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Licensing basics – Your questions answered

The ins and outs of licensing in Canada, explained by an expert

Last fall when we asked what subjects you were interested in, licensing was at the top of the list. You had questions around the roles of regulatory authorities, what was needed to apply and how residents could prepare.

To answer your questions, we interviewed Fleur-Ange Lefebvre, executive director and CEO of the Federation of Medical Regulatory Authorities of Canada (FMRAC), the organization that represents all 13 provincial and territorial medical regulatory authorities in Canada.

What’s the difference between licensing and certification?

Certification is an attestation, by a recognized authority, that a physician has completed all the postgraduate medical education (PGME) training requirements and may now refer to themself as having a particular medical or surgical specialty. In Canada, the three recognized authorities are

• the College of Family Physicians of Canada,
• the Royal College of Physicians and Surgeons of Canada and
• the Collège des médecins du Québec.

Licensure is an ongoing process whereby a provincial or territorial medical regulatory authority (MRA) in Canada deems that a physician has the required qualifications to practise medicine in a particular jurisdiction. In addition to verified academic credentials (such as, for example, graduation from a recognized medical school and certification from the Royal College), the MRA will seek assurance that the physician also maintains their competence throughout their practice lifetime and has a satisfactory Certification of Professional Conduct.

A license to practise comes with a set of professional standards and ethics that a physician commits to for the privilege of practising medicine in that jurisdiction.

Do residents only apply for licensure when they transition to practice or other times as well?

Residents require an educational license, issued by the MRA in the province of their faculty of medicine, beginning on the first day of their residency. The license must be maintained throughout residency.

They also require a license in another province or territory if they are going out-of-province for an elective.

The same applies to medical students in undergraduate programs in every jurisdiction except Ontario (where medical students do not have an educational license)

What criteria must be met  to apply for a licence to practise?

Physicians applying for the first time for a full, unrestricted license to practise medicine in a Canadian jurisdiction may achieve full licensure only if they meet all of the components listed below (known as the Canadian Standard):

• have a medical degree [from a medical school that, at the time the candidate completed the program, was listed in the World Directory of Medical Schools (WDMS)], or a Doctor of Osteopathic Medicine degree from a school in the United States accredited by the American Osteopathic Association Commission on Osteopathic College Accreditation, and the medical school listing must include the Canada sponsor note];
• are a Licentiate of the Medical Council of Canada;
• have satisfactorily completed a discipline-appropriate postgraduate training program in allopathic medicine and an evaluation by a recognized authority; and
• have achieved certification from the College of Family Physicians of Canada, the Royal College of Physicians and Surgeons of Canada, or the Collège des médecins du Québec.

All physicians who have achieved the Canadian Standard are and will continue to be eligible for full licensure in every Canadian province and territory.

Applying for licensing can seem confusing and stressful. What can residents do to prepare – mentally and otherwise – for this process?

Educate yourself early, and often, on licensing requirements throughout your resident career. There are often nuances among the various provincial and territorial MRAs and it’s best to know, as soon as possible, what’s expected in an application in that particular province or territory. Links to all the MRA websites can be found at www.fmrac.ca/members.

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