Toronto Metropolitan University’s School of Medicine in Brampton, Ont., in August, 2025.Sammy Kogan/The Canadian Press
Ontario has quietly dropped its controversial rule that only medical-school graduates who previously completed at least two years of high school in the province will be eligible to apply for medical residency spots.
And not a moment too soon.
The jingoistic policy, announced in early October, 2025, never made any sense.
It seriously disadvantaged international medical graduates, physicians who studied abroad but became permanent residents of Canada. IMGs make up more than one-quarter of the province’s physician work force, and they are the backbone of care in rural and remote areas of Ontario.
The policy, announced just as medical students were applying for residency positions, was almost immediately challenged on constitutional grounds.
Last November, the court issued a judicial stay, and a hearing was scheduled to begin on June 8.
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But, on Thursday, the deadline for both parties to submit written legal arguments, lawyers for the province told the court the policy has been rescinded.
Clearly, they could see that the writing was on the wall.
In an interlocutory judgment issued in December – a ruling that suspended the policy until a full hearing could be conducted – Justice Markus Koehnen made it abundantly clear that discriminating against medical students because they had not gone to high school in Ontario violated at least two sections of the Constitution: Section 6, which guarantees mobility rights of workers, and Section 15, on equality rights.
Demanding that medical residents attend Ontario high schools is not a way of ensuring they are well educated, it’s a proxy for weeding out candidates based on their national origin.
That is a blatant violation of constitutional protections.
It also entrenches barriers for international and racialized students, a group that is historically under-represented in the medical profession, and already faces long-standing systemic barriers in medical training and licensing.
Adding insult to injury, if you will.
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The testimony of the two applicants who challenged the law was also quite telling.
Nathalia Da Silveira is a vascular surgeon trained in Brazil who spent more than $15,000 in fees to be eligible for a residency spot, only to see her dreams dashed because she had gone to high school elsewhere.
Ailan Polegatto Lagosta is a surgical oncologist who immigrated to Canada from Brazil as part of the federal skilled worker program. She worked as a housecleaner and dishwasher to scrape together enough money to do the tests that allowed her to apply for a residency spot, only to see the rules change at the last moment.
We should be tripping over ourselves to hire highly qualified physicians like Dr. Da Silveira and Dr. Lagosta. Our beleaguered health system desperately needs them.
Instead, we create ridiculous hurdles and unfair rules. In our policy-making, we cut off our nose to spite our face.
The only argument the Ontario government has ever put forth for justifying the “studied in an Ontario high school” rule was that it would ensure medical residents remain in the province after they complete their training.
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(The unspoken reason is that it would give a leg up to Canadians who studied medicine abroad in places such as Ireland, and who are technically IMGs, but not immigrants.)
Many cheered the approach, saying jobs should go to Ontarians or Canadians, not foreigners.
But the fact is that only permanent residents can apply for the IMG residency spots. And these new doctors will almost all become citizens.
As Justice Koehnen noted, both the applicants in this case have already made a “considerable” commitment to Canada and Ontario, including each having children with Canadian citizenship, not to mention paying their taxes.
According to the province’s own data, both international medical graduates and Canadian medical graduates have the exact same retention rates – 87 per cent.
Having suffered a legal smackdown, it’s not clear what Ontario will do next.
But the smartest approach would be to do nothing. Tacitly acknowledge that limiting the job opportunities of IMGs was a boneheaded move and recognize that we should be making it easier, not harder, for qualified physicians to find work in a system that desperately needs them.