Canada
Canada registers internationally trained doctors through the Medical Council of Canada (MCC) for licensing examinations, the Royal College of Physicians and Surgeons of Canada (RCPSC) for specialty certification, and the College of Family Physicians of Canada (CFPC) for family medicine. Provincial and territorial medical regulatory authorities issue the licence itself.
The route most internationally trained doctors take runs through two examinations, not one: the MCCQE and the NAC Examination. Both are required to enter the residency match, and in either order.
Your pathway
- Check eligibility
- Pass the licensing exam
- Register with the authority
- Specialty or board exam
Exams and products
MCCQE — Route to Licensure
NAC Examination
TDM — Therapeutics Decision Making
Royal College — Internal Medicine
Royal College — General Surgery
Royal College — Pediatrics
Royal College — Obstetrics & Gynaecology
Royal College — Gastroenterology
Royal College — Pediatric Surgery
CFPC — Family Medicine
Language requirements
Most authorities ask for an English test. Germany asks for German.
A note that saves people a year. The NAC Examination is required alongside the MCCQE for entry to the residency match. Quebec is the exception — it requires neither, and instead requires recognition of MD-degree equivalence from the Collège des médecins du Québec. British Columbia and Alberta add their own programmes.
Which Exams You Need
| Your goal | What you sit |
|---|---|
| Enter the R-1 residency match | MCCQE and the NAC Examination, in either order |
| Enter the R-1 match in Quebec | Neither. MD-degree equivalence recognition from the Collège des médecins du Québec |
| A Practice Ready Assessment place | TDM Examination for most PRA programmes. Passing the TDM alone does not confer PRA eligibility |
| Royal College specialty certification | Written and Applied examinations, after a Practice Eligibility Route assessment |
| Family Medicine certification | SAMP and SOO examinations |
English and French Language Requirements
Language requirements are set provincially and administered through CaRMS, not by the Medical Council.
| Test | Requirement |
|---|---|
| IELTS Academic | 7.0 in each component |
| OET | Grade B in each component |
| CELPIP | 9 in each component |
| TOEFL iBT | 93 overall with 24 in speaking — Ontario IMGs only |
| French | Provincial French-language options apply |
Each score must be achieved in the same sitting. For the 2027 R-1 match, results must be valid until 1 July 2027.