ASSESSMENTS

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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.

About

Practice Ready Ontario streamlines the process for internationally trained physicians who have completed postgraduate training and have experience of independent practice in family medicine or as a general practitioner outside Canada.

 

Practice Ready Ontario is a positive development for the public in Ontario and for internationally trained physicians who hope to work in the province. The program provides a pathway for internationally trained physicians to become licensed more rapidly.

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 provide up to 50 family physicians in 2024, with more to follow in 2025. All successful candidates are required by the provincial government to fulfill a three-year return of service as a family physician in a rural high needs community.

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Announcements

  • Family physicians interested in becoming a clinical field assessor for PRO, complete the Expression of Interest Form
  • Internationally trained physician interested in applying for PRO, the application portal is now closed.
  • To receive important reminders, sign-up for our mailing list below
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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. 

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Internationally Trained Physicians

Practice Ready Ontario is an assessment program that recognizes the competence of internationally trained physicians who have completed postgraduate training and have experience of independent practice in family medicine or as a general practitioner outside Canada. The program considers qualifications and experience, in a clinical setting, to determine the readiness of applicants for independent practice.

This rigorous program includes a 12-week clinical field assessment in a designated Ontario community. Successful candidates will be required to complete a three-year return of service as a family physician in the province.

Internationally trained physicians are already an essential component of Ontario’s health care system with nearly a third of all doctors in the province receiving their medical degrees outside Canada.

Practice Ready Ontario is available to internationally trained physicians and does not distinguish between the nationalities at birth of applicants. Canadian citizens or permanent residents who trained internationally and meet other criteria are eligible to apply for this program.

Applicants

Process Overview

Practice Ready Ontario offers a route to practice in the province for internationally trained family physicians with demonstrated competence and in-depth practice experience outside Canada. It aligns with the Medical Council of Canada’s National Assessment Collaborative pan-Canadian standards for practice ready assessments. Applications will take place in two phases. In the third phase candidates complete a clinical field assessment.

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.

  • Phase 1: program administrators determine the eligibility of applicants. This includes a review of medical qualifications, postgraduate training and rotations, and the hours of independent practice. Applicants will then be deemed eligible or ineligible.
  • Phase 2: eligible applicants who are also chosen to proceed submit evidence of certain requirements, write the Therapeutics Decision-Making Examination, interview and apply for a restricted license through the CPSO. Reaching the second phase does not guarantee being selected to enter the program and the clinical field assessment.
  • Phase 3: selected candidates complete a program orientation followed by the 12-week clinical field assessment. 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.
  • Return of Service: candidates who successfully complete this clinical field assessment will be required to enter into a three-year agreement with the Ministry of Health, and complete any other applicable licensure requirements.

This is a competitive program. Meeting the minimum requirements for each phase does not guarantee that an applicant will be selected to advance to the next phase of the program.

Ineligible applicants can apply again, once they meet the criteria.

There will be costs associated with participating in the Practice Ready Ontario program. Please see our Candidate Fees overview for more information.

PRO Timeline Activities (Simplified)

Requirements

To be eligible to participate in Practice Ready Ontario applicants must have completed a medical degree at a recognized school, as well as at least two years of postgraduate training in family medicine or general practice. Up-to-date practical experience is also essential.

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

Applicants must hold Canadian citizenship or permanent residency.

Successful completion of a medical degree issued by a school listed in the World Directory of Medical Schools.

Evidence of English Language Proficiency can be demonstrated in these ways: 

  • Successful completion of one of the following language proficiency exams:
  • 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); or 
  • 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) 

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 

Successfully passed and achieved an accepted score in the following Medical Council of Canada examinations:

AND

      • March 2013 to September 2018: 75
      • March 2019 to March 2020: 429 
      • September 2020: Pass with Superior Performance. A “pass” will not meet minimum eligibility requirements.
      • October 2021 to April 2023: 1405
      • May 2023 onwards: 608 

Please note: PRO will not accept NAC exam scores for exam sessions prior to March 2013. 

Evidence of a minimum of two years of postgraduate training in family medicine or general practice in another jurisdiction. Postgraduate training is defined as the successful completion of a postgraduate/internship/residency training program in family medicine or general practice that is at least 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.  

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. 

Evidence of having completed a minimum of three consecutive years of independent practice as a general or family physician (patient’s Most Responsible Physician) in another jurisdiction in the past. Preference to be given to recent independent practice experience and experience with minimal interruptions or gaps.

