IMG Support and Resources
Welcome from Dr. Chiebere Onyebuchi Ogbuneke, PGME IMG Coordinator
The goal of developing this site is to give incoming International Medical Graduates (IMGs) a bird’s eye view of some of the resources available to them at NOSM University and in our northern communities.
Previous IMG residents have shared experiences that they had as new residents & what they wished was easily accessible/available in their first few weeks of residency.
We hope that this site will bridge some of the gaps that previous residents identified. “You do not wish to let the bridge fall, once you have crossed, you make it better so that the ones coming after you can benefit more”. With this philosophy, the older IMG residents provided information that assisted in compiling this information; and we hope, will help in no small way to make integration a little easier for new /incoming IMGs. This site briefly mentions and references other resources at NOSM University, which you will find useful.
We believe that this site would create an atmosphere that reduces cultural shock, anxiety, and the burden of wondering how to get around or obtain resources needed to settle down in your new community. While it is by no means an exhaustive orientation resource, it does provide information on available materials/ resources at NOSM University and within our distributed communities at large.
Finally, we hope that you will find these resources helpful in supporting your educational and personal goals.
Do enjoy your reading and share your experiences to make this better for your future colleagues coming after you. If you find resources helpful to you throughout your journey, please share them with us via firstname.lastname@example.org and will we work to share them with others.
IMG Coordinator’s Role
The IMG Coordinator is a confidential support for all internationally trained physicians and families throughout residency for both educational and personal support.
They are a liaison for IMG residents and families prior to arrival in northern communities as well as help in addressing concerns brought forward by IMG residents throughout residency.
The IMG Coordinator also collaborates with various programs to share resources and support for IMG residents and is available to provide support to programs in the selection process of IMGs as well as helping to identify the candidates who will enter the next steps of the PRP and Assessment Verification Period (AVP).
The IMG Coordinator will also collaborate with NOSM University faculty to promote and improve the educational experiences for IMGs.
Onboarding for New Residents
General resources that have been collected for all new NOSM U residents can be found on the Onboarding for New Residents site.
Assessment Verification Period (AVP) – Information and Process
The following is information and processes related to the Assessment Verification Period (AVP) as governed by the Council of Ontario Universities (COU) AVP Policy
- All IMGs must complete as per College of Physicians and Surgeons of Ontario (CPSO) requirements for licensing
- Twelve (12) weeks at beginning of residency with temporary license
- Assess clinical skills, technical skills, knowledge and judgement, communication, and professionalism
- Evaluations at two (2), eight (8) and ten (10) weeks with Preceptor
- Three (3) half-day observation sessions with supervisor who is not AVP preceptor
- Final Assessment with Program Director
- Option to appeal if unsuccessful. If the appeal is successful, repeat AVP.
To obtain an unrestricted Postgraduate Medical Education (PGME) certificate of registration (educational license) from the CPSO), IMGs entering from Canadian Resident Matching Service (CaRMS) or the Advanced Level Postgraduate Training Program, are required to undergo an AVP. Successful completion of the AVP is required before candidates can obtain an educational license from the CPSO prior to full acceptance into an Ontario residency.
The AVP is an assessment process that evaluates IMGs to determine if they can function at their reported level of training. It is twelve (12) weeks in duration.
Candidates will be evaluated in terms of their clinical skills in the program to which they are seeking entry, as well as their basic skills in Internal Medicine, Obstetrics and Gynaecology, Paediatrics, Psychiatry and General Surgery, appropriate for practice in the chosen discipline.
The AVP assesses candidates in a supervised clinical, multidisciplinary environment where there is patient input on an ongoing basis. Assessment also ensures that candidates are: mentally competent to practice medicine; able to practice with decency, integrity and honesty and in accordance with the law; have sufficient knowledge, skill and judgment to engage in postgraduate medical training as authorized by the educational license; can communicate effectively and display an appropriate professional attitude.
After a training program accepts an IMG candidate, the PGME Office sends a Letter of Appointment to the CPSO. The CPSO will then send an application package to the candidate. When the application is complete the CPSO will issue a restricted educational license number to the candidate for the AVP.
