Ford government quietly reverses medical residency rule that excluded most immigrant physicians

The rule change — abruptly made by the Health Ministry on Oct. 8 — caused an uproar among internationally trained immigrant physicians and Canadians who graduate from medical school abroad and didn’t go to an Ontario high school.

It was also criticized by physician advocacy groups that said the rule would lead to unfilled residency spots and harm Ontario’s efforts to boost the number of family doctors, when so many people lack access to primary care.

Due to the ongoing litigation, the Ontario Superior Court of Justice has ordered an interim injunction to prevent the policy from taking effect for the 2026 applicants. 

In a memorandum obtained by the Star, Ontario assistant deputy health minister Dr. Karima Velji wrote to the Council of Ontario Faculties of Medicine — a body representing the province’s seven med schools — to reverse the policy.

“I am writing to confirm that the government has now rescinded the 2026 policy direction that was set out in my memo dated September 16, 2025,” Velji wrote in the one-page document dated March 23, 2026.

“We will engage with you further as we consider an approach for the 2027 CaRMS process,” she added, referring to the Canadian Resident Matching Service, the national, non-profit organization that facilitates the residency application and matching process.

The memorandum did not provide a reason for the province’s decision. The Star has not been able to find any public announcement about the policy reversal.

In response to the Star’s inquiry about the rescission, the Health Ministry maintained that medical school residents are more likely to practise in the region where they receive their training, saying in an email that “our government is taking bold action to ensure Ontario has a strong pipeline of highly skilled doctors for years to come.”

“This includes our record investments to increase medical school residency positions by over 47 per cent, with over half being reserved for family medicine, standing up new primary care teams, enhancing digital tools and expanding programs … that will add nearly 1,500 new family doctors with full rosters, to connect every person in Ontario to publicly funded primary care by 2029,” the ministry said.

The Council of Ontario Faculties of Medicine said in a statement it acknowledges the ministry’s revised direction and is “aligned with the updated approach.”

The Ontario Medical Association, which had previously warned the rule would worsen the province’s primary care crisis, said in a statement that it welcomes the government’s decision.

“With many Ontarians still without access to a family doctor, it is important that every qualified candidate — including internationally trained physicians — can compete for residency positions and help connect patients with the care they need,” the OMA said.

The association, which represents about 50,000 Ontario doctors, medical students and retired physicians, said it will work “with the government and Ontario’s medical schools to support Ontario students while maintaining fair opportunities for internationally trained physicians in future matching cycles.”

The Internationally Trained Physicians of Canada said it welcomed the government’s move, which marks a “significant and necessary step” toward restoring fairness in the residency process. “The rights of qualified, hardworking and deserving ITPs have been upheld,” it said. “However, it remains deeply concerning that such a discriminatory policy was implemented in the first place, particularly during an active match cycle, and required legal action and sustained advocacy to reverse.”

The Canadian medical residency application is a months-long process where candidates apply in the fall and submit transcripts, requested documents and references, and have them translated and verified. After interviews in January and February, programs rank their desired candidates and applicants rank their preference for matches. Results are released nationally in March. Unfilled spots will move to the second round.

The Ontario government changed the rule last fall, weeks after the registration for 2026 placements started July 9. The sudden, mid-cycle implementation upended residency plans for hundreds of international medical graduates, many of whom had already invested time and money in the extensive application process. 

Litigation started in November and a hearing was scheduled for June. Warda Shazadi Meighen and Allan Rock, counsel for the plaintiffs, declined to comment about the policy reversal.