Orthopaedic Fellowships in Canada: Licensing, Visas & Pay
Canadian orthopaedic fellowships are post-residency clinical posts that you apply for directly through a university department, not through a national match. Each province's medical regulator licenses fellows through the host university's postgraduate medical education (PGME) office, and international fellows normally need an LMIA-exempt C45 work permit. This guide sets out what official regulator, government and university pages say, with programme examples in Canadian dollars.
Educational guidance, not legal, immigration, licensing or admissions advice.How orthopaedic fellowships work in Canada
A clinical fellowship in Canada is training taken after residency by a surgeon who already holds specialist status. The University of Toronto's orthopaedic division describes clinical fellows as surgeons from Canada or abroad who have already attained orthopaedic surgery specialist status in their country of origin. Fellowships are not part of CaRMS: Dalhousie describes its departmentally funded clinical fellowships as non-CaRMS appointments, and Manitoba notes that fellowship training is not recognised as training towards Royal College or CFPC certification. You apply to the department or programme, the programme selects you, and the university PGME office then handles the appointment, licensing paperwork and immigration documents.
- Most clinical orthopaedic fellowships last 12 months. UBC programmes run 1 July–30 June or 1 August–31 July, and U of T's Sunnybrook spine fellowship usually runs from August to the following July.
- Selection comes first, licensing second. Manitoba states that fellows apply to CPSM only after the university has accepted them, and Alberta's CPSA needs approval from an Alberta medical school before it can register a learner.
- The Canadian Orthopaedic Association (COA) keeps a fellowship directory listed by programme and subspecialty and tells applicants to contact centres directly.
- COA travelling fellowships, such as the ABC and North American Travelling Fellowships, are tours for early- to mid-career COA members. They are not clinical training posts.
When to apply: lead times of 18 months to two years
Canadian orthopaedic fellowships recruit well ahead of the start date. Many deadlines fall 18 to 24 months before you start, and immigration and licensing take months on top of that. Université de Montréal says the steps for a moniteur (fellow) must begin at least twelve months ahead, and Sherbrooke tells applicants to allow about 12 months for administration before the fellowship starts.
- UBC Orthopaedics: applications open 15 April and close 31 October two years before the start. For July/August 2028 starts the deadline is 31 October 2026, and selection may take 3–6 months.
- U of T, Toronto Western Shoulder & Elbow: applications are due 1 December, 18 months before the start date.
- Western University, Fowler Kennedy Sport Medicine: the deadline is 30 November 2026 for the 2028–2029 programme.
- Western University, Shoulder Surgery: applications are due 31 December for a start two years later, and selection takes place in mid-February.
- University of Alberta, Sports Medicine & Arthroscopy: applications open 1 July two years before the proposed start and close 1 February of the preceding year. Early or incomplete applications are returned.
- McGill PGME: for 2027–2028, applications opened on 15 May 2026, and the deadline for most fellowship programmes was 1 September 2026.
- Licensing lead times: U of T PGME advises starting your CPSO application at least four months before the appointment. UBC needs complete fellow applications at PGME at least 8 weeks before the start, and CPSBC needs them six weeks before.
Provincial licensing for clinical fellows
Every province requires a fellow to hold an educational licence before training starts. In practice, the university PGME office sponsors the application, and the fellow supplies the documents. The bullets below list what each regulator or its partner university states. Fees and forms change often, so always confirm with the PGME office.
- Ontario (CPSO): you need a postgraduate education certificate to train at an Ontario medical school. CPSO lists a medical degree, an appointment at an Ontario medical school and, for international graduates, the MCC Evaluating Examination or MCCQE Part 1 as requirements. Its policy for internationally trained clinical fellows says the certificate ends after two years but can be renewed for a third, fourth and fifth year in the same programme. U of T PGME says international graduates starting a clinical fellowship must complete the Pre-Entry Assessment Program (PEAP), normally 4–12 weeks, and that CPSO receives a signed form of educational objectives.
- British Columbia (CPSBC): fellows hold an educational – postgraduate (fellow) licence, applied for through the UBC Faculty of Medicine. You must have met RCPSC specialist educational requirements or be recognised as a specialist in your jurisdiction, meet CPSBC English proficiency rules, and be legally able to live and work in BC. The licence lasts up to four years, and training cannot begin until it is issued.
- Alberta (CPSA): all medical learners register with CPSA after approval by the University of Alberta or University of Calgary. CPSA lists degree verification through physiciansapply.ca, English proficiency and criminal record checks, and a one-time fee of $400 for 2026 and 2027.
