Medicine Licensing

The steps below are a simplified version of the common and major steps taken by graduates of Australian medical schools who are returning to Canada to practice medicine.

There are variations to this process dependent on the province or territory you’re looking to practice in, or the specialization you’re hoping to practice.

As a graduate of an Australian medical school, you’d be considered an international medical graduate (IMG) when returning to Canada to practice. Please contact your provincial or territorial medical regulatory authority to ensure you are familiar with their specific requirements and processes for IMGs.

The Medical Council of Canada’s Pathways for international medical graduates page is also a great resource for up-to-date information.

The main steps involved in the Canadian medical licensing process are as follows:

• Complete the National Assessment Collaboration Objective Structured Clinical Examination (NAC OSCE) and the Medical Council of Canada Qualifying Exam (MCCQE)
• Apply and match for a residency through the Canadian Resident Matching Service (CaRMS)
• Complete your medical residency training program, leading to licensure and registration

National Assessment Collaboration Objective Structured Clinical Examination (NAC OSCE)
The National Assessment Collaboration Objective Structured Clinical Examination (NAC OSCE) is a standardized practical examination that tests the knowledge, skills, and aptitudes essential for entrance into postgraduate training in Canada. Only international medical graduates (IMGs) are required to complete this exam. Candidates rotate through a series of 12 stations that present clinical problems and tasks to complete.

This exam is usually taken in your final year of medical school. It is completed in person in Canada and runs twice per year, typically May and September.

Medical Council of Canada Qualifying Exam (MCCQE)
The Medical Council of Canada Qualifying Exam (MCCQE) is a multiple-choice style exam that evaluates your grasp of knowledge and applications from your medical school training.

This exam is offered online and can be taken anywhere in the world, with several sit dates between May and November each year. It is common for candidates to take this exam in Australia during their final year of medical school. IMGs must take this exam before applying for residency.

Canadian Resident Matching Service (CaRMS)
The Canadian Resident Matching Service (CaRMS) is the organization through which you apply to match with a medical residency training program in Canada. This step is completed by both Canadian medical graduates (CMGs) and IMGs.

For IMGs, both the NAC OSCE and the MCCQE must be completed before you apply to match for residency through CaRMS.

The CaRMS process involves providing your background information and application documents and selecting the residency training programs in which you’re most interested. You will then interview with residency training programs that are interested in you. From there, both parties (candidates and programs) rank their preference, which creates a rank list. The rank list is then fed into an algorithm with the aim of finding the best match for both parties.

The CaRMS website provides information about matching, procedures, and reports about past matches.

According to CaRMS, Australian medical school graduates have the highest match rate of any region at 76.3% in 2026 (see CaRMS 2026 R-1 Match Data Overview).

Becoming Licensed to Practice
Postgraduate medical training can take anywhere from 2 years (as is often the case with family medicine) to 6+ years, depending on your specialty.

During these years you’ll complete training specific to your specialty and work towards the following:

• Certification – This refers to meeting the national standards (competencies) in your specialty/area of practice either through the College of Family Physicians of Canada (CFPC), or the Royal College of Physicians and Surgeons of Canada (RCPSC).
• Licensure & Registration – Licensure is your legal permission to practice medicine. Registration is the administrative enrollment as a physician through Canada’s medical regulatory authorities (MRA).

Studying medicine in Australia gives you the option to stay after graduation to do postgraduate training without requiring citizenship. This is not the case in many other countries, which makes Australian a top medical school destination for Canadians. It opens your options after graduation even further.

Although not guaranteed, your chances of securing an internship (the start of your postgraduate medical training in Australia) are favorable, especially if you’re flexible about your internship location.

There is variation in this process; however, here is a simplified overview of the common pathway:

• Provisional registration: One year of supervised medical internship (PGY1)
• General registration: One or more years of medical residency (PGY2+)
• Registrar training with a specialist medical college: 3–7 years
• Fellowship & ability to practice independently

The Australian Medical Association’s (AMA) Pathways in Medicine page is a great resource!

Provisional Registration & Medical Internship (PGY1)
Once you complete your medical degree, you’ll apply for provisional registration though the Medical Board of Australia and complete a paid medical internship program in Australia (in any state). This is referred to as your postgraduate year one (PGY1) training.

The intent of your PGY1 is to gain supervised generalist clinical training. It consists of 47 weeks (full-time equivalent) clinical practice, with core rotations in medicine, surgery, and emergency medicine, along with additional approved terms.

Many OzTREKK students have enjoyed the opportunity to complete additional generalist training before deciding on a specialty.

For full details about PGY1 requirements, visit the Medical Board of Australia’s website.

General Registration & Medical Residency
Some specialist medical colleges only require PGY1; however, most prefer (or require) additional postgraduate medical training. These additional postgraduate training years are referred to as your residency years (or PGY2, PGY3, etc.) and in most states you’ll be referred to as a resident medical officer (RMO).

You’ll continue in generalist training; however, if your goal is to enter a specialty, you will use these years to meet specialty college prerequisites.

