Guidelines for Residency Waivers and Accelerated Training

Postgraduate Medical Education, Temerty Faculty of Medicine at the University of Toronto

Date of original approval: November 27th, 2025
Date of last revision and approval:
Date for next review: November 2029

Preamble

The College of Family Physicians of Canada (CFPC) and the Royal College of Physicians and Surgeons of Canada (RCPSC) require residents to complete all program training requirements, including duration and competence. However, the university can set policies regarding criteria by which waivers of training time (if any) may be granted. This document describes the circumstances under which training may be waived.

Description

A waiver of training results in a shorter duration to completion of all program training requirements. There are two possible ways that a postgraduate resident may be granted a waiver of training at the University of Toronto: a resident returns from a Leave of Absence and, under exceptional circumstances, is not required to make up all of the Leave of Absence time missed; or a resident meets Acceleration of Training criteria. Details, considerations, and limitations are described below.

Related Policies and Resources

PGME Guidelines for Residency Leaves of Absence
CFPC Requirements for Residency Eligibility – Leaves of absence and waivers.
Royal College of Physicians and Surgeons of Canada (RCPSC) Competence by Design Technical Guide 6: Leaves
RCPSC Competence by Design, CBD Policies, Waivers of Training.
RCPSC Clarifying the role of mandatory training time in Competence by Design

PGME GUIDELINES

1) Returning From a Leave of Absence

It is expected that residents will make up time lost, or rotations missed, with equivalent time in residency upon return from a leave of absence.

However, the PGME office may allow a waiver of training following a leave of absence from a training program. A waiver of training may be granted on the premise that the resident is expected to reach the required level of competence set by their training program by the end of their final year. A waiver of training is not automatic and may be granted only in the absence of concerns regarding the resident’s ability to meet the required level of competence and complete program requirements.

The reasons for the leave of absence are not considered in assessing a waiver of training, except in cases when the resident was placed on a mandatory leave for reasons of professionalism or safety. All leaves of absence – including but not limited to those for health, personal or parental reasons – are granted according to CFPC, RCPSC, and PGME policies and guidelines and thus have previously met an approved standard.

a) Family Medicine Training

Residents in family medicine must successfully complete 24 months of training, at a minimum. Normally, these 24 months are completed in sequence. The PGME Associate Dean, on recommendation of the Program Director, may grant interruptions which require a leave of absence from the training program. A leave may result in a waiver of training, but only in exceptional circumstances. Competency is related to time in training, such that waivers are typically only granted for the exceptional resident who has optimized the volume and variety of clinical experiences necessary to achieve both competency and preparedness for comprehensive family practice. The maximum length of a waiver of training for residents in family medicine will be 4 weeks.

b) RCPSC Training

For RCPSC specialty residents, the duration of training eligible for waiver is up to a maximum of six weeks for programs of 2-3 years in length, and up to a maximum of 3 months for programs 4-6 years in length.¹ The actual duration of waiver granted in any particular case may be less and will be determined based on the anticipated time required to achieve competency and complete all remaining program requirements.

c) Process

i) A resident may submit a request for a waiver of training following a Leave of Absence to their Program Director (PD) for review to determine eligibility.
ii) The PD, in consultation with the Competence Committee (CC), will review the request for a waiver of training and make a recommendation to the PGME Associate Dean as to whether a waiver of training ought to be granted and, if so, the length of time that ought to be waived.
iii) The PGME Associate Dean will consider the recommendation and make a final decision whether to grant a waiver of training and, if so, the length of time that will be waived.
iv) If the waiver of training is approved, the CFPC or RCPSC will be notified of the waiver by PGME prior to submission of the completion of training notice to the College.
v) Where a waiver of training is granted, it may be rescinded or reduced in length later in the resident’s training if there are concerns that the resident will not achieve the required level of competence by the end-of-training date.
vi) Residents who have completed a portion or all of their training on a part-time basis may be eligible for a waiver of training. The total time spent away from training while on part-time status is considered equivalent to a single, continuous leave of the same duration.
vii) The resident’s privacy of personal and health information will be maintained at all times during the waiver of training consideration process.

