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Return to Practice in Ontario

In order to return to practice in Ontario as a fully licensed osteopathic physician (osteopath), one must have completed 4 years of undergraduate education followed by 4 years of osteopathic medical training accredited by the American Osteopathic Association's Commission on Osteopathic College Accreditation

After completion of osteopathic medical school, graduates must then apply to residency programs to solidify their area of practice. Most osteopathic physicians enter into primary care roles such as Family Medicine, Internal Medicine, or Emergency Medicine residencies. With this said, osteopathic graduates are able to apply into any area of practice they desire including surgery and subspecialties and internal medicine and subspecialties. 

There are different avenues in which DO's can return to Ontario to Practice. First is a residency in Canada. In order to do these the graduate must apply through the Canadian residency match (CaRMS). Click here for pathway.

Secondly a DO graduate can apply to the ACGME Match in the United States. In 2020 the completion of the AOA and ACGME merger, all graduates of medical schools in the United States (DO and MD) apply into the same match.  Click here for pathway.


CaRMS residency match in Canada is challenging to get into. This is due to the fact that most provinces in Canada (excluding Quebec) consider DO graduates to be International Medical Graduates. Therefore to get into a residency in Canada can be quite challenging as one would have to compete with applicants from around the world. Whereas our MD colleagues from the US are considered Canadian Medical Graduates.


The OOMA and the COA have been working diligently with residency associations as well as medical regulators across the Canada to ensure equal rights for DO and MD applicants to the CaRMS match. However currently DO's are still listed as International Medical Graduates.

After completeion of a CaRMS residency, DO graduates must complete the exam in their field of study. Once completed and passed the DO graduate is able to practice in Ontario, unrestricted, in that field of study.





For residency in the United States graduates of osteopathic medical schools will apply to ACGME accredited residencies. DO graduates are eligible for all residencies under this match.


Currently the OOMA's recommendation is to complete a residency through the ACGME pathway. The reason for this recommendation stems from DO graduates, historically, having better success of matching into the program of their choice. Secondly, DO graduates, through rotations at their medical school, will be at hospitals who have these residency programs. The potential for successful matriculation into a residency of choice in the USA is significantly higher. 

After completion of ACGME residency, DO graduates wishing to return to Ontario must follow Pathway 3 set out by the CPSO. This will give them a license to practice medicine in Ontario. After a license has been granted, the graduate must then apply through the College of Family Physicians of Canada (for family physicians) or through the Royal College of Physicians and Surgeons of Canada (for all other specialties).


Please note that the CPSO places a 1 year mentorship over new licensees. In most jurisdictions this means chart review by a colleague in the same field of medicine will be required during that year. After 1 year, the CPSO does a review of that licensee prior to establishment of full license. This is the same for both DO and MD graduates.

If the DO graduate is a Family Physician from an ACGME residency in the United States you qualify under Category A to sit for the College of Family Physicians of Canada (CFPC) exam. If they are any other specialty they will have to apply through the Royal College of Physicians and Surgeons of Canada (RCPSC) for exam eligibility.


Please note that the RCPSC has a different year requirement for residency equivalent (i.e. Neurology is 4 years in the US and 5 year in Canada). Some graduates may require additional fellowships to complete the RSPSC requirement

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