first year seats available. Schools made a total of 3805 offers (some applicants received multiple offers) and 2889 students are enrolled. Overall 18.6% of applicants received at least one offer (CMES Table F-11). There is an increasing number of applicants every year, while the number of positions available for entry does not increase significantly. For detail information about the entry positions and statistics on applications and success rates for each school, Please visit AFMC website , the official quota position are available Here.
How much does it cost to apply to Canadian medical school?

Every Canadian medical school charge a non-refundable application fee to open an applicant file. Some programs charge an additional service fee.

In Ontario, where applications are centralized through the Ontario Medical Schools Application Service (OMSAS), there is a one-time service fee of $220 (CAD) charged by OMSAS that is added to the individual university application fee.

The only other school that receives its applications from an external service is Memorial University of Newfoundland, which works through the Canadian Resident Matching Service (CaRMS) Online Admissions Application Service. The service fee associated with this application is $155 (CAD) plus taxes.

Summary Application Cost 2019/20

 

 

 

 

 

University / Province

Application Fees

Other Fees

MCAT

 CASPer

Memorial University of Newfoundland

$231.75

$155(CaRMS)

$315 (USD)

 

Dalhousie University

$70

 

$315 (USD)

$50

Université Laval

$84

 

 

 

Université de Sherbrooke

$82

 

 

$50

Université de Montréal

$99

 

 

 

McGill University

$160

 

$315 (USD)

$50

University of Ottawa

$345

$220 (Ontario has a one time fee to use OMSAS application portal)

 

$50

Queen’s University

$125

$315 (USD)

 

University of Toronto

$130

$315 (USD)

 

McMaster University

$345

$315 (USD)

$50

Western University

$125

$315 (USD)

 

Northern Ontario School of Medicine

$100

 

$50

University of Manitoba

$100

 

$315 (USD)

$50

University of Saskatchewan

$150

 

 

 

University of Alberta

$180

 

$315 (USD)

$50

University of Calgary

$150

 

$315 (USD)

 

University of British Columbia

$124.25

 

$315 (USD)

 

What variations exist among provinces with respect to admissions?

All provinces have large proportion of quota for they own province applicants. The selection factor includes applicants’ residence (within province or outside province).

     

 

Province and School Quota 2019/20

     

 

Province

Faculty of Medicine

Quota

Quota allocation

 

within province

%

outside province

%

 

Nfld & Labrador

Memorial Univ.

80

74

92.50%

6

7.50%

 

Maritime Provinces

Dalhousie Univ.

109

100

91.74%

9

8.26%

 

Quebec

Laval, Université

221

214

96.83%

7

3.17%

 

Sherbrooke, Univ. de

199

166

83.42%

33

16.58%

 

Montréal, Univ. de

291

278

95.53%

13

4.47%

 

McGill University

250

239

95.60%

11

4.40%

 

Ontario*

Ottawa, Univ. of

156

139

89.10%

17

10.89%

 

Queen’s University

100

77

77%

23

23%

 

Toronto, Univ. of

259

Not Reported

 

McMaster University

203

190

93.6%

13

6.4%

 

Western University

171

154

90.06%

17

9.94%

 

Northern ON Schl of Med

64

59

92.19%

5

7.81%

 

Manitoba

Manitoba, Univ. of

110

105

95.00%

5

5.00%

 

Saskatchewan

Saskatchewan, Univ. of

100

95

95.00%

5

5.00%

 

Alberta

Alberta, University of

162

138

85.00%

24

15.00%

 

Calgary, University of

150

128

85.00%

22

15.00%

 

British Columbia

British Columbia, Univ. of

288

259

89.93%

29

10.07%

 

   
                 

 

Differences application process may exist in provinces.

Quebec has a different system from the rest of Canada.

Medical Schools in Québec:

• McGill University Faculty of Medicine – Location: Montréal, QC

• Université Laval Faculté de Médecine *FRENCH ONLY* – Location: Québec City, QC

• Université de Montréal Faculté de Médecine *FRENCH ONLY* – Location 1: Montréal, QC; 2: Trois-Rivières, QC (in partnership with Université du Quebec à Trois-Rivières)

• Université de Sherbrooke Faculté de Médecine et Des sciences de la Santé *FRENCH ONLY* – Location 1: Sherbrooke, QC; 2: Chicoutimi, QC (in partnership with Université du Québec à Chicoutimi); 3: Moncton, NB (in partnership with Université de Moncton)

 

The pre-interview screening is solely based on your grades. After the Multiple mini-interview MMI, the rank list will be established from your MMI score and your cumulative R-score (50 : 50).

 

R-score (Cote R) The grading system in Quebec is slightly different from the rest of Canada. The French universities (ULaval, UdeM, and Sherbrooke) will transform your GPA to a R-score (or CRU, Cote de Rendement Universitaire). The R-score is calculated based on your cumulative GPA, and the ISG of your program (Indicator of the Strength of the Group). This score usually varies between 20-40. Usually 33-34 is the cut-off to get an interview from the medical schools.

Summary of Quebec Faculties of Medicine requirements

Applicant category

Application deadline

Academic requirements

Supporting documents

MCAT

Basic science prerequisites

Quebec Applicants

15-Jan

120-credit degree OR 90-credit degree with DEC

CV , CASPer score, academic history workbook, transcripts

Not required (only McGill required)

2 biology, 3 chemistry, 2 mathematics,3 physics

Out of province Canadians

15-Jan

120-credit degree

CV , CASPer score, academic history workbook, transcripts

Not required (only McGill required)

2 biology, 3 chemistry, mathematics, 3  physics

International

15-Jan

120-credit degree

CV, CASPer score, academic history workbook, transcripts

Not required (only McGill required)

2 biology, 3 chemistry, 2 mathematics, 3  physics

McGill Med-P

01-Mar

DEC in science

CV, CASPer score

Not required (only McGill required)

Biology, chemistry, mathematics, physics

           

In Ontario, application to any of the province’s six medical schools can be done online using the centralized (OMSAS) Ontario Medical Schools Application Service . Applicants simply submit their completed application and required documentation to OMSAS, which then forwards their files to the selected schools.
 

For more detailed information on admission requirements for specific provinces and faculties of medicine, please consult the admissions pages of their websites. Most medical schools in Canada make it possible for applications to be made directly through the admissions page of their website.

Are certain entry positions allocated to specific groups of applicants?

The provincial governments establish the number of positions available for admission at each faculty of medicine in their jurisdiction. Most of the positions in these annual quotas are reserved for applicants who reside in the faculty’s province (or region), while a certain number of others may be set aside for specific groups of applicants, such as:

  • Aboriginal or Inuit applicants
  • French-speaking applicants
  • applicants wishing to complete a joint MD/PhD program

The University of Ottawa has a partnership with the Consortium national de formation en santé through which eight entry positions per year are reserved for French-speaking applicants from outside Quebec and Ontario. This promotes the training of healthcare providers in other parts of the country to help improve service to francophone communities across Canada.

The following table from the Canadian Medical Education Statistics  publication, shows the quota and specific allocation of entry positions at each of Canada’s 17 medical schools.

What are the demographics of students admitted to Canadian medical schools?

The following demographics applied to the 2,951 first-year students who enrolled in Canadian faculties of medicine in 2016/17. The majority were 20 to 25 years old, 58.2% were women in 2016/17.

The women enrolment in Canadian Faculties of Medicine in 2016/17:                                 

  • 66.3% at Memorial University of Newfoundland
  • 55.0% at Dalhousie University
  • 70.0% at Université Laval
  • 61.5% at Université de Sherbrooke
  • 66.3% at Université de Montréal
  • 53.6% at McGill University
  • 60.2% at University of Ottawa
  • 62.0% at Queen’s University
  • 60.05% at University of Toronto
  • 55.6% at McMaster University
  • 40.9% at Western University
  • 73.4% at Lakehead University/Laurentian University (Northern Ontario School of Medicine)
  • 49.1% at University of Manitoba
  • 50.0% at University of Saskatchewan
  • 55.5% at University of Alberta
  • 55.7% at University of Calgary
  • 53.7% at University of British Columbia
     
  • 90 were permanent residents
  • 25.3% chose French as their language of instruction
    • Université Laval, Université de Sherbrooke, Université de Montréal, and University of Ottawa are the only schools that offer French-language instruction
    • University of Ottawa is the only bilingual medical school in Canada
  • Almost 3.5% (101 in total) were not Canadian citizens
  • 11 had a student or diplomatic visa
What qualifications do international student need to apply to Canadian medical school?

There is a limited number of positions for the international student. The following schools accept international medical students: Memorial, Dalhousie, Laval, Sherbrooke, Montréal, McGill, Ottawa, Queen’s, Toronto, McMaster, Western, Saskatchewan, Calgary and UBC.

 

There is a general guide as to admission requirements and policies for international students in school’s admission website, as listed in the Admissions Requirements Guide. Some Institutes have an agreement with certain nations to get more of their citizens as foreign student, which are known as “supernumerary” positions (i.e. creating extra position through a contractual agreement with countries).

 

An international applicant is eligible to apply Canadian medical school as a member of this category if he or she (a) requires a permit to study in Canada (not as a Canadian citizen or permanent resident), and (b) will have, before the entering year, an undergraduate (Bachelor's) degree for admission as per the Degree requirements, and (c) Applicants with foreign (non-Canadian and non-US) transcripts must go through a credentialing ​evaluation if the university degree was completed outside of Canada, and (d) Students whose first language is not English or French must have verifiable proof of their language fluency. English proficiency evidence can be accomplished by showing up in a TOEFL, IELTS,  MELAB  or CAEL English assessment test. Other tests may be accepted by the individual schools, but you should check this ahead of time.

International students should also make sure they have taken the Medical College Admission Test (MCAT) prior to application if their school of choice requires it.

What international medical school are recognized in Canada?

There are 17 accredited medical education programs at Canadian faculties of medicine and 147 Accredited MD Programs in the United States. Canadian medical schools are accredited by the Committee on Accreditation of Canadian Medical Schools (CACMS) and the Liaison Committee on Medical Education (LCME). American medical schools are accredited by the LCME. Accreditation refers to a standards-based, peer-reviewed process of continuous quality assurance/improvement of the medical education program.

Unless indicated otherwise, Medical degrees obtained from these medical schools are acceptable to the provincial/territorial medical regulatory authorities in Canada, and therefore acceptable to all medical organizations in Canada. For more information about the acceptable medical schools as defined in the Model Standards for Medical Registration in Canada click here.

