Relocating to Canada to work as a doctor from Nigeria or as a foreign medical graduate is not an easy task, although it can be achieved.

The process requires funds, certifications and verification of documents, licencing and qualifying examinations before you can work as a doctor in Canada. However, with the right information and resources foreign-trained doctors can navigate the process with relative ease.

This article will explain the steps required for a Nigerian-trained doctor and other international medical graduates to migrate to Canada to work as a doctor. We will also explore the common immigration pathways to migrate to Canada.

Pathways to Work in Canada as a Doctor from Nigeria

There are three common pathways to work in Canada as a Nigerian-trained doctor or International medical graduate (IMG)

1. Residency pathway
2. Practice Ready Assessment
3. Province-based specialist pathway: 1. Clinical fellow, 2. Research fellow
4. Royal College Specialist Pathway: 1. Approved Jurisdiction Route, 2. Practice Eligibility Route, 3. Sub speciality Examination Affiliate Program (SEAP)

Canadian Resident Matching Service (CaRMS)

The residency program in Canada is quite competitive but achievable. It is suitable for IMG with no post-graduate training or those who did their post-graduate training in countries/institutions not recognised by the Royal Medical and Surgical College of Canada. Such IMG may need to repeat residency before they can practice in Canada.

The residency program in Canada requires that the foreign-trained doctor opens a physiciansApply.ca account, verifies their credentials and writes MCCQE1, NACOSCE and English proficiency language tests.

After meeting all the requirements, there is a matching system similar to that of the US that you apply to and get matched for speciality training. There are two intakes in a year and any doctor is qualified. The training usually spans 2 to 6 years depending on the speciality.

Please note that you must be a Canadian citizen or have a permanent residence (PR) before you can get matched for residency training in Canada.

Canada Provincial Practice Ready Assessment (PRA) Program

PRA programs are designed to offer clinical field assessments (CFA) for foreign-trained doctors who have completed residency training outside Canada. The PRA program seems to favour Family Physicians or doctors with postgraduate training in family medicine and is province-specific.

In some countries, family medicine is not a medical speciality, thus if you are a general practitioner with at least 24 – 36 months of post-graduate clinical experience in general practice, you might be eligible for this assessment depending on the province. Saskatchewan, Manitoba and British Columbia currently accept experienced general practitioners while Alberta only accepts Family Physicians with official Family Medicine training.

The PRA clinical field assessments ensure that internationally trained doctors possess the appropriate clinical skills and knowledge to provide quality patient care in Canada.

Each participating Canadian province offers a PRA program where foreign-trained doctors work under supervision for 12 weeks and are evaluated during this period. The aim is for the participants to obtain an independent licence to practice in Canada.

The focus of the PRA program is to meet the needs of the remote and rural parts of Canada, thus successful PRA participants are deployed to remote and rural parts of Canada for return of service for about three years.

Canadian Provinces Offering Practice-Ready Assessment Programs

The following Canadian provinces offer Practice Ready Assessment programs for Family Physicians:

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

Please note that Ontario, Prince Edward Island, New Brunswick, Yukon, Nunavut and the Northwest do not currently participate in the National Assessment Collaboration’s Practice Ready Assessment program for internationally trained medical graduates.

Also note that to participate in the PRA program, you must be a Canadian citizen or have a permanent residence (PR) to apply except for the PRA of the province of British Columbia (BC).

For BC PRA, after passing the MCCEQ1 and TDM exams and meeting their eligibility criteria, you can apply for a work permit from your country; and will be eligible for a PR within 6 months of arrival in British Columbia or they can nominate you for PR via the Express Entry program.

Steps to Work as a Doctor in Canada from Nigeria via the PRA pathway

The steps to work as a doctor in Canada from Nigeria are a guide to simplify the process and some overlap exists between steps.

Step 1. Select your preferred province

Canada consists of 13 provinces, 7 of which offer the Practice Ready Assessment program which allows Nigerian-trained doctors and other international medical graduates to apply, get licenced and practice in Canada.

However, to participate in the PRA program in most participating provinces, you must be a Canadian citizen or have a residency permit (PR) except for British Columbia (BC) which allows Nigerian-trained doctors to apply for a work permit from Nigeria after meeting the eligibility criteria.

Step 2. Open an account with PhysiciansApply.ca

Creating an account with PhysiciansApply.ca will require payment of a non-refundable fee with your credit card.

The physiciansaspply.ca account supports submission of your credentials, source verification of your credentials with EPIC/ECFMG, applying for Education Credential Assessment and registration for the Medical Council of Canada exams (MCC).

Step 3. Primary source verification of your credentials

Foreign-trained doctors must verify their credentials with the Medical Council of Canada (MCC) to receive an Education Credential Assessment (ECA) report. This is done through your Physicianapply.ca account and is performed via the EPIC/ECFMGs portfolio.

You need to verify the following documents: Medical degree(MBBS), internship certificate, postgraduate training letter, full registration with MDCN and Fellowship qualifications. Once the degree and other required documents are verified, candidates must secure the ECA report from PhysiciansApply.ca.

