IMG Support and Resources

The IMG Coordinator is a confidential support for all internationally trained physicians and families throughout residency for both educational and personal support. 

They are a liaison for IMG residents and families prior to arrival in northern communities as well as help in addressing concerns brought forward by IMG residents throughout residency. 

The IMG Coordinator also collaborates with various programs to share resources and support for IMG residents and is available to provide support to programs in the selection process of IMGs as well as helping to identify the candidates who will enter the next steps of the PRP and Assessment Verification Period (AVP). 

The IMG Coordinator will also collaborate with NOSM University faculty to promote and improve the educational experiences for IMGs.

General resources that have been collected for all new NOSM U residents can be found on the Onboarding for New Residents site.

IMG residents have the opportunity to engage in meetings with the IMG coordinator to address any challenges or issues they may be facing during their residency. These meetings are confidential to ensure privacy and comfort for the residents. The primary goal of these discussions is to provide support to the IMG residents and work towards implementing positive changes in the residency program to better cater to their needs. This space is intended to be a safe and open environment where residents can openly discuss their concerns and seek guidance.

The following is information and processes related to the Assessment Verification Period (AVP) as governed by the Council of Ontario Universities (COU) AVP Policy  

 Summary:  

• All IMGs must complete as per College of Physicians and Surgeons of Ontario (CPSO) requirements for licensing 
• Twelve (12) weeks at beginning of residency with temporary license 
• Assess clinical skills, technical skills, knowledge and judgement, communication, and professionalism  
• Evaluations at two (2), eight (8) and ten (10) weeks with Preceptor 
• Three (3) half-day observation sessions with supervisor who is not AVP preceptor  
• Final Assessment with Program Director  
• Option to appeal if unsuccessful. If the appeal is successful, repeat AVP.  

Purpose: 

To obtain an unrestricted Postgraduate Medical Education (PGME) certificate of registration (educational license) from the CPSO), IMGs entering from Canadian Resident Matching Service (CaRMS) or the Advanced Level Postgraduate Training Program, are required to undergo an 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. 

Process: 

The AVP is an assessment process that evaluates IMGs to determine if they can function at their reported level of training. It is twelve (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 PGME 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 PGME Office for the Dean’s signature. 

Once signed, the PGME 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 PGME Office. 

Supervision: 

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, 8th, and 10th  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 six (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 PGME Dean must support the request to CPSO. 

An additional six (6)-week period can be requested.  This must be approved by the CPSO Registration Committee. 

Possible Outcomes: 

• Satisfactory 
• AVP candidate continues in the postgraduate training program. 
• Unsatisfactory 

A candidate with an unsatisfactory assessment has his/her appointment with the University terminated. The PGME 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. 

Withdrawal: 

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 (MOHLTC) Return of Service Agreement. Candidates should consult the MOHLTC regarding their RoS (return of service) 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 not permitted to take vacation during the AVP, as it may put their assessment in jeopardy. 

Return of Service: 

Candidates must contact the Ontario MOHLTC  regarding arrangements for Return of Service (RoS) agreements. 

• Ontario Ministry of Health Return of Service Q&A 
• Ontario RoS Guidelines (CaRMS)  

Assessment Verification Period (AVP) Policy- (COU PG CoFM)  

Assessment Verification Period (AVP) Form- Final (COU PG CoFM) 

Assessment Verification Period (AVP) Flow

The transition from being a medical student to becoming a resident, with greater responsibility can be a very difficult and exciting endeavour/time for anyone. It is even most difficult for those who are getting into the role of a resident in a country and/or environment with a different health care system, available resources (only read about until now), hospital culture and new colleagues. This could be equated to the feeling a child has when they find themselves in a new school, in a new community/country with no friends; a situation which can be made worse if the class teacher is not empathic or inpatient with these unique set of learners. 

Due to these challenges, NOSM University has a Peer Mentorship Program, where incoming IMG residents are matched with mentors based on a few criteria (when able to). It is believed that matching incoming residents with current residents or faculty members (former IMG residents), who share some level or commonality will help the incoming resident settle-in a lot quicker and feel comfortable /at home. The 2023-2024 IMG Peer Mentorship Program pairs have been assigned. If you have any questions about this program, please contact the PGME IMG Coordinator.

In addition, it could be suggested that distributive learning may limit contact for support with the immediate family and may not allow much opportunity to develop the needed social capital, within the home base for the new IMG residents. It becomes important to develop a social networking platform to share a unique experience on an informal and voluntary basis. 

