International PGME Trainees: Work Permits, Letters of Eligibility, Credentials and More



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International PGME Trainees: Work Permits, Letters of Eligibility, Credentials and More Hira Mirza - Nicole Parchment - Samantha Chin Visa Trainee Processing Jessica Filion, Coordinator John Kerr, Manager, International Programs May 12, 201

University of Toronto PGME Trainees Residents Training leads to RCPSC or CFPC certification Research Fellows No patient contact whatsoever PGME registration optional Clinical Fellows Highly tailored topping off training for medical specialists or family physicians Electives Short term training (6 months max) for residents or fellows registered at other medical schools Observers No UofT status Arranged through hospitals Post-Doctoral Fellows Post-PhD period of mentored research No patient contact No PGME registration 2/ 2

Visa Trainees All residency trainees and fellows who are not Canadian citizens or Canadian permanent residents require a work permit for the duration of their PGME program Many nationalities require a temporary resident visa to enter Canada in addition to a work permit for training Over 900 visa trainees from over 70 countries register annually with PGME Over 400 visa trainees are new registrants each year Extensions of training ordinarily require an extension of the work permit 3/ 2

Application Process for Internationally Sponsored Doctors Internationally sponsored applications for training are submitted to PGME Office via the Sponsored Trainee Application Registry (STAR) by the sponsoring agencies Contracts between Faculty of Medicine and international sponsoring agencies Eligibility requirements (e.g. MCCEE) Competitive process Departmental PEAP programs must be and 4 to12 their weeks respective in duration Program Directors make admissions decisions Those accepted for training require a work permit 4/ 2

Work Permit Process Program sends training appointment and supporting documents to PGME PGME requests Letter of Eligibility (LOE) from CPSO PGME Office sends CIC Offer of Employment form, CIC receipt, and LOE to appointee Appointee applies for work permit from Citizenship and Immigration Canada (CIC) Appointee presents CIC s approval letter at Canadian port of entry and receives work permit Appointees must satisfy all requirements of the CIC Visa Office, including the CIC medical examination that can take more than 6 weeks for CIC to review and approve PEAP must be 4 to12 weeks in duration Process can take 6 months to complete, from departmental letter of appointment to arrival of visa trainee in Canada / 2

Required Documents: A Checklist Departmental letter or signed form confirming the residency or fellowship appointment (with remuneration information) Up-to-date curriculum vitae Passport identity page Medical degree Specialty certification (clinical fellows only) Statement of educational objectives (clinical fellows only) MCCEE results (residents only) UofT Visa Processing Fee 6/ 2

Contacting the New Appointee We contact the new appointee immediately to confirm we have received the required documents and to share information PGME registration requirements, including: Work permit College of Physicians and Surgeons of Ontario (CPSO) registration (including physiciansapply.ca requirement) Canadian Medical Protective Association (CMPA) membership UofT Letter of Appointment Immunization data 7/ 2

Processing the Work Permit Paperwork We request a Letter of Eligibility (LOE) from the CPSO Once we receive the LOE, we issue it to the doctor with a CIC Confirmation of Employment form and a CIC receipt for our payment of the Employer Compliance Fee The doctor can then apply online for the Work Permit 8/ 2

Additional Advice for the New Appointee We also inform new appointees about what they should do before and immediately after their arrival in Toronto, including: Health care coverage (UHIP and OHIP) Social Insurance Number (SIN) Finalizing Canadian Medical Protective Association (CMPA) membership Criminal record check using the Canadian Police Information Centre (CPIC) database for the CPSO On-line Security Attestation (via POWER) A reminder about source verification of their medical degree by physiciansapply.ca 9/ 2

Arriving in Toronto 10/ 2

Work Permit Issued to the visa trainee at the Canadian port of entry Visa trainee must present the original to PGME for review PGME may sign off on a copy of the work permit for the CPSO if there are inaccurate entries in employer, employment location, and occupation fields that CIC will not revise Work permit conditions are not subject to sign off but require CIC change 11/ 2

An Open Work Permit An open work permit is a work permit that is not job-specific An open work permit is not acceptable for employment in a clinical setting unless there is evidence that the applicant has undergone a CIC-approved medical examination 12/ 2

Potential Sources of Delay Department-related delay in starting the process: Appointment package is submitted to PGME incomplete and/or with insufficient lead time CPSO-related delay in issuing LOE for the work permit: Unexplained gaps in the applicant s c.v. Evidence of specialty certification is absent or unacceptable to the CPSO (clinical fellows only) CIC-related delay in issuing work permit approval: CIC regulation changes, labour relations issues, local political unrest Transactions between the applicant and CIC after the doctor has received documentation from PGME 13/ 2

