By Dr. Bilal Akil, MD — Emergency Medicine, Schulich School of Medicine & Dentistry, Western University · founder of mccQbank
Short answer: In October 2026 the College of Physicians and Surgeons of Ontario (CPSO) announced a registration policy that lets physicians certified by the Royal College or the College of Family Physicians of Canada (CFPC) be granted a provisional certificate to practise independently in Ontario without the MCCQE or the LMCC (CPSO Dialogue, October 2026). It does not change the road into residency: CaRMS still lists a pass on the NAC examination and the MCC’s qualifying exam among the basic requirements for international medical graduates (CaRMS eligibility criteria).
Headlines like “Ontario drops the MCCQE” are true for one group of doctors and misleading for many IMGs. This post separates the two, using the CPSO’s own policy text. Everything below was checked on 12 November 2026.
What the CPSO announced
The October 2026 issue of Dialogue, the CPSO’s publication for Ontario doctors, says the College “has approved a new registration policy that enables physicians to be granted a provisional certificate of registration to practise independently in Ontario without completing the Medical Council of Canada Qualifying Examination (MCCQE) or holding the Licentiate of the Medical Council of Canada (LMCC)”.
The article names the group it is written for: “Canadian- and internationally-trained physicians who are certified by the Royal College of Physicians and Surgeons of Canada or the College of Family Physicians of Canada”. For them, the CPSO says, they are no longer required to challenge the MCCQE or hold the LMCC to register with the College.
The CPSO also gives its reason. The MCCQE assesses knowledge and clinical decision-making at the end of medical school, and the College says it is “not an appropriate registration requirement for physicians who have already demonstrated competence through Canadian certification” and, for mid-career physicians, prior practice experience.
What the policy itself says
The policy is published on the CPSO’s site as Exemption From the Medical Council of Canada Qualifying Examination. Three details in it matter more than the headline.
It is an alternative to a rule in regulation, not a repeal of it. Section 3 of Ontario Regulation 865/93 still lists the standard qualifications for a certificate authorizing independent practice, and the policy says it “provides an alternative to the requirement for the successful completion of the MCCQE or the Licentiate of the Medical Council of Canada (LMCC) Qualification”.
The certificate is provisional, and the decision is the committee’s. The wording is that the Registration Committee “may direct the Registrar to issue a provisional certificate of registration” to qualifying applicants. That is a power the committee can use, not an automatic right.
The groups it covers are wider than the news article. The policy lists applicants who have obtained Royal College certification by examination or CFPC certification; or Subspecialist Affiliate status from the Royal College; or successful completion of specialty training and specialist certification by a certifying body in an approved jurisdiction, under the CPSO’s separate approved-jurisdictions policy. In each case they must also be otherwise qualified under Section 3 of the regulation.
Two lines in the policy are easy to miss. The Registration Committee may also direct the Registrar to issue LMCC holders a certificate authorising independent practice. And “[a]ll applicants must satisfy the non-exemptible requirements set out in Section 2(1) of Ontario Regulation 865/93”, so the exemption covers the exam and the Licentiate, not the rest of registration.
Who no longer needs the MCCQE or the LMCC in Ontario
Read together, the article and the policy describe one main group: physicians who already hold Canadian specialty or family medicine certification, whether they trained in Canada or abroad, and who apply to the CPSO for registration. For that group, the CPSO’s Registration Committee may now grant a provisional certificate without the MCCQE or the LMCC.
In practice this is most relevant to:
- Royal College or CFPC-certified physicians who never sat the MCCQE, or never obtained the LMCC, and want to register in Ontario;
- physicians the policy treats the same way, such as Royal College Subspecialist Affiliates and specialists certified in an approved jurisdiction.
Even for them, the outcome is a provisional certificate issued at the Registration Committee’s direction. Anyone in this group should read the policy and the CPSO’s registration requirements for their own route before relying on it.
Who may still need them
IMGs applying to residency through CaRMS. This is the group the headlines most often mislead. CaRMS’s R-1 eligibility criteria for international medical graduates still say applicants must “have written and passed” the National Assessment Collaboration (NAC) Examination and the MCC’s qualifying exam, which CaRMS still calls the Medical Council of Canada Qualifying Exam Part I (the MCC now calls it the MCCQE, formerly MCCQE Part I). CaRMS adds that some provinces may allow exceptions, so read the provincial criteria for each province you apply to (CaRMS eligibility criteria). The CPSO article says the same thing from the other side: the qualifications may still be required “through the Canadian Resident Matching Service (CaRMS) for entry into postgraduate training programs”.
Anyone planning to work outside Ontario. The CPSO notes that the MCCQE and the LMCC may still be required by medical regulatory authorities in other provinces. The MCC describes the LMCC as part of the requirements those authorities set for a licence (MCC: LMCC). One province’s policy does not change another’s.
Medical students. The CPSO also names medical schools among those that may still require the exam.
Doctors who are not yet certified. The exemption depends on certification (or one of the listed equivalents). A physician without it is outside the policy and stays on the usual requirements.
What this means if you are an IMG preparing now
If your plan is a Canadian residency, nothing in your plan should change this month. The NAC is the MCC’s assessment of “readiness of international medical students and graduates who want to apply to a Canadian residency program”, and the MCC still describes the MCCQE as a standard that “all who want to practice medicine in Canada must pass” (MCC: Examinations and assessments).
Where the change may matter is later. A physician who matches, completes residency and gains Royal College or CFPC certification could then be eligible to apply under this policy, at the Registration Committee’s discretion. But that point comes after residency, and CaRMS still lists both exams as basic requirements, subject to provincial exceptions.
So the core requirements are unchanged: CaRMS still lists passes on the MCCQE and the NAC, and some provinces add their own assessments or requirements. If the Licentiate itself is confusing you, our guide to what the LMCC is and how you get it covers the MCC’s January 2026 changes and now this Ontario policy. For the residency side, see CaRMS citizenship and residency requirements for IMGs.
Frequently asked questions
Did Ontario get rid of the MCCQE?
Not for everyone. The CPSO approved a policy under which physicians certified by the Royal College or the CFPC can be granted a provisional certificate to practise independently without the MCCQE or the LMCC. The regulation’s standard requirements still exist, and the policy is described as an alternative to them (CPSO policy).
Do IMGs still need the MCCQE and the NAC for CaRMS?
Yes, as a basic requirement. CaRMS’s IMG criteria say applicants must have written and passed the NAC examination and the MCC’s qualifying exam, and note that some provinces may allow exceptions (CaRMS).
Do I still need the LMCC in Ontario?
Not if you are certified by the Royal College or the CFPC and the CPSO’s Registration Committee issues you a provisional certificate under this policy. Holding the LMCC remains another route to a certificate authorizing independent practice (CPSO policy).
Does this apply in other provinces?
No. It is a CPSO policy for registration in Ontario, and the CPSO itself says regulators in other provinces may still require the MCCQE and the LMCC (CPSO Dialogue).
If you are on the residency route, the MCCQE is still the exam to prepare for. Try 30 free MCCQE questions to see where you stand.
This article explains a regulator’s policy; it is not legal or licensing advice. The CPSO, the MCC and CaRMS are the authorities on their own requirements.
