Restrictive permit – Clinician – Practice Ready Assessment (PRA)

To obtain a sponsorship letter, you must first register with Recrutement Santé Québec (RSQ). RSQ is an agency of the ministère de la Santé et des Services sociaux (MSSS) that will help you find a health care institution willing to recruit you (position) based on the medical workforce needs identified by the MSSS.

Sponsorship includes financial support from the RSQ. RSQ will cover the costs related to the file review and the organization and completion of the assessment period (see the Fee schedule). RSQ will send the sponsorship letter—duly signed by all stakeholders—directly to the Collège.

Without this sponsorship, you will not be able to continue the restrictive permit route. In such case, you may consider the regular permit route (see the Regular permit to practice – By recognition of the equivalence of an M.D. Degree).

You must pass one of the following examinations:

• Medical Council of Canada Evaluating Examination (MCCEE) – Completed before 2019;
  or
• Medical Council of Canada Qualifying Examination, Part I (MCCQE – 1);
  or
• United States Medical Licensing Examination, Step 2 Clinical Knowledge
  (USMLE, Step 2 CK).

To apply for an examination, you must create a personal account on the Medical Council of Canada (MCC) portal at physiciansapply.ca, then select “Examinations.”

Once you have obtained a sponsorship through RSQ and passed the required examination, you may submit an application for a restrictive permit (clinician).

To submit an application, log in to your personal physiciansapply.ca account on the MCC website, then select:

1. Application for medical registration
2. QC Collège des médecins du Québec
3. Restrictive permit – Clinician sponsored by Recrutement Santé Québec

You must also provide the required documents, some of which must be sent to the Collège while others must be submitted through physiciansapply.ca for source verification purpose.

It is your responsibility to follow up on the documents you submitted and disclosed to the Collège through the physiciansapply.ca portal. Note that the documents must be given the “Passed” verification status before the restrictive permit can be issued.

Lead times

• Acknowledgement of receipt of the application for medical registration: 5 business days.

You have completed steps 1 to 3, which means your file is ready for review by the CAP. This Committee regularly convenes to assess the eligibility of applications for a restrictive permit. You will then be notified of the CAP’s.

Lead times

• CAP meetings: approximately every 7 weeks;
• Decision of the Committee: available in the secure section on the CMQ website within 15 business days following the meeting.

Section 35 of the Charter of the French language stipulates that “The professional orders shall not issue permits except to persons whose knowledge of the official language is appropriate to the practice of the profession.”

Before the assessment period, you will be asked to provide proof of your proficiency in the French language, by either:

1. passing the French examination administered by the Office québécois de la langue française (OQLF);
   or
2. providing an attestation of studies or any school certificate as stipulated in the exemption criteria.

You were authorized by the CAP to continue the process in order to complete an assessment period. The Collège’s Medical Education Division will identify the site where you will complete your assessment period, which will be coordinated in collaboration with the identified institution. Individual initiatives are prohibited.

The estimated time before you start your assessment period may vary depending on a number of factors, including your availability, the time needed to identify a site for your assessment, and the lead times for processing your application to obtain the work permit you need to complete the assessment period, which takes four to twelve months on average.

Note that the assessment period is not a training period; the goal is to assess your readiness to practice in the specialty in question in Quebec.

The assessment period lasts 12 consecutive weeks preceded by a week of observation. It takes place in an accredited university clinical setting or any other setting designated by the Collège, and includes the assessment of both skills and attitudes in the main areas of the specialty in question.

Two reports (mid assessment and final reports) will be completed by the supervisor and sent to the Collège. They will be added to your file for review by the CAP as part of its subsequent review of your application for a restrictive permit.

Any candidate for a restrictive permit has the right to report a situation of harassment and to request information and advice in relation to this situation, or even file a complaint with their assessment site or the Commission des normes, de l’équité, de la santé et de la sécurité du travail (CNESST). The harassment prevention and complaints policy of the assessment setting explains the steps to follow. Further details concerning the resource to which the candidate can refer to, in the event of a harassment situation, will be provided when the assessment period is launched. The candidate must also notify the Collège as soon as the assessment environment has been informed of a harassment situation.

The Committee on Admission to Practice (CAP) will make its decision to issue the restrictive permit (clinician) based on the candidate’s complete file, including the assessment period reports.

Lead times

• Meeting of the CAP: approximately every 7 weeks;
• Decision of the Committee: available in the secure section on the CMQ website within 15 business days following the meeting.

You may request that the Collège’s Request Committee review the decision, provided you submit your request in writing to the secretary of the CAP within 30 days following the receipt of the CAP’s decision letter. The Request Committee also gives you the opportunity to attend the meeting for the review of your file and to make oral observations. The Request Committee’s decision will be shared with you within 30 days following the date of said decision. This decision is final and cannot be appealed.

If the CAP has resolved to issue you the restrictive permit, you will be asked to:

• complete the ALDO-Quebec educational activity which covers the legal, ethical, and organizational aspects of the practice of medicine in Quebec, before the restrictive permit is issued;
• log in to the secure section on the CMQ website to:
  • fill out the “Update of medical activities and Declarations” form;
  • pay the permit issuance fees based on the actual fee schedule.

Lead times

• Acknowledgement of receipt of the Update of medical activities form: 24 h to 48 h;
• Issuance of the permit within 24 h to 48 h once the file is complete (i.e., when all required conditions are met).

For more information, please contact the Collège’s permit section at demandepermis@cmq.org.

Once you have received your permit to practice, and before you start practicing medicine in Quebec, you must:

• take out professional liability insurance (and maintain it thereafter);
• fill out the “First registration on the Roll of the Order” form in the secure section of the CMQ website.

Lead times

• Processing of your first registration on the Roll of the Order and relay of your permit number and the confirmation from your professional liability insurance to the RAMQ on the business day following your registration to the Roll of the Order

At this point, you do not have to follow any procedure with the RAMQ. If you have any questions, please visit the RAMQ website (available in French only).