Statement of Need Program for Medical Graduates Pursuing Postgraduate Medical Training in the US: 2018 and 2019

Important Notice:

Applicants should review these instructions before they apply for postgraduate training in the United States (US) for which they need to request a Statement of Need.

All J-1 physicians sponsored by Educational Commission for Foreign Medical Graduates (ECFMG) for clinical training are subject to the two-year home country return requirement under the United States’ Immigration and Nationality Act.

Those wishing to pursue a career as a physician in Canada must take into account the realities of Canada’s current physician workforce needs and will need to be flexible with regard to their choice of specialty and the type and location of their future practice. It is important to note that those who complete residency training outside of Canada have no guarantee of securing employment in their desired specialty or practice location upon return.

When foreign national medical graduates wish to pursue postgraduate medical training in the US, they must obtain an appropriate visa that permits entry to the US to undertake clinical training activities. The designated visa for foreign national medical graduates is the J-1 Visa, a temporary non-immigrant visa, reserved for participants in the Exchange Visitor Sponsorship Program (EVSP), issued by the Educational Commission for Foreign Medical Graduates (ECFMG).

A Statement of Need is one of a number of requirements of the EVSP that must be met before a J-1 Visa can be issued to a medical graduate by the ECFMG.

Statements of Need are issued by Health Canada, in collaboration with provincial and territorial ministries of health, to medical graduates as a requirement to obtain a J-1 Visa to enter the US to pursue postgraduate medical training.

Below you will find a description of the program as well as instructions on how to apply for a Statement of Need from Health Canada.

J-1 Visa requirements

All foreign national medical graduates must apply to the Educational Commission for Foreign Medical Graduates (ECFMG) to obtain the J-1 Visa, as part of the Exchange Visitor Sponsorship Program. Before ECFMG will issue a  J-1 Visa, foreign national medical graduates must, among other requirements, obtain a Statement of Need from their home country.

Statements of Need in Canada

Health Canada issues Statements of Need, on behalf of Canadian provincial and territorial ministries and departments of health, to medical graduates as part of the requirement to obtain a J-1 Visa to enter the US for the purpose of participation in postgraduate medical training.

A Statement of Need is a letter issued by Health Canada to medical graduates as a requirement in order to obtain a J-1 Visa to enter the US to pursue postgraduate medical training. Statements of Need confirm that certain qualified medical practitioners are needed in Canada and that the medical graduates who are pursuing postgraduate medical education in the US sincerely intend to return to Canada and practice medicine in the field of medicine in which they will receive the training. Applicants are expected to pursue training that is needed in Canada (see the List of Needed Specialties). Applicants are expected to pursue medical training that is recognized by the Royal College of Physicians and Surgeons of Canada, or the College of Family Physicians of Canada, and Canadian medical regulatory authorities, and that will lead to specialty certification and medical licensure in a province or territory.

Eligibility for a Statement of Need

Applicants must be either a Canadian citizen or a permanent resident of Canada possessing a valid Permanent Resident Card.

List of Needed Specialties

The Pan-Canadian List of Needed Specialties is a list of eligible fields of practice for which physicians seeking post-graduate medical training in the United States may obtain a Statement of Need. This list is intended for Category B applicants wishing to pursue specialty training.

Each provincial and territorial government has their own methodology for determining their physician workforce needs and then works with Health Canada to define an overall pan-Canadian list.  This allows for evolving pan-Canadian physician workforce planning to be reflected in the Statement of Need Program.

Once the limits have been reached for a particular specialty, no further Statements of Need will be issued that year for that field of training, as the pan-Canadian need has been met.

Please note that specialty training that does not appear on this List will NOT be supported.

Application requirements for a Statement of Need

To apply for a Statement of Need, applicants must complete an application form and provide a number of documents to Health Canada. There is no fee for applying for a Statement of Need. The specific requirements for the issuing of a Statement of Need depend on the profile of the applicant and the type of medical training being sought in the US. The requirements for obtaining a Statement of Need from Health Canada are subject to change as they are reviewed annually by provincial and territorial ministries and departments of health.

Consult the descriptions below and select the category that best describes you. The specific page for each category describes the documents and conditions required to apply for a Statement of Need.

NEW: Please see additional information and descriptions of applicant categories for upcoming changes to the Statement of Need program.

Click the terms below for more information on that category.

Category A

Medical graduate currently enrolled in a Canadian specialty or subspecialty residency training program who wishes to pursue a fellowship.

Category B

Final year medical student currently enrolled in any medical school, or a medical graduate of any medical school, who has not yet completed a medical specialty training program in Canada or the US who wishes to pursue medical specialty training, or a licenced physician who wishes to pursue a new field of practice.

