Ontario Removes Barriers for Internationally Educated Physicians

CPSO REMOVES BARRIERS FOR INTERNATIONALLY EDUCATED PHYSICIANS: CLARIFICATIONS PROVIDED IN RESPONSE TO A REQUEST OF THE SOCIETY FOR CANADIANS STUDYING MEDICINE ABROAD (SOCASMA)

SOCASMA met with the College of Physicians and Surgeons of Ontario (CPSO) about the changes the CPSO has made to bring down barriers for certain internationally trained physicians. https://www.cpso.on.ca/News/News-Articles/CPSO-Removes-Barriers-for-Internationally-Educated

The following clarifications were provided in response to our questions:

CPSO – Alternative Pathways to Registration for Physicians Trained in the United States

Pathway A. For family and specialty physicians who are American Board certified, the CPSO has modified a pathway/class of licensure which eliminates the previous requirement of supervision and assessment. The CPSO will issue a restricted license to practice independently within one’s scope of practice. The “restricted” license in practice is no different than having a full license to practice independently which classification requires CFPC or RCPSC certification EXCEPT that one cannot hold themselves out to be CFPC or RCPSC certified. There is no difference in billing or scope of practice between these two classes. In other words, this “restricted” license allows an American Board-certified physician to do everything a CFPC or RCPSC certified physician can do and bill at the same rate. This new approach applies to all specialties, including family medicine. It also means that U.S. trained physicians do not need to do the CFPC or RCPSC exams.

Why a different classification to do the same work at the same rate? These changes were made to address the physician shortage by the CPSO acting within its legal right to establish policies which address the public interest. The full license to practice independently which requires CFPC or RCPSC certification is created by the Ontario Legislature which moves more slowly than CPSO.

Pathway C. In addition, the CPSO has established a new pathway for US trained physicians who are not American Board certified AND are not more than 5 years out of training. This may be of particular interest to American trained physicians who trained in disciplines where American training is shorter than Canadian training (pediatrics, anesthesiology, obstetrics, etc.) AND are eligible to take their American Board exams. This is a time-restricted license to practice under supervision for 3 years. Supervision will no longer be required when one has completed a training program accredited by the ACGME AND passed their American Board Exams AND successfully complete the USMLEs or an acceptable qualifying exam within the three years. Physicians who have successfully completed these U.S. exams will not be required to do the CFPC or the RCPSC exams.

These pathways do not impede a person from obtaining RCPSC certification should they want to. It is simply no longer necessary to be able to work and bill independently.

CPSO – Registration of family physicians trained in the United States, the United Kingdom, Ireland and Australia

Physicians who have trained and have successfully passed the family medicine exams in the above noted jurisdiction will be able to get a licence to practice in Ontario within the scope of practice of family medicine. These physicians will not need to pass the exams of the CFPC.

The process for identifying and approving jurisdictions is conducted by the College of Family Physicians of Canada (CFPC). A call for interest in becoming an approved jurisdiction was sent out to a number of countries, to which the above-mentioned jurisdictions responded positively. SOCASMA will be following up with the CFPC with regards to the opportunity of expanding the number and type of approved jurisdictions.

USMLE in lieu of MCCQE

Another change made in 2022 is that USMLEs or an acceptable qualifying exam are accepted by the CPSO in lieu of the MCCQE.

Practice Ready Assessments

The CPSO is also working to bring down more barriers, including for physicians who trained in other countries. The new Practice Ready Assessment Program (PRA) is being implemented by the Ontario government and administered by the Touchstone Institute https://touchstoneinstitute.ca/ The plan is to admit 50 physicians into the family medicine cohort. It is anticipated that the process of announcing eligibility criteria and collecting applications will begin later this month. The government has not yet approved PRA for specialties.

The CPSO continues to look at new and existing routes within the constructs of the current legislation. To follow developments go to cpso.on.ca, click on About, then Council, then Council meetings.

For more on CPSO policies/classifications that are being reviewed go to https://www.cpso.on.ca/en/Physicians/Registration/Registration-Policies

Sincerely,
Rosemary Pawliuk
Executive Director
SOCASMA