Registration assessment policies
Our registration assessment policies outline the processes for Practice Readiness Assessments, transferring from our Provisional Register to our General Register, and Summative Assessments.
Practice Readiness Assessments
A Practice Readiness Assessment (PRA-AB) is the required final step of an alternate path to independent practice in Alberta for IMGs who don’t have complete Canadian credentials. Once an IMG registers with CPSA, they must pass this 2-part assessment of their clinical competence, chart management and professionalism to join CPSA’s temporary Provisional Register. If a Canadian medical graduate fails a national exam, they also have to participate in a portion of this assessment and pass before joining the Provisional Register.
Part A: Preliminary Clinical Assessment (PCA)
Over 3 months, you’ll work under direct observation in the medical practice of a CPSA-approved assessor. The assessor will always be the physician in charge of the practice and will oversee everything you do. They’ll review your clinical competence, chart management and professionalism. The assessment can be stopped at any time if CPSA has enough evidence to make a decision about your ability to practice in Alberta. Part A could be waived based on your location of medical training or specialty certification, previous experience in a Canadian setting, an appointment to a full-time academic position, or if you are a Canadian-trained applicant who has not passed the national certification exams.
Part B: Supervised Practice Assessment (SPA)
Over 3 months, a CPSA-approved supervisor will observe you in independent practice where you are the physician in charge. During this phase, you can bill Alberta Health for your medical services. The supervisor will visit you regularly to review charts and collect feedback from your patients, colleagues and staff. The assessment can be stopped at any time if CPSA has enough evidence to make a decision about your ability to practice in Alberta.
Start your PRA-AB
Below are the steps you need to take before a PRA-AB Assessment. Once these are complete, CPSA finds you an assessor and arranges the assessment dates. This may take some time as we are very thorough in finding assessors that are available, qualified and do not have conflicts of interest.
- Submit a Review of Qualifications for Independent Practice: Through your physiciansapply.ca account, you need to submit a Review of Qualifications to CPSA. This is our pre-screening process for every applicant to confirm you meet all the CPSA eligibility requirements. We’ll send you a CPSA Eligibility Letter confirming if you can move to the next step. It outlines which CPSA Register you can apply to and what assessment you need. You also need this letter for AHS sponsorship. For more information, check out applying for independent practice.
- Apply for the TDM exam: If you are a Family Medicine physician, you need to pass the Therapeutics Decision Making exam. Family Medicine physicians who aren’t eligible for independent practice on the General Register, or who do not have Recognized Training and Certification Outside Canada through the College of Family Physicians of Canada, must write the TDM exam.
- Secure AHS sponsorship: You need to apply for sponsorship from Alberta Health Services (AHS). This sponsorship helps make sure new-to-Alberta physicians can enter the workforce while also serving communities that have the highest need for physicians. AHS sends us a sponsorship form. To apply for or see what jobs are available in Alberta, visit doctorjobsalberta.com.
- Submit your supporting documents: Your CPSA Registration Administrator will contact you after we receive your TDM exam results (if applicable) and AHS sponsorship form. At this stage, you will need to answer background questions through your physiciansapply.ca account and provide us with supporting documentation. Your CPSA Registration Administrator will let you know what documentation we need.
- Start the PRA-AB: Once we have your full application and supporting documents, we’ll send your file to the PRA program and start setting up your assessment.
Information for AHS Medical Affairs
All PRA-AB assessments depend on the applicant physician having and maintaining AHS sponsorship. This information helps AHS employees know what we need from AHS. It also helps us understand what the physician is being sponsored for and what kind of assessment they need. Applicant physicians have to maintain their sponsorship once they join the Provisional Register.
- AHS reviews the applicant’s CPSA Eligibility Letter to help with their selection process. The letter outlines which CPSA Register the applicant can apply to and what assessment they need.
- AHS completes and submits the Physician Sponsorship form. This outlines the applicant’s type of practice, scope of practice and practice location.
- AHS updates CPSA with any changes to an AHS-sponsored physician’s practice by completing the Change to Physician Sponsorship form.
Fees (taxes are included) for a PRA-AB Assessment are paid by the sponsor and cover the cost of the assessors’ time and any expenses they incur related to the assessment. They also include any fees we pay to the Medical Council of Canada (MCC) to be a part of the pan-Canadian PRA program (NAC-PRA). Applicants may be responsible for their own assessment fees—please review your employment and sponsorship contracts for details.
If you’ve been out of practice for more than 3 years, you may have to complete a return-to-practice assessment to make sure you can start working again safely. This assessment determines what kind of re-training or other support you might need to care for Albertans after a long absence from medicine.
CPSA will review your application and let you know if you need an assessment and additional training. We’ll arrange any required assessment and training.
Return-to practice assessment fees
Physicians are responsible for any costs associated with their return-to-practice assessments.
If you are already practising medicine in Alberta and would like to add a new medical service to your practice, you may need an assessment to make sure you have the training, experience and competence to offer this service to Albertans.