Category C

Physician specialist licenced in Canada who wishes to pursue postgraduate training in a fellowship in the same field of practice.

Address to send your application

Please submit all required documents by email to the Program Administrator, Health Canada. Only complete packages can be considered for a Statement of Need. It is your responsibility to ensure all required documents are submitted.  .

Please submit your application by email:

NOTE: When applying for a Statement of Need for specialty training on the List of Needed Specialties, applicants must submit all required documents in one email (if you have a preliminary year and categorical position, documents need to be submitted in the same email to secure a Statement of Need).

When to submit an application

Category A and Category C- post-residency fellowship

Applications for a Statement of Need in support of post-residency fellowships can be submitted up to one year prior to the starting date of the fellowship.

Category B - specialty; family medicine

Applications for a Statement of Need in support of specialty or family medicine training programs can be submitted after the results of the National Residency Matching Program (NRMP) are released on March 16, 2018 at 1 p.m. EST; the date for March 2019 has yet to be determined.  Please see the NRMP webpage for more details on matching.

Please check regularly for the exact application submission date in March, as Statements of Need for Category B applicants are issued on a first-come, first-served basis.

Category B - subspecialty

For those applicants who started their training in 2015 or earlier, applications for a new Statement of Need in support of subspecialty training programs can be submitted after the sub-specialty match results and up to one year prior to the starting date of the program.

Category B - family medicine fellowship; chief resident; one-year ACGME-accredited program.

Applications for a Statement of Need in support of the above-mentioned training programs can be submitted upon receipt of a letter of offer or training contract and up to one year prior to the starting date of the program.

How are applications process and timing

Please allow 30 working days for processing. Applications are processed on a first-come, first-served basis from the time the application is received by email.

When limits are applicable, all required documents must be submitted for your application to be included within the Statement of Need limits for that year.

If your email contains more than 20 megabytes, please send a zip version. You will be notified by email:

  • once your application is received
  •  if you are under or over the limits (if limits are applicable) within 7 business days from the date of receipt.
  •  if there are errors or deficiencies in your application that must be corrected.
  • when the Statement of Need has been issued and sent to the Educational Commission for Foreign Medical Graduates.

The Statement of Need is delivered directly to the Exchange Visitor Sponsorship Program in Philadelphia by courier. A copy will be sent, for your records, via regular mail, to your mailing address provided in the application form.

Tips for completing application

Submissions must be made by email. Attach all required documents in an email and send to j1visa@hc-sc.gc.ca. If your email contains more than 20 megabytes, please send a zip version.

Notarize documents

Please contact one of the following professionals to notarize / certify your documents:

  • Notary Public
  • Lawyer, Attorney-at-Law
  • Commissioner of Oaths
  • Designated official at a Canadian Embassy or Consulate or a designated official at an American, Australian or British Embassy or Consulate or High Commission
  • Medical Doctor or Dentist currently licenced in Canada
  • Police officer in Canada: municipal, provincial, or federal (RCMP)
  • Justice of the Peace, Judge, Magistrate or Mayor, in Canada
  • Professional accountant who is a member of the Association of Practicing Accountants (APA) (United Kingdom); or one of the following professionals: Chartered Accountant (CA), Certified General Accountant (CGA), Certified Management Accountant (CMA), Public Accountant (PA), Registered Public Accountant (RPA)
  • Member of Parliament (MP); Member of Provincial Parliament (MPP)(Ontario); Member of National Assembly (MNA)(Quebec); Member of House of Assembly (MHA) (Newfoundland and Labrador); Member of the Legislative Assembly (MLA)(all other provinces and territories)
  • Funeral director in Canada
  • Pharmacist in Canada
  • Veterinarian in Canada
  • Professional Engineer in Canada
  • Municipal Clerk at a City Hall in Canada
  • Minister of religion in Canada
  • Social Worker: Bachelor of Social Work (BSW), Master of Social Work (MSW), Doctorate of Social Work (DSW) in Canada

This person cannot be a family member. Most professionals will prepare the document according to their professional practice. Otherwise, this person must see the original document, make a photocopy of the original document, compare the original document to the photocopy, and print the following on the photocopy: "I certify this to be a true copy of the original document".

This person must also write on the photocopy:

  • the name of the original document,
  • the date of certification, his or her name, and
  • his or her official position or title.

Please note: This person must also sign the photocopy. Applicants should not sign anywhere on the photocopy of the document.

Once notarized, create a copy that is clear and legible, and include these documents in your email submission. Documents that are unclear or illegible may cause delays in processing of application as information needs to be verified.

