Ontario proposes residency priority for medical graduates who studied abroad

On April 17, the Ford government announced legislative changes regarding who medical residencies are prioritized for.

According to the announcement, the provincial government intends to prioritize residency spots for Ontario students who attended medical school abroad to “protect Ontario’s health care workforce.”

The proposed changes are intended to make it easier for Ontario students who study medicine abroad to return to Canada and build a career in the province, according to the Ford government.

Under the framework, an Ontario International Medical Graduate (IMG) would include someone who either attended an Ontario secondary school for at least two years, attended an Ontario university full-time and in-person for at least two years, or lived continuously in the province for 24 continuous weeks during a prescribed period beginning the year before the application.

The announcement builds on the Ford government’s efforts to increasingly educate, train, and eventually hire medical students from within the province.

In October 2024, the Ford government announced Ontario medical schools would be required to reserve at least 95 per cent of undergraduate medical school seats for Ontario residents, with the remaining five per cent reserved for students from elsewhere in Canada. The changes took effect July 1, 2025.

As of its most recent class, Queen’s School of Medicine is an entirely Canadian student body. 

In a statement to The Journal, the University confirmed that 95 per cent of current Doctor of Medicine (MD) students are from Ontario, while the remaining five per cent were admitted from other provinces.  

“Queen’s University does not admit international students to the MD program,” the University wrote.  

According to Queen’s, the MD program received over 5,000 applications for the Class of 2030. Of those applicants, 772 were interviewed for 136 available seats, a decrease from the 142 students enrolled in 2025. 

Although international students typically pay higher tuition fees than domestic students, the University maintained that “International tuition revenue does not meaningfully affect the medical school’s budget.”

While the 2024 announcement focused on admissions to Ontario medical schools, the government’s 2026 announcement introduced changes to postgraduate residency admission, prioritizing international medical graduates with ties to Ontario.

Medical residency positions are currently filled through the Canadian Resident Matching Service (CaRMS), a two-round process that matches Canadian and international medical graduates with postgraduate training programs across the country. 

According to an Ontario government brief, IMGs filled 492 of Ontario’s 1,464 residency positions in 2025, with nearly 20 per cent of first-round positions dedicated to IMGs.

Under the proposed changes, graduates of Ontario medical schools would retain their first-round priority, while a dedicated stream would be reserved for Ontario students who completed their medical education abroad. 

The proposal wouldn’t change the existing five-year return-of-service requirement for IMGs, which requires them to practise in an underserved Ontario community after completing residency. The province also says more than 270 postgraduate residency positions will be added by 2028-29.

“Where provincial regulations affect the candidacy of prospective learners, for example the prioritization of IMGs, the CaRMS matching service makes the corresponding adjustments to the application and matching process,” Queen’s wrote.

The government plans to work with medical schools and CaRMS to develop the framework.