Foreign medical or dental residents and medical research fellows – [R205(c)(ii) – C45]– International Mobility Program

This section contains policy, procedures and guidance used by IRCC staff. It is posted on the department’s website as a courtesy to stakeholders.

In these instructions, “officer” refers to employees of both Immigration, Refugees and Citizenship Canada and the Canada Border Services Agency.

The instructions on this page should be reviewed in conjunction with

The Minister has designated the work performed by foreign nationals who have been accepted for a medical or dental residency or a medical research fellowship and are not funded by a Canadian public source as necessary for public policy reasons related to the competitiveness of Canada’s academic institutions, or economy, under subparagraph 205(c)(ii) of the Immigration and Refugee Protection Regulations (IRPR). This designation was implemented on September 1, 2010.

On this page:

Foreign medical residents and fellows do not take away employment or training opportunities from Canadians as these positions are specifically created for and funded entirely by foreign governments, in the case of residents. Foreign fellows support medical faculties with advanced clinical and research training due to ongoing shortages of Canadians available and interested in occupying such clinical or research positions.


To be eligible under the administrative code C45, a foreign national must

Documentary evidence

The following documents should be submitted with the work permit application:

Note: In some provinces, fellows, particularly research fellows, have no patient contact. Regardless of whether contact with patients occurs, fellows, like all residents, are required to pass an immigration medical exam pursuant to section R30.


Medical Residents

Foreign medical residents are holders of a medical degree equivalent to that of a Canadian Medical Doctorate (MD) who are coming to Canada to complete a residency at a Canadian hospital or in a clinical setting as part of their medical training.

In Canada, a Medical Doctorate is provided to those who have passed their coursework in the field of medicine or surgery from an accredited medical school. In Canada, the MD is technically considered an undergraduate degree.

The foreign medical degree may be directly equivalent (for example, MD, Doctor of Dental Surgery, Doctor of Dental Medicine) or in some countries such as the United Kingdom, Ireland, etc. it may be referred to as a Bachelor of Medicine, Bachelor of Surgery (M.B.B.S).

Positions occupied by these foreign nationals are non-ministry (not publicly) funded places that have been created by Canadian medical faculties with financial support from the country sponsoring the training of the foreign resident.

Publicly funded

The income offered to the foreign worker not to be funded by the Canadian public means that the income offered to the foreign workers must not be funded by Canadian tax payers’ money or public means through a national or subnational Canadian government institution, as opposed to private institutions, private universities or foreign governments.

For example, foreign nationals can get a placement with the University of Ottawa (Canadian publicly funded institution) under C45 as long as their wages are not being paid by the University of Ottawa.

Examples with different types of institutions:

Examples of publicly funded universities:

Examples of private Canadian universities:

As another example, certain foreign nationals are coming from the Kingdom of Saudi Arabia (KSA) to work in Canada (University of Toronto) under the medical resident category. In this case, the University of Toronto is the employer, but the government of KSA provides the wages of those workers.

In situations where the wages may be partially Canadian funded (that is, 50% Canadian funding and 50% foreign institution funding), as long as the Canadian portion is not being paid by a publicly funded Canadian institution, the work permit may be issued if the foreign national meets all other requirements under this category.

Medical Fellowship Holders

Foreign medical fellows are holders of a medical degree equivalent to that of a Canadian Medical Doctorate (MD) and recognized medical specialists who have completed residency training and accept to continue specializing in some highly specific field of study to advance clinical or medical research. Foreign medical fellows doing clinical work/research are typically performing very specific clinical/research work in a hospital, clinical or research setting. These positions may be publicly or privately funded.

Global Case Management System (GCMS) fields to review in the offer of employment

Field Considerations
LMIA Exemption Code

C45 – the employer should have selected this code

Ensure that the exemption code matches the description in ‘Requirements Exemptions met’

Requirements Exemptions Met

Information in this field should outline when and where the foreign national received their MD and the source of funds to support the position.

Please note that the information regarding how the employer and applicant meet the LMIA-exemption category requirements may be in an attachment to the offer.


The National Occupational Classification (NOC) Code used should be for the position being offered, including the area of specialty.

Duration and Expected Start Date

Duration of the work should be for the length of the residency training or fellowship period (number of months).

Residents: Typically, terms of 2 to 7 years, or more, depending on the area of medical specialization.

Fellowships: Typically for a term of 1 to 2 years.

Wages The wage should be commensurate with that of a Canadian performing the same duties in the same location of work.
Alternate compensation or Additional information For medical or dental residents, one of these fields should indicate the source of the income offered to the foreign worker. The income source for Residencies cannot be from Canadian public funds.

These are the activities that the foreign national will be performing. Do they align with the occupation and what is described in the National Occupational Classification?

Job Requirements

It should be indicated if a licence by the provincial College of Physicians and Surgeons is required in order to undergo their residency or fellowship in that province.

An indication of whether the position is covered by a collective agreement

Minimum Education Requirements A Canadian Medical Doctorate (MD) or the foreign equivalent.
Location The Address list section should provide the physical work location (up to two locations) for the duration of the residency or fellowship. If there are more than two locations, the additional locations will be listed in the Duties field.

Work permit issuance in GCMS

Under the Application screen, officers should enter the following information in the specified fields:

Field Considerations
Case type 52 – Employer-specific LMIA-exempt applications
Province of destination

The province of destination entered by the applicant should match the address of employment in the LMIA-exempt offer of employment.

This information is under the Employment Details – LMIA-exempt tab.

City of destination

The city of destination entered by the applicant should match the address of employment in the LMIA-exempt offer of employment.

This information is under the Employment Details – LMIA-exempt tab.

Exemption code

This code is auto-populated from the LMIA-exempt offer of employment.

Officers must manually enter the code when the use of the IMM 5802 is authorized. Code entered should match the code on the IMM 5802.

This code should only be changed in specific circumstances. For further instruction see the following: Changes between the offer of employment and the work permit application.

NOC The NOC code is auto-populated from the LMIA-exempt offer of employment.
Intended occupation

Job title

This is auto-populated from the LMIA-exempt offer of employment.

LMIA/LMIA-exempt #

“A” number from the work permit application.

This number is auto-populated from the work permit application, and it is what is used to “match” in the Portal. If the work permit application was submitted on paper, the officer must manually enter the number.

Valid to

Should match the duration of the offer of employment or be valid until the travel document expires, whichever is earlier.

If the foreign national is exempt from the travel document requirement (for example, they are a United States citizen), the work permit should be issued for the full duration of the offer of employment.

Refer to Validity period for work permits

Previous updates

Operational Bulletin (OB) 230 - September 1, 2010 - New Labour Market Opinion (LMO) Exemption – Foreign Medical Residents and Medical Research Fellows (expired)

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