- Québec (CMQ): McGill says fellowship candidates must be judged eligible for a CMQ training card (carte de stages). After you accept an offer, the CMQ issues a letter of eligibility following source verification through the Medical Council of Canada. You need this letter before you can start your work permit application.
- Nova Scotia (CPSNS): a Postgraduate Training licence is the educational licence for training at Dalhousie. CPSNS states that its exam requirements do not apply to candidates trained outside Canada who are applying for an elective or fellowship at Dalhousie. English proficiency rules still apply, for example IELTS Academic 7 in each component, OET Medicine B or CELPIP General 9.
- Manitoba (CPSM): internationally trained fellows most often register in the Provisional (Academic – Post Certificate Trainee) class. You need a request signed by you, the supervising department head and the dean. The class allows up to 24 consecutive months, which the Registrar can extend.
- Saskatchewan (CPSS): the University of Saskatchewan PGME office must approve each clinical fellowship in advance. Its form lists the medical degree, specialty certification, MCCQE1 results, a CV and ACLS. International graduates may need IELTS, OET or CELPIP results to meet CPSS licensing criteria.
Immigration for international fellows: the C45 work permit
IRCC states that a medical resident or fellow with a degree equivalent to a Canadian MD needs a work permit, and that fellowships typically last one to two years. Fellows normally use the LMIA-exempt, employer-specific route under exemption code C45 (Foreign medical or dental residents and medical research fellows, R205(c)(ii)). Under C45, fellows must be recognised specialists who have completed residency. Unlike residents, medical research fellows may be publicly funded.
- Before you apply, the employer submits an offer of employment, pays the $230 employer compliance fee and gives you the offer number. Universities often call this number the 'A-number'.
- On the application, select 'Exemption from Labour Market Impact Assessment' as the work permit type.
- You need an immigration medical exam and a letter of employment on university letterhead. The letter must give your dates, location and income, and state whether a College of Physicians and Surgeons licence is required.
- Where applicable, IRCC asks for the provincial College's letter of eligibility for licensure. In Québec, McGill says the CMQ letter must arrive before the work permit application can start.
- McGill PGME says fellows are treated as foreign workers, not students, so you should not apply for a study permit. C45 applicants do not need an LMIA or a Québec Acceptance Certificate (CAQ).
- Spouses may qualify for an open work permit if the fellow's work permit is valid for at least 16 months. This applies to McGill trainees, according to McGill PGME.
- Visa-sponsored candidates, such as those funded by a home government, may need to apply through their sponsor as well as the programme. UBC and Manitoba both state this.
Funding and salary: what Canadian orthopaedic fellowships pay
Pay varies widely between programmes and depends on how the post is funded. Some fellowships pay a stated salary, while others rely on surgical-assist billings. Many universities do not allow self-funding. Calgary's clinical fellows policy says fellows may not use personal financial resources and must be paid at least the PGY1 rate. McGill requires non-profit funding of at least the R1 salary (about $60,000 a year, plus tuition), and Université de Montréal requires at least CAD 40,000 a year, rising to CAD 50,000 for starts from 1 July 2028. The examples below come from current official programme pages. Amounts are in Canadian dollars and are for the cycle shown on each page.
- UBC Neurosurgical & Orthopaedic Spine (Vancouver): $100,000 plus benefits where applicable, 1 August–31 July.
- UBC Orthopaedic Trauma – Vancouver Acute: $97,877 plus benefits where applicable, 1 July–30 June.
- University of Alberta Sports Medicine & Arthroscopy (Edmonton): Canadian fellows receive $80,000 a year (PGY6 level) from a fund supported by surgical-assist billings. Foreign fellows may need external funding.
- Toronto Western Shoulder & Elbow (U of T): $75,000 CAD, with the possibility of more from third-party insurance lists.
- Sunnybrook Combined Spine (U of T): four funded fellowships at $71,635.24 a year, plus unfunded places. Fellows may not bill OHIP individually.
- Western University Orthopaedic Sport Medicine, Fowler Kennedy (London, Ontario): $70,000 stipend a year; health benefits not included.
- Western University Shoulder Surgery (London, Ontario): $50,000 stipend a year.
- Université Laval Orthopaedic Trauma (Québec City): moniteurs from outside Québec must bring CAD 45,000 a year of their own funding, such as a home-country scholarship. The programme may help with part of this.
