ASSESSMENTS

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Ontario Practice Ready Assessment Program (OPRAP)

The Ontario Practice Ready Assessment Program (OPRAP) offers a route to practice for internationally educated family physicians with demonstrated competence and in-depth practice experience outside of Canada.

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About

OPRAP considers the qualifications and experience of selected applicants to determine their readiness for independent practice as family physicians and ensures their competence and practice habits are equivalent to Canadian-trained physicians.

The program consists of a highly competitive multi-step candidate screening and assessment process to ensure all eligibility criteria are met. Meeting minimum requirements or successfully completing the point-in-time assessments does not guarantee that an applicant will be selected to advance to the next stage of the program.

OPRAP Process Infographic
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Important Dates

CAPACITY: TBD
ASSESSMENT DATE:

TBD

REGISTRATION OPENS:

TBD

PARTIAL REFUND DEADLINE:

TBD

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Location

Touchstone Institute

145 Wellington St W
Suite 600
Toronto, ON
M5J 1H8

Eligibility Criteria

Before you apply, make sure you meet the minimum eligibility requirements. OPRAP is highly competitive. Meeting minimum requirements or successfully completing the point-in-time assessments does not guarantee that an applicant will be selected to advance to the next stage of the program. Touchstone Institute reserves the right to change the minimum eligibility requirements at any time without notice.

To be eligible to participate in OPRAP, all applicants must have the following:

Immigration Requirement

Canadian Permanent Resident Status or Canadian Citizenship

Medical Education

Acceptable medical degree. To ensure your degree qualifies for OPRAP, check the College of Physicians and Surgeons of Ontario’s policy on alternatives to degrees in medicine.

English Language Proficiency

Successful completion of Academic IELTS with a minimum score of 7.0 in each component, achieved in the same sitting. IELTS results are valid for a two year period from the date taken.

Examinees are exempt from English language proficiency testing if their undergraduate medical education was taken in English in one of the countries that have English as a first and native language (see list below); or they are currently in practice or in a postgraduate medical education program in a country or jurisdiction where English is a first and native language (see list below) and they met the Federation of Medical Regulatory Authorities of Canada Language Proficiency Testing model standard in order to enter postgraduate training or practice in that country jurisdiction.

List of countries that have English as a first and native language

  • Anguilla
  • Antigua and Barbuda
  • Australia
  • Bahamas
  • Barbados
  • Bermuda
  • British Virgin Islands
  • Canada
  • Dominica
  • Grenada
  • Grenadines
  • Ireland
  • Jamaica
  • New Zealand
  • Singapore
  • South Africa
  • St. Kitts and Nevis
  • St. Lucia 
  • St. Vincent
  • Trinidad and Tobago
  • United Kingdom
  • United States of America
  • US Virgin Islands
Examinations

Successfully pass the following examinations:

  1. The Medical Council of Canada Evaluating Examination (MCCEE)
  2. The Medical Council of Canada Qualifying Examination Part 1 (MCCQE I)
  3. The Medical Council of Canada Qualifying Examination Part 2 (MCQEE II)

You must achieve a cut score of 75 on the National Assessment Collaboration Objective Structured Clinical Examination (NAC OSCE).

Postgraduate Training

Two years of full-time postgraduate training in family medicine or general practice in an international jurisdiction leading to registration or recognition as a family physician/general practitioner in that jurisdiction. Postgraduate training is defined as the successful completion of a postgraduate/internship/residency training program in family medicine or general practice that is a minimum of 24 months in duration. Training in the required rotations must be from an approved university affiliated program. Community experience or observerships do not count towards postgraduate training.

Demonstration of completion of seven core rotations
  • Minimum of four weeks of full-time postgraduate training in emergency medicine, general surgery, internal medicine, obstetrics/gynaecology, paediatrics, psychiatry.
  • Minimum of eight weeks of full-time postgraduate training in family medicine/general practice.
Independent Practice

Evidence of active, independent practice as a family physician/general practitioner in another jurisdiction for a minimum of three consecutive years. Independent practice is defined as being an active, independent family physician or general practitioner practising independently as the patient’s Most Responsible Physician. This means the physician is authorized to diagnose, plan, implement, manage and follow up with plan for treatment for a patient as well as order medications and diagnostic procedures. Work arrangements that do not qualify include volunteer positions if the physician is not the Most Responsible Physician, assist work, observerships and preceptorships.