Anyone who completes a Doctor of Medicine (MD) degree outside of these accredited Canadian and American programs and wants to then undertake residency training or practice medicine in Canada is considered an international medical graduate (IMG) including Canadian citizens and permanent resident. IMG apply to residency programs in Canada, there are additional steps they must take and examinations they must pass in order to do so. It is important to note that those who complete MD training outside of the accredited programs in Canada and the US have no guarantee of securing a training position in Canada, let alone in their desired specialty or practice location.

How does a citizen or permanent resident of Canada who studied medicine abroad apply for residency training in Canada, and what are the chance of obtain a position?

Graduates of international medical schools, known as International Medical Graduates or IMGs, including Canadian citizens may apply to residency programs in Canada, but there are additional steps they must take and examinations they must pass in order to do so. It is important to note that those who complete MD training outside of the accredited programs in Canada and the US have no guarantee of securing a training position in Canada, let alone in their desired specialty or practice location.

 IMG’s applying to residency training in Canada require:

  • Academic Requirements
  1. You have earned a medical degree from a school listed on the World Directory of Medical Schools the medical school must be identified in the World Directory and include the Canada sponsor note.
  2. You meet English Language Proficiency
  • Pass the Medical Council of Canada Qualifying Examination
  1. The MCCQE Part I Examination
  2. NAC Examination
  • Multiple Mini Interview (MMI)
  • Match to a Residency Position (current service provider: CaRMS)

 

Applying for a residency, they must go through several additional steps. Provinces have different requirements and positions for IMGs. See below for provincial requirements:

NFLD&Labrador

Practising Medicine in Newfoundland and Labrador

 

Nova Scotia

International Medical Graduates Residency in Nova Scotia

 

Quebec

IMG practice of medicine in Québec

 

Ontario

IMG Practice Medicine in Ontario

 

Manitoba

IMG information on practicing in Manitoba

 

Saskatchewan

International medical graduates Practising in Saskatchewan

 

Alberta

Information for International Medical Graduates (IMGS) in Alberta

 

B.C

Resources and information for all International Medical Graduates in BC

 

Obtaining a residency position can be the most challenging step for IMGs. Some provinces have a dedicated number of positions for IMGs and most provinces now allow IMGs to compete directly with Canadian medical graduates for additional placements through the Residency match 2nd iteration.

There may also be restrictions on residency positions based on discipline, with more spots available for family medicine than specialty disciplines. There are vastly more IMG applicants for post–graduate medical training than there are available positions,

In absolute terms, most IMGs practice in Ontario, which has offered up to 200 new training and assessment spots each year for IMGs. This is followed by Quebec, Alberta, and British Columbia. Provinces with substantial rural populations such as Saskatchewan and Newfoundland rely more on IMGs and employ a higher proportion of them relative to Canadian graduates.

  •  
What are the demographics of students admitted to Canadian medical school?

The following demographics applied to the 2,916 first-year students who enrolled in Canadian faculties of medicine in 2017/18.

  • The majority students were 20 to 25 years old 62.7%,
  • 1643 were women admitted in 2017/18, especially 56.3%.
  • 41 students who admitted were permanent residents 1.4%
  • 735 students chose French as their language of instruction 25.2%
  • Almost 1.9% (55 in total) students were not Canadian citizens
  • 14 international students had a student or diplomatic visa 0.48%
How much is tuition at a Canadian medical school?

Tuition fees are mandatory fees paid by students to help cover the cost of their education. Although they may appear high, they represent a small portion of the total cost of training to become a physician. The actual costs of medical training in Canada are shared by the provincial governments, medical schools, and students. Medical education subsidies paid by the provincial governments vary both by program and province.

Tuition fees depend on a number of factors, including the program in which the learner is registered (e.g., MD, MD/PhD), the learner’s place of residence, and whether he or she is a Canadian citizen/permanent resident, foreign student, or foreign student above quota. Other compulsory fees also apply and vary widely from program to program and, in some cases, from campus to campus.

According to the Canadian Medical Education Statistics (AFMC), the average tuition fee for Canadian Citizen/Permanent Residents for Canadian medical school is $16,798 per year, with Ontario having the highest provincial average at $27,304

What will it cost to become a doctor?

The total cost of medical education in Canada may exceed $100,000, if education-related and non-education related expenses are taken into consideration. See  Costs and Funding: How much is tuition at a Canadian medical school? of the fees in Canadian Faculties of Medicine.

 According to AFMC Graduation Questionnaire 82.5% of Canadian medical graduates reported debt directly related to their medical education1.

Canadian medical graduates reported an average debt of $84,172 for medical school expenses and $80,516 of non-education related debt2.

Most learners accumulate debt while they are in medical school and pay it off over several years after they have completed their training and entered the workforce.

What scholarships are available?

Scholarships, bursaries, and awards are an excellent way of minimizing educational debt, as they can help reduce the cost of tuition and other school-related expenses. All Canadian medical schools have their own financial aid offices, where learners can obtain a list of scholarships available to them.

Many resources are available to help learners pay for their medical education. Every faculty of medicine in Canada has a student affairs office that offers financial counselling, see table below. These offices have access to a vast array of resources on a variety of topics of relevance to learners.

What kind of support is available from the Government of Canada?

Many students count on government financial assistance to pay for their studies. Applying for government financial assistance could be to your advantage because being approved for this assistance is one of the eligibility criteria for some bursaries. In addition, the loans can remain interest free while you’re a full-time student and you aren’t required to make any payments on them as long as you’re a full-time student in an approved postsecondary program.

For more information:

Government assistance page at Universty of Ottawa

 

Family medicine residents and family physicians who will be practising in rural or remote communities, including communities that provide health services to First Nations, Inuit, and Métis populations, may be eligible to have all or part of their loan forgiven through the  Canada Student Loan forgiveness for family doctors and nurses

How do provincial governments contribute to medical education?

The costs of medical training in Canada are shared by the provincial governments, individual faculties, and learners. Although medical education subsidies vary by program and province, the provinces make a greater contribution to medical education than learners themselves.

The provinces also offer a variety of student aid and assistance programs.

At the post graduate (residency) level the provincial governments fully fund the positions.

For more information about these programs—and about repayment options for medical students— visit the Student Affairs Office or Financial Aid Office in the appropriate faculty/jurisdiction.

 

Do medical students earn money?

Clerkship stipends vary significantly among provinces. Some do not offer stipends to learners for clerkship, as it is viewed as an educational process rather than a job. Others offer students who undertake Doctor of Medicine (MD) degrees several hundred dollars per month for the duration of their clerkship. This may be in the form of quarterly lump-sum instalments in a student’s final year of medical school. In provinces that do offer clerkship stipends, the stipends are the same for all of the MD education programs in that jurisdiction. It is recommended that students contact the finance and awards office at their particular faculty of interest for more specific details about clerkship stipends.

Table 7 of the Canadian Medical Education Statistics (CMES) publication (below) illustrates the Duration of Clinical Clerkship and Amount of Stipend in Canadian Faculties of Medicine for 2017/18:

How much does a resident earn?

Once learners graduate from the Doctor of Medicine (MD) degree program and enter their first postgraduate year (PGY) or residency year (R), they start earning an annual salary. The amount of the salary is determined by the province in which the MD training was completed and its professional residents’ association. It increases with every additional year of residency training completed, as shown in the chart below.

Amount paid to post-MD trainees in 2017

What are regional health authorities?

Health regions or health authorities are a governance model used by Canada's provincial governments to administer and/or deliver public healthcare to all Canadian residents. Health care is designated a provincial responsibility under the separation of powers in Canada's federal system. Most health regions are organized along geographic boundaries, but some are organized along operational lines (check here). In several provinces, regional health authorities are residents’ employers.

How much does a practicing physician earn?

In 2015-2016, total clinical payments to physicians increased 3.4% over the previous year to $25.7 billion; this is the second-lowest increase in clinical payments since the Canadian Institute for Health Information (CIHI) began collecting aggregate alternative payment data in 1999. The average gross clinical payment per physician in 2015-2016 was $339,000; this number remained virtually unchanged from 2014-2015. This year, CIHI combined fee-for-service payment data with detailed alternative payment data and for the first time is able to report average gross clinical payments per physician by specialty for 8 provinces (Alberta and Saskatchewan excluded) and Yukon. The average gross clinical payment to family medicine physicians for these selected jurisdictions combined was just more than $275,000, while the average gross payment per medical specialist was $347,000 and that per surgical specialist was $461,000.

For more information about remuneration by specialty: National Physician Database, 2015-2016 Data Release

How are physicians paid in Canada?

The provincial and territorial governments of Canada are responsible for healthcare services provided within their jurisdiction, including the remuneration of physicians and other healthcare professionals. They work in collaboration with the Government of Canada to administer Canada’s Healthcare System – Medicare – under the terms of the Canada Health Act.

There are two primary methods by which physicians in Canada are paid:

  • Fee-for-service is an arrangement whereby the professional, acting as an independent and private contractor, is paid a set amount for each service provided. In 2015-16, 72% of all clinical payments to Canadian physicians were made using this method1.
  • Alternative clinical payment includes all payment arrangements other than fee-for-service. This method is growing in popularity among new physicians, having increased from 10.6% of total clinical payments in 1999-2000 to 28% in 2015-16. Examples of alternative clinical payment include the following2:
    • Salary: Regular payment made to a professional who is an employee of an organization and is responsible to managers for services provided. In Canada, salaried physicians, although they provide services within institutions, generally receive their salary from the provincial insurer rather than the institution in which they work.
    • Retainer: A minimum salary provided to a physician that can be coupled with fee-for-service payments to encourage service provision in areas of lower patient volume.
    • Capitation: Payment made according to the number of people on a patient list. The fee structure can include a premium for complex cases and may be adjusted for the socio-demographic profile of the patient population.
    • Target payments: Payments made for reaching a target level of services delivered that are particularly useful for preventive services.
    • Blended: Payment made using a combination of several remuneration methods. Emerging interdisciplinary primary care practice models (e.g., Family Health Teams in Ontario) combine salary, capitation, and sometimes fee-for-service compensation.
    • Block funding: A funding arrangement commonly used in Canadian hospitals, in which the institution is paid an annual amount to provide services. This amount is generally calculated according to the type and quantity of services provided the previous year and is adjusted for changes in demographics, healthcare costs, and inflation.
    • Funding by episode of care: A remuneration method in which fees are scheduled according to the patient’s diagnosis and classified in a way that reflects the average cost of care required for that diagnosis.

 

For more information about remuneration methods:

A profile of physicians in Canada in 2016

New in Practice Guide, Canadian Medical Association

2014 Survey Results, National Physician Survey

Canada’s Health Care System, Health Canada

National Health Expenditure Trends, 1975 to 2017

What is a “return for service” agreement?

