Ontario moves to retain homegrown talent with changes to physician residency matching process

Proposed legislation would reserve residency positions for Ontario-connected graduates trained abroad as part of broader effort to grow physician workforce.

The Ontario government says it plans to introduce legislation aimed at strengthening the province’s health-care workforce by prioritizing internationally trained medical graduates with established ties to Ontario for residency positions.

The proposed changes would create a dedicated stream within the Canadian Resident Matching Service, known as CaRMS, to give preference to Ontario students who studied medicine abroad. The goal is to make it easier for those graduates to return, complete their residency training, and begin practicing as doctors in the province.

If passed, the legislation would bring Ontario in line with other provinces, including Nova Scotia, New Brunswick and Prince Edward Island, which have implemented similar approaches. Officials say the move is intended to retain more physicians long term, as graduates with ties to Ontario are more likely to stay and practice in the province after completing their residency.

“Our government is protecting Ontario’s health-care system by taking bold action to strengthen Ontario’s physician workforce now, and into the future,” said Deputy Premier and Health Minister Sylvia Jones in a statement. “This proposed change to the matching process would make it easier for Ontarians studying medicine abroad to attend residency and have a career as a doctor back home in Ontario.”

Residency placements in Canada are currently filled through CaRMS, a national matching system that connects medical graduates with postgraduate training programs through a two-round process. While graduates from Ontario medical schools already receive priority in the first round, the proposed legislation would add a separate pathway specifically for Ontario-based international medical graduates.

To qualify under the proposed criteria, applicants would need to demonstrate a strong connection to Ontario. This could include attending secondary school in the province for at least two years, completing two or more years of full-time in-person study at an Ontario university, or living continuously in Ontario for at least 24 weeks during a specified period prior to applying.

The province plans to work with medical schools and CaRMS beginning in summer 2026, with the goal of implementing the changes in time for the September 2026 application cycle for the 2027 residency match.

The proposal is part of Ontario’s broader strategy to increase the number of physicians, particularly in primary care. The government says it is adding more than 270 new residency seats at medical schools across the province, bringing the total to 1,739 positions. That represents an increase of nearly 50 per cent since 2018.

Officials say Ontario has also added 551 residency positions since 2018 and nearly 20,000 physicians overall, including a more than 14 per cent increase in family doctors. Additional measures include expanding medical education capacity at existing institutions such as the University of Toronto, McMaster University, the University of Ottawa, and the Northern Ontario School of Medicine University, as well as establishing new medical schools at Toronto Metropolitan University in Brampton and York University in Vaughan, with a focus on training family doctors.

The province has also taken steps to attract health-care workers from outside Canada, including easing pathways for United States-licensed nurses and board-certified physicians to practice in Ontario. In 2025 alone, more than 2,300 nurses and over 570 doctors from the United States chose to work in the province.

The proposed legislation is tied to the province’s health-care plan, which focuses on expanding access to care and building a more sustainable workforce. Officials say reducing barriers for internationally trained graduates with Ontario connections is one way to address ongoing physician shortages and improve access to care closer to home.