How To Work in Canada as a Doctor: A Guide for Internationally Trained Physicians

Nearly 14% of Canadians don’t have a regular family doctor. A 2025 Health Canada study showed a shortfall of over 23,000 family physicians. It also stated that there are only around 1,300 domestic medical graduates per year.  

As a result, the government is prioritizing immigration programs for foreign physicians. Canada recently announced a new Express Entry category for physicians with Canadian experience and 5,000 dedicated PR spaces for provincially nominated doctors. If you’re a physician trained in the United States, there may even be a path to full independent licensure without any additional examinations. 

This guide covers what you need to know to work in Canada as a physician: how licensing works, and your work permit and PR options in 2026. Although we focus primarily on US physicians due to the special pathways available to them, doctors around the world can benefit from this guide. 

Key Takeaways 

• US-certified physicians (ABMS, ABFM, or AOA) can get full independent licensure in several provinces with no additional exams required. 

• A new dedicated Express Entry category for physicians with Canadian work experience offers an easier pathway to PR. 

• Foreign nationals need both a valid work permit and a provincial licence to practice medicine. 

How to Get Licensed as a Doctor in Canada

In Canada, medicine is a regulated occupation, and you need a licence to practice. Licensing is a two-step process. 

1. Apply for a Licentiate of the Medical Council of Canada (LMCC)

The LMCC is not a licence to practice medicine. However, it is a prerequisite for licensing. It is issued by the Medical Council of Canada (MCC) to individuals who have:  

• Graduated from a recognized medical school 

• Passed the MCCQE Part I exam (In some provinces, US physicians with an ABMS, AOA or ABFM certification may be exempt) 

• Completed at least 12 months of postgraduate medical training, and  

• Paid the LMCC application fees. 

To apply for a LMCC, you must create an account on PhysiciansApply.ca. This is MCC’s portal where your credentials are verified and where you register for the MCCQE exam. The portal also lets you share verified documents with the provincial college for licensing or with IRCC for immigration purposes.

2. Get Licensed by Your Provincial Regulator

Each province has its own medical regulator, or College of Physicians and Surgeons. The registration requirements and licensing processes vary by province. 

Once you have your LMCC, you must apply to the province to get your licence to practice medicine. Different provinces may also offer different types of licences, ranging from independent practice to clinical observership. 

So, before you start the licensing process, ask yourself “Which province do I want to practice in?” Once you’ve made that decision, review the registration requirements on the provincial College website. 

Note: Although the three territories (Northwest Territories, Yukon, and Nunavut) have medical regulators, they need internationally trained medical graduates to get a full licence in another Canadian jurisdiction first. 

American Doctors Have an Advantage 

If you’re certified by the American Board of Medical Specialties (ABMS), the American Board of Family Medicine (ABFM), or the American Osteopathic Association (AOA), you may not need to take the MCCQE exam.  

You can obtain full independent licensure in British Columbia, Alberta, Saskatchewan, Manitoba, Nova Scotia, New Brunswick, and Prince Edward Island without any additional examinations or certifications. 

Ontario gives American doctors alternative pathways too. AOA/ABMS-certified physicians can get a restricted independent practice licence, limited to their specialty. This limited licence is for five years, after which US-educated doctors can qualify for full licensure in Ontario. 

US-trained doctors are usually also exempt from the proof of English (or French) proficiency requirement. Language proficiency is typically a provincial licensing requirement for most internationally qualified physicians. 

Practice-Ready Assessments 

For internationally trained physicians who don’t hold a US board certification, Practice-Ready Assessments (PRAs) offer an alternative route to licensure. PRAs are offered by all Canadian provinces except Prince Edward Island. 

Instead of the MCCQE exam, PRAs evaluate clinical competence directly. Doctors work under supervision in a real practice setting, typically for 12 weeks, and are assessed by certified evaluators. You can only start a PRA after registering with the provincial college. 

Work Permit Options for Doctors in Canada 

If you’re not a permanent resident or citizen of Canada, you will need a work permit to practice. This is in addition to the provincial medical licence. With a few exceptions, you will need a valid Canadian job offer to apply for a work permit. 

Your employer will need a neutral or positive Labour Market Impact Assessment (LMIA) to hire you. LMIA applications are time-consuming and costly. The employer will need to show that they tried and failed to hire a qualified Canadian for that role.  

Although US citizens can also qualify for LMIA-exempt work permits under the Canada-United States-Mexico Agreement (CUSMA), these are only an option for physicians who want to teach or undertake research in Canada. Physicians cannot practice medicine under a CUSMA work permit. 

Permanent Resident (PR) Pathways for Doctors 

Many of Canada’s permanent residence programs are aimed at bridging crucial skill gaps and focus on economic immigration. As a result, there are many pathways for internationally trained doctors to move to Canada permanently. These include: 

Express Entry Streams 

Canada manages its federal high-skilled immigration programs through the Express Entry system. Eligible candidates submit an Express Entry profile to enter the candidate pool. Your ranking in the pool is determined by your Comprehensive Ranking System (CRS) score, which is based on factors like age, education, language proficiency, and work experience.   

IRCC conducts periodic draws and invites top-ranking candidates in various Express Entry programs or categories to apply for permanent residence. Here are the key programs for physicians: 

Provincial Nominee Programs 

In addition to the federal immigration programs, all provinces and territories, except Quebec and Nunavut, have their own provincial nominee programs (PNPs). Some are delivered through the Express Entry system, while others are managed by the provinces themselves. 

If you’re taking the Express Entry PNP route, a provincial nomination adds 600 CRS points to your score. This essentially guarantees you an invitation to apply for PR.  

For 2026, the federal government has reserved 5,000 PNP admission spaces for licensed physicians with job offers. Doctors with a provincial nomination also qualify for expedited open work permits.  

The application process and eligibility criteria for provincial nominee programs can vary significantly. Doctors can qualify under the skilled worker streams most provinces offer, but some provinces also have PNP streams specifically designed for healthcare professionals and doctors with job offers. 

Regional PR programs for Physicians 

If you’re open to settling outside Canada’s major cities, a few additional programs are worth exploring. The Atlantic Immigration Program (AIP) offers a direct route to PR for physicians willing to settle in one of Canada’s four Atlantic provinces. 

The Rural Community Immigration Pilot and the Francophone Community Immigration Pilot (for French speakers) operate across smaller designated communities and have physician occupations among their priorities.  

All three are employer-driven, so you’ll need a job offer from a designated employer in the relevant community to qualify. You can then apply for an LMIA-exempt work permit and start working in the community while your PR application is being processed. 

Moving to Canada as a Physician 

The licensing and immigration processes are separate, but they need to move together. If you’re a foreign-trained physician looking to work in Canada, start your LMCC process and identify your target province now, because the licensing process takes time.  

Since Canada is actively seeking internationally educated doctors, make sure you understand the various PR or work permit options available to you and find the best fit.