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Acceptable Alternatives to the LMCC

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Section 19 of the Medical Practitioners Regulations states that one of the requirements for registration is “a licentiate of the Medical Council of Canada, or an acceptable alternative as determined by resolution of Council“.

This policy sets out the acceptable alternatives to the Licentiate of the Medical Council of Canada, as determined by resolution of Council.


The following are acceptable alternatives to the Licentiate of the Medical Council of Canada (LMCC) in an application for registration:

  1. United States Medical Licensing Exam (USMLE) Steps 1, 2 and 3; or
  2. Federation Licensing Examination (FLEX) Components 1 and 2; or
  3. National Board of Medical Examiners (NBME) Parts I, II, and III; or
  4. The Comprehensive Osteopathic Licensing Examination (COMPLEX-USA) Levels 1, 2 and 3. (This applies only to graduates of osteopathic schools accredited by the American Osteopathic Association); or
  5. For physicians currently licensed with the College, a Comprehensive Clinical Assessment of Practice that is satisfactory to the Registration Committee; or
  6. For physicians who are more than five years removed from completion of their undergraduate training, a minimum of five years recent practice experience as the most responsible physician that is satisfactory to the Registrar or Registration Committee.


In determining whether practice is satisfactory in accordance with (f), the Registrar or the Registration Committee may consider:

  • disciplinary history;
  • certificates of professional conduct from any of the jurisdictions from where the Applicant has practised;
  • three verifiable references supporting competence, capacity and good character;
  • satisfactory participation in a continuing professional development program:
    • the Mainpro+ program of the College of Family Physicians of Canada; or
    • the Maintenance of Certification (MOC) CPD program of the Royal College of Physicians & Surgeons of Canada; or
    • the continuing professional development program established or approved by jurisdiction from where the Applicant currently practises.
  • where applicable or where available, Supervision reports, Sponsorship reports and recommendations, or formal practice evaluations; and
  • other information as deemed relevant.


Applicable Legislation

Medical Practitioners Regulations – Section 19, 59 (1)(a-b)

Approved by

Executive Committee

Approval date

September 21, 2018

Review date

April 2020