Independent practice is defined as being an active, independent family physician / general practitioner acting as a Most Responsible Physician with the authority to diagnose, implement, manage, and follow up on patient treatment plans 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.  

Evidence demonstrating 24 weeks (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 850 hours must be in-person care). Preference will be given to applicants with recent clinical practice experience.

Clinical practice is defined as active, independent practice as a family physician or general practitioner acting as the Most Responsible Physician.  Work arrangements that do not qualify include volunteer positions if the physician is not the most responsible physician, assist work, observerships and preceptorships.

  • Valid Medical Identification Number for Canada (MINC)
  • Valid Medical Council of Canada candidate code
  • Valid Canadian or international drivers license
  • No more than one previous practice ready assessment attempts in Canada
  • A current curriculum vitae following this format

Phase 1: Application and Screening

Applications will be completed through the Practice Ready Ontario Application Portal. At this phase, applicants confirm their eligibility, and share documentation with program administrators through physiciansapply.ca.

  1. Check eligibility criteria and contact Practice Ready Ontario if you have questions.     
  2. Gather your supporting documents.   
  3. Prepare to share your physiciansapply.ca documents with Touchstone Institute. This will simplify the process for you, so that there is no duplication of document submission. Touchstone Institute has a formal agreement with the MCC to access your document only with your consent. See Touchstone Institute’s Practice Ready Ontario Privacy Policy for more information about how we use and safeguard your data.
  1. Create your account in the PRO Application Portal.
  2. Complete the multi-step form.  

In Phase 1, applicants must provide the following to confirm their eligibility:

  • MCC candidate code / MINC number
  • Previous practice ready assessment attempts (in any Canadian province)
  • Medical education
  • English language proficiency
  • Examinations
  • Postgraduate training and rotations
  • Curriculum Vitae, following the format of this template
  • Acknowledgment of currency of practice, postgraduate training, independent practice requirements

Applicants will also provide program administrators with consent to access the following documents through physiciansapply.ca:

  • Proof of Canadian citizenship or permanent residency
  • Details of any previous practice ready assessment attempts (in any Canadian province)
  • Medical degree / diploma(s)
  • Medical school transcripts(s)
  • MCC exam results / exam dates (MCCQE1 and MCCQE2 / NAC)

Phase 2: Verification and Selection

Eligible candidates who are chosen to proceed to Phase 2 will receive an invitation by email to complete the Phase 2 application form in the portal. During this part of the process the applicant’s credentials will be verified by the program administrators. They will also write the Therapeutics Decision-Making Examination, interview and apply for a restricted license through the CPSO.

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

When you are ready to apply:   

  1. Log in to your account in the PRO Application Portal. 
  2. Complete the multi-step form.  

Please note, access to the Phase 2 portion of the PRO portal will be granted by invitation only after completion and verification of applicants selected from Phase 1. 

  • Provide contact details for three references, including but not limited to those who formally overseen the applicant or colleagues.
  • Demonstrate completion of the seven core rotations.
  • Demonstrate 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 850 hours must be in-person).
  • Demonstrate a minimum three consecutive years of independent practice.
    • Scope in which you practiced independently for three consecutive years as a family physician or general practitioner is required.
  • Demonstrate evidence of English language proficiency.
  • Indicate other certifications or qualifications (such as ACLS, ATLS or PALS).

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 for the Practice Ready Ontario will be able to write the TDM Examination in an exceptionally scheduled session in September 2023. Details will be shared with selected applicants through Touchstone Institute. For more information, read the TDM Candidate Information Guide.   

All applicants who progress to Phase 2 of the application will participate in an interview.

Practice Ready Ontario will refer all applicants progressing to a Clinical Field Assessment directly to the CPSO. Please visit their website for information on the provisional licensing process. 

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.

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:

  1. Secure an offer of employment with an eligible location, where the three-year return of service will be completed.  

  2. Sign a return of service agreement with the Ministry of Health. 

  3. Touchstone Institute will begin pairing candidates with clinical field assessment locations.

  4. Obtain a provisional license for the Practice Ready Ontario clinical field assessment from the CPSO.  

  5. Attend an orientation program through Touchstone Institute.  

Candidates will complete the clinical field assessment in a community that is comparable to the location where they will ultimately complete their return of service.