The prospective IMG resident is to be assessed by the department at the end of the 2nd week and at the mid-point using the Detailed Assessment Form. At the end of the prescribed AVP period, the department/program will complete the AVP Final Assessment Form and forward it to the PGME Office for the Dean’s signature.
Once signed, the PGME Office will submit the AVP Final Assessment Form to the CPSO (with a copy to Touchstone Institute), which will convert the AVP registration to an unrestricted postgraduate certificate, if successful. Registration may then be completed at the PGME Office.
The AVP assessment must take place within appropriate, supervised clinical activity in a multidisciplinary environment with patient input on an ongoing basis.
AVP candidates may sign their own orders; however, the clinical supervisor may choose to have orders co-signed initially, or for the duration of the assessment period. The certificate granted for the AVP states that the candidate may practice medicine “under a level of supervision that is determined to be appropriate for the holder and the program of medical education and assessment, by a member of the College of Physicians and Surgeons of Ontario designated by the director of the program.” It is up to the supervising physician to determine whether or not the candidate may write orders. In addition, there may be hospital policies which require AVP candidates to have their orders co-signed throughout the AVP.
Program Directors must ensure that candidates are evaluated and given written feedback on a regular basis during the AVP. Evaluations and meetings should be well-documented and should take place at the end of the 2nd, 8th, and 10th week. If the candidate has been assigned to one or more rotations, the evaluation form completed by the supervisor should be forwarded to the Program Director for compilation in the final AVP evaluation form.
Application for a six (6)-week extension of the AVP can be made to CPSO if remediation is required (without Registration Committee referral) to allow for adequate assessment of the candidate, but not for remediation. A letter from the Program Director is required confirming the reasons for the extension and how the extension and how the weaknesses will be addressed. The PGME Dean must support the request to CPSO.
An additional six (6)-week period can be requested. This must be approved by the CPSO Registration Committee.
- AVP candidate continues in the postgraduate training program.
A candidate with an unsatisfactory assessment has his/her appointment with the University terminated. The PGME Office informs the CPSO and Touchstone Institute by forwarding copy of completed AVP form. An unsuccessful AVP result will be communicated to all Ontario medical schools.
An AVP candidate may choose to withdraw from the AVP at any time. Withdrawal may have an impact on the terms of the Ministry of Health and Long-Term Care’s (MOHLTC) Return of Service Agreement. Candidates should consult the MOHLTC regarding their RoS (return of service) obligations.
Candidates should refer to individual school and hospital policy regarding suspension or other potential outcomes.
Reapplication of Failed/Withdrawn Candidates:
As a failed AVP is not creditable residency training, a candidate who failed an AVP (PGY1 or PGY2 level) may apply to the first iteration of CaRMS.
Restriction on the re-application of failures:
- Cannot apply to the same specialty at the same level of entry. They may apply to a lower level of entry in the same specialty, if applicable (see (a) above).
- May apply to a different specialty.
Vacation Requests during the AVP:
The AVP is a high stakes assessment over a short timeframe. As such, candidates are not permitted to take vacation during the AVP, as it may put their assessment in jeopardy.
Return of Service:
Assessment Verification Period (AVP) – Policy, Forms and Flow
IMG Peer Mentorship Program
The transition from being a medical student to becoming a resident, with greater responsibility can be a very difficult and exciting endeavour/time for anyone. It is even most difficult for those who are getting into the role of a resident in a country and/or environment with a different health care system, available resources (only read about until now), hospital culture and new colleagues. This could be equated to the feeling a child has when they find themselves in a new school, in a new community/country with no friends; a situation which can be made worse if the class teacher is not empathic or inpatient with these unique set of learners.
Due to these challenges, NOSM University has a Peer Mentorship Program, where incoming IMG residents are matched with mentors based on a few criteria (when able to). It is believed that matching incoming residents with current residents or faculty members (former IMG residents), who share some level or commonality will help the incoming resident settle-in a lot quicker and feel comfortable /at home. The 2023-2024 IMG Peer Mentorship Program pairs have been assigned. If you have any questions about this program, please contact the PGME IMG Coordinator.
