Special authorization

Should a physician from another jurisdiction want to provide care on a regular basis to patients in Quebec, they must hold a permit to practice from the Collège des médecins du Québec (CMQ), a specialist’s certificate, and be registered as an active member on the Roll of the Order.

However, the CMQ may issue a special authorization, in-person or via telemedicine, granting a person legally authorized to practice the profession outside Quebec the right to use a title reserved for members of the Order or to engage in professional activities in Quebec that are reserved for such members.

The special authorization is an exceptional and temporary measure used to enable physicians outside of Quebec to carry out medical activities with patients in Quebec, in person, for the purpose of learning or teaching medical activities, or also to practice on an ad hoc basis with a specific person or group of people. A special authorization is also issued to allow telemedicine services to be offered.

Please refer to the section "Application for special authorization – Regular and accelerated application" for the required documents in view of obtaining a special authorization. (Note for holders of a regular permit in Canada: see documents required for an accelerated application.)

Eligibility requirements

1. In-person special authorization

• Hold a medical degree from a medical school listed in the International Medical Education Directory (IMED) published by the Foundation for Advancement of International Medical Education and Research (FAIMER) or the World Directory of Medical Schools;
• Hold a specialist’s certificate in the relevant specialty;
• Be legally authorized to practice the medical profession outside Quebec (holder of a permit/license) and be in good standing with the organization that issued the authorization to practice;
• Be invited by a health care institution, university or other organization to learn or teach medical activities;
• Or be invited by a health care institution, university or other organization to practice on an ad hoc basis with a targeted individual or group of individuals;
• Hold professional liability insurance covering authorized medical activities.

2. Special authorization via telemedicine

• Hold a medical degree from a medical school listed in the International Medical Education Directory (IMED) published by the Foundation for Advancement of International Medical Education and Research (FAIMER) or the World Directory of Medical Schools;
• Hold a specialist’s certificate in the relevant specialty;
• Be legally authorized to practice the medical profession outside Quebec (holder of a permit/license) and be in good standing with the organization that issued the authorization to practice;
• The medical activity is a teleconsultation or teleassistance;
• The activity is carried out on an occasional or transitory basis over a short, targeted period;
• Have a referral corridor with a physician, a health care institution or another clinic in Quebec, so that face-to-face meetings can be arranged when required (e.g. for a physical examination);
• Hold professional liability insurance covering medical activities via telemedicine.

Exception : Physicians legally authorized to practice in another Canadian province or territory are not required to obtain a special authorization from the CMQ when they offer one-time, targeted telemedicine care to one of their patients who is temporarily located in Quebec, or who is in the process of moving there.

Rights related to a special authorization:

The physician holding a special authorization may only practice the medical activities specified in the special authorization in the environment or with the people mentioned, on the dates indicated (maximum one year), and in compliance with the standards applicable to physicians who are members of the CMQ, and more specifically those related to ethics, deontology and professional secrecy.

Also, a special authorization does not give the right to:

• practice medicine at other sites or with people other than those mentioned in the special authorization;
• write medical prescriptions that must be filled outside the health care institution;
• bill the Régie de l'assurance maladie du Québec (RAMQ);
• sign certain medical documents, such as death certificates, reports that conclude that confinement (secure inpatient treatment) is required, insurance forms, forms for the Commission des normes, de l’équité, de la santé et de la sécurité du travail (CNESST), forms for the RAMQ or for any other agency acting as a third-party payer;
• have hospital-based practice recognized as a training period in view of obtaining a permit to practice medicine and a specialist’s certificate in Quebec.

To submit an application for a special authorization, in-person or via telemedicine

• Physicians who already have a file at the CMQ
  You must submit your application by email to demandepermis@cmq.org.
  If you are eligible, you will be given access to the Application for special authorization form to be completed through the CMQ’s secure Online services. Fees apply for the study of the file according to the current fee schedule.

• Physicians who are submitting their first application to the CMQ
  You must submit your application by email to demandepermis@cmq.org and include your curriculum vitae and date of birth (so that a file can be created).
  If you are eligible, you will be sent a user code and password by email so that you can complete the Application for special authorization form through the CMQ’s secure Online services. Fees apply for the study of the file according to the current fee schedule.

Application for renewal

A special authorization can be renewed, but it is not automatic. The physician must provide a letter explaining the reasons for the renewal. To make an informed decision, the CMQ may request any other relevant documents.

Professional Liability Insurance

You must have professional liability insurance in Québec covering authorized medical activities for the duration of the special authorization.