Return of service (ROS) is part of a package of strategies designed to attract physicians to Province’s underserviced communities. you will be sent an agreement describing the terms and conditions associated with the position you have been offered.

Return of Service agreements provide funding to medical trainees in exchange for their commitment to practice in a designated geographic area for a period of time after completion of their training. These agreements provide different types of monetary incentives and may target undergraduate students, postgraduate trainees, or working physicians. The incentives are often given in the form of bursaries, grants, loan forgiveness, and scholarships. Many ROS programs offer a “buy-out option” allowing borrowers to repay their bursary instead of fulfilling their service commitment.

What has been the trend in the number of residency positions in recent years?

The Canadian Post M.D. Education Registry (CAPER) is an excellent source of evidence on trends in residency. As shown in the chart below, there was a 100% increase in the number of PGY-1 trainees in Canada between 2000-01 and 2017-18 to current levels.

Post MD training by where MD received

 

First Year Trainees who are Canadian citizens/Permanent residents
YEAR OF POST-M.D. TRAINING
BY
WHERE THE M.D. DEGREE WAS RECEIVED

Training Year

Country Where the M.D. Degree was Received

Canada

Outside Canada

Total

Count

Row %

Count

Row %

Count

Row %

2014-15

2762

86.2%

444

13.8%

3206

100.0%

2015-16

2765

86.6%

426

13.4%

3191

100.0%

2016-17

2798

87.0%

417

13.0%

3215

100.0%

2017-18

2778

86.8%

423

13.2%

3201

100.0%

Total

38790

86.0%

6310

14.0%

45100

100.0%

 

The data tables in CAPER’s 2017-18 Census provide an overview of current information on residency across Canada.  Table B1 illustrates the number of residents by field of post-Doctor of Medicine (MD) training and rank (e.g., PGY-1, -2) and Table A1 summarizes the number of residents by field of post-MD training and faculty of medicine.

The postgraduate medical education (PGME) departments in each of the 17 Canadian faculties of medicine also have information on residency positions and recent trends. It must be noted that trends have no predictive value with regard to future residency positions.

What are the practice opportunities per specialty and how would a finishing resident find them?

It is challenging to obtain accurate information on available practice opportunities in the medical field, as not all are posted and those that exist in academic settings may be hard to identify. At this time, there is no pan-Canadian tool that examines trends in practice opportunities by specialty.

Since it is the responsibility of individual learners to identify learning and professional opportunities, they should begin researching them as early as possible in the medical education process—before they consider choosing a specialty.

Learners will benefit throughout their careers from developing a solid network of health professional colleagues, faculty representatives, and classmates. Upon completion of their medical residency programs (or even before), learners are advised to talk to their contacts
about possible job opportunities and research job listings on various websites. Those interested in an academic career should contact Canadian medical schools to explore career pathways and opportunities.

The following are useful links to assist students in searching for practice opportunities:

National websites:

Canadian Medical Association Career Centre

Healthcare Careers Opportunities

 

Provincial and territorial websites:

Newfoundland & Labrador: Practice Newfoundland Labrador

Nova Scotia: Physicians Nova Scotia

Brunswick: Careers in Health Care in New Brunswick

Prince Edward Island:  Healthcare career Opportunities

Quebec: Fédération des médecins résidents du Québec.

Ontario: Health Force Ontario

Manitoba: MB Healthcare Providers Network

Saskatchewan: Saskatchewan Medical Association

Alberta: Health Workforce for Alberta[RH1]

British Columbia: Health Match BC

Northwest Territories: Practice North

Nunavut: General Practice Physicians in Nunavut

Yukon: Yukon MD

For more information about transitioning into practice:

Beyond residency training, what other learning opportunities exist?

Sub-specialty residencies are programs of additional medical training undertaken after an initial “core” residency has been completed in a specialty accredited by the Royal College of Physicians and Surgeons of Canada (RCPSC). 

Subspecialty residency training supports sub-specialization in a particular specialty. Subspecialty residents can sometimes practise as physicians in the specialty in which they completed their core (initial)residency (e.g., psychiatry) but cannot practise without supervision in their subspecialty (e.g., child and adolescent psychiatry). This is not always possible, as sometimes training in the core specialty can be double counted towards both the core specialty and sub-specialty training requirements.   Subspecialty residency training programs generally last anywhere from 1 to 3 years.

Diploma programs are a different type of additional accredited learning opportunity available after core or subspecialty residency training. The RCPSC recognizes an increasing number of Areas of Focused Competence (AFC) programs, also known as Diploma Programs.  These disciplines do not meet the criteria for a subspecialty residency but are accredited by the RCPSC following successful submission of an evaluated portfolio of work in a recognized discipline. An example of this type of training is interventional cardiac catheterization, which can only be undertaken after completion of a core residency in internal medicine and a subspecialty residency in cardiology. AFC programs usually take between 1 and 2 years to complete.

Sub-specialty residencies and AFC programs are sometimes referred to (incorrectly) as “fellowships.”  In most institutions, true fellowships are unaccredited learning opportunities that allow trainees to gain expertise in a very specialized area of practice. An example would be such areas as “hand surgery”, which might be undertaken by those with core training in Plastic Surgery or Orthopedics. Fellowships are often delivered using an apprenticeship model of training where the trainee is paired with a single of small number of experts in a particular field.  These additional years of “fellowship training” are not to be confused with membership in the RCPSC, which carries the designation “Fellow of the Royal College of Physicians of Canada” or “Fellow of the Royal College of Surgeons of Canada.”

The specialty of family medicine has additional training that may be offered to residents after completion of residency. These “enhanced skills programs” are accredited under the departments of family medicine at each university. There are national standards for five enhanced skills programs: Emergency Medicine, Palliative Care, Family Practice Anaesthesia, Health Care of the Elderly, and Clinician Scholar. These are known as category 1 programs and are based on a 1 year expected program of study.  Graduates of these programs receive attestation of their completion. Family physicians who complete additional training in any of 5 areas: care of the elderly, palliative care, emergency medicine, family practice anesthesia, and sports medicine will be eligible to receive a Certificate of Added Competency (CAC). Currently, there are 3 ways to achieve a CAC: through completion of extra residency training (a fellowship); through practice experience and professional development; or by acquiring a Certificate of Special Competence in Emergency Medicine. Physicians who complete the CFPC Certification in emergency medicine can choose to use the CFPC(EM) designation, or apply for the CAC in emergency medicine.

Other learning opportunities may be offered at medical schools to assist recent family medicine graduates and family physicians in practice who want to enhance a particular skill required in their community (e.g., Addiction Medicine, Chronic Disease). These learning opportunities are also accredited under the umbrella of enhanced skills programs, to ensure they meet educational standards.  However, the range of skills that may be sought is more broad and flexible.  These programs are known as category 2 programs.

Fellowships are not necessary for all fields of practice, but some require additional training years to ensure that physicians provide the highest quality and most adapted care to their patients. The more specialized a physician is, the more he or she is limited in terms of practice settings. Highly specialized physicians are often affiliated with teaching hospitals and lead academic careers in which research is an important component of their practice.

To find out more about RCPSC subspecialty residencies and areas of focused competence, visit the College’s web portal.
To learn more about enhanced skills programs in family medicine, visit the College of Family Physicians of Canada’s website, which describes its accreditation standards for these programs. The Canadian Medical Association website provides a general overview of 38 specialties at Canada. Please note, this work is currently being updated and is not a comprehensive list of specialties in Canada.
 

How do academic and community-based careers differ? What specialties require an academic setting?

The development of distributed medical education is making it harder to differentiate between academic careers and community-based careers, as teaching settings are expanding beyond classrooms and university teaching hospitals.  

Today, many physicians invest time contributing to medical education. General practitioners/family physicians working in community practices in rural and remote regions of our country provide significant contributions to medical education training. Physicians may or may not receive remuneration for their teaching activities.

Some specialties are, by necessity, limited to specific locations such as tertiary care centres. These fields of practice also require an academic career that contains components of research and education. Other specialties, such as family medicine or paediatrics, allow for a wider set of options (e.g., rural, remote, city centres) and, as such, offer more flexibility in terms of an academic or community-based career.

For more information about requirements and expectations of various specialties:

What are the current practice patterns in various disciplines and what can be expected in terms of work setting, hours, case load, and patients?

Choosing a discipline of practice can be challenging. Since there are many factors to consider in making the best possible decision, starting early is important. There will be many opportunities over the course of a learner’s training to discuss work expectations with experienced practitioners from various practice settings. Many schools also offer integrated mentorship programs to support learners in their decision-making process.  

Every faculty of medicine has a student affairs office that offers career counselling and access to a wide variety of useful resources—both in person and online.

For more information by specialty:

  • The Royal College of Physicians and Surgeons of Canada (RCPSC) has a section of its website devoted to information on specialty training requirements, training objectives, the accreditation processes, and more. The portal is categorized by specialty, subspecialty, special programs, and the areas of focused competence (AFC) diploma.
  • The Canadian Medical Association has published profiles of 38 Canadian specialties, each of which provides an overview of setting, income, and satisfaction levels by practice type.
  • The Association of American Medical Colleges publishes its Careers in Medicine newsletter four times a year. The Choices newsletter provides pertinent information about specialty choice, getting into residency, and other important guidance related to medical student career-planning.  

Most specialties have their own college. Consult their websites for more information.

For more information about family medicine:

The College of Family Physicians of Canada (CFPC) offers a variety of information about the pathways to becoming a family physician, resources for medical students interested in family medicine, and more.

The CFPC has developed a Fact Sheet for Prospective Family Physicians about the field of family medicine that include answers about this field, including salary, training, hours, income and more. 

What tools are available to help medical students choose their electives?
What resources are available to help students decide what specialties to consider?

There are many resources available to help students think through their decision about which specialty to pursue. The following are some suggestions:

  • Visit student affairs offices to discuss options and explore relevant resources
  • Check out the 38 Canadian Specialty Profiles on the Canadian Medical Association website
  • Review the information on specialties on the Royal College of Physicians and Surgeons of Canada website: here
  • Find out more about family medicine as a career through family medicine interest groupsstudent-run groups at each university that organize clinical skills sessions and information seminars on the subject—on the College of Family Physicians of Canada’s website
  • Check out the Association of American Medical Colleges Careers in Medicine tool
  • Talk to professors, teachers, preceptors, and mentors about what it is like to be a specialist
  • Shadow faculty members

 

How many residency positions are there in each specialty?

