Changes Approved to Pathways Policies

Close-up of a stethoscope

Following a consultation, Council approved revisions to a registration policy to reflect streamlined process changes, and bring increased clarity to applicants and the public.

CPSO developed the four routes under the Alternative Pathways to Registration policy in 2008 to expand the qualifications for certificates of registration in Ontario. The pathways made it easier for candidates to become registered in Ontario by removing barriers and providing alternative options for acceptable qualifications (namely US training and board certification). The pathways also add another route to licensure for applicants who are not certified by the Royal College of Physicians and Surgeons of Canada (RCPSC) or the College of Family Physicians of Canada (CFPC), and do not currently hold a certificate of registration in a Canadian jurisdiction.

Over the years, we closely monitored the use and uptake of the pathways — and what we learned resulted in the changes to the redesigned policy.


  • Route is no longer distinguished based on the source of an applicant’s medical degree. We updated the policy’s language to simply state an applicant must hold an acceptable medical degree as defined in Ontario Regulation 865/93 under the Medicine Act, 1991. As a result, we combined Pathways 1 and 2 into one route (Pathway B) and combined Pathways 3 and 4 into another route (Pathway A).
  • We removed the requirement for a mentor.
  • We are more specific about the supervisory requirements. We updated the language in the undertakings to specify a period of limited direct observation for an initial period to be determined, and regular direct observation where appropriate.