All clinical fellows must hold a license from the CPSO before they can begin their training. It is a serious violation for a fellow to have any patient contact or clinical activity without a valid license, per the Medicine Act, 1991. The CPSO license application process is extensive and we advise fellows to apply at minimum 4 months in advance of their proposed start date. If your program is appointing an international fellow, please keep CPSO license processing and work permit processing times in mind when deciding on a start date.
All internationally-trained Clinical Fellows who have not previously completed a PEAP in Ontario are required to complete the 4-12 week Pre-Entry Assessment Program. A request for PEAP exemption can be made if a fellow has previously completed training within North America by submitting the PEAP exemption request form with the fellowship appointment documentation.
The Pre-entry Assessment Program (PEAP) is an assessment process that evaluates international medical graduates to determine whether they can function at the level of Ontario medical school graduates and are qualified to enter an Ontario training program. During the PEAP, the fellow is assessed on their clinical skills, knowledge and judgment in the discipline. The overall purpose is to determine that the candidate is mentally competent to practice medicine, has the ability to practice with decency, integrity and honesty and in accordance with the law, has sufficient knowledge, skill and judgment to engage in the kind of medical practice authorized by the certificate, and can communicate effectively and displays an appropriately professional attitude.
The program is responsible for completing a PEAP evaluation form to the PGME office no later than 7 days prior to the fellow's PEAP license expiry date. If the evaluation determines the fellow has demonstrated appropriate ability during the PEAP, the CPSO will convert the PEAP license into a full certificate of registration for Postgraduate Education.
Postgraduate Education: to obtain this certificate class, a fellow must hold a medical degree from an accredited medical school in Canada or the US. A fellow who is an international graduate of a medical school found in the World Directory of Medical Schools published by the World Health Organization (WHO) may be eligible for this certificate if they have successfully complete the Medical Council of Canada Evaluating Exam (MCCEE). The fellow must have a valid appointment for postgraduate training at an Ontario medical school.
PGE- Clinical Fellow: to obtain this certificate class, a fellow must hold a medical degree from an accredited medical school in Canada or the US, or from a medical school found in the World Directory of Medical Schools published by the World Health Organization (WHO). The fellow does not need to have written the MCCEE, but must have completed training in the same specialty discipline as their fellowship, and provide the official specialty certificate from the certifying body of their home country.
Independent Practice: to obtain this certificate class, a fellow must hold a medical degree from an accredited medical school in Canada or the US, or from a medical school found in the World Directory of Medical Schools published by the World Health Organization (WHO). The fellow must have completed postgraduate residency trainnig and be certified by either the Royal College of Physicians and Surgeons of Canada (RCPSC) or the College of Family Physicians of Canada (CFPC). A certificate of registration for independent practice authorizes the holder to engage in independent, unsupervised medical practice. The holder can bill OHIP for their services.
Restricted: Restricted certificates are time-limited, and are only granted after review by the Registration Committee at the CPSO. Files are reviewed at the CPSO if the Clinical Fellow is changing medical schools or requesting an extension beyond their initial three year appointment. Candidates who are issued a restricted certificate of registration will only practise in prescribed circumstances under monitoring or supervisory arrangements, with accountability to the CPSO for full compliance with the arrangements made. Further information can be found directly at CPSO.