The Canadian Residency Matching Service (CaRMS) website is an excellent source of data on residency positions in Canada. CaRMS data, which are updated annually, include detailed data tables on residency position in each specialty https://www.carms.ca/wp-content/uploads/2018/06/2018-carms-forum.pdf. Table 12 shows the quota offered to Canadian medical graduate applicants by discipline and Table 14, the dedicated quota offered to international medical graduate applicants by discipline.

Another useful source of current data on this topic can be found in Table G-1 of the CAPER  Annual Census  which shows first year Canadian citizen/permanent resident trainees by type of program and faculty of training.

For more information on how the match process works, see the CaRMS website The Match - how it works.

I'm A Medical Student

What are the demographics of students admitted to Canadian medical school?

The following demographics applied to the 2,916 first-year students who enrolled in Canadian faculties of medicine in 2017/18.

  • The majority students were 20 to 25 years old 62.7%,
  • 1643 were women admitted in 2017/18, especially 56.3%.
  • 41 students who admitted were permanent residents 1.4%
  • 735 students chose French as their language of instruction 25.2%
  • Almost 1.9% (55 in total) students were not Canadian citizens
  • 14 international students had a student or diplomatic visa 0.48%
How much is tuition at a Canadian medical school?

Tuition fees are mandatory fees paid by students to help cover the cost of their education. Although they may appear high, they represent a small portion of the total cost of training to become a physician. The actual costs of medical training in Canada are shared by the provincial governments, medical schools, and students. Medical education subsidies paid by the provincial governments vary both by program and province.

Tuition fees depend on a number of factors, including the program in which the learner is registered (e.g., MD, MD/PhD), the learner’s place of residence, and whether he or she is a Canadian citizen/permanent resident, foreign student, or foreign student above quota. Other compulsory fees also apply and vary widely from program to program and, in some cases, from campus to campus.

According to the Canadian Medical Education Statistics (AFMC), the average tuition fee for Canadian Citizen/Permanent Residents for Canadian medical school is $16,798 per year, with Ontario having the highest provincial average at $27,304

What will it cost to become a doctor?

The total cost of medical education in Canada may exceed $100,000, if education-related and non-education related expenses are taken into consideration. See  Costs and Funding: How much is tuition at a Canadian medical school? of the fees in Canadian Faculties of Medicine.

 According to AFMC Graduation Questionnaire 82.5% of Canadian medical graduates reported debt directly related to their medical education1.

Canadian medical graduates reported an average debt of $84,172 for medical school expenses and $80,516 of non-education related debt2.

Most learners accumulate debt while they are in medical school and pay it off over several years after they have completed their training and entered the workforce.

What scholarships are available?

Scholarships, bursaries, and awards are an excellent way of minimizing educational debt, as they can help reduce the cost of tuition and other school-related expenses. All Canadian medical schools have their own financial aid offices, where learners can obtain a list of scholarships available to them.

Many resources are available to help learners pay for their medical education. Every faculty of medicine in Canada has a student affairs office that offers financial counselling, see table below. These offices have access to a vast array of resources on a variety of topics of relevance to learners.

What kind of support is available from the Government of Canada?

Many students count on government financial assistance to pay for their studies. Applying for government financial assistance could be to your advantage because being approved for this assistance is one of the eligibility criteria for some bursaries. In addition, the loans can remain interest free while you’re a full-time student and you aren’t required to make any payments on them as long as you’re a full-time student in an approved postsecondary program.

For more information:

Government assistance page at Universty of Ottawa

 

Family medicine residents and family physicians who will be practising in rural or remote communities, including communities that provide health services to First Nations, Inuit, and Métis populations, may be eligible to have all or part of their loan forgiven through the  Canada Student Loan forgiveness for family doctors and nurses

How do provincial governments contribute to medical education?

The costs of medical training in Canada are shared by the provincial governments, individual faculties, and learners. Although medical education subsidies vary by program and province, the provinces make a greater contribution to medical education than learners themselves.

The provinces also offer a variety of student aid and assistance programs.

At the post graduate (residency) level the provincial governments fully fund the positions.

For more information about these programs—and about repayment options for medical students— visit the Student Affairs Office or Financial Aid Office in the appropriate faculty/jurisdiction.

 

Do medical students earn money?

Clerkship stipends vary significantly among provinces. Some do not offer stipends to learners for clerkship, as it is viewed as an educational process rather than a job. Others offer students who undertake Doctor of Medicine (MD) degrees several hundred dollars per month for the duration of their clerkship. This may be in the form of quarterly lump-sum instalments in a student’s final year of medical school. In provinces that do offer clerkship stipends, the stipends are the same for all of the MD education programs in that jurisdiction. It is recommended that students contact the finance and awards office at their particular faculty of interest for more specific details about clerkship stipends.

Table 7 of the Canadian Medical Education Statistics (CMES) publication (below) illustrates the Duration of Clinical Clerkship and Amount of Stipend in Canadian Faculties of Medicine for 2017/18:

How much does a resident earn?

Once learners graduate from the Doctor of Medicine (MD) degree program and enter their first postgraduate year (PGY) or residency year (R), they start earning an annual salary. The amount of the salary is determined by the province in which the MD training was completed and its professional residents’ association. It increases with every additional year of residency training completed, as shown in the chart below.

Amount paid to post-MD trainees in 2017

What are regional health authorities?

Health regions or health authorities are a governance model used by Canada's provincial governments to administer and/or deliver public healthcare to all Canadian residents. Health care is designated a provincial responsibility under the separation of powers in Canada's federal system. Most health regions are organized along geographic boundaries, but some are organized along operational lines (check here). In several provinces, regional health authorities are residents’ employers.

How much does a practicing physician earn?

In 2015-2016, total clinical payments to physicians increased 3.4% over the previous year to $25.7 billion; this is the second-lowest increase in clinical payments since the Canadian Institute for Health Information (CIHI) began collecting aggregate alternative payment data in 1999. The average gross clinical payment per physician in 2015-2016 was $339,000; this number remained virtually unchanged from 2014-2015. This year, CIHI combined fee-for-service payment data with detailed alternative payment data and for the first time is able to report average gross clinical payments per physician by specialty for 8 provinces (Alberta and Saskatchewan excluded) and Yukon. The average gross clinical payment to family medicine physicians for these selected jurisdictions combined was just more than $275,000, while the average gross payment per medical specialist was $347,000 and that per surgical specialist was $461,000.

For more information about remuneration by specialty: National Physician Database, 2015-2016 Data Release

How are physicians paid in Canada?

The provincial and territorial governments of Canada are responsible for healthcare services provided within their jurisdiction, including the remuneration of physicians and other healthcare professionals. They work in collaboration with the Government of Canada to administer Canada’s Healthcare System – Medicare – under the terms of the Canada Health Act.

There are two primary methods by which physicians in Canada are paid:

  • Fee-for-service is an arrangement whereby the professional, acting as an independent and private contractor, is paid a set amount for each service provided. In 2015-16, 72% of all clinical payments to Canadian physicians were made using this method1.
  • Alternative clinical payment includes all payment arrangements other than fee-for-service. This method is growing in popularity among new physicians, having increased from 10.6% of total clinical payments in 1999-2000 to 28% in 2015-16. Examples of alternative clinical payment include the following2:
    • Salary: Regular payment made to a professional who is an employee of an organization and is responsible to managers for services provided. In Canada, salaried physicians, although they provide services within institutions, generally receive their salary from the provincial insurer rather than the institution in which they work.
    • Retainer: A minimum salary provided to a physician that can be coupled with fee-for-service payments to encourage service provision in areas of lower patient volume.
    • Capitation: Payment made according to the number of people on a patient list. The fee structure can include a premium for complex cases and may be adjusted for the socio-demographic profile of the patient population.
    • Target payments: Payments made for reaching a target level of services delivered that are particularly useful for preventive services.
    • Blended: Payment made using a combination of several remuneration methods. Emerging interdisciplinary primary care practice models (e.g., Family Health Teams in Ontario) combine salary, capitation, and sometimes fee-for-service compensation.
    • Block funding: A funding arrangement commonly used in Canadian hospitals, in which the institution is paid an annual amount to provide services. This amount is generally calculated according to the type and quantity of services provided the previous year and is adjusted for changes in demographics, healthcare costs, and inflation.
    • Funding by episode of care: A remuneration method in which fees are scheduled according to the patient’s diagnosis and classified in a way that reflects the average cost of care required for that diagnosis.

 

For more information about remuneration methods:

A profile of physicians in Canada in 2016

New in Practice Guide, Canadian Medical Association

2014 Survey Results, National Physician Survey

Canada’s Health Care System, Health Canada

National Health Expenditure Trends, 1975 to 2017

What is a “return for service” agreement?

Return of service (ROS) is part of a package of strategies designed to attract physicians to Province’s underserviced communities. you will be sent an agreement describing the terms and conditions associated with the position you have been offered.

Return of Service agreements provide funding to medical trainees in exchange for their commitment to practice in a designated geographic area for a period of time after completion of their training. These agreements provide different types of monetary incentives and may target undergraduate students, postgraduate trainees, or working physicians. The incentives are often given in the form of bursaries, grants, loan forgiveness, and scholarships. Many ROS programs offer a “buy-out option” allowing borrowers to repay their bursary instead of fulfilling their service commitment.

What has been the trend in the number of residency positions in recent years?

The Canadian Post M.D. Education Registry (CAPER) is an excellent source of evidence on trends in residency. As shown in the chart below, there was a 100% increase in the number of PGY-1 trainees in Canada between 2000-01 and 2017-18 to current levels.

Post MD training by where MD received

 

First Year Trainees who are Canadian citizens/Permanent residents
YEAR OF POST-M.D. TRAINING
BY
WHERE THE M.D. DEGREE WAS RECEIVED

Training Year

Country Where the M.D. Degree was Received

Canada

Outside Canada

Total

Count

Row %

Count

Row %

Count

Row %

2014-15

2762

86.2%

444

13.8%

3206

100.0%

2015-16

2765

86.6%

426

13.4%

3191

100.0%

2016-17

2798

87.0%

417

13.0%

3215

100.0%

2017-18

2778

86.8%

423

13.2%

3201

100.0%

Total

38790

86.0%

6310

14.0%

45100

100.0%

 

The data tables in CAPER’s 2017-18 Census provide an overview of current information on residency across Canada.  Table B1 illustrates the number of residents by field of post-Doctor of Medicine (MD) training and rank (e.g., PGY-1, -2) and Table A1 summarizes the number of residents by field of post-MD training and faculty of medicine.

The postgraduate medical education (PGME) departments in each of the 17 Canadian faculties of medicine also have information on residency positions and recent trends. It must be noted that trends have no predictive value with regard to future residency positions.

