by Mina Karabit March 25, 2023 2 min read

At its latestCouncil meeting, theCollege of Physicians and Surgeons of Ontario (CPSO) proposed and approved changes to its registration policies to encourage more US-trained physicians to practice in Ontario. The proposal is outlined in a draft policy titled “Alternative Pathways to Registration for Physicians Trained in the United States.” There are also corresponding amendments to the current“Specialist Recognition Criteria in Ontario” policy, allowing these physicians to be recognized as specialists by the CPSO without being certified by theCollege of Family Physicians of Canada (CFPC) or theRoyal College of Physicians and Surgeons of Canada (RCPSC).

In proposing these changes, Council considered the similarities between Canadian and US physician training programs and the comparable standard of US board certifications with RCPSC certification. Therefore, the current assessment requirements may be unnecessarily burdensome, and their removal would not compromise the integrity of the registration process.  

The proposed amendments aim to address two groups of US-trained physicians: (i) board-certified physicians and (ii) board-eligible physicians. 

US Board-Certified Physicians 

Currently, US board-certified physicians can obtain licensure to practice independently in Ontario after completing a minimum of a year of supervised practice and an assessment. This is referred to as ‘Pathway A’ of the CPSO’s “Alternative Pathways to Registration” policy. 

The draft policy modifies ‘Pathway A,’ granting board-certified physicians a restricted certificate to practice independently without the supervision or assessment requirements. 

Moreover, the proposed changes to the “Specialist Recognition Criteria in Ontario” policy would allow board-certified physicians to retain their specialist recognition by removing the requirement to undergo a practice assessment. 

US Board-Eligible Physicians 

Unlike board-certified physicians, US-trained physicians eligible to sit a US specialty board examination do not currently have an alternative pathway to registration.

The new draft policy creates a new pathway, ‘Pathway C,’ to grant board-eligible physicians a time-limited, restricted certificate of registration to complete their US board exam. The certificate expires within three years if the physician does not complete the board exam. Once the physician completes their board exam, the physician can obtain full licensure under the newly proposed ‘Pathway A.’ 

It is important to remember that the proposed policies arenot yet in force. While Council approved the changes to current policies, the changes must be circulated in accordance with section 22.21 of theHealth Professions Procedural Code. For now, the old pathways still apply and interested US-trained physicians should look to the CPSO for timely updates. 

NOTE: Our blog is not a substitute for legal advice, particularly when circumstances evolve and policies change. The team at Wise Health Law has expertise in navigating the CPSO’s registration process. Please contact us to see if we are able to assist you. 

To learn more about Wise Health Law and our services, please contact us!



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