The Professional Association of Residents of Ontario (PARO) is the official representative voice for Ontario’s doctors in training. PARO’s priority is to advocate on behalf of its members, addressing professional and educational concerns in order to optimize the training and working experience of Ontario’s newest doctors thus ensuring that patients receive the best possible medical care. 

As a resident in Ontario, you are entitled to a salary and benefits negotiated by PARO through the PARO-OTH Collective Agreement.  This salary increases annually as the resident moves from one PG year to another.  An up-to-date table of the income by year of residency can be obtained through the salary and benefits section of the PARO website.  

 Additionally, PARO has created A Resident Financial Primer which includes useful tools, links and basic information that will demystify the world of personal finance and help you understand your options for everything from filing taxes to paying down your debt. It’s not meant to replace professional advice; rather, consider it as a guide to the choices that await you.

NOSM University Learner Support Services 

NOSM University’s Learner Support Services Office operates in consultation with the academic program but is a confidential service for individual learners, at arm’s length from academics. Learner Support Services offers services and support which assist learners academically, personally, and financially. It also has a primary role in career development, learner wellness, and support for learner initiatives.

In support of learner wellness, the Virtual Health and Wellness Hub is a resource hub that caters to enhancing the physical, social, financial, and academic well-being of NOSM U learners. The Hub can be accessed remotely and has a wealth of resources, including virtual and physical aid.

As a part of Learner Support Services, the Learner Affairs Officers (LAOs) assist residents and support requests, including, but not limited to, wellness and accommodations. The LAOs are the primary contact for all program stakeholders, including residents, faculty, academic teaching centers, internal stakeholders, and community partners. In collaboration with the Assistant Dean, Resident Affairs, the LAOs provide intake services for residents in distress or seeking the services of the Wellness Program.

Homewood Health (SAP) 

All NOSM University learners will have access to the Student Assistance Program (SAP) services through Homewood Health. Homewood Health is known for its personal touch and exceptional level of clinical service delivery. The SAP program from Homewood Health will include several new services and will provide access to a full range of health and wellness services. Visit www.Homeweb.ca 

Immediate support 24/7/365-day at 1-800-663-1142 (EN) or 1-866-398-9505 (FR) 

PARO 24-Hour Helpline 

In a nutshell, The Professional Association of Residents of Ontario (PARO) is the official representative voice for Ontario’s resident doctors in training.  

They advocate for professional and educational voice, to optimize training and work experience. 

They deal with the following: Agreement grievances, dismissals, vacation and vacation related issues, STAT holidays.  

The PARO 24-Hour Helpline is a confidential support service for residents, medical students, their partners, and families. They will assist you with issues such as: stress management, career crisis, intimidation, harassment, substance abuse, relationship counseling 

The toll-free number is accessible anywhere in Ontario, 24 hours a day, 7 days a week.  

PARO Help Line: 1-866-HELP-DOC (1-866-435-7362). 

Ontario Medical Association (OMA)  Physician Health Program  (PHP) 

The OMA confidential services are available to all residents in Ontario. Clinical team members are available by phone during OMA business hours to answer questions and assist with a wide variety of concerns. The PHP can offer support in a number of ways including:  

• Prompt advice and support (callers may remain anonymous) 
• Referrals for clinical services, with clinicians experienced in physician health 
• A range of assessment services 
• Monitoring and advocacy for ongoing mental health and workplace concerns 

The PHP also offers a wide variety of health and well-being resources 

CMA- Canadian Medical Association   

The CMA unites physicians and medical learners to drive bold reform in health, the health system and the health workforce, focusing on areas where we can have the greatest impact.  

OMA- Ontario Medical Association 

The OMA advocates for the well-being of our members and the health of Ontarians.   

PARO- Professional Association of Residents of Ontario 

The Professional Association of Residents of Ontario (PARO) is the official representative voice for Ontario’s doctors in training and a Go-To resource for everything you need to navigate your way into, through and out of your residency training in Ontario. As a resident training in Ontario, you are automatically a member of PARO. 

BPAO- Black Physicians Association of Ontario 

BPAO organization was created to focus on medicine and continue advocacy for improving the health of people in Black communities in Ontario.   

CANPAD- Canadian Association of Nigerian Physicians and Dentist 

CANPAD recognizes and represents the professional and social interests of physicians and dentists of Nigerian descent living in Canada and aims to contribute meaningfully to further advancement of the health sector in Canada and Nigeria through its educational and charitable programs as well as through social programs embracing development, science, arts and culture.

