Assessment Verification Period (AVP)

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To obtain an unrestricted postgraduate medical education certificate of registration (educational license) from the College of Physicians and Surgeons of Ontario (CPSO), international medical graduates entering from CaRMS or the Advanced Level Postgraduate Training Program, are required to undergo an Assessment Verification Period (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 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 Postgraduate 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 Postgraduate Office for the Dean’s signature.

Once signed, the Postgraduate 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 Postgraduate 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.

Assessment/Evaluation Format

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 and 6th 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.

Licensure Extension

  • Application for a 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 Postgraduate Dean must support the request to CPSO.
  • An additional 6 week period can be requested.  This must be approved by the CPSO Registration Committee.

Possible Outcomes


AVP candidate continues in the postgraduate training program.


A candidate with an unsatisfactory assessment has his/her appointment with the University terminated. The PG 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 Return of Service Agreement. Candidates should consult the MOHLTC regarding their ROS 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 discouraged from taking vacation during the AVP, as it may put their assessment in jeopardy.

Return of Service

Candidates must contact the Ontario Ministry of Health and Long Term Care regarding arrangements for Return of Service contracts.

Note: Before downloading these forms, please check with your central Department Office  for a Department-specific form.

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