Toronto Metropolitan University’s School of Medicine is seen, in Brampton, Ont., in August. Critics say the new residency rule is discriminatory and short-sighted when many people are without a family doctor in the province.Sammy Kogan/The Canadian Press
Ontario is standing firm in its decision to change eligibility requirements for international medical graduates to apply for first-round residencies despite mounting pressure to reverse course from advocacy groups, health system leaders and applicants.
The province announced last week a new rule for international medical graduates, or IMGs – doctors who trained outside of Canada and have permanent residency or Canadian citizenship. They must now have completed at least two years at an accredited Ontario high school to qualify for provincial residency positions in the first match.
Critics say the change is discriminatory and short-sighted when many people are without a family doctor. There are concerns that the new rule will lead to qualified candidates applying elsewhere and discourage future applicants from Ontario.
Ontario Health Minister Sylvia Jones’s spokesperson, Ema Popovic, said in a statement on Tuesday that the change provides “more opportunities for Ontarians” who completed their education abroad.
“We know medical-school residents are likely to practice in the region where they receive training and this will ensure Ontario has a strong pipeline of world-class, Ontario-trained doctors for years to come,” said Ms. Popovic.
IMGs who did not attend high school in Ontario can apply in the second round to any unfilled positions.
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Ontaro’s NDP on Wednesday called the government’s decision “arbitrary and harmful.” The Canadian Medical Association and the College of Family Physicians of Canada, also on Wednesday, added their voice to a growing chorus urging Ontario to re-evaluate its policy.
“With the academic year already under way and the application window halfway through, international medical graduates have already initiated the process for this match at significant expense and time commitment,” said a joint statement.
“The government is urged to postpone this ill-timed policy.”
David Barber, chair of the Ontario Medical Association’s section of family practice, said family medicine programs will be significantly affected because they rely heavily on internationally trained doctors.
About 60 per cent of Ontario’s family medicine residency positions were filled by IMGs in 2025. The association estimates that, under the new rule, eligible applicants in the first round will drop to 170 from more than 1,200.
“It’s quite likely that we’ll end up with unfilled positions,” said Dr. Barber, which means fewer family doctors will graduate, exacerbating the issue of 2.5 million patients estimated to be without a primary care physician in Ontario.
He said this could also affect funding in these programs, which are based on the number of residents.
“The sad thing is, there’s some way to fix it and still have the outcome that the Ford government wants, but they’re just digging their heels in and not looking at the other options,” said Dr. Barber.
Zainab Hamid, who trained in Pakistan and has been working in Toronto’s health care system since moving to Canada in 2018, is one of the IMGs stuck in limbo after the change was announced.
She said she spent thousands on exams and additional classes to better her chances at securing an Ontario family medicine residency this year. Ms. Hamid said if she had known about the requirement before the application period opened, she may have spent that money to boost her odds in another province.
But Ms. Hamid said her goal has been to work in the province that she now calls home.
“I love Ontario. I love living here. My family and I, we built our life here,” she said, adding that it is unfair that she could have to leave behind everything she loves “because of something I cannot change about my past.”
“I have gone through the stages of grief – the anger, the bargaining, the denial … acceptance has still not hit,” said Ms. Hamid. “I am still very much hoping that this change will just get reversed.”
Carla Henderson, chief of anesthesiology at Peterborough Regional Health Centre who trained in Ireland, said IMGs make up about 30 per cent of her department. She said the “bizarre” new rules will make it harder to fill specialized positions, especially in communities outside of urban centres.
Dr. Henderson completed her residency in Ottawa in 2019.
She said if the province’s goal is to improve retention, she is proof that many IMGs who did not attend an Ontario high school dig deep roots in the province after finishing postgraduate training.