Canada has a shortage of family physicians throughout the country and plenty of opportunities for international medical graduates (IMGs) with post graduate training in family medicine or general practice. This guide will take you through the processes required to secure a job in Canada.

What is a Family Physician?

A Family Physician is the professional job title for the primary healthcare physician who provides general medical care to patients of all ages in the community and refers patients to specialist physicians if required. The title family physician is specifically North American, used in Canada and the United States of America (USA), whilst the rest of the world mostly uses the title General Practitioner. Essentially the titles are interchangeable and the generalist scope of practice in primary care the same.

Family Physicians comprise 52% of registered physicians in Canada, making family medicine the largest medical discipline. The provinces of Ontario and Quebec, which are Canada's most populous, have the greatest number of family physicians whilst some of the more rural provinces and territories have shortages.

What is The College of Family Physicians of Canada (CFPC)?

The College of Family Physicians of Canada (CFPC) is the professional organization which represents more than 42,000 practising family physician members across the country. It is the the voice of family medicine in Canada, responsible for maintaining the standards of training and practice for the speciality.

Its formal duties include:

• publication of the Canadian Family Physician Journal, a peer-reviewed medical journal
• organisation of the annual Family Medicine Forum (Forum en Medecine Familiale), a 4 day event.
• international representation with membership of the World Organization of National Colleges, Academies and Academic Associations of General Practitioners/Family Physicians. (WONCA) who's short name is the World Organization of Family Doctors.
• establishment of the standards for undergraduate graduate family medicine training in Canada's 17 medical schools and postgraduate residency training programs in family medicine
• certification of qualified family physicians
• accreditation of residency programs
• review and certification of continuing professional development programs and materials that enable family physicians to meet certification and licensing requirements.
• support of family medicine teaching and research
• advocacy on behalf of the specialty of family medicine, family physicians, and the patients they serve.

What is Certification in the College of Family Physicians of Canada (CCFP)?

The CFPC conducts the Certification Examination in Family Medicine twice a year, in the spring and autumn, in multiple centres across Canada, in both official languages, English and French.

The examination format has a written and oral component with testing over 2 days.

• Written component—computer-based short-answer management problems (SAMPs), four hours in length (Wednesday, Thursday, or Friday)
• Oral component—five, 15-minute simulated office oral exams (SOOs) (Saturday or Sunday)

The Certification Examination in Family Medicine is open to members of the College of Family Physicians of Canada (CFPC) who have either successfully completed an approved residency training program in family medicine or successfully completed a combination of training and practice experience as outlined in the eligibility guidelines.

Members who successfully complete both an approved training program and the Certification Examination in Family Medicine will be awarded Certification in Family Medicine and will be able to use the designation, Certification in the College of Family Physicians of Canada (CCFPC). Members with the CCFPC Special Designation will be responsible for maintaining these credentials by maintaining valid membership and participating in the College’s Maintenance of Certification Program (Mainpro+®).

What are the Eligibility Criteria for the CFPC?

You are eligible for the CCFP exam if you meet either of the two criteria below:

• Graduates of the College of Family Physicians of Canada- (CFPC) accredited family medicine residency programs, who have successfully completed a minimum of 24 months of training
• Successful graduates of postgraduate family medicine training programs in jurisdictions where the standards for accreditation of postgraduate family medicine training are judged comparable and acceptable to the CFPC

Approved jurisdictions with equivalent accreditation standards for family medicine training include:

• United States: graduates of family medicine residency programs who have been accredited by the Accreditation Council for Graduate Medical Education (ACGME)
• Australia: graduates of Australian General Practice Vocational Training programs who have been accredited by the Australian Medical Council (AMC) and meet the standards of the Royal Australian College of General Practitioners (RACGP)
• Ireland: graduates of general practice vocational training schemes who have been accredited by the Irish College of General Practitioners (ICGP)
• United Kingdom: graduates of general practice vocational training programs who have been accredited by the General Medical Council (GMC) and who meet the standards of the Royal College of General Practitioners (RCGP) and hold the Membership of the Royal College of General Practitioners (MRCGP) and Certificate of Completion of Training (CCT)

What is the alternative route to obtaining a licence as a family physician without CCFPC?

If you do not meet the requirements to obtain the CCFP, there is an alternative route to registration as a Family Physician in seven of Canada's thirteen provinces and territories.

The National Assessment Collaboration’s (NAC) Practice-Ready Assessment (PRA) programs are offered in seven provinces across Canada as a route to licensure for international physicians who have already completed their residency and practiced independently abroad. These programs offer a clinical field assessment over a period of 12 weeks. After completion, successful candidates must complete a return of service in a rural area of the province of assessment.

What is PRA?

