Who enrols in the PEAP?

The PEAP is mandatory for international medical graduates (IMGs) entering residency training outside the CaRMS match process, for IMGs entering clinical fellowship training, or for IMGs entering elective residency training (but only if the IMG’s home residency program is outside Canada and the U.S.).


How long is the PEAP?

For residents and clinical fellows, the PEAP must be at least four weeks and no more than twelve weeks in duration. It can be extended to a total of 16 weeks in special circumstances, such as illness, a leave of absence or supervisor unavailability. The PEAP for out-of-country elective residents is two weeks in duration and is completed concurrently with the elective rotation.


How is the PEAP for residents different from the PEAP for fellows?

The PEAP for residents is an assessment of the IMG to determine if they can function at the level of an Ontario medical school graduate and enter a residency program. The PEAP for fellows is an assessment of the IMG to determine if they can function at the level of an Ontario resident who has completed their primary certification and enter a fellowship program. Residency training begins for the IMG only after they have successfully completed the PEAP. IMGs enrolled in the PEAP for fellows, on the other hand, are able to count their activity during the PEAP towards the fulfilment of the educational goals and objectives of the clinical fellowship. The two-week PEAP for elective residents from international residency programs takes place concurrently with the elective.


Is there special consideration for an IMG who needs help in order to pass the PEAP?

The PEAP is an assessment process to confirm whether or not the IMG has the general knowledge and competency appropriate for practice in the discipline, as well as the language proficiency sufficient for safe and effective medical practice. It is not a period of preparation for training . The College of Physicians and Surgeons of Ontario (CPSO) will not approve an extension of the PEAP for remedial purposes.


What is the difference between failing and withdrawing from the PEAP?

Failure in the PEAP is final. If the candidate is unsuccessful in the PEAP the CPSO will not permit them to enter another PEAP in the same discipline in Ontario. The CPSO will communicate the result to all Ontario medical schools. Withdrawal from the PEAP for personal reasons allows the candidate to enter the PEAP again at a later date.


Can some international medical graduates be exempted from the PEAP?

Yes, a non-Canadian IMG entering residency training at the University of Toronto can be exempted from the PEAP if they have recently completed at least one year of residency training in Canada or the U.S. or if they are taking up residency training in the same discipline as a residency they have already completed in Canada or the U.S. An IMG can be exempted from the PEAP for fellows if they have completed one year or more of clinical fellowship in the same discipline in Canada or the U.S. The Program Director can always require an IMG to complete the PEAP regardless of their eligibility for PEAP exemption.

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