Currency of Practice

Minimum of 24 weeks (960 hours) of clinical practice as a family physician/general practitioner in the immediately preceding three years as at the date of submitting the application. Clinical practice is defined as active, independent practice as a family physician or general practitioner acting as the Most Responsible Physician.

Other
  • A physiciansapply.ca account
  • No existing return of service (ROS) in another Canadian jurisdiction
  • Maximum of one previous PRA attempt made in the past five years in any Canadian jurisdiction (a PRA attempt is defined as starting the Clinical Field Assessment period)

How to Apply

OPRAP is a two-phase application process.

  • Phase 1 is a pre-screening form open to all applicants who meet the minimum eligibility criteria. Fee: $300
  • Phase 2 is available by invite only to applicants who have demonstrated that they meet the pre-screen requirements in the Phase 1 Application. Fee: $285

Payment via PayPal is required upon submission of each phase of your application. However, you do not need to sign up for a PayPal account to do this. Application fees are applied to cover administrative costs of the review process; as such, no refunds are available.

Phase 1

Before you apply:

  1. Check the minimum eligibility criteria above.
  2. Gather your supporting documents.
  3. Share your physiciansapply.ca documents with Touchstone Institute. To do this, log into your physiciansapply.ca account and select the option to share your documents with Touchstone Institute (we are found under the “Evaluating Body” category). Failure to complete this step will result in a delay in your assessment.
  4. Read the Application Guide.

When you are ready to apply:

  1. Create your account in the OPRAP Application Portal.
  2. Complete the multi-step form.
  3. Pay the administrative fee and submit your application.

You will receive a confirmation email when your application has been successfully submitted.

Once we receive your Phase 1 application, the details will be reviewed by Touchstone Institute to verify accuracy and completion. Examinees who have successfully met the minimum criteria of the Phase 1 application will be invited to continue to Phase 2.

Required Supporting Documents

As part of your OPRAP application, you will need to share the following documents with Touchstone Institute through your physiciansapply.ca account.

  • Canadian permanent resident card and/or Canadian Passport
  • Medical degree or diploma (including the verification certificate and verified credential)
  • Medical school transcripts (including the verification certificate and verified credential)
  • Postgraduate training documents confirming completion of the required seven rotations
  • Medical Council of Canada (MCC) Examination results for the following: Medical Council of Canada Evaluating Examination, MCC Qualifying Examination Part 1, MCC Qualifying Examination Part 2 and the National Assessment Collaboration OSCE

If you do not select to share your documents specifically with Touchstone Institute, they will not be accessible to us. This will result in a delay in your assessment. For instructions on sharing documents from your physiciansapply.ca account, read the OPRAP Application Guide.

To complete your application, you will be asked to upload the following documents to the OPRAP Application Portal. Documents must be less than 5 MBs and in one of the following formats: PDF, JPEG or PNG.

  • A notarized/certified photocopy of your IELTS Test Report Form or an e-transfer of the report from your test provider. Please contact your test provider for instructions on how to e-transfer your report to us.
  • Up-to-date curriculum vitae
  • Assessment report or result letter received from all previous practice ready assessment attempts made in Canada (if applicable)
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Phase 2

Examinees who are eligible to proceed to Phase 2 of the Application Portal will receive an email notification granting them access the Phase 2 Application form.

Before you apply for Phase 2, collect all your supporting documents (below).

When you are ready to apply:

  • Log in to your account in the OPRAP Application Portal.
  • Complete the multi-step form.
  • Pay the administrative fee and submit your application.

Required Supporting Documents

Please note, access to the Phase 2 portion of the OPRAP portal will only be granted after successful completion and verification of Phase 1.

References:
Three completed Reference Forms must be sent via mail directly to Touchstone Institute. OPRAP will accept scans of completed reference letters but the original hard copies must also be submitted to Touchstone Institute by mail. For verification purposes, we recommend using traceable mail (i.e., with a tracking number) to track delivery and ensure that documents arrive on time. Download the Reference Form.

