The Honest Answer Most People Avoid
Most IMGs want to practice in Ontario or BC — Toronto or Vancouver. The lifestyle, the communities, the income. This is completely understandable.
The honest answer is that both provinces have become significantly harder for IMGs compared to 5 years ago. Ontario no longer has a PRA program. BC has one, but it is competitive and location-restricted. CaRMS match rates in Ontario programs have dropped for IMGs due to Ontario's 2024 policy restricting IMG eligibility for Ontario-funded residency positions.
Here is the real comparison.
Ontario for IMGs in 2026
CaRMS in Ontario Ontario programs are the most competitive in Canada for IMGs. In 2024, Ontario introduced restrictions on IMG eligibility for provincially-funded residency positions — only IMGs with a connection to Ontario (prior residence, family, Canadian education) qualify for an increasing number of Ontario programs.
Family medicine programs in Ontario still accept IMGs nationally, but spots are limited. Specialty programs in Ontario are largely inaccessible to IMGs without an Ontario connection.
PRA in Ontario Ontario does not have a PRA program. Full stop. IMGs cannot get an independent practice license in Ontario through the PRA route. This eliminates the fastest pathway to practice for most IMGs targeting Ontario.
Income in Ontario Ontario physician income is among the highest in Canada, particularly in underserved areas. Rural Ontario family physicians can earn $250,000–$350,000+ CAD/year.
Verdict for Ontario If Ontario is your target, CaRMS is your only route. Strengthen your application with Ontario clinical experience and an Ontario connection. Family medicine gives you the best odds.
BC for IMGs in 2026
CaRMS in BC BC programs are competitive but generally more accessible to national IMG applicants than Ontario. Family medicine programs across BC, including rural programs, have historically accepted IMGs without a BC connection. UBC's family medicine program has been one of the more IMG-friendly programs nationally.
PRA in BC BC has the IMG-BC program — a PRA pathway for family medicine. Unlike Saskatchewan, it is not score-ranked, but applicants with a connection to BC (prior residence, Canadian education in BC) are significantly advantaged. Rural commitment post-assessment is mandatory.
Income in BC BC physician income is strong. Rural family physicians in BC earn $200,000–$280,000+ CAD/year. BC also has some of the most attractive lifestyle locations in Canada.
Verdict for BC BC is more accessible than Ontario for most IMGs. If you are willing to practice rurally for 2 years, the IMG-BC PRA pathway is a realistic option. CaRMS in BC is also more nationally open than Ontario.
The Underrated Alternative: Saskatchewan + Atlantic
Saskatchewan has the highest volume of IMG-accessible positions in Canada. Atlantic provinces (Nova Scotia, New Brunswick, PEI, Newfoundland) have lower competition, accessible PRA pathways, and are often overlooked because IMGs fixate on major cities.
A common and effective strategy: complete PRA in Saskatchewan or Atlantic Canada, build 2–3 years of Canadian experience, then move to BC or Ontario for your preferred location with Canadian physician credentials.
The Right Question to Ask
Instead of 'which province is best?', ask 'which pathway gets me to independent practice fastest, and which province fits that pathway?'
imgpass.ca/pathway-navigator maps the fastest realistic pathway based on your graduation country, years of practice, and target location.