ASSESSMENTS

Practice Ready Ontario (PRO)

Touchstone Institute is working with the Government of Ontario and the College of Physicians and Surgeons of Ontario (CPSO) and others to administer a practice ready assessment program for internationally trained family physicians in Ontario.

Veuillez noter que le programme Préparation à la pratique médicale en Ontario est actuellement offert qu’en anglais. Cliquez ici pour vous rediriger vers la page française de Préparation à la pratique médicale en Ontario.

About

Practice Ready Ontario (PRO) helps internationally trained family physicians who have completed postgraduate training and independent practice in family medicine or as a general practitioner outside Canada begin working in Ontario more quickly.

Hiring more physicians is the most effective step to ensure that you and your family are able to see a doctor where and when you need to. Practice Ready Ontario will add up to 100 new family physicians by the end of 2025. Successful candidates must complete a three-year return of service as a family physician in a rural high-need community.

Applications

Apply for Practice Ready Ontario

Application Portal

Practicing family physicians in Ontario interested in becoming a clinical field assessor are invited to complete the Expression of Interest Form.

Assessor Expression of Interest

Contact Practice Ready Ontario

Please carefully review the information available on our website. If the information does not address your inquiry, please fill out the contact form below.

Internationally Trained Physicians

Practice Ready Ontario assesses the skills of internationally trained family physicians to confirm readiness for independent practice in Ontario.

This program includes a 12-week Clinical Field Assessment (CFA) in a designated Ontario community, followed by a three-year return of service in a rural or high-need area.

Nearly one-third of Ontario’s doctors were trained outside of Canada. PRO builds upon this important contribution by offering eligibility to Canadian citizens and permanent residents with international medical training who meet the program criteria.

Applicants

Process Overview

Practice Ready Ontario offers a pathway to practice in the province for internationally trained family physicians with proven training and independent practice experience outside Canada. The program follows the Medical Council of Canada’s National Assessment Collaborative pan-Canadian standards for practice-ready assessments.

Phase 1—Eligibility Review: Applications are reviewed for medical qualifications, postgraduate training, clinical rotations, and independent practice hours to determine eligibility.
Phase 2—Verification: Eligible applicants submit required documents, complete the Therapeutics Decision-Making Examination, attend an interview, and apply for a restricted certificate through the CPSO.
Phase 3—Clinical Field Assessment: Selected candidates complete an orientation and a 12-week Clinical Field Assessment in Ontario. Before starting, candidates must sign a three-year Return of Service agreement with the Ontario Ministry of Health.

Important Notes:

PRO is competitive; meeting minimum requirements does not guarantee selection.
Ineligible applicants may reapply once the criteria are met.
Program fees apply. See the Candidate Fees page for details.

Requirements

To be eligible to participate in Practice Ready Ontario applicants must have completed a medical degree at a recognized school, as well as a combination of postgraduate training in family medicine or general practice and practice experience or have an acceptable equivalency (see below). Up-to-date practical experience is also essential.

Click on each category below to read about Practice Ready Ontario applicant requirements:

Immigration status

Medical education

English-language proficiency

Evidence of English language proficiency can be demonstrated by one of the following:

Completion of an undergraduate or postgraduate medical education in English in one of the countries that have English as a first and native language (see list below)

Current practice in a country or jurisdiction where English is the first and native language and more than 50% of patient care is provided in English (see list below)
- This must be supported by a letter of support/attestation from a colleague or supervisor indicating evidence of active use of English in a professional context during this period.

Successful completion of one of the following language proficiency exams written within two years at time of application:
- Academic International English Language Testing System (IELTS Academic) with a minimum score of 7.0 in each of the four components, achieved in the same sitting.
- Occupational English Test – Medicine (OET) with a minimum grade of B in each of the four subsets, achieved in the same sitting.
- Canadian English Language Proficiency Index Program General (CELPIP-General) test with a minimum score of 9 in each of the four skills, achieved in the same sitting.
- Applicants may also submit an expired English proficiency exam (listed above) accompanied by a letter of support/attestation from a colleague or supervisor indicating evidence of active use of English in a professional context during this period. The exam must be within last three years at time of application.

