Family Medicine – Practice Ready Assessment

About

The Physician Assessment Centre of Excellence (PACE) assesses internationally trained physicians who want to practise primary care or hospitalist medicine in Nova Scotia through a detailed workplace-based assessment. The eligibility criteria for these two programs differ, and details can be found below.

If you are selected for a PACE assessment, you must have a Clinical Assessment licence during your assessment.

If you review the credentials checklist and think you do not qualify, you can learn more about getting a Clinical Assistant licence.

Before you apply

  1. Ensure you meet all qualifications for licensure listed in the credentials checklist.

  2. Verify your medical degree, postgraduate training, and specialty certificates through physiciansapply.ca: Verification of credentials | Medical Council of Canada (mcc.ca)

  3. Review PACE’s webpage to determine whether applications are open*.

    • If applications are open, submit the preliminary application. The PACE team will complete a review of your submission, considering eligibility and selection criteria. Applicants identified to continue in the screening process will be referred to the College to apply for a review of qualifications.

    * Applications to the College are accepted only during open PACE periods. Once invited by PACE, the College will reach out to you with instructions on how to submit your College application to review your qualifications. This approach ensures your time and effort are spent where they matter most.

Credentials

Recognized medical degree

Training and practice experience (primary care)

You must have both training and work experience in family medicine or general practice. You can qualify in one of two ways:

  1. Complete 24 months of internship or postgraduate resulting in certification, registration, or recognition in family medicine or general practice, plus 12 months of independent unsupervised licensed practice in family medicine or general practice.
  2. Or, complete 12 months of internship or postgraduate resulting in certification, registration, or recognition in family medicine or general practice, plus 24 months of independent unsupervised licensed practice in family medicine or general practice.

Training and practice experience (hospitalist)

  • 24 months of internship or postgraduate training resulting in certification, registration or recognition in family medicine, general practice, or internal medicine and 12 months of independent unsupervised licensed practice in primary care, internal medicine, or hospitalist medicine; OR
  • 12 months of internship or postgraduate training resulting in certification, registration or recognition in family medicine, general practice, or internal medicine and 24 months of independent unsupervised licensed practice in primary care, internal medicine, or hospitalist medicine.

    Core training rotations (primary care)

    You need to complete the following core rotations* during your internship or postgraduate training:

    • at least eight weeks in family medicine or general practice
    • at least four weeks in each of these areas: surgery, internal medicine, pediatrics, obstetrics/gynecology**, and psychiatry**

    * If you have gap in any of the listed rotations, the College may accept practice experience instead of training. Here's how it works:

    • Each one year of independent practice as a family physician/general practitioner that includes the gap in practice experience rotation will be considered as equivalent to four weeks of postgraduate training in that area. This can cover up to three missing rotations.
    • You must provide proof of practice experience in the area(s) of postgraduate rotation gap.

    ** At the discretion of the Registrar, you may be excused the requirement for 4 weeks of postgraduate training in psychiatry and/or obstetrics/gynecology, if you have the equivalent amount of extra training in family medicine.

    Core training rotations (hospitalist)

    You need to complete the following core rotations* during your internship or postgraduate training:

    • a minimum of eight weeks in family medicine or general practice and four weeks general surgery and four weeks of internal medicine; OR
    • a minimum of eight weeks in internal medicine and four weeks general surgery; OR
    • a hospitalist medicine clinical fellowship approved by the Registrar

    * If you have gap in any of the listed rotations, the College may accept practice experience instead of training. Here's how it works:

    • Each one year of independent practice as a family physician/general practitioner that includes the gap in practice experience rotation will be considered as equivalent to four weeks of postgraduate training in that area. This can cover up to three missing rotations.
    • You must provide proof of practice experience in the area(s) of postgraduate rotation gap.

    ** At the discretion of the Registrar, you may be excused the requirement for 4 weeks of postgraduate training in psychiatry and/or obstetrics/gynecology, if you have the equivalent amount of extra training in family medicine.

    Currency of practice

    Complete at least 450 hours of clinical practice in the scope you intend to practice in Nova Scotia within the five years preceding your start date in Nova Scotia. For the primary care assessment, that means 450 hours of office-based primary care experience in the last 5 years. For the hospitalist assessment, that means 450 hours of inpatient hospitalist experience in the last 5 years.

