Canadian Citizen/Permanent Resident

Steps to follow

1) Sign the Letter of Appointment (LOA) (Complete Now)

  • Login to POWER using your pin/password.
  • If needed, retrieve your pin and/or password click ‘Forgot your pin and/or password?’ on the login page. 
  • Go to the ‘LOA Documents’ folder to review and ensure accuracy of your LOA. If all is correct, type your name and click on the ‘Submit’ button. This is your electronic signature indicating your acceptance of the appointment. 
  • The LOA will only reflect training in the upcoming academic year (July 1 – June 30). If your training continues past June 30, you will receive a new LOA next spring. 

CPSO begins to accept LOAs in mid-April each year. PGME will automatically forward your signed LOA in mid-April, which is part of your CPSO licence application.

2) Renew with the College of Physicians & Surgeons (CPSO) (Complete 3 Months before Start Date)

  • Login to your CPSO account and RENEW your licence. 
  • PGME automatically forwards your signed LOA directly to CPSO in mid-April. Please allow CPSO sufficient time to process (CPSO processing time can take 3-5 weeks)
  • Regularly check on your application status in your CPSO Member Portal. 
  • If your CPSO account does not reflect the LOA by the end of May or 30 days after CPSO receives your signed LOA please email to resend.

Do not begin medical practice or postgraduate training in Ontario until you have received confirmation from the CPSO that you are renewed. It is an offence under the Regulated Health Professions Act for a person to practice medicine in Ontario, postgraduate training included, until such time as an appropriate certificate of registration has been renewed or issued.

Do you currently hold a postgraduate training licence as a resident or a clinical fellow? 
Log in to your CPSO Member Portal for specific requirements. 

If you currently hold an Independent Practice licence, CPSO renewal opens each year in early April. Please consult the CPSO Annual Membership Renewal page. 
Log in to your CPSO Member Portal for specific requirements.

3) Verify or Update Immunization Status (Complete 2+ Months before Start Date)

  • Your immunization alert(s) under ‘Messages’ in your initial view page in POWER will outline what is missing/expired and requires your attention.
  • Check under the ‘Immunization’ tab to see when your TB/Mask Fit expires, if it expires before the next academic year you must renew.
  • Download your forms from ‘LOA Documents’ folder in POWER:
    • TB Renewal Test form (if your previous test was negative, due every 12 months)
    • Mask Fit Test (required by hospitals every 24 months
  • Upload forms to the PGME Form Site
  • Your TB renewal and mask fit forms are to be completed and signed by a clinic/healthcare center, or health care professional other than yourself. 
  • Check the ‘LOA Documents’ folder for a list of occupational health office contacts.
  • Updated forms must be received within 60+ days to avoid potential delays

More details on PGME Immunization Requirements

4) Complete a Background Attestation (Complete after May 8 on POWER)

  • If you have previously submitted a Level 3 Vulnerable Sector Screen you will be required to complete a background attestation, this is an electronic statement that you attest/not attest to regarding your background. If you CANNOT ATTEST you must email a written explanation to with a copy to
  • Complete your background attestation in POWER by selecting ‘VSS & Background Attestation’ tab after May 8, 2024, if your training starts between May and June, please add the attestation prior to May 8, 2024.
  • Your VSS is valid for up to 5 years once submitted to PGME. After 5 years, a new VSS will be required. If ‘Add Attestation’ is not visible, a VSS is required.

You will receive email alerts from the POWER system reminding you to obtain the VSS or complete the background attestation in the POWER system. Only email if there is an error.

5) Renew with Canadian Medical Protective Association (CMPA) (Complete 2 Months before Start Date)

  • Renew online with the CMPA for malpractice protection. Please contact CMPA if required.
  • This is a MANDATORY registration requirement for all those with a CPSO licence.
  • Ensure your CMPA coverage dates MATCH the training dates in POWER. You cannot start without CMPA coverage MATCHING your training START date.

6) Renew Hospital Health & Safety Policy Modules (Complete Modules that require Renewal after May 8)

Our training sites and hospitals require learners to renew 7 MANDATORY Hospital Health and Safety Policy (HHSP) Modules. PGME collects the module completion on the behalf of the training sites and hospitals so that you will only need to complete per the timelines below prior to return of training. Modules 1 through 7 are available and to be completed in POWER after MAY 8.  

  • CHECK under ‘Messages’ in Initial View on POWER to see which modules require renewal.
  • Select ‘HHSP Modules’ in the main menu on POWER
  • Click on each outstanding module and work through to completion. 
    1. Donning on Doffing Personal Protective Equipment (required every 2 years)
    2. Emergency Colour Code System (required every 2 years)
    3. Integrated Privacy and Cyber Security eLearning (required annually)
    4. Hand Hygiene (required every 2 years)
    5. Sharps Safety Module (required every 2 years)
    6. Workplace Violence and Harassment (required every 2 years)
    7. WHMIS-Workers Hazardous Materials Information Systems (required every 2 years)

Completion of these modules with confirmation on the POWER system means this training does not have to be repeated as you start a rotation at a new hospital training site.

7) Pay Registration Fee (ONLY after ALL above Steps are Completed)

  • Pay your registration fee by Visa, Mastercard or American Express on POWER under Payment tab
  • The registration fee for the 2024-2025 academic year is $945 and is NON-REFUNDABLE.

If your appointment is less than a full year for example July to September your registration fee will prorated.

8) Print confirmation of registration (Only after ALL above Steps are Completed)

Upon completion you can print a confirmation of registration from the initial view page in POWER using the ‘Reg. Confirmation’ section. This may be required by the hospital training sites, UofT libraries or TCard Office as proof of registration with the Temerty Faculty of Medicine. Be sure to select the correct academic year at the top of your screen.

*For more information on access to other services please visit the PGME website