International medical graduates

International medical graduates (IMGs) can apply for licensure in the provisional class, clinical observer class, assessment class or associate physician class.

These licensure classes are for physicians or surgeons who obtained their medical degree outside of Canada that is listed in the World Directory of Medical Schools. A Canadian sponsor note is required.

Clinical observer licence for IMGs

Registration as a clinical observer can provide an educational experience for international medical graduates looking to enter a postgraduate training program in British Columbia.

Clinical observers are not authorized to practise independently and function at the level of a fourth-year medical student in the practice setting.

For supervising physicians

Supervising physicians must confirm in writing that they will

  • be responsible for the supervision of any clinical contact by the clinical observer with patients,
  • inform patients that the clinical observer is an international medical graduate participating in an educational experience under their supervision,
  • obtain verbal consent from patients to allow the clinical observer to participate in the care situation, and
  • provide direct supervision of all interactions between the clinical observer and patients.

If a portion of the educational activity is to take place in a hospital, a letter from the chief of staff supporting the registration of the applicant as a clinical observer must be submitted with the application.

The College must be informed immediately if a clinical observer leaves the observership before the expiration date of their registration. This includes clinical observers who take time away from their observership to study.

Registration Clinical Observership Agreement

Eligibility requirements for supervisors

In situations where clinical observers have demonstrated an appropriate level of competence and performance, the supervising physician may allow them to interact alone with the patient provided that:

  • the clinical observer-patient interview is followed by direct interaction between the supervising physician and the patient to confirm the findings, diagnosis and suggested investigations or treatment
  • any activities based on clinical judgement, such as procedures or activities, must be directly overseen by the supervising physician or their designate

During the period of the clinical observership, the supervising physician is responsible for ensuring that the clinical observer is complying with the ethical responsibilities set out in the Canadian Medical Association's Code of Ethics and Professionalism.

It is College policy that there should be no more than two clinical observers under the supervision of physicians in any one office location at one time. If the supervising physician practises in more than one clinic, they cannot supervise more than two clinical observers. A colleague can agree to act as the supervisor at alternate practice locations.

Eligibility requirements for supervisors


An applicant must meet the following eligibility criteria:

How to apply

The College must receive a signed clinical observership agreement from a supervising physician along with a copy of the medical school graduate's CV. These documents must arrive together, either by mail or by email to

The supervising physician must be a College registrant in the full class who is in good standing.

Registration Clinical Observership Agreement

Eligibility requirements for supervisors

Once the agreement and the medical graduate’s resume/CV have been reviewed by the College, an application package will be emailed to the medical graduate.

Completed applications must be submitted to the College six weeks prior to the anticipated start date. Failure to meet this deadline may result in a delayed start to the clinical observership.

If no additional follow-up is required, the applicant file will be submitted for a final review and approval.

Once the application is reviewed and approved, a licence will be issued.

Extending the licence

Licensure is granted for 12 months at a time

To extend a clinical observership licence, email details of your request to

Per the College Bylaws, registration as a clinical observer may be granted for a maximum of three years.

Email extension request to the College

Learn more about the policies that the Registration Committee uses to consider applications