List of countries that have English as a first and native language: Australia, Bahamas, Bermuda, British Virgin Islands, Canada, Ireland, New Zealand, Singapore, South Africa, United Kingdom, United States of America, US Virgin Islands, and the Caribbean Islands of Anguilla, Antigua and Barbuda, Barbados, Dominica, Grenada, Grenadines, Jamaica, St. Kitts and Nevis, St. Lucia, St. Vincent, Trinidad and Tobago

MCC Licensing and certification

Examinations and certifications for verification assessment and selection

While the following examinations are not required to be eligible for PRO application, the exams will be required for the subsequent PRO verification assessment phase. It is recommended that applicants have successfully completed the following exams at time of application because the exam may not coincide with a PRO Cohort intake dates at this time.

Applicants must have successfully passed the following:

Medical Council of Canada Qualifying Examination (MCCQE) Part 2 (pre-2021, exam no longer delivered)

National Assessment Collaboration (NAC) Examination
- Note: PRO will not accept NAC exam scores for exam sessions prior to March 2013.

AND

Therapeutic Decision-Marking Exam - PASS (TDM).
- Applicants can fall into three categories: those who have already successfully completed a TDM (may move through the process more quickly), those referred by another PRA program and scheduled to complete a TDM soon, and those who meet all other eligibility criteria but have not yet completed a TDM. Applicants in the latter group who are selected to proceed to the next step in verification, will be referred by PRO to the next scheduled TDM exam.

Postgraduate Training & Independent Practice

Applicants must have a total of 48 months (4 years) of training and practice experience as a general/family physician or have an acceptable equivalency (see below), at the time of PRO application submission.

Evidence of training and practice experience demonstrated in these ways:

Evidence of 12 months postgraduate/internship/residency training in another jurisdiction leading to registration or recognition as a general/family physician in that jurisdiction

AND

36 months of independent practice (as patients' Most Responsible Physician) as a full scope general practitioner or family physician in another jurisdiction in the past. Preference to be given to recent independent practice experience and experience with minimal interruptions or gaps

Evidence of 24 months postgraduate/internship/residency training in another jurisdiction leading to registration or recognition as a general/family physician in that jurisdiction

AND

24 months of independent practice (as patients' Most Responsible Physician) as a full scope general practitioner or family physician in another jurisdiction in the past.

Demonstration of completion of seven core rotations

Ability to demonstrate completion of the below seven core rotations.

Minimum of 8 weeks postgraduate training in family medicine or general practice.
Minimum of 4 weeks postgraduate training in emergency medicine, general surgery, internal medicine, obstetrics/gynecology, pediatrics, and psychiatry.

Training in the required seven rotations must be from an approved university affiliated program. Community experience or observerships do not count towards postgraduate training.

Postgraduate gaps may be met through the following equivalencies:

If a candidate has a gap in any of the listed rotations, the program may accept practice experience or other rotation experience in lieu of training in the following way:

Each 1 year of independent practice as a family physician/general practitioner that includes the gap in practice experience rotation will be considered as equivalent to 4 weeks of postgraduate training in that area. For up to 3 rotation deficiencies.
- Attestation to prove practice experience in the area(s) of postgraduate rotation gap is required from a physician or a chief administrator in a health care setting such as a Chief Nursing Officer, Chief of Staff, Department or Division Head, Director of Care, Senior Colleague, Program Director, Medical Director, or Academic Director who can attest to clinical skills and experience.

The gap in postgraduate training rotation is covered within another rotation experience
- Attestation to prove practice experience or coverage within another rotation experience in the area(s) of the postgraduate training rotation gap(s), is required from a physician or a chief administrator in a health care setting such as a Chief Nursing Officer, Chief of Staff, Department or Division Head, Director of Care, Senior Colleague, Program Director, Medical Director, or Academic Director who can attest to clinical skills and experience.

Currency of practice

Applicants must have evidence demonstrating 960 hours of clinical practice as a family physician or general practitioner in the immediately preceding three years (virtual-care will be considered, however a minimum of 720 hours must be in-person care).

