Foreign physician accreditation project: Looking overseas to alleviate the Canadian medical staffing shortage

Authored January 24, 2023

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Medical staff walking through hospital entrance

What is the foreign physician accreditation project?

Efforts being made by the Royal College of Physicians and Surgeons of Canada to encourage foreign-trained specialists to come to Canada to practice is a welcome step toward alleviating the staffing shortage plaguing our medical system. 

According to the Globe & Mail, the Royal College – which sets national standards for doctors who specialize in fields such as surgery, cardiology and emergency medicine – is implementing changes to how it assesses foreign-trained physicians and determines their eligibility to write certification exams. 

The College is also expanding its Practice Eligibility Route program. The goal is to reduce the amount of time required for an internationally trained physician to be approved to work in their field. 

The article quotes the Royal College’s executive director of standards and assessment as saying, “We want to make it as easy as possible for people who have that competence to demonstrate that competence, regardless of where they trained. We’re really cognizant of the current health human resources strains in the system.” 

Foreign physicians: who can practice in Canada now? 

Under current rules, any foreign physician who wants to work on an independent certificate of practice as a Royal College certified specialist in Canada must have graduated and completed specialty training in an approved jurisdiction, or, if their training was not completed in an approved jurisdiction, they must also complete a minimum of five years of practice in their specialty with at least two years of practice in Canada and then pass the Royal College certification examination. Foreign physicians from approved jurisdictions can work on restricted certificates as long as they are affiliated and on staff at an academic institution.

Approved jurisdictions historically have been Australia, New Zealand, Hong Kong, Singapore, South Africa, Switzerland, United Kingdom and Ireland.

What does the foreign physician accreditation project mean for foreign physicians going forward? 

With this project, a meaningful attempt is being made to allow specialists from other international jurisdictions to be eligible to take the Royal College specialty examination in a shorter time. Depending on the circumstances, including years of practice in their own country, that could be after as little as 12 to 16 weeks of practice in their specialty in Canada. 

This is a major improvement on its face, but no information has been forthcoming on how foreign-trained specialists will be able to find a place to do their training. A cardiologist coming from Germany, not an approved jurisdiction for example, would have to find a hospital training spot. That would either require an education licence or a special hospital privilege appointment.  

While this is a bold step in the right direction, someone must address how these foreign-trained specialists will be accommodated in our hospitals in order to complete even a  matter of weeks of re-training so they can meet the Royal College examination eligibility requirements. 


Several years ago I was fortunate enough to have been selected as a Tremayne-Lloyd Fellow here at Western Law. I used the funds to finish a book and to begin work on a new one. It dawned on me far too late that I had never thanked you for that splendid gift. The new book is to be published by Harvard Press in 2010. The TTL Fellowships provided ritual seed capital for this project, which required me to spend a good deal of time and money at The National Archive in Washington. Again, with many thanks.

R. W. Kostal Professor of Law and History

Tracey Tremayne-Lloyd Health Law