Ask an international medical graduate in Canada what they are working towards and a good number will say “my LMCC”. Ask what the LMCC will let them do, and the answers get vaguer. Somewhere between the forums, the WhatsApp groups and a great many blog posts written before 2026, the Licentiate has picked up a reputation as the finish line — the document that turns a physician who trained elsewhere into a physician who can work here.
It is not that. It never was. And as of this year the route to it is not what most of the guides online still describe.
The question behind the question
When someone asks about the LMCC they are almost always asking one of three different things: what do I need to pass, what will let me work, or what does a residency program want to see. Those have three different answers, and the Licentiate is only a partial answer to the first.
So it is worth being precise, because the cost of being imprecise here is measured in months.
A qualification, not a licence
The Licentiate of the Medical Council of Canada is a qualification granted by the Medical Council of Canada. Holding it means the MCC is satisfied that you have met its standard and that your name can be entered in the Canadian Medical Register.
What it does not do is authorize you to see a single patient.
Medicine in Canada is licensed provincially and territorially, not federally. The body that decides whether you may practise is the College of Physicians and Surgeons in the province you want to work in — the CPSO in Ontario, the CPSBC in British Columbia, the CPSA in Alberta, and so on. Each sets its own requirements, each has its own registration classes, and each makes its own decision about you. The MCC does not license anyone.
The cleanest way to hold the distinction is this. The MCC assesses. The college licenses. The Royal College and the College of Family Physicians of Canada certify you in a specialty. Three different organizations, three different pieces of paper, and you will need more than one of them.
What a provincial college actually wants
A college assembles a picture: your medical degree and where it was earned, your postgraduate training, your certification, your practice history, your language proficiency, your character and conduct references. The LMCC is one input into that picture. For most routes to independent practice it is a necessary one. It has never been a sufficient one.
This matters practically, because a candidate who treats the Licentiate as the goal tends to stop reading at the MCC’s website. The requirements that will actually decide whether you work in Ontario or Saskatchewan are on that province’s college website, and they differ enough from each other that reading only one will mislead you about the others.
What changed on 26 January 2026
For years the Licentiate ran through two examinations, and then through one examination plus a year of postgraduate training. Both of those steps have now gone.
The first went in 2021, when the MCC confirmed on 10 June 2021 that it was stepping away from delivering the MCCQE Part II, and the route was rebuilt around the remaining written examination. If you want the detail of what took its place, we covered it in what replaced the MCCQE Part II. The examination that remained was renamed on 1 April 2026 — “MCCQE Part I” became simply the MCCQE, per the MCC’s name update, which is the reason you will see both names in circulation and why older forum threads read strangely. We wrote that one up separately: the MCCQE Part I rename.
The second went this year. In Important update to LMCC eligibility and issuance starting January 26, 2026, published 26 January 2026, the MCC stated that candidates would “no longer be required to complete twelve months of postgraduate training” to qualify for the Licentiate. The Council set out its reasoning separately, in Changes ahead for issuance of the LMCC.
That is a genuine change in the shape of the pathway, not a paperwork tidy-up. It means the Licentiate now arrives earlier in an IMG’s training than it used to — potentially years earlier — and it means a guide that tells you to finish residency before you can hold an LMCC is describing a process that no longer exists.
What the MCC requires now
As the MCC’s LMCC page sets it out, eligibility now rests on four things: that your medical school qualifies (an accredited Canadian school, a school listed in the World Directory of Medical Schools with the relevant sponsor note, or a US school of osteopathic medicine accredited by the AOA); that you hold a pass on the MCCQE; that your medical degree has been successfully source-verified through the MCC, or that the executive director and CEO has accepted other evidence; and that your LMCC application fee and any other MCC fees are paid.
Read that page rather than a summary of it, including this one. The route has been rebuilt twice in five years, and a sizeable amount of what is written about the LMCC online describes a version of it that has been retired.
The piece of this that catches people out is source verification. The MCC needs your medical degree and related documents confirmed with the institution that issued them, submitted through your physiciansapply.ca account; the MCC sets out how at How to submit your documents for source verification. For an IMG this is the step most likely to be the long pole, because it depends on a university in another country responding to a request on someone else’s timetable. Start it early. Start it before you think you need to.
Where the Licentiate sits in an IMG’s timeline
Laid out end to end, the ordinary path looks roughly like this. Open a physiciansapply.ca account. Begin source verification of your medical degree. Sit the MCCQE. If you are going through CaRMS, sit the NAC OSCE as well, because the NAC is what residency programs read and it is a separate examination with its own application windows. Apply to CaRMS. Match, and complete residency. Then apply to a provincial college for a licence, and to the Royal College or the CFPC for certification.
Notice where the LMCC falls. It is not a CaRMS prerequisite and it is not a substitute for the NAC OSCE. Programs want your MCCQE result and your NAC result; the Licentiate is not the thing that gets you an interview. A candidate who delays a CaRMS application while waiting for a Licentiate to arrive has misread the order of operations, and there is no way to get that cycle back.
Four mistakes that cost people months
Treating the LMCC as permission to work. It is a qualification. The licence comes from a provincial college, on that college’s terms.
Waiting on it before applying to CaRMS. Different tracks, different timing. Apply when the CaRMS window is open.
Reading a pre-2026 guide as current. If an article describes two examination parts, or tells you to complete a year of postgraduate training before you can hold the Licentiate, it is out of date. This includes articles that have been quietly re-dated.
Leaving source verification until after the exam. It runs on your medical school’s schedule, not yours, and it is the step you cannot compress by studying harder.
Cost, paperwork, and the one thing the MCC has not published
The January change moved the cost as well as the requirements. The MCC’s LMCC page states that if you applied for the MCCQE after 26 January 2026, the Licentiate is issued automatically at no additional cost. The Licentiate is now issued digitally by default; the physical Testamur and wallet card that used to be sent out are no longer issued automatically, though they can still be bought on request. Current figures live on the MCC’s Examination and service fees page — check the number there rather than take it from a blog, including ours.
What we have not found published anywhere is a service standard for issuance: how many days or weeks it takes between meeting the requirements and the Licentiate appearing. The MCC’s stated aim in rebuilding the process was that it be simpler and faster, but we have not found a committed timeline. If you need one for a deadline, ask the MCC directly through your physiciansapply account. We will update this post if the MCC publishes a number.
What to do this week
If you have not opened a physiciansapply.ca account, open it. If you have one and source verification has not been started, start it — today, not after your next practice test.
Then deal with the part you actually control, which is the examination. The MCCQE is the gate the Licentiate now hangs on, and unlike credential verification it responds directly to how you prepare. It is worth knowing how long an MCCQE result stays valid before you plan a sitting, and worth looking at how IMG and CMG pass rates actually compare rather than at forum folklore.
And prepare the way the examination is actually written — clinical decision-making under time pressure, not recall. Our MCCQE question bank is built for that, in English and in French, by physicians who write and sit these examinations in Canada.
Start with 30 free questions and see where you are before you book anything.
Reviewed by Dr. Bilal Akil, Emergency Medicine, Western University. This article explains a process; it is not legal or licensing advice, and the Medical Council of Canada and your provincial college are the authorities on their own requirements.
