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How US Doctors Can Practice Medicine in Canada: Licensing, Job Search, and Salaries

  • Jan 23
  • 9 min read

For a number of reasons, we are seeing increasing (almost daily!) questions submitted in our online physician communities from doctors that are looking to explore practicing medicine in Canada or moving to Canada.  Below, we cover things that physicians should know about practicing medicine in Canada such as if they would need additional training, if their license transfers to Canada, how much Canadian physicians make, and how to get started.


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What licensed US physicians should know when considering a move to practice medicine in Canada


Why do so many physicians want to move to Canada to practice medicine?


As the United States healthcare landscape continues to become increasingly challenging for physicians, whether it be secondary to insurance companies, declining reimbursement, other financial issues, the need to combat misinformation, or political reasons, there are many doctors who are exploring options to practice internationally. Canada is particularly attractive given the vicinity to the United States for those with family and friends they want to stay close to and a relative ease of acclimation due to a shared language and (in many aspects, though not all), culture.



How hard is it for a licensed US physician to practice medicine in Canada?


The first thing to know is that each Canadian province and territory, similar to each US state, has its own College. What this means is that the criteria for registration and licensure is different from province to province, and there is no single Canadian license. Additionally, there may be different criteria for different specialties, in part secondary to need for physicians of certain specialties and in part secondary to differences in training in Canada.


However, many Canadian Colleges of Physicians and Surgeons recognize the US board certification or board eligibility, and don’t require any additional training, or even retaking exams. 


Others require that the number of years that you’ve engaged in residency and fellowship are equivalent to those required in Canada. So if you haven’t done a fellowship after residency, and the Canadian residency program for your specialty is longer than that in the United States, you may encounter some more hurdles. We’ll touch more on these below.


In general, the more needed you are (like in a rural province), the faster the system will work to get you fully licensed quickly. You probably need to start the process 6-18 months ahead of time to ensure you have a smooth transition.


Additionally, remember that licensing is not the same as immigration. Immigration and work permits are a separate process that is handled separately by the federal government. That said, many provinces have PNP programs to help recruit physicians. 



Which Canadian provinces and territories make it particularly easy for US trained physicians to get licensed and registered to practice medicine?


In general, Ontario (CPSO), British Columbia (CPSBC), and Nova Scotia (CPSNS) don’t require additional exams or training to practice medicine in these provinces. These are current as of 1/2026, but please check back with the individual provinces for any changes.


Canadian provinces & territories that make it particularly easy for US trained physicians to get licensed: Ontario, British Columbia & Nova Scotia


Ontario


The College of Physicians and Surgeons of Ontario (CPSO) is trying to combat the physician shortage by making it particularly easy for internationally trained physicians to practice there. There are no supervision or assessment requirements for physicians trained and board certified in the United States (as long as it’s within their scope of practice), and for those that are board eligible but not yet board certified, there are options to practice with supervision until board certified as long as they pass their board certification exam within 3 years. 



British Columbia


As of July 7, 2025, US trained physicians and surgeons are eligible to apply for a full license. Board certified family medicine physicians (ABFM or AOBFP) who were trained in an ACGME or AOA accredited residency program are eligible for registration in the full family class of licensure in British Columbia. Specialist physicians who are board certified with their respective ABMS member board and completed an ACGME accredited program are similarly eligible. 


Read more and explore details here. 



Nova Scotia


Physicians trained in America often qualify for a full license. They must have an approved medical degree from a school that is approved by the Council, have done a residency with an ACGME approved program, have current certification with a member board of the American Board of Medical Specialties or the American Osteopathic Association, and must be a Licentiate of the Medical Council of Canada (LMCC) or an acceptable alternative to the LMCC (which includes passing USMLE Steps 1-3, or several other alternatives outlined here).


Read more and explore details here. 



What specialties may face challenges getting licensed in certain Canadian provinces?


As mentioned above, some provinces require that the length of training you had is equivalent to the length of training you would have had to practice medicine in that specialty in Canada.


It’s important to know that an internal medicine residency in Canada lasts 4 years instead of the 3 in the United States, and that an emergency medicine residency lasts 5 years instead of the 4 in the United States. 


Fortunately, fellowship years also apply towards that credit, so if you’ve done a fellowship in those specialties, you may not have an issue. Additionally, some provinces may factor in your years of experience practicing medicine, or otherwise factor in other aspects of your application, especially if there is a pressing need for physicians in your specialty. Therefore, it’s advised to reach out to the individual medical college of the province you want to practice in for more details and clarification on processes.



What other challenges may a licensed US physician face when applying to work in some provinces?


