The case for a pan-Canadian licensure model

All signs point to a repeat of last summer’s crises in emergency departments (EDs), when rolling closures, chronic staffing shortages and increasing wait times disrupted patient care across Canada.

Health-care workers continue to sound the alarm about the patient and provider impacts of a crisis that doesn’t show any signs of easing. Front-line workers – who have had a hard year holding our health systems together – are now bracing for worse in the months ahead. There are many changes needed in parallel to stabilize the crises happening in EDs, but one key change gaining traction is Pan-Canadian licensure.

The Canadian Medical Association (CMA) continues to advocate for greater physician mobility to alleviate seasonal pressures as well as dire staff shortages in the longer term – particularly in rural and remote regions.

We are joined by an ever-expanding list of other organizations, including the Canadian Association of Emergency Physicians, the Society of Rural Physicians of Canada and the Federation of Canadian Municipalities.

Some provincial governments are removing barriers to practice. The just-launched Atlantic Register is a collaboration between the four Atlantic provinces allowing physicians to practise without restrictions anywhere in the region. Ontario intends to recognize the credentials of a wide range of health professionals licensed elsewhere in Canada, though implementation must be carefully observed to ensure it has the desired impact.

While these are helpful first steps, the CMA is urging governments to implement a truly pan-Canadian licensure model within three years to ensure physicians and other key health professionals can work wherever they’re needed most.

Pan-Canadian licensure would enable physicians to practise or train anywhere in Canada without going through a complex, costly process to acquire more than one licence – a barrier for more than 77 per cent of respondents to a January 2023 CMA member poll in.

The same poll showed overwhelming support (95 per cent of physicians and medical learners) for pan-Canadian licensure and agreement that it would improve access to both primary care and inter-provincial/territorial virtual care.

Far too many Canadians struggle to access care in a timely fashion.

Far too many Canadians struggle to access care in a timely fashion. Statistics Canada reported in 2021 that 4.7 million Canadians lack a family doctor, while other estimates have put that figure as high as six million.

As one patient told the CMA: “As a P.E.I. resident, critical and specialty cardiac care requires physically going to Halifax or Saint John – six hours round-trip for either location. This means time off work and out-of-pocket transportation, hotel, child care and family visitation expenses. My hope for the future would be a scenario where specialists would have the option of serving patients in other provinces through virtual care.”

These challenges are exacerbated in rural and remote communities: Only eight per cent of medical professionals support 18 per cent of the population.

Health-worker mobility would also improve provider wellbeing, enabling peer support across jurisdictions. The CMA’s poll showed that physicians would be more likely to seek out locum opportunities, provide coverage to rural and remote communities and practise part-time into retirement under a pan-Canadian model.

Other countries have shown national licensure makes common sense.

In 2010, Australia adopted all-jurisdiction licensure for a broad range of health-care practitioners. Each profession has a national board that regulates and registers practitioners, and develops standards, codes and guidelines.

This approach ensures standardized, high-level medical competence and quality of care while making it easier for health professionals to work across different states – in person and virtually.

Since implementing all-jurisdiction licensure, Australia has seen improvements in workforce mobility and patient safety. Its system has also resulted in better data for workforce planning.

Canada’s workforce remains in crisis. With hospital overcrowding and staff shortages putting EDs at risk, pan-Canadian licensure is a crucial part of any plan to help ease the pressure.

Efforts to bridge gaps in staffing and resources aren’t enough to address critical system-wide shortfalls. Instead, health-care workers and patients deserve coordinated, comprehensive and long-term action.

The comments section is closed.

  • Dr. John Wan says:

    Pan-Canadian licensure model should be implemented as soon as possible before next natural disaster, that BC is expecting, a BIG earthquake that can happen in any moment; it would likely result in many many casualties. Overnight surge in demands for all sort of medical professionals can not be met unless manpower can be mobilized instantly and that requires fully mobile workforce.

  • Rita says:

    I’m certainly for this

  • James Murtagh says:

    Pan-Canadian licensure would constitute a long overdue advance. As much as health professionals like to critique government, the current fragmented system is in place because health professions (and their Colleges) are heavily invested in the status quo. Taking medicine as an example, the profession should have been advocating for radical change a decade ago. But, overhauling licensure will not be enough. When I began working in healthcare 30+ years ago it was a given that a physician trained in Ireland, England, Australia, South Africa was sufficiently trained to practice medicine in Canada. The medical profession in Canada led the charge in changing the training requirements for Canadian MDs and now these foreign trained docs no longer make the grade. Really!

  • Sevket Tunc says:

    Everybody knows that there is a big shortage of doctors in Canada. This shortage is not only for family physicians but also for specialists. Please don’t ignore this fact.
    As an IMG specialist I will ask you to give some oppotunities for IMG specialists as well.
    Royal College is accepting foreign specialists for equivalence exams only from certain jurisdictions. Please stop this discrimination.

  • JOHN WAN says:

    We all know a big Canadian west coast earthquake is overdued. It can strike at any moment. It would be a disaster when doctors, nurses and other medical professionals are not able to come to the aid of people in BC at the break of the news. No government Emergency Acts are going to be quick enough to see mobilization of health care professionals because there are layers of barriers needed to be peeled one by one. To be fully prepared is to have National Licence in place asap.


Alika Lafontaine


Dr. Alika Lafontaine is the president of the Canadian Medical Association and an anesthesiologist in Grande Prairie, Alta.

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