Fee for obtaining a Statement of Need

There is no fee.

Procedure to complete the application form

Print the PDF form located on the Health Canada website. Fill in the information required ensuring you write your ECFMG or United States Medical Licensing Examination (USMLE) number in the boxes provided. Affix hand written signatures. Read and initial each section under Part E of the Application Form.

Witness to my signature on application form

Any adult can sign as your witness.

Consent Form for the Purpose of Recruitment

Print the PDF form located on the Health Canada website. Read both pages of the form first, then initial page one and sign page two with a witness.

Part D of application “proposed training in the US"

Provide the standard wording accepted by the Exchange Visitor Sponsorship Program (EVSP). The EVSP/Educational Commission for Foreign Medical Graduates (ECFMG) requires the exact name of the training program be written on your Statement of Need. For specialties, write down the field of medicine: Internal Medicine, Family Medicine, Anesthesiology, etc. For post residency fellowships, write down the specialty as well as the title of the fellowship: Anesthesiology - Pain Medicine. For non-standard fellowships, the accepted wording is usually on your letter of offer or contract; however, you should consult your ECFMG Training Program Liaison to verify you write down the accepted title of the training program.

Obtaining an ECFMG number

If you have a United States Medical Licensing Examination (USMLE) number, the Exchange Visitor Sponsorship Program (EVSP)/ Educational Commission for Foreign Medical Graduates (ECFMG) will use that as your numeric identifier. If you do not have a USMLE number, contact the EVSP at evsp-support@ecfmg.org to obtain your number.

Obtaining proof of Accreditation Council for Graduate Medical Education (ACGME)

Accepted documents are (a) a copy of your program information from the ACGME website, or, (b) a copy of the letter issued by the ACGME to the training program confirming its accreditation (including duration of training program, program title and location). Submit information about your specific program; do not send multi-program, multi-page reports. The proof is required because only ACGME accredited training is recognized by the Royal College of Physicians and Surgeons of Canada for eventual certification and licensure in Canada.

Receipt of application

You will be notified by email once we have received your application. Please do not re-submit your application unless advised by the program administrator.

You will be notified by email if there are errors or deficiencies that must be corrected. Please do not re-submit your application unless advised by the program administrator. Once the Statement of Need has been issued and sent to the Exchange Visitor Sponsorship Program / Educational Commission for Foreign Medical Graduates, you will be notified by email.

Health Canada sends Statements of Need directly to the Exchange Visitor Sponsorship Program / Educational Commission for Foreign Medical Graduates via courier. A copy of the Statement of Need will be mailed to you by regular mail to the mailing address provided in your application form. The copy is for your records only and should not be sent to the EVSP/ECFMG.

Timing of application submission

For Category A and C applicants, and Category B applicants applying for subsequent training, you can submit your application up to a maximum of one year in advance of training.

If you are a new Category B applicant applying for a Statement of Need for specialty or family medicine training programs, you can submit your application after the results of the National Residency Matching Program are released on March 16, 2018 at 1 p.m. EST.  Applications are processed on first-come, first-served basis from the time the application is received by email.

Duration of Statement of Need for residency training

Normally, the duration of a Statement of Need matches the duration of your residency. Check the duration on the Physician Information Page attached to your Statement of Need. However, if your original Statement of Need supports only a preliminary or transitional year, then the duration of the Statement of Need is one year and you must apply for another Statement of Need once you have a new training position.

Pursuing a one-year fellowship after my residency program

You must apply for another Statement of Need if you wish to pursue any additional training.

Chief resident

You should know that the position of chief resident is not accredited by the Accreditation Council for Graduate Medical Education and the Exchange Visitor Sponsorship Program treats chief resident positions as non-standard training. To apply for a Statement of Need for a chief resident position, you must prove the position is at least 60% clinical activity. As proof of clinical activity, please include a letter or email confirmation, of level of clinical activity from the program director.

Medical licence in the US and applying under Category C

Category C is only for doctors who possess a medical licence in Canada.

Contact the Educational Commission for Foreign Medical Graduates (ECFMG)

You must contact the Exchange Visitor Sponsorship Program (EVSP) of the ECFMG so you can apply for the J-1 Visa. The EVSP issues the J-1 Visa, not Health Canada. The Statement of Need issued by Health Canada is >only one document required by the EVSP to complete your J-1 Visa application.

Two-year home country presence requirement

This is a US requirement, not Health Canada. For complete information on this requirement, contact the Educational Commission for Foreign Medical Graduates’ Exchange Visitor Sponsorship Program, the US Department of State, or an American immigration attorney.