This requirement may be considered met for those who have been working with a comparable scope as a family physician as:

Licensed Clinical Assistants, Associate Physicians, in a Canadian jurisdiction, or CPSO short-duration licensed family physicians related to family practice in last 3 years. Roles that are not considered comparable include: Physician Assistant, Medical Officer, unlicensed Clinical Assistant, Hospitalist.
Trainees who hold Canadian post-graduate educational licenses related to family practice in last 3 years
Individuals who hold restricted licensures in a Canadian jurisdiction related to family practice in last 3 years

Other requirements

Phase 1: Application and Screening

Applications are submitted through the Practice Ready Ontario Application Portal, with supporting documents shared via physiciansapply.ca. Touchstone Institute has a formal agreement with MCC to access your documents only with your consent. See the Privacy Policy for details.

At the end of Phase 1, applicants will be notified whether they are eligible to proceed to Phase 2.

Before you apply

PRO Application Portal: Steps

Create an account in the PRO Application Portal.
Complete the multi-step application form.

You must upload:

An up-to-date Curriculum Vitae (following PRO template).
An application form with:
MCC candidate code / MINC number
Record of previous practice ready assessment attempts in Canada
Medical education details
English language proficiency
Examinations and certifications
Postgraduate training and rotations

Documentation from physiciansapply.ca

With your consent, program administrators will access the following:

Proof of Canadian citizenship or permanent residency
Record of previous practice ready assessment attempts (any province)
Medical degree(s) / diploma(s)
Medical school transcripts(s)
MCC exam results and dates

Note: LMCC information is automatically included in your physiciansapply.ca profile.

Phase 2: Verification and Selection

Eligible candidates will receive an invitation to complete the Phase 2 application form in the portal. During this stage:

Credentials are verified by program administrators
Applicants complete the Therapeutics Decision-Making (TDM) Exam
Applicants attend an interview
Successful applicants apply to the CPSO for a restricted certificate to enter the Clinical Field Assessment (CFA)

PRO Application Portal: Steps

Before you apply, collect all your supporting information for Phase 2.

When you are ready to apply:

Log in to your PRO Application Portal account.
Complete the multi-step Phase 2 form (access is by invitation only).

Provide the following information:

One or more referee attestations, which confirm Your completion of 960 hours of clinical practice as a family physician or general practitioner in the immediately preceding three years (virtual-care will be considered, however a minimum of 720 hours must be in-person).
Experience in independent practice as a family physician or general practitioner.

Three referees attestations (including but not limited to colleagues and/or those who have formally overseen the applicant), which confirm:
- Proof of English language proficiency including proof of exam or attestation of work experience or attestation of medical education country.

Listing on the application form of other certifications or qualifications (such as ACLS, ATLS or PALS)

Therapeutics Decision-Making Examination

This examination is a three-hour short-answer test with approximately 40 cases or patient-based scenarios. The cases and scenarios represent common or important presentations from across four dimensions of care:

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

Eligible applicants will be referred to write the TDM Examination. Exam dates will be shared with applicants through Touchstone Institute. For more information, read the TDM Candidate Information Guide.

Interview

Applicants will take part in an interview scheduled by PRO.

Application for CPSO provisional license

Applicants who are successful in Phase 2 apply to the CPSO for a restricted certificate to begin the Clinical Field Assessment. Please visit the CPSO website for information about the restricted certificate. Information and guidance will be provided by PRO and the CPSO.

Phase 3: Clinical Field Assessment

Candidates who are chosen to proceed to Phase 3 will work under the direct supervision of experienced physician assessors who will observe, assess and provide feedback on the candidate’s clinical and non-clinical skills that relate to family medicine. Over the course of the twelve-week clinical field assessment, candidates should experience a broad range of patient presentations that are common to family practice, including emergency practice. They will need to demonstrate throughout that they have the required competencies for independent practice as a family physician in Ontario. Successful candidates will be assigned to a clinical field assessment site after signing a return of service agreement with the Ontario Ministry of Health. The return of service process is described in the section below.

Before starting the clinical field assessment

Candidates will spend the duration of the clinical field assessment in a designated community under the direct supervision of an assessor. Before starting the clinical field assessment the following steps must be completed:

Sign a return of service agreement with the Ministry of Health so that Touchstone Institute can pair candidates with clinical field assessment locations.
Obtain a restricted certificate for the PRO clinical field assessment from the CPSO.
Secure an offer of employment with an eligible location for the three-year return of service will be completed.
Attend an orientation program for clinical field assessment through Touchstone Institute (see below).

