Working in Canada

Healthcare system

Canada, like Britain, has a well-established and comprehensive publicly funded healthcare service for the entire population – medicare. The service provides universal coverage for medically necessary hospital and physician services based on need rather than ability to pay. The biggest difference between the British and Canadian systems is that, although the federal government has the ultimate responsibility, the roles and responsibilities are shared with the provincial/territorial governments. The latter being responsible for the management, organisation and delivery of health services for their residents.

Primary care is the foundation of the healthcare system and patients do not pay for medical consultations or treatment and can have direct access to specialists without needing a GP referral.

Medical education
After completing an undergraduate course for two to four years, Canadian students then undertake a medical degree lasting three to four years. The final one or two years of this course are spent in hospitals or doctors’ offices. Upon completion of their medical studies, they join a residency programme which provides additional training in an area of specific focus. Depending on the field of medicine they select, this can take between two and seven years. At the end of the residency programme, doctors take a final exam which entitles them to practise medicine.

Registration
Before an immigration application can be approved, international medical graduates must establish professional competence. Registration is under the jurisdiction of the medical licensing authorities in each province, which can be a complicated business. Most of the licensing authorities will require you to pass the Medical Council of Canada Evaluating Examination (MCCEE), administered by the Medical Council of Canada (MCC). This is an exam for international medical graduates which tests general clinical competence in comparison with the standard of graduates from Canadian Medical Schools. It can be taken in French or English and is a general assessment of an individual’s basic medical knowledge in the principal fields of medicine. Specialists who have been certified by a Board member of the American Board of Medical Specialties or certified by the Royal College of Physicians and Surgeons of Canada or the College of Family Physicians of Canada may request exemption from the MCCEE. Doctors wishing to apply to CaRMS need to have passed the MCCEE.

Once the MCCEE is passed, doctors can take the Medical Council of Canada Qualifying Examination (MCCQE) Part 1. This is a one-day computer based test assessing an individual’s competency for entry into supervised clinical practice in postgraduate training programmes. Sittings for the MCCQE Part 1 usually take place in spring and autumn.

In order to join the Canadian Medical Register as a Licentiate of the Medical Council of Canada doctors are required to pass the MCCQE Part 2. To be eligible you will have to have passed MCCQE Part 1 and completed a minimum of 12 months postgraduate medical training. This training can be undertaken anywhere. The MCCQE Part 2 assesses an individual’s knowledge, skills and attitudes essential for medical licensure in Canada. Some licensing authorities also require supplementary professional examinations and/or language examinations prior to registering a doctor.

All postgraduate residents and all practising physicians must hold an educational or practice licence from the medical licensing authority in the province in which they study or practise. Detailed information may be obtained from registrars in the Provincial Medical Regulatory (Licensing) Authorities at the addresses listed below.

Specialist qualifications gained overseas are no longer considered when granting a specialist licence in Canada. Instead you are now required to obtain a fellowship of the Royal College of Physicians and Surgeons of Canada.

Immigration
You need employment authorisation from the Canadian High Commission before leaving the UK, and will have to have a medical examination carried out by an approved GP. A list of designated medical practitioners who are able to conduct the medical examination can be request . Note: Quebec has a similar, but separate immigration procedure. 
You will need to apply to the Canadian High Commission for a work permit, normally only issued on the basis of a temporary offer of employment, confirmed by a Canada Employment Centre certifying that there are no qualified Canadian citizens/permanent residents who are available to undertake the position offered. This would normally be a job offer which has been officially endorsed by the Canadian government.

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