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Recommendations for physicians who hold a restrictive permit for graduating residents (RPGR)


Due to the pandemic, the Royal College of Physicians and Surgeons of Canada (Royal College), the College of Family Physicians of Canada (CFPC) and the Medical Council of Canada (MCC) have decided to postpone the certification examinations and the MCC Qualifying Examination Part I and Part II. Consequently, the Collège des médecins du Québec (CMQ) has decided to allow graduating residents to practice as physicians without having passed all the examinations prescribed by the regulations.

At its special meeting of March 24, 2020, the CMQ's Board of Directors therefore adopted new guidelines in order to allow a restrictive permit to be issued to graduating residents. 

The permit will be valid until one of the following deadlines, whichever comes first:

  • the date the results of all the examinations that apply to the permit holder (Royal College, CFPC and MCC) are obtained – note that failure of any of the examinations concerned will result in the immediate withdrawal of the permit;
  • June 30, 2021;
  • for those who obtained their RPGR before July 1, 2020, in which case the restrictive permit is valid for only one year after its date of issue, and in the event that the date the examination results are obtained is after the expiry date of the RPGR, the CMQ will renew the RPGR during the waiting period for the results, but not beyond June 30, 2021.

A physician who holds an RPGR will automatically receive a regular permit to practice and their specialist’s certificate once the CMQ receives confirmation that they have successfully completed the certification examination and if all the other conditions for the issue of the permit are met (e.g., LCMC, ALDO-Quebec educational activity, Office québécois de la langue française French examination, where applicable). The physician will then be able to continue their practice.

A physician who holds an RPGR who has successfully completed their certification examinations and whose permit has been converted to a regular permit remains responsible for the follow-up of the patients who were under their care while they were a holder of an RPGR, regardless of where they practice once the regular permit is issued. 

Withdrawal of the RPGR will take effect within 24-48 hours of receipt of a fail result on the Royal College, CFPC or MCC examination. The physicians concerned will have to take the necessary steps to ensure continuity of care for their patients (see below).

Continuity of care in the event of withdrawal of a restrictive permit for graduating residents (RPGR)

To ensure continuity of care for patients who are under the responsibility of a physician who holds a restrictive permit for graduating residents and whose restrictive permit has been withdrawn as a result of failure of the certification examination, the permit holder will have to arrange with the chief of service or department head for appropriate referral or the assignment of another physician who will be responsible for continuity of care. Although the risk of failing the certification examinations is low, it is important to establish this plan for the takeover of care in advance.

Together with their department head, chief of service or the most senior physician in their practice setting, a physician who holds an RPGR will have to ensure that all the required elements have been complied with to ensure a safe transfer of care. The follow-up of the results of investigations and consultations prescribed for patients will have to be taken into account in the context of this transfer. 

In summary 

In the event of failure of the certification examination or the MCC examination: 

  • as soon as notification from the Royal College, the CFPC or the MCC is received, you will have to contact your department head or chief of service or the most senior physician in your practice setting to ensure continuity of care for your patients in accordance with the pre-established plan for the takeover of care;
  • the withdrawal of the permit by the CMQ will take place quickly (within 24 to 48 hours) following notification from the Royal College, the CFPC or the MCC and you will be contacted by the CMQ’s Permit Section (;
  • you may be able to apply to your faculty of medicine for an extension of training, where applicable. 
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Last update: July 13, 2020