Some provinces preclude you from getting a full license to practice until you’ve had clinical supervision for some period of time, usually ranging from a year to 18 months. Until then, you may have to hold a provisional license and have a licensed supervising physician who will review some of your cases every month and provide feedback or mentor you on standard of care locally. 



What should I know about the Canadian health system and physician employment and payment?


As you may know, Canada does offer universal healthcare through a public system called Canadian Medicare, which is funded and administered primarily by each province and territory as well as the federal government, each with its own insurance plan. However, while this provides catastrophic coverage and basic healthcare, the majority of Canadians who can afford to will purchase supplementary insurance or seek private healthcare for excluded services or access to private doctors.


There is a mix of public and private Canadian hospitals, with most territories outside of Ontario having public hospitals and Ontario having a lot of private not for profit hospitals. 


It’s important to note that instead of being employed physicians, many Canadian doctors are independent contractors in private practices. This is especially true for specialists. 


Fee for service is the primary mode of payment, although there are also other payment methods through salaries or capitulation models. Even hospital based physicians usually aren’t hospital employees and are instead paid fee-for-service directly by the provincial ministries of health. 


What this means is that for insured services, the patient isn’t usually directly billed, but rather the bill goes to the province, and there is less variability related to insurance contracts. 


You should expect differences in wait times for services, including referrals and access to imaging and procedures. There is also stronger gatekeeping at the primary care level, and more set pathways and protocols for doing things.


In general, malpractice premiums are lower and the system is more regulated and less adversarial, allowing for less defensive medicine. Most physicians are covered by the CMPA and premiums are generally only a few hundred a month at most.



What kinds of salaries can I expect to receive as a physician in Canada?


As in the United States, salaries can range widely depending on your specialty and practice environment. Workload and the province also make a difference, similar to how rural and urban areas in the US.


That said, generally speaking, you will make less in Canada than you do in the US, especially when accounting for the relative strength of the US dollar. However, you will also pay less in malpractice insurance, have lower administrative burden, and deal less with insurance companies. Therefore, your net take home may not be as different as it may look on paper. Volumes may also be lower depending on your work environment. 


It appears that across all specialties and provinces, on average, physicians in Canada gross approximately 380,000-430,000 Canadian dollars per year. Perhaps not surprisingly, certain specialists and surgeons tend to make higher salaries, and primary care fields tend to be on the lower side. Canadian physicians are one of the highest paid professions in Canada, similar to the United States.



How do I find a physician job in Canada as a US based physician?


Because licensing depends on the province, your first step should be to decide what province you want to practice in. You may already have a place in mind, but if not, you could start by looking at where doctors are in demand, where immigration is the easiest, and where you are eligible for licensing without the need for any further exams, qualifications, or supervision. While Ontario and BC are obvious places of appeal given the big cities, they are also more in demand and therefore the job search there can be more competitive. 


Most physician jobs in Canada are found through recruitment agencies tied to the province, direct contact with existing clinics and hospitals, word of mouth (use your professional networks - you may find some physicians on our online doctor communities as we have many Canadian members!), and postings by health authorities. There are of course job boards out there as well, but start with the provincial health authority websites, hospital hiring pages for the department, and job listings at the Canadian Medical Association or specialty specific societies. 


The cool thing about the provisional recruitment agencies is that these aren’t traditional recruiters, but more akin to the in house recruiters at a hospital system. They’re publicly funded, free, agencies that don’t get paid on the basis of whether you get a job. Each province has an official agency that will help with job leads including introductions to clinics and hospitals, as well as help you to navigate the licensing and immigration processes. Some even offer relocation incentives depending on the demand and need for doctors. 


You’ll need to send them your CV, details about your training and board certification, and of course, what types of jobs you’re interested in, and they’ll get started right away, even before you have your provincial license. 



Expect the interview process to be similar, but also different


While every job will want to know about your qualifications and experience, in many cases, they’ll also be emphasizing fit. This includes how well you fit into the community and how likely they think you are to stick around, given the shortages. In some rural jobs, they’ll need you to be pretty versatile in your skillset. They’ll also need call coverage and the ability to be a team player. 



Conclusion


We hope this introduction to the licensing and job search process in Canada is helpful. The big take home point is that you need to realize that each province and territory is different, so you’re going to want to go to the specific website associated with the province or territory to get more information, as well as to see where you can find job postings and listings. There is a very real physician shortage in many parts of Canada, and therefore, there has been a big push to make the pathway to practice as easy as possible for US licensed and board certified physicians. Take some time to get to know the ecosystem so that you are sure it’s a good fit, as it’s a big step that requires planning ahead of time and big changes in life in general. Good luck!



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