Québec specifics: French, funding and the moniteur category
Québec uses its own terms and rules. A fellow from outside Québec is a moniteur, defined at Université de Montréal as a doctor in an approved host or exchange programme who is not paid under the FMRQ resident agreement. Québec graduates and people already trained in Québec cannot join the moniteur category, but they may take a RAMQ-paid formation complémentaire instead. Expect French to matter at francophone universities.
- Université de Montréal lists 'sufficient knowledge of French' among its mandatory conditions for moniteurs, alongside CMQ requirements and the funding minimum.
- Université Laval (orthopaedic trauma) requires written proof of French. If you cannot provide it, you must pass the TCF Tout public with at least 450, or you may be admitted conditionally with at least 361. The programme also assesses oral French at interview.
- Université de Sherbrooke notes that the CMQ no longer formally assesses French for some categories, so medical faculties now verify it themselves.
- McGill teaches in English, and you can apply in English or French. McGill also states that Québec law requires physicians to be able to provide care in French and English, and that residents take PGME French courses.
- Self-funded and privately funded fellowships are not permitted at Université de Montréal, Sherbrooke or McGill. All three require funding from a university, government or recognised agency.
City guide: where Canada's orthopaedic fellowships are
Most Canadian orthopaedic fellowships sit in university teaching hospitals. Use these city pages to see current programmes, deadlines and stated funding in each centre. Each city page lists its current programmes, deadlines and stated funding; the main hubs are also linked under related pages.
- Toronto (U of T, six hospital sites including Sunnybrook, St. Michael's, Toronto Western and SickKids)
- Vancouver (UBC; also New Westminster and North Vancouver)
- Montréal (McGill, Université de Montréal, CHUM, CHU Sainte-Justine)
- Ottawa (University of Ottawa)
- Calgary (University of Calgary)
- Edmonton (University of Alberta)
- Hamilton (McMaster University)
- London, Ontario (Western University, Fowler Kennedy, Roth|McFarlane HULC)
- Kingston (Queen's University)
- Halifax (Dalhousie University, IWK)
- Winnipeg (University of Manitoba, Pan Am Clinic)
Checklist for Canadian and international applicants
Use this as a planning list, then check every item against your target programme and PGME office.
- Start 24 months before your preferred start date, and note each programme's deadline (UBC 31 October; Western Sport Medicine 30 November; Toronto Western Shoulder & Elbow 1 December).
- Gather evidence of specialist status. UBC asks for a letter from your home specialty college confirming training and exams, with notarised translations where needed.
- Prepare a month/year CV that explains any gaps, plus three reference letters on letterhead.
- Secure acceptable funding. Many programmes need a sponsor letter and refuse self-funding.
- Take an English test if required (for example IELTS Academic 7 in each component). For francophone Québec programmes, prepare proof of French.
- Set up a physiciansapply.ca account for source verification where your province or programme uses it.
- After acceptance, complete licensing through the PGME office (CPSO, CPSBC, CPSA, CMQ, CPSNS, CPSM or CPSS), then apply for the C45 work permit with the employer's offer number.
- Arrange CMPA liability cover, and private health insurance until provincial coverage begins.
Sources checked and applicant checklist
Every rule, date and amount in this guide was read on official regulator, Government of Canada, university PGME, department or Canadian Orthopaedic Association pages on 8 October 2026. Programme salaries and deadlines change each cycle, so confirm with the programme before applying.
Before you act
- Confirm the programme's current deadline and intake year on its own page.
- Ask the university PGME office which licence class and documents apply to you.
- Confirm funding in writing before applying for a work permit.
- Reopen the regulator and IRCC pages before paying fees; rules and fees change.
Official sources
- You need a work permit: medical resident or fellow ↗Immigration, Refugees and Citizenship Canada: Fellows need a work permit; fellowships 1–2 years; employer offer, $230 compliance fee, LMIA-exemption selection, medical exam, employment-letter contents (checked 8 October 2026).
- Foreign medical or dental residents and medical research fellows [R205(c)(ii) – C45] ↗Immigration, Refugees and Citizenship Canada: C45 exemption code; fellows must be recognised specialists; research fellows may be publicly funded; provincial College letter of eligibility where applicable (checked 8 October 2026).
- Immigration (McGill PGME) ↗McGill University Postgraduate Medical Education: Fellows are foreign workers, not students; C45 LMIA-exempt employer-specific permit; no LMIA or CAQ needed; A-number; spousal open work permit 16-month rule (checked 8 October 2026).
