International Mobility Program: Authorization to work without a work permit – Health care students

This section contains policy, procedures and guidance used by Immigration, Refugees and Citizenship Canada staff. It is posted on the Department’s website as a courtesy to stakeholders.

R186(p) allows foreign students, registered at foreign educational institutions outside Canada, to do their clinical clerkships or short-term practicums in Canada in fields such as:

  • medicine
  • occupational and physical therapy
  • nursing
  • medical technology

Written permission from the body that regulates the particular health field is required in order to ensure that Canadian health care students are placed for clinical practice first. The primary purpose of the practicum must be to acquire training in the related field; therefore these positions will often be unpaid and should be of no more than four months’ duration.

Note: Foreign medical residents and medical fellows coming to work temporarily in Canadian clinical settings or research facilities for long-term (typically longer than four months) paid training or research periods are not exempt under this regulation but may qualify for a Labour Market Impact Assessment exemption under Public policy, competitiveness and economy, exemption code C45.

Further to consultation with provincial Colleges of Physicians and Surgeons, requirements for medical students destined to specific provinces are as follows:

For medical students destined to Ontario

Is a letter from College of Physicians & Surgeons required?

No. Does not wish to be involved

The College of Physicians and Surgeons in Ontario has informed CIC that it does not want to be involved in these cases, and it does not object to foreign health students working in medical teaching institutions in Ontario. This non-involvement can be interpreted as approval from the regulatory body, which will enable visa officers to process the application without written approval for each case.

Notes in the Global Case Management System (GCMS) for approved cases should reflect the position of 'no objection' and the rationale, so when the student is seeking to enter Canada, the POE is aware that the matter of 'approval from a regulatory body' has been explored and no involvement from the regulatory body for this occupation has been interpreted as the required approval (or that university acceptance is sufficient).

For medical students destined to British Columbia

Is a letter from College of Physicians & Surgeons required?

No. Acceptance from a university in B.C. sufficient.

The College of Physicians and Surgeons in British Columbia has advised CIC that the College licenses all foreign medical students who arrive under R186(p) for short-term practicums, whether at the under-graduate or post-graduate level. The College and the universities have special procedures in place that are strictly adhered to. Acceptance by the university is sufficient proof that the College has given approval.

For medical students destined to Alberta

Is a letter from College of Physicians & Surgeons required?

No. Acceptance from a university in Alberta sufficient.

The College of Physicians and Surgeons of Alberta has advised that it treats undergraduate medical students doing electives in Alberta the same as out of province undergraduates. They must first register with the undergraduate elective office at either the University of Alberta or the University of Calgary, which then provides applicants with all the information the university requires and also provides them with the College's undergraduate elective application for registration.

The entire process is handled through the university, which then notifies the College of Physicians and Surgeons to finalize the registration. In essence, proof of acceptance by a university in Alberta (Edmonton or Calgary) is sufficient evidence of approval by the regulatory body, that is, the Alberta College of Physicians and Surgeons.

For medical students destined to Quebec

Is a letter from College of Physicians & Surgeons required?

Yes.

Le Collège des médecins du Québec advised that the foreign student who is coming to Canada to do a short clinical internship must obtain a “lettre d'admissibilité” (admissibility letter) from the “Collège des médecins du Québec”.  The issuance of a letter from a University is not sufficient to authorize the student to perform a short internship. Medical students coming to Canada for observation or research internships are not required to obtain this admissibility letter.

For medical students destined to Saskatchewan

Is a letter from College of Physicians & Surgeons required?

No. Acceptance from a university in SK sufficient; college does not wish to be involved.

For medical students destined to other provinces and territories

If the College of Physicians and Surgeons for that province has not provided the student with written approval, the visa office should contact the Operational Management and Coordination Branch for assistance in determining whether the province or territory has elected to be involved in health care student practicums for international students.

Persons entering Canada to perform this type of work are required to pass an immigration medical exam according to R30. (See: Assessing medical requirements for foreign nationals.).

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