What are the practice opportunities per specialty and how would a finishing resident find them?

It is challenging to obtain accurate information on available practice opportunities in the medical field, as not all are posted and those that exist in academic settings may be hard to identify. At this time, there is no pan-Canadian tool that examines trends in practice opportunities by specialty.

Since it is the responsibility of individual learners to identify learning and professional opportunities, they should begin researching them as early as possible in the medical education process—before they consider choosing a specialty.

Learners will benefit throughout their careers from developing a solid network of health professional colleagues, faculty representatives, and classmates. Upon completion of their medical residency programs (or even before), learners are advised to talk to their contacts
about possible job opportunities and research job listings on various websites. Those interested in an academic career should contact Canadian medical schools to explore career pathways and opportunities.

The following are useful links to assist students in searching for practice opportunities:

National websites:

Canadian Medical Association Career Centre

Healthcare Careers Opportunities

 

Provincial and territorial websites:

Newfoundland & Labrador: Practice Newfoundland Labrador

Nova Scotia: Physicians Nova Scotia

Brunswick: Careers in Health Care in New Brunswick

Prince Edward Island:  Healthcare career Opportunities

Quebec: Fédération des médecins résidents du Québec.

Ontario: Health Force Ontario

Manitoba: MB Healthcare Providers Network

Saskatchewan: Saskatchewan Medical Association

Alberta: Health Workforce for Alberta[RH1]

British Columbia: Health Match BC

Northwest Territories: Practice North

Nunavut: General Practice Physicians in Nunavut

Yukon: Yukon MD

For more information about transitioning into practice:

Beyond residency training, what other learning opportunities exist?

Sub-specialty residencies are programs of additional medical training undertaken after an initial “core” residency has been completed in a specialty accredited by the Royal College of Physicians and Surgeons of Canada (RCPSC). 

Subspecialty residency training supports sub-specialization in a particular specialty. Subspecialty residents can sometimes practise as physicians in the specialty in which they completed their core (initial)residency (e.g., psychiatry) but cannot practise without supervision in their subspecialty (e.g., child and adolescent psychiatry). This is not always possible, as sometimes training in the core specialty can be double counted towards both the core specialty and sub-specialty training requirements.   Subspecialty residency training programs generally last anywhere from 1 to 3 years.

Diploma programs are a different type of additional accredited learning opportunity available after core or subspecialty residency training. The RCPSC recognizes an increasing number of Areas of Focused Competence (AFC) programs, also known as Diploma Programs.  These disciplines do not meet the criteria for a subspecialty residency but are accredited by the RCPSC following successful submission of an evaluated portfolio of work in a recognized discipline. An example of this type of training is interventional cardiac catheterization, which can only be undertaken after completion of a core residency in internal medicine and a subspecialty residency in cardiology. AFC programs usually take between 1 and 2 years to complete.

Sub-specialty residencies and AFC programs are sometimes referred to (incorrectly) as “fellowships.”  In most institutions, true fellowships are unaccredited learning opportunities that allow trainees to gain expertise in a very specialized area of practice. An example would be such areas as “hand surgery”, which might be undertaken by those with core training in Plastic Surgery or Orthopedics. Fellowships are often delivered using an apprenticeship model of training where the trainee is paired with a single of small number of experts in a particular field.  These additional years of “fellowship training” are not to be confused with membership in the RCPSC, which carries the designation “Fellow of the Royal College of Physicians of Canada” or “Fellow of the Royal College of Surgeons of Canada.”

The specialty of family medicine has additional training that may be offered to residents after completion of residency. These “enhanced skills programs” are accredited under the departments of family medicine at each university. There are national standards for five enhanced skills programs: Emergency Medicine, Palliative Care, Family Practice Anaesthesia, Health Care of the Elderly, and Clinician Scholar. These are known as category 1 programs and are based on a 1 year expected program of study.  Graduates of these programs receive attestation of their completion. Family physicians who complete additional training in any of 5 areas: care of the elderly, palliative care, emergency medicine, family practice anesthesia, and sports medicine will be eligible to receive a Certificate of Added Competency (CAC). Currently, there are 3 ways to achieve a CAC: through completion of extra residency training (a fellowship); through practice experience and professional development; or by acquiring a Certificate of Special Competence in Emergency Medicine. Physicians who complete the CFPC Certification in emergency medicine can choose to use the CFPC(EM) designation, or apply for the CAC in emergency medicine.

Other learning opportunities may be offered at medical schools to assist recent family medicine graduates and family physicians in practice who want to enhance a particular skill required in their community (e.g., Addiction Medicine, Chronic Disease). These learning opportunities are also accredited under the umbrella of enhanced skills programs, to ensure they meet educational standards.  However, the range of skills that may be sought is more broad and flexible.  These programs are known as category 2 programs.

Fellowships are not necessary for all fields of practice, but some require additional training years to ensure that physicians provide the highest quality and most adapted care to their patients. The more specialized a physician is, the more he or she is limited in terms of practice settings. Highly specialized physicians are often affiliated with teaching hospitals and lead academic careers in which research is an important component of their practice.

To find out more about RCPSC subspecialty residencies and areas of focused competence, visit the College’s web portal.
To learn more about enhanced skills programs in family medicine, visit the College of Family Physicians of Canada’s website, which describes its accreditation standards for these programs. The Canadian Medical Association website provides a general overview of 38 specialties at Canada. Please note, this work is currently being updated and is not a comprehensive list of specialties in Canada.
 

How do academic and community-based careers differ? What specialties require an academic setting?

The development of distributed medical education is making it harder to differentiate between academic careers and community-based careers, as teaching settings are expanding beyond classrooms and university teaching hospitals.  

Today, many physicians invest time contributing to medical education. General practitioners/family physicians working in community practices in rural and remote regions of our country provide significant contributions to medical education training. Physicians may or may not receive remuneration for their teaching activities.

Some specialties are, by necessity, limited to specific locations such as tertiary care centres. These fields of practice also require an academic career that contains components of research and education. Other specialties, such as family medicine or paediatrics, allow for a wider set of options (e.g., rural, remote, city centres) and, as such, offer more flexibility in terms of an academic or community-based career.

For more information about requirements and expectations of various specialties:

What are the current practice patterns in various disciplines and what can be expected in terms of work setting, hours, case load, and patients?

Choosing a discipline of practice can be challenging. Since there are many factors to consider in making the best possible decision, starting early is important. There will be many opportunities over the course of a learner’s training to discuss work expectations with experienced practitioners from various practice settings. Many schools also offer integrated mentorship programs to support learners in their decision-making process.  

Every faculty of medicine has a student affairs office that offers career counselling and access to a wide variety of useful resources—both in person and online.

For more information by specialty:

  • The Royal College of Physicians and Surgeons of Canada (RCPSC) has a section of its website devoted to information on specialty training requirements, training objectives, the accreditation processes, and more. The portal is categorized by specialty, subspecialty, special programs, and the areas of focused competence (AFC) diploma.
  • The Canadian Medical Association has published profiles of 38 Canadian specialties, each of which provides an overview of setting, income, and satisfaction levels by practice type.
  • The Association of American Medical Colleges publishes its Careers in Medicine newsletter four times a year. The Choices newsletter provides pertinent information about specialty choice, getting into residency, and other important guidance related to medical student career-planning.  

Most specialties have their own college. Consult their websites for more information.

For more information about family medicine:

The College of Family Physicians of Canada (CFPC) offers a variety of information about the pathways to becoming a family physician, resources for medical students interested in family medicine, and more.

The CFPC has developed a Fact Sheet for Prospective Family Physicians about the field of family medicine that include answers about this field, including salary, training, hours, income and more. 

What tools are available to help medical students choose their electives?
What resources are available to help students decide what specialties to consider?

There are many resources available to help students think through their decision about which specialty to pursue. The following are some suggestions:

  • Visit student affairs offices to discuss options and explore relevant resources
  • Check out the 38 Canadian Specialty Profiles on the Canadian Medical Association website
  • Review the information on specialties on the Royal College of Physicians and Surgeons of Canada website: here
  • Find out more about family medicine as a career through family medicine interest groupsstudent-run groups at each university that organize clinical skills sessions and information seminars on the subject—on the College of Family Physicians of Canada’s website
  • Check out the Association of American Medical Colleges Careers in Medicine tool
  • Talk to professors, teachers, preceptors, and mentors about what it is like to be a specialist
  • Shadow faculty members

 

How many residency positions are there in each specialty?

The Canadian Residency Matching Service (CaRMS) website is an excellent source of data on residency positions in Canada. CaRMS data, which are updated annually, include detailed data tables on residency position in each specialty https://www.carms.ca/wp-content/uploads/2018/06/2018-carms-forum.pdf. Table 12 shows the quota offered to Canadian medical graduate applicants by discipline and Table 14, the dedicated quota offered to international medical graduate applicants by discipline.

Another useful source of current data on this topic can be found in Table G-1 of the CAPER  Annual Census  which shows first year Canadian citizen/permanent resident trainees by type of program and faculty of training.

For more information on how the match process works, see the CaRMS website The Match - how it works.

I'm Studying Internationally

What qualifications do international student need to apply to Canadian medical school?

There is a limited number of positions for the international student. The following schools accept international medical students: Memorial, Dalhousie, Laval, Sherbrooke, Montréal, McGill, Ottawa, Queen’s, Toronto, McMaster, Western, Saskatchewan, Calgary and UBC.

 

There is a general guide as to admission requirements and policies for international students in school’s admission website, as listed in the Admissions Requirements Guide. Some Institutes have an agreement with certain nations to get more of their citizens as foreign student, which are known as “supernumerary” positions (i.e. creating extra position through a contractual agreement with countries).

 

An international applicant is eligible to apply Canadian medical school as a member of this category if he or she (a) requires a permit to study in Canada (not as a Canadian citizen or permanent resident), and (b) will have, before the entering year, an undergraduate (Bachelor's) degree for admission as per the Degree requirements, and (c) Applicants with foreign (non-Canadian and non-US) transcripts must go through a credentialing ​evaluation if the university degree was completed outside of Canada, and (d) Students whose first language is not English or French must have verifiable proof of their language fluency. English proficiency evidence can be accomplished by showing up in a TOEFL, IELTS,  MELAB  or CAEL English assessment test. Other tests may be accepted by the individual schools, but you should check this ahead of time.

International students should also make sure they have taken the Medical College Admission Test (MCAT) prior to application if their school of choice requires it.

What international medical school are recognized in Canada?

