Foreign physicians coming to work in underserved regions in Quebec [R205(a) – C10] – International Mobility Program

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

The instructions should be reviewed in conjunction with

• Employer-specific work permits — General processing — International Mobility Program
• Conditions and validity period on work permits (temporary workers)
• Public list of Employers who have been non-compliant

The department uses specific administrative codes to identify certain situations where it considers the work of a foreign national to create significant social, cultural or economic benefits or opportunities for Canadian citizens or permanent residents, within the meaning of paragraph 205(a) of the Immigration and Refugee Protection Regulations (IRPR). The factors provided for each code demonstrate how the situation may meet the requirements of paragraph R205(a). Officers must also always be satisfied that all requirements of section R200 are met.

The administrative code C10 is the code used to indicate that the work of certain foreign nationals entering Canada to work as physicians in Quebec’s underserved regions may create significant economic or social benefits to Canada.

Starting on July 31, 2025, foreign doctors will no longer be required to apply for 2 separate work permits to complete the evaluation or adaptation internship period in an accredited university clinical setting or any other clinical setting designated by the Collège des Médecins du Québec (CMQ) and to begin their practice in a healthcare facility. They will be able to obtain a work permit tied to a given employer under code C10, valid for a maximum of 5 years, which covers both the evaluation or adaptation internship period (13 consecutive weeks) and the practice period if they meet the requirements of the work category.

The goal of the adaptation/assessment period is to assess the applicant’s adaptability, professional integration and readiness to practise medicine in the specialty in question in Quebec.

Applications received starting on July 31, 2025, will be assessed according to the new instructions, and applications received before July 31, 2025, will be assessed according to the instructions that were in effect before that date.

Note that prior to July 31, 2025, foreign physicians were required to obtain 2 work permits under administrative code C10 to work in underserved regions in the province of Quebec:

1. Applicants submit the first work permit when they were selected for an assessment period or adaptation period lasting 13 consecutive weeks, including a week of observation, in an accredited university clinical setting or any other clinical setting designated by the Collège des Médecins du Québec (CMQ) [college of physicians and surgeons of Quebec],
2. Once they receive a restrictive permit for practice from the CMQ, they would submit the second work permit application under the same code C10. The permit for practice is issued for a maximum of 5 years.

On this page

• Eligibility
• Application submission
• Assessing the application
• Final decision
  • Approval
  • Refusal
• Previous updates

Eligibility

To be issued an employer-specific work permit under exemption C10, the applicant must meet all of the following criteria at the time of application submission:

• Must have a valid immigration medical exam
• Must have included the following 3 letters in their application for work permit:
  • a confirmation letter issued by the CMQ indicating that the foreign doctor has been admitted to the evaluation or adaptation period
  • a letter of promise to hire from Santé Québec to support the application for eligibility for a restrictive permit (a version for family or for specialized medicine)
  • a financial assistance agreement to be sponsored, obtain a restrictive permit and practise medicine (a version for family or for specialized medicine) signed by the applicant, the host institution and Santé Québec
• The employer (the public health care institution) must have submitted an Offer of employment covering the 13-week assessment or adaptation period and the period of scheduled work under the restrictive permit of practice
  • The offer of employment must clearly set out the period during which the applicant will work for the health care institution
  • The 13-week assessment or adaptation period may be in a separate health care institution designated by the CMQ, which arranges the adaptation/assessment period
    • In these cases, the 2 work locations will have to be named in the offer of employment: the primary work location is the employer’s address, and the secondary work location is where the adaptation/assessment period takes place
    • When the employer is completing the offer of employment in the employer portal, they should answer “Yes” to “Will the worker perform duties at more than 1 job location?” and then complete the second job location section.
  • In rare cases, the CMQ may exempt applicants from the requirement to undergo an adaptation/assessment period because of previous work experience in Quebec or an exceptional background
    • These applicants must then provide a copy of the restrictive permit issued by the CMQ and the other documents showing that they are being sponsored (promise to hire and financial assistance agreement) in order to obtain a work permit

Application submission

Applications submitted at the port of entry must meet the eligibility requirements outlined in Persons who may apply at a port of entry.

Applications should be received electronically unless the applicant is exempt from the mandatory requirement to apply online.

• for outside of Canada applicants – refer to the ministerial instructions on the submission of online applications for temporary resident visas and other documents for overseas applicants
  • Applications submitted online benefit from a faster processing under the Global Skills Strategy.
• for in-Canada applicants – refer to the Programs exempt from the in-Canada mandatory electronic application (e-application) requirement for temporary residents page and the list of National Occupational Classification (NOC) codes for priority processing

Assessing the application

Processing officers will ensure that the requirements for the employer-specific permit are met and the applicant is not inadmissible.

To determine whether the work permit application meets the criteria for the category, officers should review the offer of employment in the “Employment Details” tab in the Global Case Management System (GCMS) to verify the information provided by the employer or the corresponding fields in form IMM 5802 (if the employer was authorized to use it).

In the “Main duties of the job” section of the offer of employment, the employer must include the following information:

• a list of duties that the foreign worker will be expected to perform for this specific position (especially those that are not covered by the NOC description)
• information about multiple work locations (if applicable)
• other information that the employer cannot clarify in the “Alternate compensation scheme” field due to character limitations
• any additional information about the duties the foreign worker will be performing that the employer could not include in the “Alternate compensation scheme” field

In the “Alternate compensation scheme” field, the employer should specify that the worker will have a 13-week adaptation period at the beginning of their contract.

Final decision

Approval

If the work permit application is approved, under the Application screen, officers should enter the following information in the specified fields:

Refusal

When officers are not satisfied that the specific elements of this provision and of R205(a) are met, they need to clearly document their reasons in the refusal note. 

A decision is reasonable when the review tribunal is able to trace the decision maker’s reasoning, without encountering serious flaws in the overarching logic, and is satisfied that there is a line of analysis within the given reasons that could reasonably lead the tribunal from the evidence before it to the decision maker’s conclusion.

The officer needs to engage with the documentary evidence that was provided by the applicant. Simply stating ‘I have reviewed the submissions and I am not satisfied that R205 is met’ is not sufficient for another reasonable person to understand the logic of the decision without reviewing all of the evidence again. 

Previous updates

• May 15, 2024
• March 29, 2019