Pre-Entry Assessment Program (PEAP) Guidelines for Electives

Overview

The Pre-Entry Assessment Program (PEAP) is mandated by the College of Physicians and Surgeons of Ontario (CPSO) to ensure International Medical Graduates (IMGs) meet the qualifications for residency training. Completion of the PEAP is required to obtain an unrestricted educational license (medical education certificate of registration) from the CPSO.

Applicability

The Elective PEAP is mandatory for IMGs who:

Are enrolled in a residency program outside North America, and
Are registered for an elective at the University of Toronto.

Criteria for Elective PEAPs

To be eligible for an elective PEAP, the following criteria must be met:

Training: Learners must have completed at least two years in a specialty or one year in Family Medicine.
Language of Patient Care: Patient care during those years must have been conducted in English and/or French.
Letter of Support: A letter from the Postgraduate Dean (or authorized equivalent) of the learner’s home institution must accompany the application, confirming the learner's training level and abilities.
Funding: Learners must be fully funded for the duration of the elective by an acceptable sponsoring agency from one of the following countries: Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, or the United Arab Emirates, in accordance with the pay scale outlined in the PARO-OTH Collective Agreement.
Work Permit: Learners who are not Canadian Citizens or Permanent Residents must have a valid work permit for the during of the elective. PGME will provide the elective learner with the work permit application information and a Citizen and Immigration Canada (CIC) “Letter of Employment” that will enable the learner to apply for the appropriate work permit.
Letter of Appointment (LOA): The Letter of Appointment, which will outline the elective period must be signed via POWER.
Elective Duration: The elective period must be at least one month and no more than six months.
Registration Requirements: The elective learner must complete all registration requirements in POWER prior to beginning their elective.
Assessment Requirement: A final evaluation must be completed at the end of the elective period and sent to the learner’s home institution.

Definition

The Elective PEAP is a two-week assessment conducted concurrently with the elective rotation to confirm the IMG's ability to perform at the expected level. This assessment takes place in a supervised clinical multidisciplinary setting with continuous patient interaction. The assessors are responsible for ensuring that learners:

Are mentally competent to practice medicine;
Demonstrate decency, integrity, and honesty in accordance with the law;
Possess the knowledge, skills, and judgment required for postgraduate medical training under the educational license;
Communicate effectively and display appropriate professional attitudes.

Note: PEAP enrollment begins only after the CPSO issues a Certificate of Registration, and the learner registers with Postgraduate Medical Education (PGME) for the PEAP period. Practicing medicine in Ontario without CPSO authorization is an offense under the Regulated Health Professions Act. It is the learner’s responsibility to ensure all registration requirements are completed in POWER before training begins.

Assessments & Required Documentation

PEAP assessments for electives must:

Be conducted over a two-week period during the learner's elective rotation.
Assess the learner’s clinical skills, technical skills, knowledge and judgment, communication skills, and professional attitudes.
Conclude with a “yes” response to the question, “Has the candidate successfully completed the two-week assessment period?” on the final assessment form.
Be sent to the learner’s home institution upon completion.

Please note that the PEAP is not a remedial period and cannot be extended due to poor performance concerns.

The learner must submit:

Letter of Support: A letter from the Postgraduate Dean (or equivalent) of the learner's home institution, confirming their eligibility, training level, and abilities.

An Unsuccessful PEAP

A learner is unsuccessful if they receive a "no" on the final assessment form to the question, “Has the candidate successfully completed the two-week assessment period?” They may still pass if appropriate explanatory comments are provided. However, if the assessment is unsatisfactory:

Termination of Appointment: The learner's elective appointment with the university will be terminated.
CPSO Certificate Termination: The CPSO certificate of registration will be terminated as of the PEAP end date on the final assessment form.
Home Institution Notification: International learners' home institutions are likely to be notified of the unsuccessful outcome.