Orientation

Prior to starting the clinical field assessment, all candidates must attend a mandatory orientation program at the Touchstone Institute offices in Toronto. The orientation includes sessions led by Canadian physicians, who will orient candidates to the Ontario health care system and the Practice Ready Ontario process. More information about the orientation will be available closer to the program start dates.

Clinical field assessment

Assessment outcome

Return of Service

The Ontario Ministry of Health requires that all successful candidates in the program complete a minimum three-year return of service as family physicians in an area identified by the government:

The return of service must be fulfilled in the Ontario community in which the offer of employment was secured.
All candidates will be required to sign a return of service agreement with the Ontario Ministry of Health before they start their clinical field assessment.
This agreement contracts them to work for three years full-time as family physicians, on the successful completion of their assessment.

The Ontario Ministry of Health has determined that practice locations in communities with a Rurality Index of Ontario (RIO) score of 40 and above, and those in Northern Urban Referral Centres (i.e., Timmins, North Bay, Sudbury, Sault Ste. Marie, and Thunder Bay) are eligible for successful candidates to complete their return of service.

RIO is a measure of rurality that is derived from three factors: population (count and density), travel time to a basic referral centre, and travel time to an advanced referral centre.
RIO scores are assigned to Statistics Canada census subdivisions. Please the Ontario Medical Association for community RIO scores.

Participating physicians with pre-existing return of service obligations must disclose these at the time of application. PRO candidates cannot participate in both the International Medical Graduate Training return of service program and Practice Ready Ontario.

Program Fees

Please be advised that costs incurred will vary depending on individual circumstances. Below is a summary of the anticipated costs associated with participating in the Practice Ready Ontario program.

Phase 1 – Application & Screening

Item	Fee
Practice Ready Ontario application fee	Covered by program
MINC	No charge
physiciansapply.ca account fee (if applicable)	CAN$ 320
Language proficiency test (if applicable) *	IELTS: ~ CAN$ 300 OET: ~ USD$ 450 CELPIP: ~ CAN$ 300
MCCQE 1 Examination fee (if applicable) *	CAN$ 1,420
NAC OSCE Examination fee (if applicable) *	CAN$ 3,145
LMCC Application fee (if applicable) *	CAN$ 255

* Examination fees are set by the provider and subject to change without notice.

Phase 2 – Verification Assessment & Selection

Item	Fee
Therapeutics Decision-Making Examination	CAN$ 2850 until January 2026 CAN$ 2910 as of June 2026
Applicant interview	Covered by program
Criminal record check *	~ CAN$ 75
CPSO Application **	CAN$ 1,035
CPSO Annual membership **	CAN$ 1,725
CPSO Additional required documentation (if applicable) **	Additional fees may apply

* Criminal record check fees vary by location.
** Licensure fees are set by the College of Physicians and Surgeons of Ontario and are subject to change without notice.

Phase 3 – Orientation & Clinical Field Assessment

Item	Fee
Candidate orientation program fee	Covered by program
Clinical Field Assessment fee	Covered by program
Accommodation & travel for candidate orientation	Costs will vary
Relocation, housing, etc. for Clinical Field Assessment	Costs will vary

Candidates are provided with a stipend during the clinical field assessment.

Post Practice Ready Ontario Program

Item	Fee
Return of Service relocation	Costs will vary
CPSO Application for ROS restricted certificate **	TBD
CFPC Certification Examination in Family Medicine *	CAN$ 3,520
CPSO request to modify terms, conditions on restricted certificates **	CAN$ 431.25
CPSO Class transfer **	CAN$ 1,035

* Examination fees are set by provider and subject to change without notice
** Licensure fees are set by the College of Physicians and Surgeons of Ontario and are subject to change without notice

Optional & Recommended

Item	Fee
Advanced Cardiovascular Life Support (ACLS)	~ CAN$ 250–600
Pediatric Advanced Life Support (PALS)	~ CAN$ 200–600
Advanced Trauma Life Support (ATLS)	~ CAN$ 1,700

* Courses fees vary based on location of completion

Assessors

Overview

Practice Ready Ontario is providing a pathway to increase the number of family physicians in high-need communities by screening and assessing qualified internationally trained family physician candidates and general practitioners through a 12-week clinical field assessment at designated host sites.