Step 4. MCCQE1 Examination

The Medical Council of Canada Qualifying Examination Part 1 (MCCQE1) is a prerequisite for all Nigerian-trained doctors and international medical graduates who intend to work as a doctor in Canada.

You can apply and assess preparatory materials for the Medical Council of Canada Qualifying Examination Part 1 via your PhysicianApply.ca account.

The Medical Council of Canada Qualifying Examination Part 1 can be taken at the Prometric test centre in Lagos or online from the comfort of your home. For information about the MCCQE1 exam schedule, application and fees check the MCC website.

Note: In 2021, the Medical Council of Canada removed the MCCQE II test as a pre-requisite for the Licentiate of the Medical Council of Canada (LMCC), consequently, foreign-trained doctors only need to pass one exam to get their LMCC.

Step 5. Evidence of English Language Proficiency

The official language in most Canadian provinces is English, thus to Work as a doctor in Canada you need to sit for the International English Language Testing System (IELTS) academic or Occupational English Test (OET) medicine for Canada.

A minimum score of seven in each part of the IELTS or B component in all OET parts is required. Similarly, medical practice in Quebec needs evidence of French Language Proficiency.

The best time to write the English Language proficiency test is after you have passed the MCCQE1 exam because the English exam has a life span of two years, after two years you will need to rewrite the exam if you have not started a medical practice in Canada.

Step 6. Assessment of Eligibility for Practice Ready Assessment

Having completed the steps above, you should apply to the appropriate college for a provisional licence to practice medicine in the selected province.

However, Nigerian-trained doctors are not currently eligible for provisional licences from the colleges thus they need to go through an alternative pathway; National Assessment Collaboration’s Practice Ready Assessment program.

Eligibility Requirements for Practice Ready Assessment for Family Physicians

The following are the general eligibility criteria for PRA for family physicians, there are subtle variations in the eligibility criteria for different participating provinces.

1. Medical degree.
2. Two years of postgraduate training and passing the fellowship examinations in Family Medicine leading to registration or recognition as a family physician.
3. Evidence of completion of 7 core rotations: A minimum of 4 weeks of postgraduate training in the following departments: internal/general medicine, general surgery, obstetrics/gynaecology, paediatrics, psychiatry, & emergency medicine; and a minimum of 8 weeks of postgraduate training in family medicine.
4. Scope of Practice: Evidence of having practised independently for at least 2 years.
5. Verification of medical degree, passport, and postgraduate training letters that confirm completion of the 7 core rotations through physiciansapply.ca.
6. Currency of practice. Evidence of a minimum of 24 weeks (960 hours) of clinical practice as a Family Practitioner 3 years preceding your application.
7. Evidence of English language proficiency.
8. A passing score on the MCCQE Part 1 and be a Licentiate of the Medical Council of Canada (LMCC).

Note: Alberta does not require independent practice experience post-part 1 family medicine rotation. British Columbia and Nova Scotia require 2 years of independent practice experience.

General practitioners with at least three years of practice as independent most responsible physicians will need to pass NACOSCE in addition to the MCCQE1, TDM and English exams.

Step 7. Apply for the Therapeutic Decision Making Exam (TDM) exam

The TDM Examination aims to assess the competence of foreign-trained Family Physicians at the level required of a Family Physician practising independently and safely in Canada.

Application for the TDM Examination is usually through your PRA program. Once your application is approved, you will receive a notification via your physiciansapply.ca account with the exam details. The TDM exam can be written at the Prometric Centre in Lekki Lagos or online.

For more information about the TDM exam schedule, application and fee check the MCC website. Once you pass the TDM exam, you will receive a result letter via email which will be added to your physiciansapply.ca account.

Step 8. Secure Sponsorship

International trained medical graduates, who have met all the above requirements, will need to apply for sponsorship from the health service of the Canadian province they wish to practice.

Step 9. Practice Readiness Assessment

The selection process for Practice Readiness Assessment programs is quite competitive after the screening process that evaluates the applicants’ credentials and work experience. The PRA programs select foreign-trained doctors who meet the minimum eligibility and sponsorship requirements for the practice-ready assessment route.

After your Practice Readiness Assessment program, the PRA committee reviews the results of your 12 weeks of Clinical Field Assessment (CFA)and mails them to the college to be assessed by the registration committee for approval. Successful foreign-trained family doctors are given a defined licence to practice.

During the Clinical Field Assessment candidates will be provided with accommodation allowance and weekly stipends.

Step 10. Return of Service (ROS) Agreement

Upon completing the Clinical Field Assessment (CFA), successful candidates will sign a 3-year ROS agreement and be posted to a rural community to practice. After the expiration of the three years, the Family doctor can relocate to other parts of Canada or may decide to continue practising there.

Canada Immigration Options for Foreign-Trained Doctors

Due to the high demand for physicians in Canada, the Canadian government has implemented federal and provincial immigration programs to help fill labour market gaps, however, for physicians who wish to settle permanently in Canada the fastest option to achieve permanent residence seems to be the Canada Express entry pathway.