CPSA will review your application and let you know if you need an assessment and additional training. We’ll arrange any required assessment and training. Physicians are responsible for any costs.
If you are registered with CPSA and have new certification from either the Royal College of Physicians & Surgeons of Alberta (RCPSC) or the College of Family Physicians of Canada (CFPC), please first contact firstname.lastname@example.org to let us know about your new credentials.
A Registration Administrator will respond with the next steps.
Change-in-scope assessment fees
Physicians on CPSA’s temporary Provisional Register have 6 years to get all their Canadian credentials and transfer to the General Register. Those who don’t have to pass a Summative Assessment at their own cost if a Summative Assessment is a requirement on their Registration Understanding Acknowledgement.
The Summative Assessment is a mandatory, 3 to 4 day pass/fail assessment of your medical knowledge, procedural skills, clinical decision-making skills, communication and professionalism to prove you qualify for registration on the General Register. Without getting the required credentials or passing the Summative Assessment, your registration on the Provisional Register will expire. This is a high-stakes pass/fail assessment—physicians who fail can no longer practise medicine in Alberta. There is an appeal process for those who fail the Summative Assessment. During an assessment or appeal, your registration on the Provisional Register will remain valid.
We encourage physicians to get all their Canadian credentials within 6 years.
Summative assessment fees
Registration Assessment FAQs
To see more FAQs related to Registration, click on All FAQs and filter by "Registration"All FAQs
Are there any exemptions from the Summative Assessment process, other than obtaining my Canadian certification and LMCC?
Physicians on the Provisional Register who were exempt from the Preliminary Clinical Assessment (PCA) part of their initial Practice Readiness Assessment are also exempt from the Summative Assessment (e.g. academic appointments). In these cases, CPSA will review their file near the expiry of their provisional registration to confirm they still meet all the requirements to transfer to our General Register, including being in satisfactory practice.
Can CPSA increase the exam frequency and number of spots for the exam?
Every jurisdiction has a differing number of spots for the exam. This is because of logistics, resources and average exam applicants. NAC PRA only offers this exam two times per year.
Do I need to take this exam if I am a specialist?
How can I avoid a Summative Assessment?
You can ensure a smooth transition from the Provisional Register to the General Register by getting your Canadian Credentials, updating us with source-verified credentials, remaining in good standing with CPSA Standards of Practice, Code of Ethics and Code of Conduct, and keeping current with your Continuous Professional Development.
How do I find out when my Provisional Registration expires?
Details on your Provisional Registration can be found in your Registration Understanding Agreement. If you don’t have your copy available, contact email@example.com.
How long does it take to receive my TDM exam results?
You should receive your TDM exam results within 4 weeks of writing the exam. We’ll send it to you by email and it is automatically uploaded into your physiciansapply account.
How long is my TDM exam result valid for and how many times can I take the exam?
If you pass, you can use those results on Canadian registration applications for two years.
If you fail, you can take the test once more, at least seven months after your first attempt. You can’t take two back-to-back tests.
You can write the TDM exam a maximum of four times in a lifetime.
Due to the impacts of COVID-19 causing some PRA program intakes to be postponed and/or cancelled, the MCC and PRA programs have decided to extend the TDM Examination result validity period from two years to three years for individuals currently holding a valid pass result. For those who wrote and passed the TDM exam administrations between Fall 2018 to Winter 2020, please see the TDM Exam Guidelines for more information.
Find other important information in the TDM Candidate Guidelines.
Is there a waiting list for the TDM exam?
If you apply for an exam and it fills up before MCC’s cutoff date, we place you on a waiting list for that specific exam and contact you if someone withdraws.
What could delay or prevent my transfer to the General Register?
Each physician’s situation is assessed individually. We consider a number of factors, including any open CPSA complaints or interventions, non-compliance with the Continuous Professional Development (CPD) rules or practice restrictions or conditions, un-verified credentials, not completing at least 5 years of satisfactory practice in Alberta while on the Provisional Register, lack of evidence of good character or a history of serious professional conduct issues like professional misconduct, imposed practice restrictions or a failure to remediate quality-of-care issues with the Continuing Competence Program.
When will CPSA review my file to transfer me from the Provisional Register to the General Register?
CPSA reviews your status every time you tell us about new certifications, or when you reach your five or six-year anniversary on the Provisional Register. We may ask you for information about your certifications at that time to help us determine if you are eligible for the General Register.
Where else can I take the TDM exam?
TDM is a national exam offered through the Medical Council of Canada. In addition to Alberta, you can take this exam in British Columbia, Saskatchewan, Manitoba and the Maritimes. For more information, visit MCC NAC PRA.
Who is completing my registration assessment?
We rely on qualified physician assessors from across Alberta to help us review physicians who are new-to-Canada, have changed their practice or are returning from a long break.
Our assessors are highly-respected clinicians who help us ensure we’re registering competent and well-trained physicians.
Questions or feedback? We'd love to hear from you.
Toll-free: 1-800-561-3899 ext. 4924 (in Canada)