It is common for OzTREKK students to remain in Australia upon graduation and to successfully enter internships/residency in the state in which they graduated.

As a foreign graduate of an Australian medical school (FGMAS), you’ll want to have an open mind regarding the locations of internships and residencies to which you’ll apply. Each state has their own set of guidelines for prioritizing medical graduates for internships. Although your chances of gaining internship are very good, there are no guarantees.

Registrar Training Programs
After a year in an internship and a year or more as an RMO, you’ll apply to become a registrar in a college’s medical specialty training program. Registrar training programs range in length from 3 to 7 years, depending on the specialty. Upon completion, you’ll gain your fellowship with the college and be able to practice medicine independently.

Australian postgraduate specialty training is recognized by the Royal College of Physicians and Surgeons of Canada (RCPSC) in many approved specialties, although additional assessment and RCPSC examinations are often still required. Australian family medicine training is recognized by the College of Family Physicians of Canada (CFPC) through approved-jurisdiction certification routes that may allow certification without examination.

• RCPSC – Approved Jurisdictions
• CFPC – Recognized Training and Certification From Outside Canada

The steps below are a simplified version of the common and major steps taken by graduates of Australian medical schools who are returning to the United States to practice medicine.

Graduates of Australian medical schools returning to practice in the USA are considered international medical graduates (IMGs) in the licensing process.

ECFMG Application & Credential Verification
The Educational Commission for Foreign Medical Graduates (ECFMG) is a key player in the medical licensing process for IMGs. They evaluate qualifications of IMGs, verify USMLE requirements and issue ECFMG Certification, which is required to participate in the National Residency Matching Program or “the Match.”

Medical schools listed in the World Directory of Medical Schools and have a Sponsor Note showing they meet ECFMG requirements are eligible for ECFMG Certification.

Students generally start their ECFMG Certification application in their final year of medical school and this indicates their intent to complete the ECFMG Certification process.

United States Medical Licensing Examinations (USMLE)
The United States Medical Licensing Examination (USMLE) is a three-step examination for medical licensure in the United States. Completion of the first two steps are required to apply for residency, and the third step is required for full medical licensure eligibility.

USMLE Step 1 –This exam is a science-heavy, computer-based multiple-choice test taken over a full day. This is typically taken in year 2 of medical school.

USMLE Step 2 Clinical Knowledge (CK) – This exam is more focused on what you have learned in the second half of your medical degree. It consists of a multiple-choice exam taken over a full day, assessing medical knowledge, skills and clinical sciences. This is typically taken in year 4 of medical school.

USMLE Step 3 – This is a two-day computer-based exam (multiple choice and simulations), with an emphasis on patient management. USMLE.org describes this exam as “a final assessment of physicians assuming independent responsibility for delivering general medical care.” You can complete Step 3 before, during, or after residency.

After passing Step 1 and Step 2 CK, and meeting ECFMG requirements, you’re eligible to become ECFMG certified.

Apply for U.S. Residency & Complete “the Match” Process
Once ECFMG Certification is issued, candidates apply through the Electronic Residency Application Service (ERAS), and send USMLE scores to the National Residency Matching Program (NRMP).

Candidates will apply and interview with medical residency programs, after which both parties submit a Rank Order List (ROL). These ROLs will be fed into an algorithm with the aim of finding the best match for both parties.

To better understand the process, you can refer to the NRMP video.

Statistics on country specific match rates are not published; however, in 2026, U.S. International Medical Graduates (IMGs) had a match 70% and non-U.S. IMGs had a match rate of 56.4%.

See ECFMG – IMGs Continue to Strengthen U.S. Health Care in 2026 Residency Match

Full Medical Licensure
To become fully licensed in the United States, candidates need to pass the USMLE Step 3 and meet any state specific medical board requirements.

Each state’s medical board has different requirements around when (at what point of your residency) you’re able to apply for licensure and the processes and requirements involved. Contact your state medical board for more information.

Specialties & Locations
Your chances of matching a residency program can vary drastically by location and specialty. The more flexible you are, the better your chances. For example, as of 2026, 34% of all residency spots in Florida were filled by IMGs, while 11% of Washington’s residency spots were filled by IMGs.

Similarly, IMGs filled 38% of all internal medicine residency spots but only 2% of dermatology spots. Keep in mind lower percentages doesn’t mean that you can’t match in your preferred location or field, but you may want to keep your options open if your first priority is residency in the United States in general.

Of course, we couldn’t put all the information here, but we hope this helps you get started. In addition to this, OzTREKK hosts several medical pathway webinars for students who have submitted their med school application via OzTREKK. These info sessions provide the latest information regarding the accreditation and medical licensing processes in Canada and the United States, as well as outline options for internships in Australia—an option that a growing number of students choose.

OzTREKK Medical Pathways webinars cover

• how to improve your chances to match;
• how to get an overview of support services;
• recent stats and trends in all the pathways;
• how to complete training in Australia and return to Canada.

As always, you’ll have the opportunity to ask us questions about these topics as we go through them. If you have any specific questions about the medical licensing pathways, please feel free to email our medicine admissions officer at medicine@oztrekk.com.