    English language proficiency

    You will be exempt from language testing if you have one of the following:

    • you successfully completed one of the following technical examinations in English:
      • Medical Council of Canada Qualifying Examination (MCCQE) Part I
      • College of Family Physicians of Canada certification examinations (written and oral)
      • Royal College of Physicians and Surgeons of Canada certification examinations (written and oral)
    • a letter from your postgraduate training program confirming that your training was conducted in English and that the primary language for patient care was also in English
      • please note this only applies if you completed your postgraduate training within the last 5 years

    Otherwise, the College will require one of the following:

    • IELTS* – Academic taken within the 24 months prior to applying, with a minimum score of 7 on each component
    • OET – Medicine taken within the 24 months prior to applying, with a minimum score of B on each component
    • CELPIP* – General taken within the 24 months prior to applying, with a minimum score of 9 on each component

    * The College will only accept the IELTS-Academic and CELPIP-General until January 1, 2027. Any test results dated before January 1, 2027, will be considered when determining an applicant’s ELP.

    Review of qualifications

    The licensure application is comprised of a two-part process: a Review of Qualifications and the balance of the application.

    The purpose of a Review of Qualifications is to review and verify your credentials to confirm your eligibility for licensure.

    You start this review by submitting an ‘application for medical registration’ through physiciansapply.ca. This is separate from verifying your documents through the same portal.

    Before initiating a Review of Qualifications, please ensure you have completed the following:

    • A review of the credentials checklist to ensure you meet all qualifications.
    • The preliminary application and invitation from PACE to apply with the College.
    • When applicable, have your English language test reports ready for submission.

    What to expect after submitting the Review of Qualifications:

    • A Registration Agent will be assigned to your file and will be in touch to provide a list of documents to complete your review.
    • Upon receipt of all required documents and confirmation of requirements for licensure eligibility, you will be referred to PACE to undergo additional screening.

    Selection

    • After the College confirms you are eligible for licensure with PACE, PACE will review your currency of practice, the relevance of your rotations, your performance on standardized exams, your Canadian health care experience, and your continuing professional development. These factors will be used to rank your application.
    • The most qualified applicants will be referred to Nova Scotia Health for an interview, which is the last step in the selection process.
    • For more details, see: Selection and Review for PACE Assessment Program

    Outcome

    • If you are selected to join PACE, PACE will notify the College. Your Registration Agent will contact you with instructions to complete your application for a Clinical Assessment licence.
    • You will also receive the details of your contract with PACE, your return of service agreement with the government, and your offer from Nova Scotia Health.

    Clinical Assessment licence

    At this stage, you will need to provide documents that show your character, skills, and ability to practise medicine in Nova Scotia.

    Your next steps:

    • complete balance of application through physiciansapply.ca
    • you will receive a list of required documents to finalize your application
    • submit the required documents
    • once all required documents are received, your file can be approved and your licence issued within 1–3 business days

    Assessment

    • Your Clinical Assessment licence is valid until you finish the PACE assessment.
    • The PACE assessment is competence-based and will end when there is enough information to decide if you are ready to practise independently.
    • After the assessment, the PACE Competence Committee will recommend one of the following to the College:
      • ready to practise independently with supervision (Defined licence)
      • ready to practise independently without supervision (Restricted licence)
      • ready to practise under supervision indefinitely (Clinical Assistant licence)
      • not ready to practise independently (no licence)

    Approval for long-term licensure

    • Once PACE makes a recommendation, the Registrar will decide on your licence.
    • If you are approved for independent, long-term licensure (Defined or Restricted), your Registration Agent will send you a final list of documents needed.
    • These may include:
      • enrolment in the College of Family Physicians of Canada’s Mainpro+ program for continuing professional development
      • a letter of intent for your return of service practice location
      • proof of updated liability coverage
      • documents from your sponsor and supervisor, if needed (Nova Scotia Health can help with this)
      • licensure and supervision fees
      • a virtual interview to review your licensing agreement
    • If you are not approved for independent licensure and are recommended for Clinical Assistant licensure, you must first apply for an Associate physician role with Nova Scotia Health or the IWK. You need an offer from an approved physician extender program before you can get Clinical Assistant licensure.

    Outcome

    • Once your application is complete and your licence is issued, you will start independent practice at the location in your return of service agreement.
    • If you are approved for a Defined licence, you will practise independently under supervision for at least six months.
    • A decision on long-term Restricted licensure can be made as early as six months after you start, if you have completed a successful period of supervision. With this pathway, you can get long-term Restricted licensure without more supervision or having to challenge additional exams.
    • If you are approved for a Restricted licence, you will practise independently with no further supervision required.

    After licensure

    Supervision

    Here are some resources to help you settle into your new life and your new practice in our province:

    The College acknowledges that we are in Mi’kma’ki, the ancestral and unceded territory of the Mi’kmaq people. This territory is covered by the Treaties of Peace and Friendship. We also acknowledge that people of African descent have been in Nova Scotia for over 400 years, and we honour and offer gratitude to those ancestors.