Canada is actively recruiting internationally educated health professionals (IEHPs) to fill a critical shortage in its healthcare system. Here is everything you need to know about the programs, pathways, funding, and provincial options available to foreign doctors and nurses hoping to practice in Canada.

1. Canada's Healthcare Workforce Crisis

Canada's healthcare system is under acute and growing strain. The numbers clearly show the scale of the challenge.

Sources: CD Howe Institute 2024; Statistics Canada JVWS 2024; Government of Canada

Healthcare vacancies have nearly tripled since 2016, with severe shortages in rural regions. Healthcare is now one of Canada’s largest employment sectors and is expected to grow significantly over the next decade.

Burnout Is Making It Worse: Nearly 78.7% of healthcare workers experience burnout, with nurses facing even higher levels.

Immigration is expected to account for 100% of Canada’s labour force growth, placing IEHPs at the center of workforce strategy.

2. What Is an IEHP? Definitions & Context

An IEHP (Internationally Educated Health Professional) is someone who obtained healthcare education outside Canada and wants to practice within the Canadian healthcare system.

• Internationally Trained Physicians (ITPs/IMGs)
• Internationally Educated Nurses (IENs)
• Allied Health Professionals

Internationally trained physicians already represent 20–25% of Canada’s workforce, yet many remain underutilized due to licensing barriers.

3. Federal IEHP Programs & Funding

The Foreign Credential Recognition Program (FCRP) supports faster credential recognition and workforce integration.

The Foreign Credential Recognition Program (FCRP)

FCRP funds initiatives that help streamline licensing and improve workforce integration.

• $27.3M annual base funding
• $115M added in Budget 2022
• $86M announced in 2024

Key Programs

Alberta Health Services – SMART Initiative

Supports employment and credential alignment for IEHPs.

BC College of Nurses & Midwives

Virtual assessment system for nurses.

YWCA – Health Connect

Supports women IEHPs with mentoring and employment pathways.

National Nursing Assessment Service (NNAS)

NNAS is the primary credential assessment body for internationally educated nurses in Canada.

4. Pathways for Internationally Educated Nurses (IENs)

The nursing pathway follows a structured process involving credential verification and licensing.

Step-by-Step NNAS Process

• Create NNAS account
• Submit documents
• Credential verification
• Receive advisory report
• Apply to provincial regulator
• Pass NCLEX-RN exam

U.S.-licensed nurses may qualify for expedited licensing in some provinces.

Ontario SPEP Program

Provides supervised work experience while licensing is in process.

N4/SPU Program

A 12-week training program to help IEHPs integrate into the Canadian system.

5. Pathways for Internationally Trained Physicians (ITPs)

Foreign-trained doctors have multiple pathways depending on experience and background.

Pathway 1: Canadian Residency (CaRMS)

• Requires MCCQE + NAC exams
• Full residency required

Pathway 2: Practice-Ready Assessment (PRA)

• 12-week supervised assessment
• No residency required
• Return-of-service agreement

Pathway 3: Approved Jurisdiction (MRA)

• Faster credential recognition
• Available for countries like US, UK, Australia

6. Practice-Ready Assessment (PRA) Programs Explained

The PRA program is arguably the most significant IEHP initiative for physicians in Canada and deserves a detailed breakdown. For experienced foreign doctors, it represents the fastest legitimate route to independent practice — and it has been expanding rapidly.

How PRA Works

ITPs who participate in PRA programs are assessed in authentic professional environments using a workplace-based assessment (WBA) model — a method for evaluating what doctors actually do in practice. Unlike examinations, PRA puts candidates in real clinical settings.

A PRA program is not a training program; it is an evaluation process. It typically involves a multi-week, hands-on clinical assessment where the IMG practices under the direct supervision of experienced, licensed Canadian physicians.

Eligibility Requirements (Common Across Provinces)

• Must be a Canadian citizen or permanent resident
• Graduation from a medical school listed in the World Directory of Medical Schools
• Completion of postgraduate medical training and independent clinical practice outside of Canada in a context not known to be comparable with Canadian medical practice
• Passing the MCCQE Part I and (in most provinces) the Therapeutics Decision-Making (TDM) Examination
• Recent independent practice experience, typically within the last 3–5 years

PRA by Province (2024–2025)

Return of Service Requirements

Most provinces require a Return of Service (ROS) commitment, meaning successful candidates must agree to practice in an underserved or high-needs area for a specified period, typically ranging from one to three years. This helps address physician shortages in rural and remote communities across Canada.

In Ontario, for example, Practice Ready Ontario contracts candidates to work for three years full-time as family physicians in communities with a Rurality Index of Ontario (RIO) score of 40 and above, or in designated Northern Urban Referral Centres such as Timmins, North Bay, Sudbury, Sault Ste. Marie, and Thunder Bay.

7. Provincial IEHP Programs Breakdown

While the federal government funds the overarching framework, IEHP programs are largely administered at the provincial level. Each province has developed its own combination of regulatory reforms, recruitment incentives, and integration programs.