Prior to starting the clinical field assessment, all candidates must attend a mandatory orientation program at the Touchstone Institute offices in Toronto. The orientation will include 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. 

Successful applicants who complete the screening and selection process will move forward to the clinical field assessment. Only those who have successfully completed the rigorous screening process will be selected to proceed to the assessment. Candidates will spend 12-weeks in a designated assessment community under the direct supervision of an assessor(s). A stipend will be provided for the duration.

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.

Candidates' assessment results will be reviewed by the PRO Assessment Committee to make a final determination on the outcome of the assessment.

Return of Service

Practice Ready Ontario will provide a pathway to increase the number of family physicians in high need communities in the province. 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 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 visit the site linked here for community RIO scores.

Participating physicians with pre-existing return of service obligations must disclose these at the time of application. Practice Ready Ontario 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 in 2023-2024.

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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.

 As physician assessors, selected applicants will:

  • Receive training, certification, and competitive remuneration for the role
  • Participate in activities that are eligible for continuing professional development credits from the College of Family Physicians of Canada 
  • Contribute to a health human resource strategy to help alleviate physician shortages 
  • Participate in a growing network of rural and remote communities in support of addressing underserved populations 
  • Professionally develop as a mentor and give back to the profession through the provision of feedback to future practicing Ontario physicians 

 Selected assessors will be responsible for:

  • completing certification training through attending an in-person training workshop and completing additional online learning modules prior to the start date of the clinical field assessment  
  • being available on-site or else assign a delegate to be available when the candidate is caring for patients 
  • submitting assessment forms through easily accessible web-based forms, the responsibility of which will be divided amongst the primary and secondary assessors 
  • evaluating and providing recommendations on a candidate’s readiness for independent practice in Ontario, with an understanding that these recommendations will be evaluated by a larger assessment committee who will make the final decision on candidate success  

 You are eligible to apply if you are a family physician:

  • With a full license in good standing from the College of Physicians and Surgeons of Ontario; 
  • Who has had an active clinical practice for at least three years, one of which must have been in Ontario; 
  • Who is practicing in a community with a RIO score of 40 and above, or in a Northern Urban referral Centre (i.e., Timmins, North Bay, Sudbury, Sault Ste. Marie or Thunder Bay); and 
  • With the skills required to be in an evaluating, mentoring, and teaching role. 

 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: 

  • Meet the RIO score of 40 and above, or be located in a Northern Urban referral Centre (i.e., Timmins, North Bay, Sudbury, Sault Ste. Marie or Thunder Bay) 
  • 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

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 return of service.

Practice Ready Ontario candidates will complete their clinical field assessment in a community similar to that in which they will be completing their three-year return of service. Clinical field assessments must also take place in a community with a RIO score of 40 and above or in Northern Referral Centre.

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 visit the site linked here for community RIO scores.

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. 

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FAQs

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.   

Potential Applicants

Program applicants must meet Applicant Requirements at the time of application. See below for a list of criteria and contact Practice Ready Ontario if you have any questions.  

  • A permanent resident or citizen of Canada;   
  • Completed a medical degree at a recognized school and at least two years of postgraduate training in family medicine or general practice; 
  • Completed three consecutive years of independent practice in family medicine or general practice, including at least 24 weeks within the past three years;  
  • Demonstrated competence in English;  
  • Successfully passed and achieved an accepted score in specific Medical Council of Canada examinations as specified under Applicant Requirements. 

While the clinical field assessment is 12 weeks, the full process can take up to one year from initial application and screening to the start of return of service. The process may take longer for applicants who are not accepted in the first round due to limited spaces or not meeting application criteria. See Applicants - Process Overview for more information. 

The Government of Ontario set an initial program target of licensure of 100 family physicians by 2025, all of whom will be required to complete a three-year return of service in a specified Ontario community. A first cohort is already underway, and a second cohort will open early in 2024. 

It is a highly competitive application process and meeting the minimum requirements does not guarantee selection to the assessment program. Preference will be given to the most qualified applicants. Due to the limited number of candidate spaces available in the program, not all eligible applicants will proceed to the second phase. If an applicant is found eligible but cannot proceed to the next phase due to restricted space, the applicant will be invited to apply for the next intake. These applicants will be able to update their existing application, rather than start from the beginning. 

There are three phases to Practice Ready Ontario and there are varied limits on applications for the different phases.  