The program is currently in a two-year pilot phase to assess program design and implementation, including eligibility criteria and candidate selection. As a result of ongoing learning, elements of the program may evolve over time. Any material changes to the program will be communicated through the PRO website.

During the clinical field assessment, candidates will work under the direct supervision of physician assessors, who will observe, assess and provide feedback on their clinical and non-clinical skills related to family medicine. The clinical field assessment is not a training period, but a supervised assessment period. Based on the results of this 12-week assessment period, outcomes will be reviewed by the Practice Ready Ontario Assessment Committee who make final determinations regarding candidate success.

Following the clinical field assessment, the Ontario Ministry of Health requires that successful candidates complete a minimum three-year return of service as family physicians in a community with a Rurality Index for Ontario (RIO) score of 40 and above, or within a Northern Urban Referral Centre such as Timmins, North Bay, Sudbury, Sault Ste. Marie and Thunder Bay. To create an authentic assessment environment, clinical field assessments are designed to take place in a demographically similar community as each candidate’s agreed upon return of service community.

Touchstone Institute is currently seeking physician assessors who meet role requirements and who are committed to the provision of quality care for underserved communities in Ontario.

A group of four clinicians gather around an electronic tablet and papers in discussion

The success of Practice Ready Ontario greatly relies on the commitment of experienced and active family physicians who are familiar with the challenges of rural and remote communities. Over the 12-week duration of a candidate’s clinical field assessment, assessors will observe and evaluate a candidate according to structured assessment processes. For each candidate, there will be one primary and up to two secondary assessors. It is possible that a primary assessor for one candidate can be a secondary assessor for another, and vice versa. Primary and secondary assessors will work together to divide their time with the candidate.

Clinical field assessments will look different for each assessor and candidate, however over the 12-week duration, the amount of observation time required will likely decrease. Ultimately it is up to the assessor(s) to decide how they structure a clinical field assessment to suit their practice, colleagues, and the candidates. Assessors will be given substantial training and guidance on how best to structure the clinical field assessment as a component of assessor certification.

If you are a family physician interested in becoming a clinical field assessor for PRO, please complete the Expression of Interest Form.

Physician Assessors

As a physician assessor, you will:

Receive training, certification, and competitive remuneration
Participate in activities that are eligible for continuing professional development credits from the College of Family Physicians of Canada
Support Ontario’s health human resource strategy by helping to address physician shortages in rural and underserved communities
Join a growing network of rural and remote physicians and
Build your professional skills as a mentor by giving feedback to future Ontario family physicians

Responsibilities

Selected assessors will:

Complete certification training (in-person online workshop plus online learning modules) before the Clinical Field Assessment (CFA) begins
Be available on-site, or assign a delegate, whenever the candidate is caring for patients
Submit assessment forms using a web-based system, the responsibility of which will be divided amongst the primary and secondary assessors
Evaluate and recommend on a candidate’s readiness for independent practice in Ontario. Final decisions are made by the Assessment Committee)

Eligibility

You may apply if you are a family physician:

Full licensed in good standing with the CPSO and with an acceptable investigative history
In an active clinical practice for at least three years (including at least one year in Ontario)
Practising in a setting where key competencies for return of service communities can be confirmed
Skilled in evaluating, mentoring, and teaching

As a role requirement, physician assessors should be actively practicing or have privileges in a community that meets the assessment site criteria.

The ideal clinical field assessment site will:

Be in an area where competencies necessary to work in the specified return of service communities can be confirmed
Have the support of co-assessors and colleagues to host the assessment
Have the appropriate workspace to host the candidate(s)
Expose candidates to all aspects of family medicine
Expose candidates to a variety of settings such as an office, hospital, ER, nursing home and home care

Communities

Practice Ready Ontario is designed to help address the family doctor shortages in rural communities.

A candidate’s three-year return of service, which is mandatory at the end of the program, must be within an area with Rurality Index of Ontario (RIO) score of 40 or higher or within a Northern Urban Referral Centre (i.e., Timmins, North Bay, Sudbury, Sault Ste. Marie, and Thunder Bay).

The preceding 12-week clinical field assessment will take place in areas that can confirm competencies necessary to work in the specified return of service communities.