- Requirements (certificates of registration) ↗College of Physicians and Surgeons of Ontario: Postgraduate education certificate requirements: degree, Ontario medical school appointment, MCCEE/MCCQE1 for IMGs; renewed annually (checked 8 October 2026).
- Postgraduate Education Term for Clinical Fellows ↗College of Physicians and Surgeons of Ontario: Certificate ends after two years; renewable for third–fifth years in the same programme (checked 8 October 2026).
- Training Preparation ↗University of Toronto PGME: PEAP mandatory for IMG clinical fellows (4–12 weeks); educational objectives form submitted to CPSO; apply to CPSO at least four months ahead; CMPA (checked 8 October 2026).
- Postgraduate fellow licence ↗College of Physicians and Surgeons of British Columbia: Fellow licence via UBC; eligibility; English proficiency; legal status; six-week deadline; four-year maximum; no training before licence issued (checked 8 October 2026).
- Postgraduate Fellows ↗UBC Faculty of Medicine PGME: Home specialty-college letter; 8-week PGME deadline; department obtains CPSBC licence; salary set in training agreement (checked 8 October 2026).
- Apply as a Medical Student, Resident or Fellow ↗College of Physicians and Surgeons of Alberta: Medical-school approval before registration; standard requirements; one-time $400 fee for 2026/2027 (checked 8 October 2026).
- Clinical Fellows Policy (August 2022) ↗University of Calgary Cumming School of Medicine: No personal financial resources; minimum PGY1-equivalent stipend; CPSA registration; work permit naming employer (checked 8 October 2026).
- Prospective fellows: admissions ↗McGill University Postgraduate Medical Education: 2027–28 window opened 15 May 2026, deadline 1 September 2026; non-profit funding of at least R1 salary (about $60,000) plus tuition; English instruction; French/English care obligation; CMQ eligibility (checked 8 October 2026).
- Fellows éventuels (French version of admissions) ↗McGill University Postgraduate Medical Education: CMQ carte de stages eligibility; CMQ letter of eligibility needed before work permit; fellowships do not lead to RCPSC/CFPC certification (checked 8 October 2026).
- Moniteur – Études médicales postdoctorales ↗Université de Montréal, Faculté de médecine: Moniteur definition; sufficient French; CMQ requirements; minimum CAD 40,000 (CAD 50,000 from 1 July 2028); no self-funding; start 12 months ahead (checked 8 October 2026).
- Formation complémentaire (fellowship) en chirurgie orthopédique traumatique ↗Université Laval, Faculté de médecine: 1 July–30 June; French proof or TCF TP 450 (conditional 361); oral French at interview; CAD 45,000 funding for moniteurs; RAMQ-paid route for Québec trainees (checked 8 October 2026).
- Admission Fellowship ↗Université de Sherbrooke: CMQ letter of eligibility before work permit; no personal/private funding; allow about 12 months (checked 8 October 2026).
- Procédure 2655-013: exigences linguistiques ↗Université de Sherbrooke: CMQ no longer formally assesses French for some categories; faculties verify (checked 8 October 2026).
- Postgraduate training licence ↗College of Physicians and Surgeons of Nova Scotia: Educational licence for Dalhousie training; exam requirements waived for externally trained fellowship applicants; English proficiency options (checked 8 October 2026).
- Departmentally Funded Clinical Fellowships ↗Dalhousie University PGME: Non-CaRMS appointments; CPSNS postgraduate licence and CMPA; PGME handles immigration (checked 8 October 2026).
- Registration in the Provisional (Academic – Post Certificate Trainee) Class ↗College of Physicians and Surgeons of Manitoba: Signed request by applicant, department head and dean; specialist recognition; English; legal status; 24-month limit with possible extension (checked 8 October 2026).
- PGME Fellowships ↗University of Manitoba, Max Rady College of Medicine: CPSM categories for fellows; apply to CPSM only after acceptance; visa-sponsored route; fellowship not recognised for RCPSC/CFPC certification (checked 8 October 2026).
- 7.a Clinical fellowship appointment form ↗University of Saskatchewan PGME: PGME advance approval; required documents incl. MCCQE1 results and ACLS; English tests for CPSS licensing; department coordinates work permit (checked 8 October 2026).
- Clinical Fellowships (UBC Orthopaedics) ↗UBC Department of Orthopaedics: Window 15 April–31 October two years ahead; 31 October 2026 for 2028/29; 3–6 month selection; documents; funding letter; English tests (checked 8 October 2026).