• Express Entry

This pathway allows eligible skilled workers to secure permanent residence in Canada. Doctors, especially Family Physicians and surgeons fall under this category and qualify under the Express Entry Federal Skilled Worker Program.

The Express Entry system is a point-based program that invites the candidate with the highest point to apply for permanent residence. Foreign-trained doctors with low points can choose to move to Canada through the Provincial Nominee Programs (PNPs)

Express Entry Requirements for Doctors

Foreign-trained doctors need only 3 documents to enter the Express Entry pool:

1. Valid International passport
2. IELTS General
3. Education Credential Assessment (ECA) report 

For medical doctors, verification of their credentials is through the MCC (Medical Council of Canada)

How to Verify Credentials via PhysiciansApply.ca

The steps for verification of the MBBS certificate for ECA are outlined below.

1. Open an account on www.physiciansapply.ca. A non-refundable fee is charged.
2. Request source verification (svr) of your credentials via PhysiciansApply.ca and pay the stipulated fee. Note: the payments can be made with Nigerian MasterCard(ATM/Debit card).
3. Send your Documents to MCC via email or courier. Email is faster and very pocket-friendly. The documents to send include a certified copy of your MBBS degree certificate, international passport and certified identity confirmation page ( You will need two passport photographs (50mmX70mm) for this page, a cover letter for your medical certificate and another cover letter for your international passport.

Please note: females who are married and have different names on their medical certificates and International passports, will need to add evidence of change of name (marriage certificate, affidavit for change of name) to the documents being sent to MCC.

4. Within 7-14 days after receiving your documents, MCC will forward your degree certificate to ECFMG who then sends a request for a source verification of your degree to your school via regular mail. This will take an average of 6-8 weeks to get to your school (with a copy of your degree, a form to be filled and a pre-addressed envelope).

Please note: that to speed up the process, you should contact your medical school to look for your documents. You also pay the necessary fee for your school to send back the verified documents to ECFMG Philadelphia. If the school does not respond within 60 days, they will send another request to the school. At this point, you can opt for a courier delivery to your school. They will only repeat this step 4 up to a maximum of 3 times.

5. ECFMG responds to your school and processes your verification within 20 working days and then you can proceed to step 6.
6. Request for an ECA from MCC and pay the stipulated fee. This will take about 21 working days to process. ECA certificate appears in your PhysiciansAapply.ca account afterwards. This certificate is without the official stamp and may not be accepted for Express Entry.
7. Pay a courier fee for delivery of your ECA to Nigeria. This is your official ECA document. Alternatively, some people request that their ECA be sent to friends or family residing in Canada to save costs. These friends/family then scan and email the scanned ECA to you. This you can use for your Express Entry process.

• Provincial Nominee Programs (PNPs)

Each Canadian province has their nominee programs aimed at satisfying specific labour needs. Due to the lack of Family physicians and general practitioners British Columbia, Saskatchewan, and Nova Scotia each have nominee streams specifically for Physicians.

Province-based Specialist Pathway With Hospital Specific Licence

This is another pathway for international medical graduates who have completed the residency program in low and middle-income countries outside Canada to migrate and work as a doctor in Canada without repeating residency and does not require an MCCQE1 exam, citizenship or permanent residence.

This pathway entails getting a job with a university hospital in Canada as a clinical fellow, after an initial pre-assessment program(PEAP) for about 4 to 12 weeks.

The clinical fellowship will span from 3 to 5 years after which the doctor will progress from clinical fellow to assistant professor, associate professor then full professor. These are academic positions licensed to practice medicine in a specified hospital.

The journey to full professor will take about 10 years after which the doctor will have a full unrestricted licence to practice in any hospital in Canada however, they will never be Royal College eligible or certified.

During the journey from assistant professor to full professor, the doctor in addition to clinical practice will be involved in a lot of research, proposals, grants, publications and presentations in national and international journals. Selection into this program includes a bit of luck and the specific needs of the university hospital.

Research fellow programs for doctors also exist in Canada and do not require prior residency training and license to enrol. These are purely academic positions with no patient contact or care.

Royal College Specialist Pathway

This involves three routes: 1. Approved Jurisdiction Route, 2. Practice Eligibility Route, 3. Subspecialty Examination Affiliate Program (SEAP).

Eligibility to practice in Canada via this route depends on your speciality and the country where you did your residency training. The following countries with Royal College-accredited programs are eligible: Australia, New Zealand, Hong Kong, Singapore, South Africa, Switzerland, the UK and Ireland. Application and further details are on the Canada Royal College website.

Conclusion

To work as a doctor in Canada as an international medical graduate is not an easy task, although it can be achieved with the right guidance. There are several pathways and immigration options available. This article is a guide to simplify your journey towards medical practice in Canada. For more information on how to work as a doctor in Canada check the MCC website. Please explore Canadian Visa Requirements and How to Apply. Good luck.