Canada has published a route map for internationally trained physicians, and IRCC has been drawing attention to it again this week. It sets out five ways a doctor can reach permanent residence, and three things that changed in 2026: a new Express Entry category for physicians, 5,000 federal immigration spaces reserved for provinces to nominate doctors, and a work permit processed in 14 days once a province nominates you.
The pages themselves are not new — the main one is dated 14 January 2026. What is worth your time is the part IRCC states plainly and most coverage skips: everything above sits on the permanent residence side, and the step that actually holds most doctors up has not moved at all.
What IRCC is offering
Three items carry a “New” badge on the government’s page:
- An Express Entry category for physicians. It is for doctors with at least one year of full-time work experience as a physician in Canada, gained in the last three years.
- 5,000 federal immigration spaces reserved through the Provincial Nominee Program, for provinces and territories to nominate physicians who hold a job offer or a letter of support.
- A work permit processed in 14 days for physicians already nominated by a province or territory, so they can start work while their permanent residence application is processed.
Family members can be included: a spouse or common-law partner, a dependent child, and a dependent grandchild.
The five routes to permanent residence for physicians
IRCC lists five programmes for a physician who has not yet worked as a doctor in Canada. The conditions below are the government’s own.
| Route | What it asks of you |
|---|---|
| Provincial Nominee Program | A job offer or letter of support to work as a physician in a province or territory. Up to 5,000 federal spaces are reserved for these nominations. |
| Express Entry | Eligibility for one of the three programmes managed through Express Entry, experience working as a physician, and no job offer in Canada yet. |
| Atlantic Immigration Program | Work experience or post-secondary education in Atlantic Canada, a job offer from a designated employer, and an interest in living there. |
| Rural Community Immigration Pilot | At least one year of experience as a physician in the last three years, or graduation from an eligible post-secondary school; a job offer from a designated employer; and an interest in living in a smaller, rural community. |
| Francophone Community Immigration Pilot | At least one year of experience as a physician in the last three years, or graduation from an eligible post-secondary school; a job offer from a designated employer; the ability to communicate in French; and an interest in living in a Francophone community outside Quebec. |
Four of the five want a job offer or a letter of support from an employer or a province. Express Entry is the one that does not, and IRCC lists it for physicians who have not worked in Canada. What Express Entry does not hand you is the new physicians category inside it, because of these five routes that is the only one asking for Canadian experience.
Two gaps in the map are worth knowing. Nunavut has no Provincial Nominee Program, and neither does Quebec, which runs its own immigration programmes separately.
The step that comes before all five
Before any of these routes leads to work as a doctor, IRCC says you must do two things:
- have your foreign credentials assessed, and
- get licensed as a physician through the regulatory authority of the province or territory where you intend to practise.
IRCC’s own wording on this is worth quoting: “It can take time to complete both these steps.” That is all the government says about duration, and the honest answer is that it varies by province and by candidate. Licensing is decided by the provincial or territorial regulator, not by IRCC, and each province sets its own route. For the licensing side IRCC points readers to the Medical Council of Canada’s routes for international medical graduates. One of those routes, Nova Scotia’s Defined Licence, is covered separately, as are the language requirements for physicians — where the licensing test and the immigration test are not the same test.
Why the new Express Entry category may not be your route
This is the part to read twice. The new category asks for at least one year of full-time work as a physician in Canada, within the last three years. You cannot work as a physician in Canada without a licence. So the category that made the headlines is closed to a doctor who is still in Iran, still waiting on credential assessment, or still working through a provincial licensing route.
That is not a criticism of the category. It does what it says: it moves doctors who are already practising here from temporary status to permanent residence. But if you are reading this from outside Canada, it is not your starting point. Your starting point is licensing, and then one of the five routes above — the four that run on a job offer or a letter of support, or Express Entry itself, which IRCC lists for physicians with no Canadian experience and which asks for no job offer. You can read how the system works on our Express Entry guide.
What the draws have looked like
The physicians category is not theoretical — it has already issued invitations. The most recent round, draw 440 on 3 September 2026, invited 229 candidates at a Comprehensive Ranking System cut-off of 198. In June, draw 421 invited 271 at a cut-off of 223. Draw 440 was the third physicians round of 2026; the first ran on 19 February.