There are 17 accredited medical education programs at Canadian faculties of medicine and 147 Accredited MD Programs in the United States. Canadian medical schools are accredited by the Committee on Accreditation of Canadian Medical Schools (CACMS) and the Liaison Committee on Medical Education (LCME). American medical schools are accredited by the LCME. Accreditation refers to a standards-based, peer-reviewed process of continuous quality assurance/improvement of the medical education program.

Unless indicated otherwise, Medical degrees obtained from these medical schools are acceptable to the provincial/territorial medical regulatory authorities in Canada, and therefore acceptable to all medical organizations in Canada. For more information about the acceptable medical schools as defined in the Model Standards for Medical Registration in Canada click here.

Anyone who completes a Doctor of Medicine (MD) degree outside of these accredited Canadian and American programs and wants to then undertake residency training or practice medicine in Canada is considered an international medical graduate (IMG) including Canadian citizens and permanent resident. IMG apply to residency programs in Canada, there are additional steps they must take and examinations they must pass in order to do so. It is important to note that those who complete MD training outside of the accredited programs in Canada and the US have no guarantee of securing a training position in Canada, let alone in their desired specialty or practice location.

How does a citizen or permanent resident of Canada who studied medicine abroad apply for residency training in Canada, and what are the chance of obtain a position?

Graduates of international medical schools, known as International Medical Graduates or IMGs, including Canadian citizens may apply to residency programs in Canada, but there are additional steps they must take and examinations they must pass in order to do so. It is important to note that those who complete MD training outside of the accredited programs in Canada and the US have no guarantee of securing a training position in Canada, let alone in their desired specialty or practice location.

 IMG’s applying to residency training in Canada require:

  • Academic Requirements
  1. You have earned a medical degree from a school listed on the World Directory of Medical Schools the medical school must be identified in the World Directory and include the Canada sponsor note.
  2. You meet English Language Proficiency
  • Pass the Medical Council of Canada Qualifying Examination
  1. The MCCQE Part I Examination
  2. NAC Examination
  • Multiple Mini Interview (MMI)
  • Match to a Residency Position (current service provider: CaRMS)

 

Applying for a residency, they must go through several additional steps. Provinces have different requirements and positions for IMGs. See below for provincial requirements:

NFLD&Labrador

Practising Medicine in Newfoundland and Labrador

 

Nova Scotia

International Medical Graduates Residency in Nova Scotia

 

Quebec

IMG practice of medicine in Québec

 

Ontario

IMG Practice Medicine in Ontario

 

Manitoba

IMG information on practicing in Manitoba

 

Saskatchewan

International medical graduates Practising in Saskatchewan

 

Alberta

Information for International Medical Graduates (IMGS) in Alberta

 

B.C

Resources and information for all International Medical Graduates in BC

 

Obtaining a residency position can be the most challenging step for IMGs. Some provinces have a dedicated number of positions for IMGs and most provinces now allow IMGs to compete directly with Canadian medical graduates for additional placements through the Residency match 2nd iteration.

There may also be restrictions on residency positions based on discipline, with more spots available for family medicine than specialty disciplines. There are vastly more IMG applicants for post–graduate medical training than there are available positions,

In absolute terms, most IMGs practice in Ontario, which has offered up to 200 new training and assessment spots each year for IMGs. This is followed by Quebec, Alberta, and British Columbia. Provinces with substantial rural populations such as Saskatchewan and Newfoundland rely more on IMGs and employ a higher proportion of them relative to Canadian graduates.

  •  
What has been the trend in the number of residency positions in recent years?

The Canadian Post M.D. Education Registry (CAPER) is an excellent source of evidence on trends in residency. As shown in the chart below, there was a 100% increase in the number of PGY-1 trainees in Canada between 2000-01 and 2017-18 to current levels.

Post MD training by where MD received

 

First Year Trainees who are Canadian citizens/Permanent residents
YEAR OF POST-M.D. TRAINING
BY
WHERE THE M.D. DEGREE WAS RECEIVED

Training Year

Country Where the M.D. Degree was Received

Canada

Outside Canada

Total

Count

Row %

Count

Row %

Count

Row %

2014-15

2762

86.2%

444

13.8%

3206

100.0%

2015-16

2765

86.6%

426

13.4%

3191

100.0%

2016-17

2798

87.0%

417

13.0%

3215

100.0%

2017-18

2778

86.8%

423

13.2%

3201

100.0%

Total

38790

86.0%

6310

14.0%

45100

100.0%

 

The data tables in CAPER’s 2017-18 Census provide an overview of current information on residency across Canada.  Table B1 illustrates the number of residents by field of post-Doctor of Medicine (MD) training and rank (e.g., PGY-1, -2) and Table A1 summarizes the number of residents by field of post-MD training and faculty of medicine.

The postgraduate medical education (PGME) departments in each of the 17 Canadian faculties of medicine also have information on residency positions and recent trends. It must be noted that trends have no predictive value with regard to future residency positions.

What are the practice opportunities per specialty and how would a finishing resident find them?

It is challenging to obtain accurate information on available practice opportunities in the medical field, as not all are posted and those that exist in academic settings may be hard to identify. At this time, there is no pan-Canadian tool that examines trends in practice opportunities by specialty.

Since it is the responsibility of individual learners to identify learning and professional opportunities, they should begin researching them as early as possible in the medical education process—before they consider choosing a specialty.

Learners will benefit throughout their careers from developing a solid network of health professional colleagues, faculty representatives, and classmates. Upon completion of their medical residency programs (or even before), learners are advised to talk to their contacts
about possible job opportunities and research job listings on various websites. Those interested in an academic career should contact Canadian medical schools to explore career pathways and opportunities.

The following are useful links to assist students in searching for practice opportunities:

National websites:

Canadian Medical Association Career Centre

Healthcare Careers Opportunities

 

Provincial and territorial websites:

Newfoundland & Labrador: Practice Newfoundland Labrador

Nova Scotia: Physicians Nova Scotia

Brunswick: Careers in Health Care in New Brunswick

Prince Edward Island:  Healthcare career Opportunities

Quebec: Fédération des médecins résidents du Québec.

Ontario: Health Force Ontario

Manitoba: MB Healthcare Providers Network

Saskatchewan: Saskatchewan Medical Association

Alberta: Health Workforce for Alberta[RH1]

British Columbia: Health Match BC

Northwest Territories: Practice North

Nunavut: General Practice Physicians in Nunavut

Yukon: Yukon MD

For more information about transitioning into practice:

Beyond residency training, what other learning opportunities exist?

Sub-specialty residencies are programs of additional medical training undertaken after an initial “core” residency has been completed in a specialty accredited by the Royal College of Physicians and Surgeons of Canada (RCPSC). 

Subspecialty residency training supports sub-specialization in a particular specialty. Subspecialty residents can sometimes practise as physicians in the specialty in which they completed their core (initial)residency (e.g., psychiatry) but cannot practise without supervision in their subspecialty (e.g., child and adolescent psychiatry). This is not always possible, as sometimes training in the core specialty can be double counted towards both the core specialty and sub-specialty training requirements.   Subspecialty residency training programs generally last anywhere from 1 to 3 years.

Diploma programs are a different type of additional accredited learning opportunity available after core or subspecialty residency training. The RCPSC recognizes an increasing number of Areas of Focused Competence (AFC) programs, also known as Diploma Programs.  These disciplines do not meet the criteria for a subspecialty residency but are accredited by the RCPSC following successful submission of an evaluated portfolio of work in a recognized discipline. An example of this type of training is interventional cardiac catheterization, which can only be undertaken after completion of a core residency in internal medicine and a subspecialty residency in cardiology. AFC programs usually take between 1 and 2 years to complete.

Sub-specialty residencies and AFC programs are sometimes referred to (incorrectly) as “fellowships.”  In most institutions, true fellowships are unaccredited learning opportunities that allow trainees to gain expertise in a very specialized area of practice. An example would be such areas as “hand surgery”, which might be undertaken by those with core training in Plastic Surgery or Orthopedics. Fellowships are often delivered using an apprenticeship model of training where the trainee is paired with a single of small number of experts in a particular field.  These additional years of “fellowship training” are not to be confused with membership in the RCPSC, which carries the designation “Fellow of the Royal College of Physicians of Canada” or “Fellow of the Royal College of Surgeons of Canada.”

The specialty of family medicine has additional training that may be offered to residents after completion of residency. These “enhanced skills programs” are accredited under the departments of family medicine at each university. There are national standards for five enhanced skills programs: Emergency Medicine, Palliative Care, Family Practice Anaesthesia, Health Care of the Elderly, and Clinician Scholar. These are known as category 1 programs and are based on a 1 year expected program of study.  Graduates of these programs receive attestation of their completion. Family physicians who complete additional training in any of 5 areas: care of the elderly, palliative care, emergency medicine, family practice anesthesia, and sports medicine will be eligible to receive a Certificate of Added Competency (CAC). Currently, there are 3 ways to achieve a CAC: through completion of extra residency training (a fellowship); through practice experience and professional development; or by acquiring a Certificate of Special Competence in Emergency Medicine. Physicians who complete the CFPC Certification in emergency medicine can choose to use the CFPC(EM) designation, or apply for the CAC in emergency medicine.

Other learning opportunities may be offered at medical schools to assist recent family medicine graduates and family physicians in practice who want to enhance a particular skill required in their community (e.g., Addiction Medicine, Chronic Disease). These learning opportunities are also accredited under the umbrella of enhanced skills programs, to ensure they meet educational standards.  However, the range of skills that may be sought is more broad and flexible.  These programs are known as category 2 programs.

Fellowships are not necessary for all fields of practice, but some require additional training years to ensure that physicians provide the highest quality and most adapted care to their patients. The more specialized a physician is, the more he or she is limited in terms of practice settings. Highly specialized physicians are often affiliated with teaching hospitals and lead academic careers in which research is an important component of their practice.

To find out more about RCPSC subspecialty residencies and areas of focused competence, visit the College’s web portal.
To learn more about enhanced skills programs in family medicine, visit the College of Family Physicians of Canada’s website, which describes its accreditation standards for these programs. The Canadian Medical Association website provides a general overview of 38 specialties at Canada. Please note, this work is currently being updated and is not a comprehensive list of specialties in Canada.
 

How do academic and community-based careers differ? What specialties require an academic setting?

The development of distributed medical education is making it harder to differentiate between academic careers and community-based careers, as teaching settings are expanding beyond classrooms and university teaching hospitals.  

Today, many physicians invest time contributing to medical education. General practitioners/family physicians working in community practices in rural and remote regions of our country provide significant contributions to medical education training. Physicians may or may not receive remuneration for their teaching activities.