  • Phase 1 - Application and Screening: There is no limit to the number of times a person can apply to the application and screening phase.  
  • Phase 2 - Verification and Selection: Applicants are permitted one Therapeutics Decisions-Making (TDM) Examination attempt per calendar year. If the applicant does not obtain a pass result, they can reattempt the examination in the following year and cannot apply to consecutive examination sessions. Currently, candidates are allowed a maximum number of four TDM Examination attempts, which includes a maximum of two pass results. For more information and up-to-date guidance, please visit the Medical Council of Canada.  
  • Phase 3 – Clinical Field Assessment: Applicants have a total maximum of two attempts at the clinical field assessments in Canada. This is also referred to as over-time assessments. This is regardless of the provincial or territorial jurisdictions where the attempts take place. Attempts must take place within a five-year period. For more information see the NAC-PRA Family Medicine Standards. 

No. Applicants must be Canadian citizen or permanent resident at the time of application. We are unable to assist with any immigration enquiries. 

Practice Ready Ontario focuses on internationally trained physicians and does not distinguish between the nationalities at birth of applicants. Canadians who trained internationally and meet all the other criteria are eligible to apply for this program. See Applicants for more information. 

Currently there are no fees associated with applying to the program. However, applicants are responsible for other costs associated with entry-to-practice practice, for example, the cost of applying for a license from the CPSO. See Applicant Fees for more information. 

 

Practice Ready Ontario is being offered in English during the pilot phase of the program (2022-25). New Brunswick offers a practice readiness assessment in French. For more information, please visit the College of Physicians and Surgeons of New Brunswick.

 

Applicants are required to submit medical qualifications, postgraduate training and rotations, and the hours of independent practice. See Applicant Requirements for more information. 

The program registration process is designed to avoid duplication of the documents requested of international physicians seeking to practice in Canada. Touchstone Institute has a formal agreement with the Medical Council of Canada to access applicant documents with the applicant’s express permission. Sharing documents with Touchstone Institute on physiciansapply.ca simplifies the application process and ensures there is no duplication of document submission. See Touchstone Institute’s Practice Ready Ontario Privacy Policy for more information about how we use and safeguard your data.

No. This program assesses family physicians and general practitioners only. 

The TDM Exam is administered by the Medical Council of Canada (MCC) for use in the selection of candidates into practice ready assessment programs across Canada. It is available to candidates by referral from a practice ready assessment program. Candidates have a maximum of four TDM Examination attempts, which includes a maximum of two pass results, and results are valid if the applicant passed within two years. 

No. The Therapeutics Decision-Making Examination (TDM) is only available to applicants deemed eligible in phase 1 of the program. See Process Overview for more information. 

Please review the Applicant Requirements and contact Practice Ready Ontario if you have questions. 

The document requirements for Practice Ready Ontario allows program administrators at Touchstone Institute to effectively assess applicants. Applicants with questions about documents are asked to fill out the Contact Form.

Ontario Health provides programs and services to help internationally trained physicians integrate into the Ontario health care system. More information can be found on their website. The College of Physicians and Surgeons of Ontario (CPSO) is another great resource. See the IMG section on their website.

Selected candidates will be provided options for return of service locations.  The clinical field assessment location will be assigned to applicants.

The clinical field assessment and the return of service must both be completed in a designated high-need, rural Ontario community or in a Northern Urban Referral Centre. They may take place in the same community, but not necessarily the same clinical practice, or they may take place in different communities with similar profiles. The goal is for the clinical field assessment to support and prepare candidates for success in their return of service. 

General Information

Practice Ready Ontario is designed to break down barriers for experienced internationally trained general or family physicians so they can get to work faster in high need, rural communities across Ontario.  It is part of a Government of Ontario initiative to expand the healthcare workforce and connect people to care.

Eligible applicants are identified through an in-depth application, selection and verification process.  Applicants are then assessed for competence and suitability during rigorous 12-week clinical field assessments in designated, rural Ontario communities. Successful candidates will then complete a three-year return of service as a family physician in a high needs rural Ontario community. The program is rigorous to ensure that we protect patient safety and public confidence in the professional competence of family physicians in Ontario.

The candidates who are selected to participate in the program must have at least three years of active experience in practice. The 12-week clinical field assessment ensures Practice Ready Ontario candidates have the knowledge and experience to practice as a family physician or rural generalist and builds familiarity with Ontario practice standards to support their integration into practice. The assessment does this by exposing candidates to all relevant aspects of generalist family medicine in a rural context and across a variety of practice settings, including office, hospital, emergency room, long-term care and home care.