Communities interested in participating in Practice Ready Ontario as a Clinical Field Assessment site, please fill out the Expression of Interest Form.

Communities interested in participating in Practice Ready Ontario as a Return of Service site, can contact Ontario Health at: practiceontario@ontariohealth.ca.

FAQs

Potential Applicants

Who is eligible for Practice Ready Ontario?

Applicants must:

Be a Canadian citizen or permanent resident
Hold a medical degree from a recognized school
Show competence in English
Pass/achieve an accepted score in required Medical Council of Canada examinations (see Applicant Requirements).
Have at least 48 months (4 years) of combined training and practice experience as a family physician or general practitioner (see Applicant Requirements).

How long will the full assessment process take?

How many physicians will be selected to participate in this program?

How competitive is the process?

How many times can I apply to Practice Ready Ontario?

I am waiting for permanent residency. Can I apply?

I am Canadian and returning from studying abroad. Can I apply?

What does it cost to apply for Practice Ready Ontario?

Is the program offered in French?

What supporting documents do I need?

Why do I need a physiciansapply.ca account?

I am not a family physician/general practitioner. Can I apply?

What is the Therapeutics Decision-Making (TDM) Examination?

Can I complete the TDM before applying?

I have practice experience outside Canada, but don’t meet all Family Medicine requirements. Can I still apply?

I meet the requirements, but don’t have all the documents. What should I do?

Where can I find other resources for internationally trained physicians?

Can I choose my clinical field assessment or return of service location?

Can the clinical field assessment and the return of service be in the same community?

When do I sign the Return of Service Agreement and the Practice Location Agreement for my Return of Service?

Who do I contact about Return of Service?

General Information

What is the goal of Practice Ready Ontario?

How does the program work?

How does PRO support integration of internationally trained physicians into practice?

Why is the focus on rural Ontario communities?

How is the program being administered?

Are there similar programs?

How does Practice Ready Ontario compare to other provinces?

Why is this program offered only for family medicine?

Will the program address other specialties?

Is Practice Ready Ontario a rigorous program?

Application Status

I submitted my application. When will I hear back and what is the timing?

Are TDM exam results from another province valid?

My exam results expired during Phase 2. Can you make an exception?

I applied before and now meet the eligibility requirements. Can I apply again?

What is the status of the intakes?

Assessors and Assessment Sites

What is the role of an assessor?

What are the requirements to be an assessor?

Assessors must:

Hold a full license in good standing from College of Physicians and Surgeons of Ontario (CPSO)
Have at least 3 years of active clinical practice, with at least one year in Ontario
Be able to provide assessment exposures in required areas
Work in a clinical practice with privileges in an Ontario community with a Rurality Index of Ontario (RIO) score of 40 or higher or within a Northern Urban Referral Centre (i.e., Timmins, North Bay, Sudbury, Sault Ste. Marie, and Thunder Bay).
Be available on-site or designate a delegate when the candidate is caring for patients
Agree to submit evaluations and recommendations on a candidate’s readiness to the Practice Ready Ontario
Complete MainPro+ accredited assessor training before the clinical field assessment start date

What are the requirements to become a clinical field assessment site?

What are the benefits of being an assessor?

Is a Practice Ready Ontario assessor similar to a residency preceptor?

What is required during the assessor training?

What is the difference between a Clinical Field Assessment (CFA) and a Return of Service (ROS) site?

Can a clinical field assessment (CFA) site host more than one candidate?

Can an assessor supervise more than one candidate at a time?

Return of Service

Where will successful applicants complete their return of service?

Can my community apply to be a Return of Service site?

How can communities support new doctors?

Welcome them! Family physicians who are newly registered to work in Ontario will be an integral part of your community for at least three years. Their contribution will help to improve medical provision in your area.

Provide housing and settlement support
Help with integration into the community
Offer social and professional support networks

These efforts make doctors feel welcome and improve retention.

How are candidates be paid during their return of service?

Resources

Applicants

Partners

Touchstone Institute is working with the Government of Ontario, College of Physicians and Surgeons of Ontario (CPSO) and the Medical Council of Canada (MCC) to put in place a practice ready assessment program for internationally trained family physicians in Ontario.

Practice Ready Ontario is funded by the Government of Ontario.