Some specialties are, by necessity, limited to specific locations such as tertiary care centres. These fields of practice also require an academic career that contains components of research and education. Other specialties, such as family medicine or paediatrics, allow for a wider set of options (e.g., rural, remote, city centres) and, as such, offer more flexibility in terms of an academic or community-based career.

For more information about requirements and expectations of various specialties:

What are the current practice patterns in various disciplines and what can be expected in terms of work setting, hours, case load, and patients?

Choosing a discipline of practice can be challenging. Since there are many factors to consider in making the best possible decision, starting early is important. There will be many opportunities over the course of a learner’s training to discuss work expectations with experienced practitioners from various practice settings. Many schools also offer integrated mentorship programs to support learners in their decision-making process.  

Every faculty of medicine has a student affairs office that offers career counselling and access to a wide variety of useful resources—both in person and online.

For more information by specialty:

  • The Royal College of Physicians and Surgeons of Canada (RCPSC) has a section of its website devoted to information on specialty training requirements, training objectives, the accreditation processes, and more. The portal is categorized by specialty, subspecialty, special programs, and the areas of focused competence (AFC) diploma.
  • The Canadian Medical Association has published profiles of 38 Canadian specialties, each of which provides an overview of setting, income, and satisfaction levels by practice type.
  • The Association of American Medical Colleges publishes its Careers in Medicine newsletter four times a year. The Choices newsletter provides pertinent information about specialty choice, getting into residency, and other important guidance related to medical student career-planning.  

Most specialties have their own college. Consult their websites for more information.

For more information about family medicine:

The College of Family Physicians of Canada (CFPC) offers a variety of information about the pathways to becoming a family physician, resources for medical students interested in family medicine, and more.

The CFPC has developed a Fact Sheet for Prospective Family Physicians about the field of family medicine that include answers about this field, including salary, training, hours, income and more. 

What tools are available to help medical students choose their electives?
What resources are available to help students decide what specialties to consider?

There are many resources available to help students think through their decision about which specialty to pursue. The following are some suggestions:

  • Visit student affairs offices to discuss options and explore relevant resources
  • Check out the 38 Canadian Specialty Profiles on the Canadian Medical Association website
  • Review the information on specialties on the Royal College of Physicians and Surgeons of Canada website: here
  • Find out more about family medicine as a career through family medicine interest groupsstudent-run groups at each university that organize clinical skills sessions and information seminars on the subject—on the College of Family Physicians of Canada’s website
  • Check out the Association of American Medical Colleges Careers in Medicine tool
  • Talk to professors, teachers, preceptors, and mentors about what it is like to be a specialist
  • Shadow faculty members

 

How many residency positions are there in each specialty?

The Canadian Residency Matching Service (CaRMS) website is an excellent source of data on residency positions in Canada. CaRMS data, which are updated annually, include detailed data tables on residency position in each specialty https://www.carms.ca/wp-content/uploads/2018/06/2018-carms-forum.pdf. Table 12 shows the quota offered to Canadian medical graduate applicants by discipline and Table 14, the dedicated quota offered to international medical graduate applicants by discipline.

Another useful source of current data on this topic can be found in Table G-1 of the CAPER  Annual Census  which shows first year Canadian citizen/permanent resident trainees by type of program and faculty of training.

For more information on how the match process works, see the CaRMS website The Match - how it works.

I'm A Resident

What are the entry criteria for Canadian medical schools?

Canadian faculties of medicine contribute to the sustainability of the healthcare system by training future physicians. As such, they seek applicants who are strong academically yet who also understand the importance of social accountability and its implications on their future practice. Individuals considering a career in medicine must be ready to work in collaboration with other healthcare professionals to provide the best possible care to those in need.

As detailed in What is the process for applying to a Canadian medical school?, the first step of the application process is to meet the entry criteria of the school to which the application is being made. Since entry criteria vary among the 17 different faculties of medicine in Canada, applicants should consult individual faculty websites for accurate, up-to-date information.

Generally speaking, entry criteria for Canadian medical schools fall into four main categories:

Eligibility requirements: Most provinces require at least two years of postsecondary education, while Quebec residents applying to a medical school in that province must complete their CEGEP training. Most schools also request that applicants complete specific basic-science courses before entering their program to prepare them for the study of medicine. Since these prerequisites vary among schools, faculty websites should be consulted for details.

Academic performance: Medical schools look closely at academic performance when evaluating candidates for potential entry into their programs. Selection committees consider grade point average (GPA) to determine whether applicants have the right study habits and intellectual capacity to pursue medical studies. Some also use Medical College Admission Test (MCAT) results and the (CASPer) Admissions Screening for People Skills results. Once again, faculty websites should be consulted for specific requirements.

Autobiographical sketch/essay: Applicants have the opportunity to differentiate themselves from other candidates by providing the selection committee with an autobiographical sketch/essay that reflects their personality and accomplishments. It should include a list of such things as volunteer and paid work, research, extra courses, hobbies, sports, awards, scholarships, and other forms of recognition.

Reference letters: Most Canadian medical schools ask for reference letters, which can come from such individuals as community members, faculty members, or previous employers. These letters give selection committees an additional perspective on the type of medical student an applicant might become.

Admission requirements of Canadian medical school

Every year, the AFMC publishes the Admission Requirements of Canadian Faculties of Medicine for students who are interested in pursuing medical studies. This document lists the admission requirements of the 17 medical schools in Canada and includes application statistics from previous years.

For more detailed information on admission requirements for specific faculties of medicine, please consult the admissions pages of their websites, the direct links to which are provided below.

ATLANTIC CANADA

 

QUEBEC

 

ONTARIO

 

WESTERN PROVINCES

Do medical students earn money?

Clerkship stipends vary significantly among provinces. Some do not offer stipends to learners for clerkship, as it is viewed as an educational process rather than a job. Others offer students who undertake Doctor of Medicine (MD) degrees several hundred dollars per month for the duration of their clerkship. This may be in the form of quarterly lump-sum instalments in a student’s final year of medical school. In provinces that do offer clerkship stipends, the stipends are the same for all of the MD education programs in that jurisdiction. It is recommended that students contact the finance and awards office at their particular faculty of interest for more specific details about clerkship stipends.

Table 7 of the Canadian Medical Education Statistics (CMES) publication (below) illustrates the Duration of Clinical Clerkship and Amount of Stipend in Canadian Faculties of Medicine for 2017/18:

How much does a resident earn?

Once learners graduate from the Doctor of Medicine (MD) degree program and enter their first postgraduate year (PGY) or residency year (R), they start earning an annual salary. The amount of the salary is determined by the province in which the MD training was completed and its professional residents’ association. It increases with every additional year of residency training completed, as shown in the chart below.

Amount paid to post-MD trainees in 2017

What are regional health authorities?

Health regions or health authorities are a governance model used by Canada's provincial governments to administer and/or deliver public healthcare to all Canadian residents. Health care is designated a provincial responsibility under the separation of powers in Canada's federal system. Most health regions are organized along geographic boundaries, but some are organized along operational lines (check here). In several provinces, regional health authorities are residents’ employers.

How much does a practicing physician earn?

In 2015-2016, total clinical payments to physicians increased 3.4% over the previous year to $25.7 billion; this is the second-lowest increase in clinical payments since the Canadian Institute for Health Information (CIHI) began collecting aggregate alternative payment data in 1999. The average gross clinical payment per physician in 2015-2016 was $339,000; this number remained virtually unchanged from 2014-2015. This year, CIHI combined fee-for-service payment data with detailed alternative payment data and for the first time is able to report average gross clinical payments per physician by specialty for 8 provinces (Alberta and Saskatchewan excluded) and Yukon. The average gross clinical payment to family medicine physicians for these selected jurisdictions combined was just more than $275,000, while the average gross payment per medical specialist was $347,000 and that per surgical specialist was $461,000.

For more information about remuneration by specialty: National Physician Database, 2015-2016 Data Release

How are physicians paid in Canada?

The provincial and territorial governments of Canada are responsible for healthcare services provided within their jurisdiction, including the remuneration of physicians and other healthcare professionals. They work in collaboration with the Government of Canada to administer Canada’s Healthcare System – Medicare – under the terms of the Canada Health Act.

There are two primary methods by which physicians in Canada are paid:

  • Fee-for-service is an arrangement whereby the professional, acting as an independent and private contractor, is paid a set amount for each service provided. In 2015-16, 72% of all clinical payments to Canadian physicians were made using this method1.
  • Alternative clinical payment includes all payment arrangements other than fee-for-service. This method is growing in popularity among new physicians, having increased from 10.6% of total clinical payments in 1999-2000 to 28% in 2015-16. Examples of alternative clinical payment include the following2:
    • Salary: Regular payment made to a professional who is an employee of an organization and is responsible to managers for services provided. In Canada, salaried physicians, although they provide services within institutions, generally receive their salary from the provincial insurer rather than the institution in which they work.
    • Retainer: A minimum salary provided to a physician that can be coupled with fee-for-service payments to encourage service provision in areas of lower patient volume.
    • Capitation: Payment made according to the number of people on a patient list. The fee structure can include a premium for complex cases and may be adjusted for the socio-demographic profile of the patient population.
    • Target payments: Payments made for reaching a target level of services delivered that are particularly useful for preventive services.
    • Blended: Payment made using a combination of several remuneration methods. Emerging interdisciplinary primary care practice models (e.g., Family Health Teams in Ontario) combine salary, capitation, and sometimes fee-for-service compensation.
    • Block funding: A funding arrangement commonly used in Canadian hospitals, in which the institution is paid an annual amount to provide services. This amount is generally calculated according to the type and quantity of services provided the previous year and is adjusted for changes in demographics, healthcare costs, and inflation.
    • Funding by episode of care: A remuneration method in which fees are scheduled according to the patient’s diagnosis and classified in a way that reflects the average cost of care required for that diagnosis.

 

For more information about remuneration methods:

A profile of physicians in Canada in 2016

New in Practice Guide, Canadian Medical Association

2014 Survey Results, National Physician Survey

Canada’s Health Care System, Health Canada

National Health Expenditure Trends, 1975 to 2017

What is a “return for service” agreement?

Return of service (ROS) is part of a package of strategies designed to attract physicians to Province’s underserviced communities. you will be sent an agreement describing the terms and conditions associated with the position you have been offered.

Return of Service agreements provide funding to medical trainees in exchange for their commitment to practice in a designated geographic area for a period of time after completion of their training. These agreements provide different types of monetary incentives and may target undergraduate students, postgraduate trainees, or working physicians. The incentives are often given in the form of bursaries, grants, loan forgiveness, and scholarships. Many ROS programs offer a “buy-out option” allowing borrowers to repay their bursary instead of fulfilling their service commitment.