Change location or undertake additional training

Applicants who wish to change the location of the training program (same specialty), or undertake additional postgraduate medical training in the US must apply to Health Canada for a new Statement of Need.

To apply for a new Statement of Need, applicants must apply under the same category used in their initial application. You do not need to resubmit proof of Canadian citizenship. However, if you are a permanent resident of Canada, proof of a valid Permanent Resident Card is required for a subsequent Statement of Need. 

Re-applications for additional training are subject to the requirements in your category and the List of Needed Specialties, which are updated annually.

If the new specialty is on the current List of Needed Specialties, you must submit an application form along with a copy of your new letter of offer or contract and proof it is a program that is accredited by the Accreditation Council for Graduate Medical Education. Note, you are subject to the limits on the List of Needed Specialties.

Letter of Exceptional Need from Health Canada

Please contact your provincial or territorial Ministry of Health to discuss your request. Health Canada will issue a letter of exceptional need based on the recommendation of your province or territory.

Switching visas - eligible for a J-1 Visa

Health Canada cannot say if you are eligible to get a J-1 Visa; contact the United States’ Exchange Visitor Sponsorship Program for eligibility requirements. However, if you are a Canadian citizen or permanent resident of Canada, you are eligible to apply for a Statement of Need.

If you are applying for a J-1 Visa for specialty training in your PGY2 and already completed your preliminary year or PGY1 under a different visa and want to switch to a J-1 Visa, you are still subject to the limits on the List of Needed Specialties for the year you apply for the Statement of Need.

Appeal process for a Statement of Need

If the applicant disagrees with a decision made regarding their Statement of Need, they can request a review of their case by the Federal, Provincial, and Territorial Statement of Need Committee.  The Committee meets on a monthly basis. 

An applicant may appeal the decision if their case is viewed as having extenuating circumstances and they are able to provide supporting evidence.

Please note, an appeal will NOT be considered for the following:

  • If an application is over the limits as per the ‘List of Needed Specialties’ at the time of submission, or
  • If an application is for training not indicated on the List of Needed Specialties and/or Sub-specialties as listed on the Health Canada website; or
  • If the applicant began residency training in the US in 2016 or later and wishes to pursue multi-year fellowship/sub-specialty under Category B.

It is at the discretion of the applicant’s Provincial Statement of Need Committee member to recommend the applicant’s case being brought forward for consideration.

Health Canada will formulate a decision based on the recommendation from the Federal, Provincial, and Territorial Statement of Need Committee and communicate the decision to the applicant.

Information on medical licensure in a province or territory in Canada

Eligibility for licensure to practice medicine in Canada is determined by provincial and territorial medical regulatory authorities.

Information on medical licensure should be obtained from the medical regulatory authority in the province or territory where you wish to practice.

Information on postgraduate medical education standards in Canada and on specialty certification is available from the Royal College of Physicians and Surgeons of Canada and the College of Family Physicians of Canada.

Essential Resources for Medical Licensure and Specialty Certification in Canada. Please visit this page for links to the above noted and other relevant organizations in Canada and the US. 

Finding employment in Canada

Health Canada does not provide direct assistance to physicians regarding medical licensure or employment. For those who complete residency training outside of Canada on a J-1 Visa, Health Canada cannot guarantee employment upon return in their desired specialty or practice location.

Information on employment can be obtained from physician recruitment agencies across Canada. Applicants are strongly encouraged to engage with individuals or entities involved in recruitment of physicians within the province or territory where they intend to practice medicine well in advance of their return date to Canada.

Consent form for recruitment purposes

From time to time, Health Canada provides a list of names of physicians who have received a Statement of Need to ministries of health and physician recruiters. If you would like to be included in this list, you must sign the pdf version of the form titled Consent to the Disclosure of Personal Information to Provincial and Territorial Governments for Recruitment Purposes.

By signing the consent form, the applicant permits Health Canada to disclose personal contact information to provincial and territorial ministries of health and to physician recruitment agencies. The consent form may be signed at the time of application for a Statement of Need or at any time during the training in the US. Signing the consent form is optional and does not affect the issue of a Statement of Need. Document can be submitted to the following email address: j1visa@hc-sc.gc.ca.

J-1 Visa sponsorship with another country

Requests for review of circumstances from physicians who already have or had J-1 Visa sponsorship with support from another country will be considered on a case-by-case basis by provincial and territorial ministries and departments of health.

Contact List for additional information

If you have questions about determining your category or require additional information about applying for a Statement of Need, please contact the Program Administrator using the following email address: j1visa@hc-sc.gc.ca. You can also reach the Program Administrator at 613-952-1912.

You may also wish to contact a Statement of Need representative in a provincial or territorial ministry or department of health.

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