- Neurosurgical & Orthopaedic Spine Fellowship ↗UBC Department of Orthopaedics: $100,000 + benefits; 1 August–31 July (checked 8 October 2026).
- Orthopaedic Trauma Fellowship – Vancouver Acute ↗UBC Department of Orthopaedics: $97,877 + benefits; 1 July–30 June (checked 8 October 2026).
- Fellowships (U of T Orthopaedics) ↗University of Toronto Division of Orthopaedic Surgery: Six hospital sites employ fellows; fellows hold specialist status from country of origin (checked 8 October 2026).
- Hand & Upper Extremity fellowship positions ↗University of Toronto Division of Orthopaedic Surgery: Toronto Western Shoulder & Elbow: $75,000 CAD; due 1 December 18 months ahead (checked 8 October 2026).
- Spine fellowship positions ↗University of Toronto Division of Orthopaedic Surgery: Sunnybrook: four funded posts at $71,635.24; August–July; no individual OHIP billing (checked 8 October 2026).
- Orthopaedic Sport Medicine Fellowships ↗Fowler Kennedy Sport Medicine Clinic, Western University: $70,000 stipend; deadline 30 November 2026 for 2028–2029; health benefits not included (checked 8 October 2026).
- Shoulder Surgery Fellowship Program ↗Roth|McFarlane Hand & Upper Limb Centre, Western University: $50,000 stipend; 31 December deadline for start two years later; August start (checked 8 October 2026).
- Orthopaedic Surgery Fellowships (University of Alberta) ↗University of Alberta Division of Orthopaedic Surgery: $80,000 for Canadian fellows from Edmonton Orthopaedic Fellowship Fund; foreign fellows may need external funding; 1 July–1 February window; typical 1 July start (checked 8 October 2026).
- Fellowships (Canadian Orthopaedic Association) ↗Canadian Orthopaedic Association: COA directory of Canadian orthopaedic fellowships by programme and subspecialty; contact centres directly (checked 8 October 2026).
- Travelling Fellowships ↗Canadian Orthopaedic Association: ABC and North American travelling fellowships for early- to mid-career COA members (checked 8 October 2026).
Frequently asked questions
How do I apply for an orthopaedic fellowship in Canada?
Apply directly to the university department or programme. There is no national match for fellowships. Programmes usually ask for a CV, a cover letter, three references, specialty certification and proof of funding. Once you are selected, the university PGME office arranges your appointment and provincial licence and, if you are an international fellow, your work permit paperwork.
When should I apply for a Canadian orthopaedic fellowship?
Plan 18–24 months ahead. UBC's deadline is 31 October two years before the start, Toronto Western Shoulder & Elbow's is 1 December 18 months before, and Western's Fowler Kennedy sport medicine deadline was 30 November 2026 for 2028–2029.
How much does an orthopaedic fellowship pay in Canada?
It depends on the programme. Current official pages show, for example, $50,000 (Western shoulder), $70,000 (Western sport medicine), $71,635.24 (Sunnybrook spine), $75,000 (Toronto Western shoulder and elbow), $80,000 (Alberta, for Canadian fellows), $97,877 (UBC trauma) and $100,000 (UBC spine), all in CAD. Some programmes require international fellows to bring external funding.
Can international medical graduates do an orthopedic fellowship in Canada?
Yes, if you are a recognised specialist in your home jurisdiction and meet the provincial regulator's requirements. These usually include English (or, in parts of Québec, French) proficiency and verified credentials. Most international fellows need an LMIA-exempt C45 work permit, and many universities require funding from a government, university or recognised non-profit sponsor rather than self-funding.
What work permit does a foreign fellow need in Canada?
IRCC says medical residents and fellows need a work permit. Fellows normally apply for an employer-specific, LMIA-exempt permit under exemption code C45. The employer submits the offer and pays the $230 compliance fee, and you need a medical exam and a university employment letter.
Do I need to speak French for a fellowship in Montréal or Québec City?
It depends on the university. Université de Montréal lists sufficient French as a mandatory condition, and Université Laval requires written proof of French or a TCF score of at least 450 for its orthopaedic trauma fellowship. McGill teaches in English but notes that Québec law expects physicians to provide care in French and English.
Is a Canadian fellowship recognised for Royal College certification?
Generally not. The University of Manitoba states that fellowship training does not lead to Royal College or CFPC certification, and McGill says fellowships do not lead to RCPSC or CFPC certification.