In addition, it could be suggested that distributive learning may limit contact for support with the immediate family and may not allow much opportunity to develop the needed social capital, within the home base for the new IMG residents. It becomes important to develop a social networking platform to share a unique experience on an informal and voluntary basis.
Income and Benefits During Residency
The Professional Association of Residents of Ontario (PARO) is the official representative voice for Ontario’s doctors in training. PARO’s priority is to advocate on behalf of its members, addressing professional and educational concerns in order to optimize the training and working experience of Ontario’s newest doctors thus ensuring that patients receive the best possible medical care.
As a resident in Ontario, you are entitled to a salary and benefits negotiated by PARO through the PARO-OTH Collective Agreement. This salary increases annually as the resident moves from one PG year to another. An up-to-date table of the income by year of residency can be obtained through the salary and benefits section of the PARO website.
Additionally, PARO has created A Resident Financial Primer which includes useful tools, links and basic information that will demystify the world of personal finance and help you understand your options for everything from filing taxes to paying down your debt. It’s not meant to replace professional advice; rather, consider it as a guide to the choices that await you.
Wellness: NOSM U and other support programs
NOSM University’s Learner Support Services Office operates in consultation with the academic program but is a confidential service for individual learners, at arm’s length from academics. Learner Support Services offers services and support which assist learners academically, personally, and financially. It also has a primary role in career development, learner wellness, and support for learner initiatives.
In support of learner wellness, the Virtual Health and Wellness Hub is a resource hub that caters to enhancing the physical, social, financial, and academic well-being of NOSM U learners. The Hub can be accessed remotely and has a wealth of resources, including virtual and physical aid.
As a part of Learner Support Services, the Learner Affairs Officers (LAOs) assist residents and support requests, including, but not limited to, wellness and accommodations. The LAOs are the primary contact for all program stakeholders, including residents, faculty, academic teaching centers, internal stakeholders, and community partners. In collaboration with the Assistant Dean, Resident Affairs, the LAOs provide intake services for residents in distress or seeking the services of the Wellness Program.
All NOSM University learners will have access to the Student Assistance Program (SAP) services through Homewood Health. Homewood Health is known for its personal touch and exceptional level of clinical service delivery. The SAP program from Homewood Health will include several new services and will provide access to a full range of health and wellness services. Visit www.Homeweb.ca
Immediate support 24/7/365-day at 1-800-663-1142 (EN) or 1-866-398-9505 (FR)
PARO 24-Hour Helpline
In a nutshell, The Professional Association of Residents of Ontario (PARO) is the official representative voice for Ontario’s resident doctors in training.
They advocate for professional and educational voice, to optimize training and work experience.
They deal with the following: Agreement grievances, dismissals, vacation and vacation related issues, STAT holidays.
The PARO 24-Hour Helpline is a confidential support service for residents, medical students, their partners, and families. They will assist you with issues such as: stress management, career crisis, intimidation, harassment, substance abuse, relationship counseling
The toll-free number is accessible anywhere in Ontario, 24 hours a day, 7 days a week.
PARO Help Line: 1-866-HELP-DOC (1-866-435-7362).
The OMA confidential services are available to all residents in Ontario. Clinical team members are available by phone during OMA business hours to answer questions and assist with a wide variety of concerns. The PHP can offer support in a number of ways including:
- Prompt advice and support (callers may remain anonymous)
- Referrals for clinical services, with clinicians experienced in physician health
- A range of assessment services
- Monitoring and advocacy for ongoing mental health and workplace concerns
The PHP also offers a wide variety of health and well-being resources
Professional Organizations for Ontario and Canadian Residents
The CMA unites physicians and medical learners to drive bold reform in health, the health system and the health workforce, focusing on areas where we can have the greatest impact.
The OMA advocates for the well-being of our members and the health of Ontarians.