Ontario

Ontario's HealthForceOntario Access Centre is the centralized point of access for all IEHPs in Ontario seeking information and advice about the licensing process and alternative career options. Its services include licensing and registration information for all regulated health professions, referral to relevant organizations, information sessions, and one-on-one appointments — all free of charge.

Ontario has also introduced a Temporary Class License for nurses, allowing IENs to practice in supervised roles while their full registration is pending — dramatically reducing the wait time before they can contribute to patient care.

British Columbia

BC has implemented one of Canada's most progressive IEHP integration strategies, combining the PRA-BC program for physicians, the BC College of Nurses and Midwives' virtualized competency assessment, and a new "Associate Physician" class of registration that allows foreign-trained doctors to practice in supervised hospital settings while pursuing full licensure.

Nova Scotia

Nova Scotia expanded the NICHE (Nova Scotia International Community Healthcare Experience) program to streamline pathways to licensure and employment for IEHPs. The province has also signed memorandums of understanding (MOUs) with the Philippines and India to reduce barriers for internationally educated nurses specifically.

Saskatchewan

Saskatchewan operates the long-running SIPPA (Saskatchewan International Physician Practice Assessment) program for foreign doctors. In Saskatchewan, 92 IEHP vacancies have been filled through the province's IEN recruitment and retention program. The province has been particularly active in recruiting Filipino nurses through targeted international agreements.

Newfoundland & Labrador

Newfoundland introduced an "Associate" registration class for physicians, allowing internationally trained doctors to begin supervised practice sooner. The province also operates the CSAT-P (Clinical Skills Assessment and Training Program) through Memorial University's Faculty of Medicine.

8. Common Barriers IEHPs Face & How Programs Address Them

Despite significant investment and reform, IEHPs continue to face real and systemic challenges when trying to practice in Canada. Understanding these barriers — and the programs that address them — is critical for any foreign-trained health professional planning their move.

Barrier: Credential Recognition Delays

The standard NNAS process for nurses historically took 12+ weeks, and IMG credential reviews could take months. Programs addressing this include the NNAS Expedited Service (5-day turnaround), virtualized competency assessments funded by the FCRP, and standardized digital document submission.

Barrier: Requirement for Canadian Work Experience

All provinces except PEI have introduced or are planning legislation to prohibit health regulatory colleges from requiring Canadian work experience for the purpose of registration. This barrier had historically trapped many IEHPs in a Catch-22: they couldn't get a license without Canadian experience, but couldn't get Canadian experience without a license.

Barrier: Financial Costs of Licensure

Credential assessments, examination fees, language tests, document translations, and bridging program tuition can cost thousands of dollars. The FCRP's FCR Loans program has helped cover these costs, providing nearly $17 million to over 1,900 skilled newcomers between 2018 and 2023 — two-thirds of them in healthcare.

Barrier: System Navigation & Information Gaps

The sheer complexity of Canada's multi-provincial regulatory environment is overwhelming for newcomers. Programs like the PEGASUS Institute IEHP web portal, the N4/SPU Online Program, and Ontario's HealthForceOntario Access Centre provide centralized guidance. The PEGASUS Institute's web portal was specifically designed to explain, guide, and inform IEHPs about the various components, processes, and pathways necessary to practice healthcare in Canada, and is available in both physician and nursing pathways.

Barrier: Cultural & Language Integration

Mentorship programs have been shown to help IEHPs foster supportive relationships and integrate culturally. Programs like the YWCA's Health Connect and the PEGASUS Institute's mentorship initiative specifically match IEHPs with established Canadian practitioners for guided cultural and professional adaptation support.

9. Financial Support & Loans for IEHPs

One of the least-publicized but most impactful aspects of Canada's IEHP support infrastructure is the financial assistance available to internationally educated health professionals. These mechanisms help reduce the upfront cost burden that prevents many qualified professionals from completing their licensure journey.

FCR Loans (Foreign Credential Recognition Loans)

The FCR Loans program provided nearly $17 million to over 1,900 skilled newcomers between fiscal years 2018–19 and 2022–23. Two-thirds of these skilled newcomers work in healthcare, with loans assisting with licensure and training costs. These loans are available through partnering financial institutions and community organizations.

Provincial Bridging Program Funding

Several provinces fund bridging programs at little to no cost for participants. Ontario, for example, offers jointly funded bridging grants to support up to 1,500 IENs per intake, covering costs of bridging education between the NNAS report and full licensure. Alberta's SMART Initiative similarly covers employment support services at no cost to the IEHP.

Return-of-Service Incentives

Physicians who complete PRA programs and commit to working in underserved areas typically receive financial incentives in addition to employment guarantees. These may include loan forgiveness, relocation allowances, and enhanced fee structures for rural practice — making the return-of-service obligation financially advantageous, not merely a regulatory burden.