Transition to Practice

Below is a list of things to be aware of as an IMG Fellow in Canada under an educational CPSO license aspiring to become appointed as an IMG Physician to a University of Toronto affiliated hospital with a restricted academic CPSO license.

Please be aware that governmental immigration and labor laws, University policies, and hospital policies change over time. For the most up-to-date information relevant to your application, please make sure to check the relevant websites.

You will have to undertake your relevant RCPSC sub-specialty exam (where applicable). The deadline for eligibility/credential assessment to sit for the exam may be over 12 months prior to the exam. For assessment and registration deadlines, please visit the Royal College website.

Things to be aware of:

  1. Once it is agreed in writing that you will be transferring from a Fellowship to a Hospital-based Clinical MD faculty position at the University of Toronto, Department of Obstetrics and Gynaecology, please contact the following:
  2. If you are on a work training visa, once your fellowship training ends, your training visa ends and you cannot stay/work in Canada. In order to continue your legal status in Canada, you will need to extend your fellowship. Therefore review your work permit. An extension request should be done 6 months prior to the end of your fellowship. You should request a 1-year extension for your fellowship training, and secure the necessary funding, so as to stay in Canada.
  3. Once your fellowship has been extended, you will have to extend your work permit with Citizenship and Immigration Canada (CIC). Please check the process and processing times at <> for more information and details. Please be aware that there can be significant delays to extend your work permit, which is required for you to remain in Canada.
  4. Contact the Department Appointments and Promotions Coordinator, who will assist you in obtaining an appointment at the University of Toronto. This process takes up to 3 months. The minimum Rank for an IMG is at Assistant Professor. You should review your likely eligibility for this higher rank. Please note that a) the entry rank at UofT is Lecturer for completion of Fellowship without significant publications and b) fellows currently enrolled in a graduate (MSc or PhD) program can only transfer to faculty at the rank of Lecturer, upon degree completion.
  5. Simultaneously, work with your hospital chief and hospital coordinator on your hospital hiring process, which may include a Labor Market Impact Assessment (LMIA) if you do not have Permanent Resident status. You hospital chief, lawyer and hospital coordinator will assist you with this process and in finalizing your employment contract. The UofT OBGYN Department has no role in assisting you with immigration or work permit issues.
  6. Once your employment contract is finalized, you will need to apply for a new work permit. Your hospital chief and lawyer will assist you in this process. For more information, please also visit the CIC website <>.
  7. Once you obtain the University appointment (at the rank of Assistant Professor or higher) and you have finalized your hospital employment contract, you will have to transfer your CPSO license status from an educational license (as a fellow) to a restricted academic license, commensurate with your academic rank. The University of Toronto will send the necessary University documents directly to the CPSO. Please check the CPSO website for more information on changing the status of your license <> The CPSO committee only meets once every 4-6 weeks.
  8. With your new CPSO status, obtain an OHIP billing number at-<$File/3384-83E.pdf>
  9. Before starting your practice you must inform the CMPA about your new status and obtain CPMA insurance. T: 1-800-267-6522.
  10. At the same time, you are required to join the Ontario Medical Association (OMA). You should immediately review your personal and family insurance needs, including disability and medical/dental coverage. The OMA provides comprehensive packages for Physicians and their legal dependents.
  11. Once you are ready to start your practice, contact the Departmental Fellowship Coordinator to end your fellowship appointment.
  12. Upon starting, meet with your hospital chief to complete an Academic Planning Document, aligned to your Job Description. You are required to provide a copy of your APD to the University Department of OBGYN (at 123 Edward St.).
  13. If you are an Assistant Professor, you will have an annual clinical and academic review with your designated clinical supervisor, and the Chair. This is done 6-8 weeks before the Chair submits a request for your annual renewal of your restricted CPSO license. Please reach out to the Chair’s assistant to schedule your meeting.
  14. You will have a 3-year review in due course. Following a successful 3-year review, you will transfer to a Continuing Appointment at the University of Toronto, Faculty of Medicine.
  15. If you are an Assistant Professor, the terms of your annually-renewed restricted academic license include a commitment to focus on successful promotion to Associate Professor in 5-7 years. This step generally implies that you have attained a National reputation in your chosen area(s) of academic interest. Your progress towards this goal will be reviewed annually.  At any time, you may request informal advice from the Department Promotions Committee.