Ontario is facing a shortage of family physicians. Rural communities are more heavily impacted as there are currently fewer family physicians practicing in rural areas compared to urban areas.  In addition, when physicians retire or leave the community, there is often a lack of access to other primary care services in rural areas. See the Communities section for more information.

Practice Ready Ontario is administered by Touchstone Institute in collaboration with the Government of Ontario, the College of Physicians and Surgeons of Ontario (CPSO) and other health sector partners. CPSO approves and issues applicable licenses, while Ontario Health manages the return of service component. Clinician assessors in communities across Ontario play a key role in observing and evaluating candidates according to structured assessment processes. Assessment data are submitted for review to the Practice Ready Ontario Assessment Committee for final determination of a candidate’s readiness for independent practice.  

Practice ready assessments are active in nine Canadian provinces and have resulted in over 600 family physicians entering the Canadian health workforce in the last five years. On average 120 family physicians every year enter the workforce via a practice readiness assessment in Canada. This is equal to the size of a graduating class from a medium-sized Canadian medical school.

Practice Ready Ontario applies the pan-Canadian assessment framework of the National Assessment Collaboration’s Practice-Ready Assessment (NAC PRA). NAC PRA develops and maintains standards, tools and materials in a collaboration with participating provinces and the Medical Council of Canada. This pan-Canadian collaboration ensures internationally trained physicians experience fair and comparable assessments across Canada. In the last five years, PRA programs across the country have facilitated the entry of over 600 physicians into the Canadian health workforce. 

There is a critical shortage of family physicians across Ontario and rural and remote areas are particularly impacted. Practice Ready Ontario is designed to break down barriers for experienced internationally trained general or family physicians so they can get to work faster in high need, rural communities across Ontario and connect patients to care providers.

Practice Ready Ontario currently addresses family medicine. 

Yes, the program is rigorous. It offers a route to practice in Ontario for internationally trained family physicians or general practitioners with demonstrated competence and in-depth practice experience outside of Canada. The requirements are designed to ensure that a candidate will be successful in making the transition to immediate practice in family medicine in Ontario. This program is for assessment and not for training. Program rigour ensures we protect patient safety and public confidence in the professional competence of family physicians in Ontario. See the Applicants Process Overview for more information.

Application Status

It takes approximately 4 to 6 months for the application, verification and selection phases. 

This is a highly competitive application process with limited spaces. Meeting the minimum requirements does not guarantee selection to the assessment program. 

The TDM Exam results are valid for Practice Ready Ontario if the applicant passed within two years, regardless of where the exam was written.  If it is more than two years, applicants are required to write the exam again.

All requirements must be met at the time of application. These requirements are designed to ensure any applicant would be successful in making the transition to full practice in family medicine in Ontario.

There are three phases to Practice Ready Ontario, with different limitations for the different phases.  

  • Phase 1 - Application and Screening: There is no limit to the number of times a person can apply to the application and screening phase.  
  • Phase 2 - Verification and Selection: Applicants are permitted one Therapeutics Decisions-Making (TDM) Examination attempt per calendar year. If you do not obtain a pass result, you may reattempt the examination in the following year. You cannot apply to consecutive examination sessions. Currently, candidates are allowed a maximum number of four TDM Examination attempts (which includes a maximum of two pass results). For more information and up-to-date guidance, please visit the Medical Council of Canada.  
  • Phase 3 – Clinical Field Assessment: Applicants have a maximum of two attempts at the clinical field assessments (also referred to as over-time assessments) in total in Canada. This is regardless of the provincial or territorial jurisdictions where the attempts take place. Attempts must take place within a five-year period. For more information see the NAC-PRA Family Medicine Standards. 

Assessors and Assessment Sites

Each candidate has one primary assessor who has oversight responsibility of the 12-week clinical field assessment and is supported by secondary assessors. Candidates work under direct supervision of physician assessors, who observe, assess, and provide feedback on a candidate’s clinical and non-clinical skills related to family medicine. If a clinical field assessment site has more than one candidate, a physician can serve as the primary assessor to one candidate and a secondary assessor to another candidate. The assessor submits assessment data to the Practice Ready Ontario Assessment Committee for final determination of a candidate’s readiness for independent practice.  