2) Acceleration of Training – for Royal College Competence By Design (CBD) Programs, only

Residents of Royal College residency programs demonstrating exceptional proficiency, according to the Specialty’s National CBD Standards and the program’s education and assessment requirements, may be afforded the opportunity to:

i. develop expertise and augment training through selectives in areas that will be most relevant to the resident’s future practice (e.g., clinical, research, education, or leadership skills); or
ii. participate in a highly tailored ‘transition to practice’ phase of training, while maintaining the typical timeline for completion; or
iii. advance through training earlier, resulting in a ‘revised end-of-training date’

a) Implications²/Considerations for Programs and Learners

In unique circumstances, it is possible for a resident to complete residency training before their expected training end date and exit the program early (i.e., the resident is no longer an active PGME trainee). However, significant consideration should be given to the potential impacts on healthcare teams, funding and contract arrangements when making these decisions.³

Programs should consider and identify potential educational experience implications to the residency training program prior to approving accelerated training requests.

If a resident fails the Royal College or CFPC certification exam, PGME/the program cannot reinstate the resident into a residency training program. Thus, careful consideration must be undertaken by PDs when considering revising a resident’s end-of-training date.

If an approved request is no longer deemed to be an optimal course of action for the program and/or learner, the program may consider re-adjusting the end-of-training date. This decision must be made prior to the learner’s revised end-of-training date.

b) Criteria to Guide PD, RPC and/or CC for Accelerated Training

i. A resident who is interested in pursuing accelerated training must:⁴
- display exceptional proficiency in the overall program of assessment
- complete all of the required specialty Training Experiences, Competencies, and program educational requirements by the end of their Core of Discipline stage
ii. The CC must determine that:
- the resident’s trajectory is on pace to acquire the required levels of competence
- there is no significant deviation from the standard curriculum training requirements or experiences or program of assessment for academic/professionalism reasons⁵

c) Operationalizing Acceleration Requests

i) A resident may submit a request for accelerated training to their Program Director (PD). The PD, together with the Competence Committee (CC) and Residency Program Committee (RPC), will review to determine feasibility and eligibility (based on performance). If accelerated training involves enrichment activities, a brief description must be provided in the request.
ii) It is recommended that the PD, together with the CC, review requests for accelerated training 3-4 months at a minimum prior to PGME approval of exam readiness and Completion of Clinical Training (CCT).
iii) A resident’s request for accelerated training can only be submitted during the last 12 months of training and no later than 9 months prior to the end-of-training date.
iv) The length of time that can be accelerated will be determined by the PD, the RPC, and/or CC.
v) If the PD, together with the CC and RPC, support the request for accelerated training, the PD must submit a standardized approval form to the PGME office for approval by the PGME Associate Dean. The form must be submitted to PGME no later than the deadline for PGME approval of exam readiness and Confirmation Completion of Training (CCT).
vi) If the outcome of an approved request is a reduction in training, PGME will confirm revised examination dates with either the RCPSC or the CFPC, as well as revise the resident’s end-of-training dates. PGME will also provide a revised Letter of Appointment to the resident. Programs should note that an approved acceleration request will impact funding, as it relates to the resident’s salary and benefits.

d) For RCPSC subspecialty programs

If a resident is approved for accelerated training in her/his/their RCPSC specialty program and has been accepted into a subspecialty training program, and there is a gap in time between the completion of one program to another (i.e., residency to subspecialty):

The resident will no longer be eligible for PARO salary, benefits, insurance, or access to PARO resources during the gap period.
It should be noted that the subspecialty program’s start date may be incongruous to the residents’ revised end-of-training date for their primary specialty

3) Program-Specific Waiver of Training Criteria

Each Department and/or residency program is expected to establish the criteria by which they will allow waivers. Such criteria should be made available to residents, preferably on the program’s portal or website.

¹ https://www.royalcollege.ca/content/dam/document/eligibility-and-exams/policy-procedure-certification-fellowship-e.pdf

²Implications may include, but are not limited to, the discontinuation of salary and benefits and/or CPSO learner licensure beyond revised end-of-training date; and PGME’s inability to reinstate learners should they fail certification exams.

³ https://www.royalcollege.ca/content/dam/documents/accreditation/competence-by-design/non-resource-documents/the-role-of-time-in-competence-by-design-e.pdf;https://www.royalcollege.ca/content/dam/document/eligibility-and-exams/policy-for-certification-cbd-model-e.pdf

⁴Benchmarks of exceptional proficiency in overall program of assessment are based on the Specialty’s CBD Standards (EPAs, Competencies, Training Experiences), and local programs of assessments

⁵Note: This criterion is not intended to impact residents with an accommodation. In the case of a resident with an accommodation, the PD may discuss the request for accelerated training with the Office of Learner Affairs.

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