What has been the trend in the number of residency positions in recent years?

The Canadian Post M.D. Education Registry (CAPER) is an excellent source of evidence on trends in residency. As shown in the chart below, there was a 100% increase in the number of PGY-1 trainees in Canada between 2000-01 and 2017-18 to current levels.

Post MD training by where MD received

 

First Year Trainees who are Canadian citizens/Permanent residents
YEAR OF POST-M.D. TRAINING
BY
WHERE THE M.D. DEGREE WAS RECEIVED

Training Year

Country Where the M.D. Degree was Received

Canada

Outside Canada

Total

Count

Row %

Count

Row %

Count

Row %

2014-15

2762

86.2%

444

13.8%

3206

100.0%

2015-16

2765

86.6%

426

13.4%

3191

100.0%

2016-17

2798

87.0%

417

13.0%

3215

100.0%

2017-18

2778

86.8%

423

13.2%

3201

100.0%

Total

38790

86.0%

6310

14.0%

45100

100.0%

 

The data tables in CAPER’s 2017-18 Census provide an overview of current information on residency across Canada.  Table B1 illustrates the number of residents by field of post-Doctor of Medicine (MD) training and rank (e.g., PGY-1, -2) and Table A1 summarizes the number of residents by field of post-MD training and faculty of medicine.

The postgraduate medical education (PGME) departments in each of the 17 Canadian faculties of medicine also have information on residency positions and recent trends. It must be noted that trends have no predictive value with regard to future residency positions.

What are the practice opportunities per specialty and how would a finishing resident find them?

It is challenging to obtain accurate information on available practice opportunities in the medical field, as not all are posted and those that exist in academic settings may be hard to identify. At this time, there is no pan-Canadian tool that examines trends in practice opportunities by specialty.

Since it is the responsibility of individual learners to identify learning and professional opportunities, they should begin researching them as early as possible in the medical education process—before they consider choosing a specialty.

Learners will benefit throughout their careers from developing a solid network of health professional colleagues, faculty representatives, and classmates. Upon completion of their medical residency programs (or even before), learners are advised to talk to their contacts
about possible job opportunities and research job listings on various websites. Those interested in an academic career should contact Canadian medical schools to explore career pathways and opportunities.

The following are useful links to assist students in searching for practice opportunities:

National websites:

Canadian Medical Association Career Centre

Healthcare Careers Opportunities

 

Provincial and territorial websites:

Newfoundland & Labrador: Practice Newfoundland Labrador

Nova Scotia: Physicians Nova Scotia

Brunswick: Careers in Health Care in New Brunswick

Prince Edward Island:  Healthcare career Opportunities

Quebec: Fédération des médecins résidents du Québec.

Ontario: Health Force Ontario

Manitoba: MB Healthcare Providers Network

Saskatchewan: Saskatchewan Medical Association

Alberta: Health Workforce for Alberta[RH1]

British Columbia: Health Match BC

Northwest Territories: Practice North

Nunavut: General Practice Physicians in Nunavut

Yukon: Yukon MD

For more information about transitioning into practice:

Beyond residency training, what other learning opportunities exist?

Sub-specialty residencies are programs of additional medical training undertaken after an initial “core” residency has been completed in a specialty accredited by the Royal College of Physicians and Surgeons of Canada (RCPSC). 

Subspecialty residency training supports sub-specialization in a particular specialty. Subspecialty residents can sometimes practise as physicians in the specialty in which they completed their core (initial)residency (e.g., psychiatry) but cannot practise without supervision in their subspecialty (e.g., child and adolescent psychiatry). This is not always possible, as sometimes training in the core specialty can be double counted towards both the core specialty and sub-specialty training requirements.   Subspecialty residency training programs generally last anywhere from 1 to 3 years.

Diploma programs are a different type of additional accredited learning opportunity available after core or subspecialty residency training. The RCPSC recognizes an increasing number of Areas of Focused Competence (AFC) programs, also known as Diploma Programs.  These disciplines do not meet the criteria for a subspecialty residency but are accredited by the RCPSC following successful submission of an evaluated portfolio of work in a recognized discipline. An example of this type of training is interventional cardiac catheterization, which can only be undertaken after completion of a core residency in internal medicine and a subspecialty residency in cardiology. AFC programs usually take between 1 and 2 years to complete.

Sub-specialty residencies and AFC programs are sometimes referred to (incorrectly) as “fellowships.”  In most institutions, true fellowships are unaccredited learning opportunities that allow trainees to gain expertise in a very specialized area of practice. An example would be such areas as “hand surgery”, which might be undertaken by those with core training in Plastic Surgery or Orthopedics. Fellowships are often delivered using an apprenticeship model of training where the trainee is paired with a single of small number of experts in a particular field.  These additional years of “fellowship training” are not to be confused with membership in the RCPSC, which carries the designation “Fellow of the Royal College of Physicians of Canada” or “Fellow of the Royal College of Surgeons of Canada.”

The specialty of family medicine has additional training that may be offered to residents after completion of residency. These “enhanced skills programs” are accredited under the departments of family medicine at each university. There are national standards for five enhanced skills programs: Emergency Medicine, Palliative Care, Family Practice Anaesthesia, Health Care of the Elderly, and Clinician Scholar. These are known as category 1 programs and are based on a 1 year expected program of study.  Graduates of these programs receive attestation of their completion. Family physicians who complete additional training in any of 5 areas: care of the elderly, palliative care, emergency medicine, family practice anesthesia, and sports medicine will be eligible to receive a Certificate of Added Competency (CAC). Currently, there are 3 ways to achieve a CAC: through completion of extra residency training (a fellowship); through practice experience and professional development; or by acquiring a Certificate of Special Competence in Emergency Medicine. Physicians who complete the CFPC Certification in emergency medicine can choose to use the CFPC(EM) designation, or apply for the CAC in emergency medicine.

Other learning opportunities may be offered at medical schools to assist recent family medicine graduates and family physicians in practice who want to enhance a particular skill required in their community (e.g., Addiction Medicine, Chronic Disease). These learning opportunities are also accredited under the umbrella of enhanced skills programs, to ensure they meet educational standards.  However, the range of skills that may be sought is more broad and flexible.  These programs are known as category 2 programs.

Fellowships are not necessary for all fields of practice, but some require additional training years to ensure that physicians provide the highest quality and most adapted care to their patients. The more specialized a physician is, the more he or she is limited in terms of practice settings. Highly specialized physicians are often affiliated with teaching hospitals and lead academic careers in which research is an important component of their practice.

To find out more about RCPSC subspecialty residencies and areas of focused competence, visit the College’s web portal.
To learn more about enhanced skills programs in family medicine, visit the College of Family Physicians of Canada’s website, which describes its accreditation standards for these programs. The Canadian Medical Association website provides a general overview of 38 specialties at Canada. Please note, this work is currently being updated and is not a comprehensive list of specialties in Canada.
 

How do academic and community-based careers differ? What specialties require an academic setting?

The development of distributed medical education is making it harder to differentiate between academic careers and community-based careers, as teaching settings are expanding beyond classrooms and university teaching hospitals.  

Today, many physicians invest time contributing to medical education. General practitioners/family physicians working in community practices in rural and remote regions of our country provide significant contributions to medical education training. Physicians may or may not receive remuneration for their teaching activities.

Some specialties are, by necessity, limited to specific locations such as tertiary care centres. These fields of practice also require an academic career that contains components of research and education. Other specialties, such as family medicine or paediatrics, allow for a wider set of options (e.g., rural, remote, city centres) and, as such, offer more flexibility in terms of an academic or community-based career.

For more information about requirements and expectations of various specialties:

What are the current practice patterns in various disciplines and what can be expected in terms of work setting, hours, case load, and patients?

Choosing a discipline of practice can be challenging. Since there are many factors to consider in making the best possible decision, starting early is important. There will be many opportunities over the course of a learner’s training to discuss work expectations with experienced practitioners from various practice settings. Many schools also offer integrated mentorship programs to support learners in their decision-making process.  

Every faculty of medicine has a student affairs office that offers career counselling and access to a wide variety of useful resources—both in person and online.

For more information by specialty:

  • The Royal College of Physicians and Surgeons of Canada (RCPSC) has a section of its website devoted to information on specialty training requirements, training objectives, the accreditation processes, and more. The portal is categorized by specialty, subspecialty, special programs, and the areas of focused competence (AFC) diploma.
  • The Canadian Medical Association has published profiles of 38 Canadian specialties, each of which provides an overview of setting, income, and satisfaction levels by practice type.
  • The Association of American Medical Colleges publishes its Careers in Medicine newsletter four times a year. The Choices newsletter provides pertinent information about specialty choice, getting into residency, and other important guidance related to medical student career-planning.  

Most specialties have their own college. Consult their websites for more information.

For more information about family medicine:

The College of Family Physicians of Canada (CFPC) offers a variety of information about the pathways to becoming a family physician, resources for medical students interested in family medicine, and more.

The CFPC has developed a Fact Sheet for Prospective Family Physicians about the field of family medicine that include answers about this field, including salary, training, hours, income and more. 

What tools are available to help medical students choose their electives?
What resources are available to help students decide what specialties to consider?

There are many resources available to help students think through their decision about which specialty to pursue. The following are some suggestions:

  • Visit student affairs offices to discuss options and explore relevant resources
  • Check out the 38 Canadian Specialty Profiles on the Canadian Medical Association website
  • Review the information on specialties on the Royal College of Physicians and Surgeons of Canada website: here
  • Find out more about family medicine as a career through family medicine interest groupsstudent-run groups at each university that organize clinical skills sessions and information seminars on the subject—on the College of Family Physicians of Canada’s website
  • Check out the Association of American Medical Colleges Careers in Medicine tool
  • Talk to professors, teachers, preceptors, and mentors about what it is like to be a specialist
  • Shadow faculty members

 

How many residency positions are there in each specialty?

The Canadian Residency Matching Service (CaRMS) website is an excellent source of data on residency positions in Canada. CaRMS data, which are updated annually, include detailed data tables on residency position in each specialty https://www.carms.ca/wp-content/uploads/2018/06/2018-carms-forum.pdf. Table 12 shows the quota offered to Canadian medical graduate applicants by discipline and Table 14, the dedicated quota offered to international medical graduate applicants by discipline.

Another useful source of current data on this topic can be found in Table G-1 of the CAPER  Annual Census  which shows first year Canadian citizen/permanent resident trainees by type of program and faculty of training.

For more information on how the match process works, see the CaRMS website The Match - how it works.