Notes for providing references:

  • References must be completed by the following individuals at the hospital/clinic where you presently practice or where you last practiced as a family physician or general practitioner: Chief of Staff, Department Head and Head Nurse.
  • If your current or previous practice is not a hospital, please arrange for the three references from physicians in authority who can comment on your current practice, e.g. Medical Director or most senior physician at the clinic.
  • If you are currently enrolled in a clinical fellowship, one of the three reference forms can be completed by your supervisor.
  • In the event you are unable to arrange for references exactly as specified (i.e. you do not practice with nurses) please upload an explanatory letter outlining the circumstances.
  • Contact information (such as primary telephone number and email address) will be required in the application portal.

Postgraduate Training:

Confirmation of Postgraduate Training Form completed by the Dean or Postgraduate Training Director at your postgraduate training program. The completed form must be mailed directly to Touchstone Institute. We recommend using trackable mail to track the delivery and ensure that documents arrive on time. Download the Confirmation of Postgraduate Training Form.

As part of your Phase 2 OPRAP application, you will need to share the following documents with Touchstone Institute through your physiciansapply.ca account:

  • Proof of two years of postgraduate training in family medicine or general practice
  • Proof of completion and length of the seven rotations

If you do not select to share your documents specifically with Touchstone Institute, they will not be accessible to us. This will result in a delay in your assessment. For instructions on sharing documents from your physiciansapply.ca account, read the OPRAP Application Guide.

In Phase 2 of the OPRAP Application Portal, you will also be asked to provide details about the following:

  • Postgraduate clinic/training location (address), start and end dates of training, supervisor’s name and title
  • Additional accredited short-term training that is verifiable, if applicable
  • Current, previous or expired medical licenses granted within Canada (issuing province/territory, date license granted, expiry date, type of license and details regarding if a term or condition was placed on the license)
  • Current, previous or expired medical licenses granted outside of Canada (issuing country, date license granted, expiry date, type of license and details regarding if a term or condition was placed on the license)
  • Past, pending or dismissed malpractice case(s), letters of caution by a medical regulatory authority or incidences of a medical license being suspended or being revoked
  • Date of completion for examinations (such as the Therapeutics Decision Making examination) and certifications or qualifications (such as ACLS, ATLS or PALS)
  • Location(s) in which you practiced as a family physician or general practitioner independently for three consecutive years (name of practice/institution/facility, role/title, city/town and province/state/region/country)
  • Scope in which you practiced independently for three consecutive years as a family physician or general practitioner is required (i.e. the percent of time spent in different clinical practice settings, provide a description and indicate volume of patients in different patient populations (i.e. paediatric, adult and geriatric) and a description of medical conditions, surgical conditions and psychiatric conditions commonly seen in each patient population)
  • Location(s) in which you practiced as a family physician or general practitioner in the past three years resulting in at least 960 hours (24 weeks) of clinical practice (name of practice/institution/facility, role/title, city/town and province/state/region/country, employer’s name and contact information)
  • Scope of the clinical practice completed in the past three years as a family physician or general practitioner is required (i.e. the percent of time spent in different clinical practice settings, provide a description and indicate volume of patients in different patient populations (i.e. paediatric, adult and geriatric) and a description of medical conditions, surgical conditions and psychiatric conditions commonly seen in each patient population)
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Point-In-Time Assessments

After the Phase 2 application period, select candidates may be eligible to proceed to the point-in-time assessments:

  1. Therapeutics Decision-Making (TDM) examination
  2. Intrinsic Skills Assessment (ISA)

Both assessments take place on one day at Touchstone Institute. There are no fees associated with these assessments. Invitations will be sent to candidates prior to the assessments with further details. 

Successful completion of the TDM examination and the ISA are required for all candidates to maintain eligibility in the program.

The TDM examination is a three-hour short-answer examination with approximately 40 cases or patient-based scenarios. The candidate’s task is to prescribe specific treatments and to provide a rationale for the choices.