Source Verification of the Medical Degree Source verification of the medical degree by physiciansapply.ca is mandatory for all international medical graduates, for CPSO registration Once the medical degree has been source verified, the MCC stores the result in the Physician Credentials Repository, where it will always be valid and available International medical graduates can request source verification of their medical degree at any time, so it s never too early 14/ 2

Orientation Resources for New Trainees Orientation handbook hard copy or can be downloaded from PGME Office website: www.pgme.utoronto.ca Facebook Forum - for the exclusive use of clinical fellows, now with 1,000 fellows participating You can find it on Facebook by searching: University of Toronto PGME Fellowship Forum 1/ 2

PGME Registration Register on POWER: PGME Letter of Appointment (LOA) Work permit CPSO Certificate of Registration CMPA membership Health care coverage (UHIP / OHIP) Immunization data Security Attestation / Vulnerable Sector Screen Hospital Health and Safety Policy e-learning Modules Registration Fee (pro-rated) Confirmation of Registration UTorID and Library Card 16/ 2

Pre-Entry Assessment Program (PEAP) PEAP is mandatory for international medical graduates entering clinical fellowship or residency training Must be 4 to 12 weeks in duration, but it can be extended to a total of 16 weeks in special circumstances (e.g. illness or a leave of absence) Is an assessment, not a period of remedial training Must end with the submission to the CPSO of a completed Final Assessment Form or notice of the trainee s withdrawal from the PEAP Should include a detailed interim PEAP assessment after the first 2 weeks for internal departmental reference 17/ 2

PEAP Process CPSO issues PEAP certificate to trainee Trainee registers with PGME Office and begins PEAP Department assesses trainee, completes PEAP final assessment form and sends to PGME Office Vice Dean, PGME, signs final assessment form and PGME Office submits form to CPSO CPSO receives signed final assessment form and processes full educational licensure of trainee PEAP must be 4 to12 weeks in duration 18/ 2

International Electives Foreign nationals with an elective appointment at UofT require a work permit for the duration of the elective If the elective trainee s home residency program is outside Canada and the U.S.: CPSO Registration Committee approval is required Elective must include a 2-week PEAP Maximum duration is 6 months (including the PEAP) Must have funding commensurate with a Canadian Same registration requirements as all PGME trainees 19/ 2

Reappointments: A Checklist Departmental Letter of Appointment Visa Processing Fee (UofT Administrative Fee) Statement of Objectives Fellowship name on Statement of Objectives determines how it will appear on Completion of Training Certificate 20/ 2

CPSO Registration Committee Clinical fellows reappointed beyond 36 months: The CPSO allows 36 months of fellowship training The CPSO begins counting the 36 months immediately after the PEAP has been completed Additional documentation required: Support letter from the supervisor and Program Director Letter from the clinical fellow explaining why the extension is necessary Registration Committee at the CPSO 21/ 2

Extending the Work Permit CIC Case Processing Centre in Vegreville, Alberta Current processing times: - 100 days for paper application - 68 days for online application Implied status a last resort measure that may be possible with CIC and CPSO cooperation Always note the work permit s expiry date 22/ 2

What can t we do? PGME cannot submit an application to the CPSO, CIC, or CMPA on the trainee s behalf PGME cannot conduct business (or intervene) on behalf of a trainee throughout the process of their applying for a work permit Bill C-3 came into force in 2011. The Act prohibits employees at educational institutions from: Providing advice with regard to immigration applications Explaining or advising on immigration options Communicate with CIC on behalf of an applicant 23/ 2

Completion of Training Certificate With departmental approval, the PGME Office produces the certificate for clinical fellows who have successfully completed the goals and objectives of their fellowship and for residents who have completed their residency training program Name of the fellowship on educational goals submitted to CPSO determines name on certificate For further information, check Current Trainees section of PGME Office website 24/ 2

Questions about International Trainees? You have only to ask Samantha Chin Hira Mirza Nicole Parchment Jessica Filion John Kerr Adult Critical Care, Paediatric Critical Care, Medical Genetics, Medicine, Obs & Gyn, Palliative Care, Radiation Oncology samantha.chin@utoronto.ca / 416-946-0904 Anaesthesia, Paediatrics, Psychiatry, Public Health & Preventive Medicine hira.mirza@utoronto.ca / 416-946-3073 Medical Imaging, Family Medicine, Lab Medicine, Ophthalmology, Otolaryngology, Surgery nicole.parchment@utoronto.ca / 416-946-3079 Internationally sponsored trainees jessica.filion@utoronto.ca / 416-946-8221 Almost anything about international trainees john.kerr@utoronto.ca / 416-978-8420 2/ 2