In order to ensure that International Medical Graduates (IMGs) and international physicians possess the appropriate clinical skills and knowledge to provide the required standard of patient care in Canada, each participating province offers a practical assessment program where candidates work under supervision and are evaluated over a period of 12 weeks with the aim of obtaining an independent licence to practise in Canada. The focus is on meeting rural and remote needs in Canada with return of service commitments ensuring employment for successful PRA candidates.

What is NAC PRA?

While each province may have distinct requirements within their jurisdictional program, the National Assessment Collaboration (NAC), a group of national and provincial healthcare organizations, has created a pan-Canadian model with a set of common standards, tools and materials for PRA programs in seven provinces.

Which Medical Regulatory Authorities Participate in the NAC PRA framework?

• Practice-Ready Assessment – Physicians for BC (PRA-BC)
• Practice Readiness Assessment Alberta (PRA-AB)
• Saskatchewan International Physician Practice Assessment (SIPPA)
• University of Manitoba International Medical Graduate Program (PRA MB – Family Practice & PRA MB – Specialty Practice)
• Collège des médecins du Québec
• Practice Ready Assessment – Newfoundland and Labrador (PRA-NL)
• Nova Scotia Practice Ready Assessment Program (NSPRAP)

Please note that Ontario, Prince Edward Island, New Brunswick, Yukon, Nunavut and the Northwest Territories do not offer practice assessments within the NAC’s pan-Canadian framework at this time.

What are the requirements for obtaining a provisional family physician licence?

In Canada there is no single national medical regulatory authority but thirteen separate authorities with jurisdiction over each province and territory. Each authority has its own specific requirements for registration but there are some features common to all. These are detailed in full in the guide to medical registration in Canada for physicians  and summarised here.

• Medical Degree from an accepted school listed in the World Directory of Medical Schools. A Canada Note for your school must be identified for it to be recognised. Alternatively, you must have a medical degree from a Canadian or American medical school accredited by the Liaison Committee on Medical Education or the Committee on Accreditation of Canadian Medical Schools.

• English or French (Quebec only) Language Proficiency demonstrated though formal testing or exemption from testing granted in specific circumstances.

• Licentiate Exam MCCQE 1 or USMLS Steps 1, 2 and 3. Read how to apply for the MCCQE 1 exam

• EPIC- primary source verification of credentials. This guide explains how to obtain an EPIC report.

• Residency - structured postgraduate training in family medicine / general practice

• CCFP Certification or PRA proof of competency to practise

What are the two important considerations for finding a family physician job?

1: Location  and Licence - Select provinces where you are eligible for a licence

Your options for places to work as a family physician will be determined by your eligibility for a provisional family physician licence with the appropriate medical regulatory authority. If you hold the CCFP or a qualification from one of the CFPC's approved jurisdictions ie UK, Ireland, USA and Australia, your options are greater, although some regulatory authorities require Canadian citizenship or permanent residence in addition.

If you need to pursue the PRA route, your work options will be restricted to the seven provinces accepting this pathway until such time as you manage to complete the requirements for CCFPC eligibility.

2: Immigration- Consider the ease of obtaining a work permit if you are not a Canadian citizen or permanent resident.

Some Canadian provinces offer easier access to work permits and eventual residency status than others. Canadian employers can sponsor visas for immigrant workers only in circumstances where no Canadian citizen or permanent resident is available to perform the work. This requirement inevitably obliges the employer to conduct an advertising campaign and labour market report for the immigration authorities before the visa sponsorship can be approved. This can be a time consuming process and sudden applications from local candidates can cause the process to be terminated abruptly in favour of the local physician.

The Atlantic provinces of Canada (Newfoundland and Labrador, Nova Scotia, New Brunswick and Prince Edward Island) have a special program, the Atlantic Immigration Program, which grants immediate permanent residency to suitably qualified physicians who agree to work in the provinces for a minimum period of two years.

What is Family Physician Remuneration in Canada?

Family Physicians have the option to work in salaried or fee for service positions. However, most positions are based upon fee for service contracts where the physician will retain a percentage of total revenues generated and contribute a percentage to the management of the practice to cover the costs of the rent and maintenance of the clinic, administrative costs and salaries. The ratio of fee splits varies by clinic and is often negotiable but 65/35 - 75/25 splits are usual.

Some clinics offer sign up bonuses, retention bonuses and incentive bonuses and some will even offer a relocation allowance, provide accommodation for a few weeks or reimburse medical licence expenses.

Typical fee for service earnings are C $250,000-500,000 pa but depend on clinic and province, and the activity of the physician. Salaried positions start from C$ 160,000 pa.

Applications for Family Physician Jobs

If you are interested in working as a family physician in Canada, please register your CV and sign up for job alerts, browse advertised jobs or get in touch with us to discuss your interest.

You can read further information about working in Canada in our news and insights section and Canada section.