TDM examination cases represent common or important presentations from across four dimensions of care:

  • Health promotion and illness prevention
  • Acute illness
  • Chronic illness
  • Safety and adverse effects

For each case, the candidate is given one or more questions; most cases have two or three questions. Each case is equally important regardless of the number of questions.

The questions are designed to assess critical thinking and decision-making. Cases and questions also assess awareness and understanding of alternative therapies, respect for negotiating a therapeutic contract and recognition of drug misuse and abuse.

OPRAP candidates are expected to apply knowledge of pharmacological and non-pharmacological management of medical problems at the level required of a family physician practicing independently in Canada.

For more information, read the TDM Candidate Information Sheet

The ISA is an assessment of interpersonal skills and decision-making capabilities. It comprises a series of objective, structured short stations in which each candidate interacts with an oral examiner, who presents them with a written scenario. After reading each scenario candidates are required to answer a set of probing questions under a time limit. Each response is graded by multiple raters, giving a very reliable view of personal and professional characteristics important to our program. No studying is required. 

Prior to beginning the Clinical Field Assessment, all candidates must attend a mandatory two-week orientation program at Touchstone Institute. Sessions led by Canadian physicians will help orient candidates to the Ontario health care system and the OPRAP process. A stipend will be provided to those who attend.

More information about the OPRAP Orientation will be available closer to program dates. 

The 12-week Clinical Field Assessment (CFA) is a workplace-based assessment designed to evaluate a candidate’s readiness for independent practice as a family physician in Ontario. Only candidates who have successfully completed the rigorous screening process will be selected to proceed to the CFA. Candidates will spend 12-weeks in a designated assessment community under the direct supervision of an assessor. A stipend will be provided for the duration of the CFA.

Read the CFA Candidate Contract

Before starting the CFA, candidates must complete the following steps:

  1. Secure an offer of employment with an eligible location, where the three-year OPRAP Return of Service (ROS) will be completed.
  2. Sign an OPRAP ROS Agreement with the Ministry of Health and Long-Term Care.
  3. Obtain a 12-week Certificate for the Purpose of Assessment and Evaluation from the College of Physicians and Surgeons of Ontario for the CFA.
  4. Attend two-week orientation program at Touchstone Institute.

Touchstone Institute will try to match candidates with an approved CFA site in a community that is comparable to the location the candidate will ultimately complete their OPRAP ROS. 

During the CFA, candidates will work under direct supervision of physician assessors, who will observe, assess and provide daily feedback on their clinical and non-clinical skills related to family medicine. The CFA allows sufficient time for the candidate to:

  • Experience the broad range of patient presentations that are common to family practice
  • Be exposed to life-threatening emergencies
  • Demonstrate the required competencies

Results will be reviewed by Touchstone Institute and clinical experts to make a final determination on the outcome of the assessment.

All participating candidates will be required to sign an OPRAP Return of Service (ROS) Agreement with the Ontario Ministry of Health and Long-Term Care (ministry). The OPRAP ROS Agreement stipulates the rights and responsibilities of the OPRAP candidates and their contractual obligation to return service for a period of three years upon completion of their clinical field assessment (CFA). The full three years of service must be fulfilled in the Ontario community where the offer of employment was secured. The ROS commitment to the Eligible OPRAP Community must commence within the timeframe set out in the individual’s OPRAP ROS Agreement with the ministry. 

Participating physicians with pre-existing ROS obligations must disclose these obligations at time of application. Please note that OPRAP candidates cannot participate in both the international medical graduate (IMG) Training ROS program and OPRAP. IMGs that have active ROS obligations may not be eligible for Ontario-funded training positions. If you are unsure of your eligibility for the program, please contact the ministry for further information.

Learn more about Return of Service Agreement

We are looking for family medical practices and communities to participate in OPRAP in the following capacities:

  • Assessment Sites – Practices with two to three physicians willing to provide oversight and ongoing assessment of the internationally educated family physician’s performance and provide a recommendation regarding their readiness to practice at the end of the 12-week assessment period. 
  • Communities – Locations listed on the Areas of High Physician Need List with a commitment and capacity to provide supervision in line with CPSO’s requirements for a 24-month period.
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