Issuance of a restrictive permit for graduating resident

New guidelines adopted by the Board of directors of the Collège
Due to the current extraordinary situation concerning the COVID-19 pandemic, measures need be taken to optimize the service offer and the contribution of all available medical human resources to contain the spread of the virus.

Given that the context related to the COVID-19 pandemic remains uncertain, so that an exceptional situation could occur and prevent a graduating resident from participating in the final examination of their specialty, the Collège has decided once again to authorize the issuance of a restrictive permit for graduating resident (RPGR) under certain conditions.

At its meeting on April 29, 2022, the Board of directors of the Collège des médecins du Québec therefore adopted new guidelines to allow a RPGR to be issued, authorizing residents to practice only those professional activities included in the discipline in which they completed their postgraduate training.

The permit will be valid for one year or at the latest until June 30, 2023, and will be renewed only if an examination session is postponed or cancelled or if success at the examination occurs after June 30.  Note also that the RPGR allows the holder to practice in both hospital and non-hospital settings.

Residents who satisfy the requirements to obtain a regular permit to practice (for example, residents in subspecialties who are already certified in internal medicine or pediatrics by the Royal College) may not apply for a RPGR; they must apply for a regular permit to practice. Once they have passed the other specialty examination, they will be able to obtain their additional specialist’s certificate.

Criteria for the issuance of a RPGR
  • Have a medical degree from a university in Canada or the United States that is accredited by the Liaison Committee on Medical Education (LCME) or have obtained recognition of equivalence of the degree from the Collège;
  • Hold the status of Licentiate of the Medical Council of Canada (LMCC);
  • Have completed a postgraduate training program in family medicine (24 months) or in one of the 59 other specialties (48 to 96 months) that is accredited by the Canadian Excellence in Residency Accreditation (CanERA) or the Accreditation Council for Graduate Medical Education (ACGME) for which the Collège has received confirmation of this end of training by the university;
  • Have participated in the educational activity on the legal, ethical and organizational aspects of medical practice in Quebec (ALDO-Quebec).
  • Be registered for the final examination and never have failed it.
Automatic withdrawal of the RPGR

In addition to the other mechanisms provided for in the Professional Code and the Medical Act, failure of one or more of the components of the final examination that give access to the permit to practice (Royal College or CFPC examination) after the RPGR has been issued will lead to the immediate withdrawal of the permit without any further formality.

A physician who holds a RPGR will automatically obtain a regular permit to practice and their specialist’s certificate once the Collège receives confirmation:

  • that they have successfully completed the certification examination; 
  • that they have completed the French examination administered by the Office québécois de la langue française (OQLF), if applicable;

and if all the other conditions for the issuance of the permit are met.  The physician will then be able to continue their practice.

A physician who holds a RPGR who has successfully completed their certification examination 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 a RPGR, regardless of where they practice once the regular permit is issued. 

Withdrawal of the RPGR will take effect upon receipt of a failed result on the Royal College or CFPC 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 RPGR

To ensure continuity of care for patients who are under the responsibility of a physician who holds a RPGR and whose permit has been withdrawn because 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 examination 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 a 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 considered in the context of this transfer.

In summary

In the event of failure of the certification examination:

  • as soon as notification from the Royal College or the CFPC 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 Collège will take place following notification from the Royal College or the CFPC and you will be contacted by the Collège’s Permit Section (;
  • you may be able to apply to your faculty of medicine for an extension of training, where applicable.

To request a RPGR, the resident must complete the Application for medical registration no later than one month before the practice start date through their personal account on the portal and select Regular permit – Practice ready in order to avoid any delay in the issuance of the permit. See the Collège’s list of fees (including fees for services).

For information
Last update: May 10, 2022