There are many different housing/Accommodations available at the home base of a resident.  In the absence of friends/family, contacting a real estate agent in the city prior to arrival will go a long way in helping one settle. Knowing what you want in terms of the number of rooms and proximity to the hospital, schools, and shopping is always helpful. 

To find a realtor service for a Northern Community please visit the Realtor.ca website.

For those new to the country or province, find information about the government of Ontario services and programs, including driver’s licenses & health cards, all in one easy place. Visit Service Ontario online  for more information or to locate a Service Ontario office near you. 

Finding a Family Physician  

Ensuring that your family gets the care they need as soon as possible is a simple, basic but at times difficult thing especially when one finds him/herself in a new country/community.   

While there are efforts by the government to address this through HealthCare Connect, the wait time can be unpredictable. 

Here at NOSM University, one of our strengths is in the relationship that exists with our learners who go on to practice within the community. These physicians have come together to answer NOSM University’s call of developing a directory of Family Physicians that are accepting patients in the community.  

You can obtain an updated list of Family Physicians Accepting new patients by 

1.  Sending an email to:  pgewellness@nosm.ca 
2. Locate this list by logging into your “MyNOSM” account and navigating to MyCurriculum 
3. Requesting this list through the NOSM U Well App feature 

If you are having difficulty obtaining entry to a practice, contact your preceptor. 

Finding a Dental Practice  

For dental services in your northern home community, the Ontario Dental Association offers an easy to use searchable “Find a dentist” database.   

If you are seeking a dental surgeon, the Royal College of Dental Surgeons of Ontario also offers a searchable database to locate a practitioner in your area. 

Banking 

Prior to coming to Northern Ontario, most residents would already have a bank account and may not need to open a new one. For those who desire to open a new bank account, the following banks operate in Northern Ontario: BMO, CIBC, RBC, Scotia Bank, TD Canada Trust, Desjardins or Credit Union. Banking cards allow for Interac service if rotation is in rural or remote community. 

Some additional resources:

Accounting 

Accounting services are a useful thing to have. Previous residents have used an accountant and accounting services within the community, you can speak to your friends, family or colleagues within the community about this. 

In addition, some accountants in the city may offer free accounting services to residents during their residency years and only start to charge accounting fees after residency. Please check with services in your area via the 211 website. 

There are licensed and unlicensed daycares. We recommend that residents wishing to enroll their children in daycare should consider doing so with a licensed daycare. These licensed daycares must meet provincial standards as set out by Day Nurseries Act. For more information about the delivery of early year’s childcare, please visit the website for the Ministry of Education. 

Find a daycare in Northern Ontario

Financial Support for Child Care

For First Nation Day Care contact local band office administration. 

It could be suggested that you consider the following, when choosing a facility of your child: 

1. Location
2. How many hours 
3. Do you have more than one child attending 
4. Ages of children in day care 
5. Cost, etc. 

As a parent of a child under the age of 12 years, you may be entitled to some subsidy or tax breaks based on line 236 of CRA personal returns. Speak to your accountant for more details. 

Elementary School grades: JK to 6 or 8

Secondary School grades: 7 or 9-12 

Find a school

For information about the delivery of publicly funded education, please visit the website of the Ministry of Education  

*** EQAO Testing (Educational Quality and Accountability Office) All public-school children tested in Ontario in literacy and math grades 3, 6 and 9 

Spiritual well-being is an important facet for most, if not all humans. Below is a list of some of the available Places of Worship by community:  

• North Bay
• Kenora  
• Sault Ste. Marie 
• Sudbury 
• Temiskaming Shores (see page 22)
• Thunder Bay  
• Timmins   

Many communities in the north have multicultural societies that help to provide support and connections to the community for newcomers from a variety of backgrounds. Reaching out to the multicultural society is a very quick way of finding people from your country, culture, ethnicity, who have made the north their home.  

Kenora 

• The Multicultural Association of Kenora & District  

North Bay  

• North Bay & District Multicultural Centre  

Sault Ste. Marie 

• Sault Community & Settlement Services 

Sudbury 

• Sudbury Mulitcultural Society and Folks Arts Association 
• YMCA Northeastern Ontario- services for newcomers 

Temiskaming Shores 

• Northeastern Ontario Immigration 

Timmins 

• Timmins & District Multicultural Centre  

Thunder Bay  

• Thunder Bay Multicultural Association  
• City of Thunder Bay Ethnocultural Groups and Services 

 Missing your community? Check out the 211 websites and explore your area for more information

Visit our Community Profiles page to learn about all NOSM University communities across Northern Ontario.

Missing your community? Check out the 211 website and explore your area for more information and contacts: https://211ontario.ca/