A cut-off of 198 is strikingly low next to a general round, and it is easy to misread. It is low because the pool for this category is small: IRCC first sets aside only the candidates who meet the category’s criteria, then ranks that much smaller group. That is why a category cut-off and a general-round cut-off are not comparable numbers. You can follow each round as it happens on our Express Entry draw tracker.
What this does not change
- It does not license you. Credential assessment and licensing are decided by the provincial or territorial regulator, and none of these immigration routes substitutes for them.
- It does not create a job offer. Four of the five routes need one, or a letter of support, and that is between you and an employer or a province.
- The 5,000 spaces are not applications you file. They are federal spaces reserved for provinces and territories to nominate physicians into. You still need a province to nominate you.
- The 14 days is the work permit, not the permanent residence. It applies after a province or territory has nominated you, and it covers the permit that lets you work while your permanent residence application is processed.
- The decision is not ours or yours. Permanent residence is decided by IRCC; your licence is decided by the regulatory authority of the province or territory where you want to practise.
Frequently asked questions
I am a physician in Iran. Which route should I look at first?
Not Express Entry’s physicians category — that category requires Canadian work experience as a physician, which you cannot have yet. The Express Entry programmes themselves are still open to you: IRCC lists Express Entry as one of the five routes for doctors with no Canadian experience. Look first at credential assessment and a provincial licensing route, and in parallel at the four routes built on a job offer or letter of support: the Provincial Nominee Program, and the Atlantic, Rural and Francophone programmes.
Do I need a licence before I can apply for permanent residence?
Not as a stated eligibility requirement: none of the five programmes lists a Canadian licence as a condition of applying, and IRCC decides permanent residence. But four of the five run on a job offer or a letter of support, and an employer or a province will be looking at whether you can actually be licensed to practise. IRCC puts credential assessment and licensing first on all three of its pages for a reason.
What exactly are the 5,000 spaces?
They are federal immigration spaces reserved so that provinces and territories can nominate physicians who have a job offer or a letter of support. They are capacity for provincial nominations, not a separate application you submit.
Who gets the work permit processed in 14 days?
Physicians who have already been nominated by a province or territory. It lets you start working while IRCC processes your permanent residence application. The 14 days is how long the permit takes to process, not how long it lasts. It is the only processing time IRCC states on these pages, and it applies to the work permit only.
Can my family come with me?
Your application can include a spouse or common-law partner, a dependent child, and a dependent grandchild — that is, the dependent child of your dependent child.
Is this a new announcement?
The route map is being promoted now, but it is not new this week. IRCC’s main physicians page is dated 14 January 2026, the page for doctors with Canadian experience 9 January 2026, and the page for those without 23 December 2025. The three items badged “New” are new for 2026.
In short
Canada has made the permanent residence side easier for physicians, and it has said so clearly: a category of its own in Express Entry, reserved provincial nomination spaces, and a fast work permit once a province nominates you. None of that touches credential assessment or licensing, which is where most internationally trained doctors actually spend their time. Read the five routes as what comes after the licence, not instead of it — and note that the new physicians category inside Express Entry only helps once you are already licensed and working here, while Express Entry itself is one of the five routes IRCC lists for doctors with no Canadian experience.
Sources
- Live and work as a medical doctor in Canada, Government of Canada — page date 14 January 2026. Statistics quoted there are attributed to the Canadian Institute for Health Information (31% of family physicians internationally trained in 2024) and Statistics Canada’s 2021 Census (1 in 4 health care workers are immigrants). The same page states that more than 11,000 health care workers arrived in 2024 through economic immigration programmes.
- Medical doctors with experience in Canada — page date 9 January 2026.
- Medical doctors who haven’t worked in Canada — page date 23 December 2025.
This article is general information, not legal advice, and it describes published official rules rather than any individual case. Hadi Imani is a Regulated Canadian Immigration Consultant, licence R522575, practising in Toronto; that licence covers Canadian immigration only.