The Professional Association of Residents of Ontario (PARO) is the official representative voice for Ontario’s doctors in training and a Go-To resource for everything you need to navigate your way into, through and out of your residency training in Ontario. As a resident training in Ontario, you are automatically a member of PARO.
BPAO organization was created to focus on medicine and continue advocacy for improving the health of people in Black communities in Ontario.
CANPAD recognizes and represents the professional and social interests of physicians and dentists of Nigerian descent living in Canada and aims to contribute meaningfully to further advancement of the health sector in Canada and Nigeria through its educational and charitable programs as well as through social programs embracing development, science, arts and culture.
Family and Community Resources
There are many different housing/Accommodations available at the home base of a resident. In the absence of friends/family, contacting a real estate agent in the city prior to arrival will go a long way in helping one settle. Knowing what you want in terms of the number of rooms and proximity to the hospital, schools, and shopping is always helpful.
Service Ontario: Driver’s License, Health Cards, Registering Births and More
Finding a Family Physician or Dental Practice
Finding a Family Physician
Ensuring that your family gets the care they need as soon as possible is a simple, basic but at times difficult thing especially when one finds him/herself in a new country/community.
While there are efforts by the government to address this through HealthCare Connect, the wait time can be unpredictable.
Here at NOSM University, one of our strengths is in the relationship that exists with our learners who go on to practice within the community. These physicians have come together to answer NOSM University’s call of developing a directory of Family Physicians that are accepting patients in the community.
You can obtain an updated list of Family Physicians Accepting new patients by
- Sending an email to: email@example.com
- Locate this list by logging into your “MyNOSM” account and navigating to MyCurriculum
- Requesting this list through the NOSM U Well App feature
If you are having difficulty obtaining entry to a practice, contact your preceptor.
Finding a Dental Practice
Banking and Accounting Services
Prior to coming to Northern Ontario, most residents would already have a bank account and may not need to open a new one. For those who desire to open a new bank account, the following banks operate in Northern Ontario: BMO, CIBC, RBC, Scotia Bank, TD Canada Trust, Desjardins or Credit Union. Banking cards allow for Interac service if rotation is in rural or remote community.
Some additional resources:
Accounting services are a useful thing to have. Previous residents have used an accountant and accounting services within the community, you can speak to your friends, family or colleagues within the community about this.
In addition, some accountants in the city may offer free accounting services to residents during their residency years and only start to charge accounting fees after residency. Please check with services in your area via the 211 website.
There are licensed and unlicensed daycares. We recommend that residents wishing to enroll their children in daycare should consider doing so with a licensed daycare. These licensed daycares must meet provincial standards as set out by Day Nurseries Act. For more information about the delivery of early year’s childcare, please visit the website for the Ministry of Education.
For First Nation Day Care contact local band office administration.
It could be suggested that you consider the following, when choosing a facility of your child:
- How many hours
- Do you have more than one child attending
- Ages of children in day care
- Cost, etc.
As a parent of a child under the age of 12 years, you may be entitled to some subsidy or tax breaks based on line 236 of CRA personal returns. Speak to your accountant for more details.
Elementary and Secondary Schools
Elementary School grades: JK to 6 or 8
Secondary School grades: 7 or 9-12
For information about the delivery of publicly funded education, please visit the website of the Ministry of Education
*** EQAO Testing (Educational Quality and Accountability Office) All public-school children tested in Ontario in literacy and math grades 3, 6 and 9
Places of Worship
Many communities in the north have multicultural societies that help to provide support and connections to the community for newcomers from a variety of backgrounds. Reaching out to the multicultural society is a very quick way of finding people from your country, culture, ethnicity, who have made the north their home.
Sault Ste. Marie
- Sudbury Mulitcultural Society and Folks Arts Association
- YMCA Northeastern Ontario- services for newcomers
Missing your community? Check out the 211 websites and explore your area for more information
Do you have suggestions for additional resources for this site? We would love to hear from you.
Please reach out to firstname.lastname@example.org with your feedback and suggestions.