To become a Practice Ready Ontario assessor, the physician must meet the following requirements: 

  • Have a full license in good standing from College of Physicians and Surgeons of Ontario
  • Be in active clinical practice for at least three years, with at least one year in Ontario  
  • Clinical practice with privileges in an Ontario community with a  Rurality Index for Ontario (RIO) score of 40 and above or a Northern Urban referral Centre as noted above (Timmins, North Bay, Sudbury, Sault Ste. Marie or Thunder Bay) 
  • Available on-site or assigning a delegate when the candidate is caring for patients  
  • Agree to evaluate and submit recommendations on a candidate’s readiness to the Practice Ready Ontario Assessment Committee for a final decision on candidate success  
  • MainPro+ accredited assessor training completed prior to clinical field assessment start date  

All assessment sites must offer the following:   

  • Expose candidates to all relevant aspects of generalist family medicine in a rural context across a variety of practice settings, including office, hospital, emergency room, long-term care and home care.  
  • Provide assessors and colleagues an appropriate workspace to host candidate(s)  
  • Located in an Ontario community with a RIO score of 40 and above or a Northern Urban Referral Centre here.

Practice Ready Ontario is a program to welcome and integrate qualified physicians into Ontario’s health system workforce. Assessors are contributing to a health human resource strategy to help alleviate physician shortage. It is also an opportunity to develop as a mentor and support the development of future practicing Ontario physicians. Assessors receive MainPro+ accredited training and competitive remuneration for the role.  

No, a clinical field assessor is very different to a resident preceptor. The clinical field assessment is not a training period, and unlike preceptors, Practice Ready Ontario assessors are not educators. They are overseeing experienced family physicians or general practitioners who have already completed their residency and practiced independently in another country for at least three years. At 12-weeks, the assessor’s time commitment is three times as long as for a resident preceptor, and the assessor’s responsibilities are more involved. As such, remuneration for assessors reflects the greater level of responsibility and time.

All assessors are required to complete assessor training prior to the start of the clinical field assessment. It is in-person with additional online modules. The training is MainPro+ accredited and participants will be remunerated. If in-person training is not feasible, an online option may be possible. 

  • Clinical Field Assessment site: Applicants must complete a 12-week clinical field assessment in an assigned location, working under direct supervision of experienced physician assessors who observe, assess and provide feedback on the candidate’s clinical and non-clinical skills that relate to family medicine.  
  • Return of Service site: The Ontario Ministry of Health requires that all successful Practice Ready Ontario candidates 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 a high-need, rural Ontario community in which the offer of employment was secured. 

A clinical field assessment can be conducted within the same site, as long as an independent assessment can be supported. The clinical field assessment should be conducted by assessors who are not involved as sponsors or signatories within a practice location agreement to minimize bias and conflicts of interests. For information on becoming a return of service site, please contact Ontario Health.   Clinicians interested in learning more about hosting a clinical assessment site are asked to fill out this contact form. 

Yes. Assessments sites that have the capacity to supervise and assess more than one candidate are welcome to apply. The assessment role requires oversight of the candidate, and the assessment process requires daily field notes and other questionnaires twice weekly.

Yes. Assessors who have supportive colleagues and who jointly have the capacity to supervise and assess more than one candidate are welcome to apply. If a clinical field assessment site has more than one candidate, a physician can serve as the primary assessor to one candidate and a secondary assessor to another candidate. The assessment role requires oversight of the candidate, and the assessment process requires daily field notes and other questionnaires twice weekly.

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 a high-need, rural Ontario community in which the offer of employment was secured. All candidates are 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. 

 Practice locations in communities with a Rurality Index of Ontario (RIO) score of 40 and above, as well as those in Northern Urban Referral Centres are eligible to apply to be host communities for a return of service candidate. The Northern Urban Referral Centres are in Timmins, North Bay, Sudbury, Sault Ste. Marie, and Thunder Bay. Communities interested in participating in Practice Ready Ontario can contact Ontario Health at: practiceontario@ontariohealth.ca

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. Make them feel at home and help them integrate. Supports with housing, community settlement and social supports are essential to welcoming and retaining a physician in your community. 

Successful Practice Ready Ontario candidates will be paid using the physician payment model in place in the practice setting where they are competing their return of service. Successful candidates will be eligible to apply for an OHIP billing number upon receipt of their restricted certificate of registration.

Resources

Applicants

Assessors

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.

 

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Practice Ready Ontario is funded by the Government of Ontario.

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