Ontario judge grants international medical school grads a temporary lifeline

Posted on December 4, 2025 in Health Policy Context

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TheStar.com – News/Canada
Dec. 4, 2025.   By Nicholas Keung, Senior Immigration Reporter, and Megan Ogilvie, Health Reporter

Health Minister Sylvia Jones has defended the rule change, with a spokesperson saying the government is “delivering more opportunities for Ontarians who started their medical education abroad to be able to complete their postgraduate training in Ontario.”

Judge extends applications for grads who would have been excluded from first round of matching for residency placements under a controversial new rule.

An Ontario judge has given a temporary lifeline to international medical school graduates who would have been excluded from qualifying for the first round of matching for medical school residency placements under the province’s controversial new rule.

On Thursday, Superior Court judge Markus Koehnen ordered the Ministry of Health to reopen the applications process so that candidates affected by the new requirement have until 5 p.m. on Dec. 8 to submit applications to the Canadian Resident Matching Service (CaRMS) for residencies in Ontario.

Abruptly announced in October, the new rule would require international medical graduates to have completed at least two years of high school in Ontario to be considered for the first round of matching for medical school residency placements.

The policy change would bar most immigrant physicians from the first round of matching, which experts say would force many of the most qualified doctors to leave the province for residency placements, or abandon their chosen specialty altogether.

The Internationally Trained Physicians of Canada, which is not part of the legal challenge but has closely monitored the proceedings, hailed the interim injunction, which will remain in effect until the disposition of a Charter challenge or further order of the court.

“Today’s court decision to halt this policy is a critical and necessary intervention,” the national advocacy group said in a statement.

“We are thankful that qualified, hard-working and deserving ITPs have had their rights upheld. However, it is deeply concerning that such a discriminatory rule had to be challenged in court to protect the basic rights of physicians who already call Ontario home and serve its communities.”

Physician advocacy groups, including the College of Family Physicians of Canada and the Internationally Trained Physicians of Canada, were quick to denounce the Oct. 8 rule, calling it both restrictive and discriminatory. The Ontario Medical Association has warned the rule will worsen the province’s family doctor shortage.

OMA president Dr. Zainab Abdurrahman said restoring access to the first round of matching is an important win for fairness, and for patients who need doctors in Ontario. The OMA, which represents about 50,000 Ontario doctors, medical students and retired physicians, “supports a process that keeps every path open for qualified doctors who want to care for Ontarians.”

The OMA urges the province and medical schools to rethink the policy and work on an approach that is fair, practical and focused on patient need, she said.

The Ford government has previously said the new requirement will deliver “more opportunities for Ontarians who started their medical education abroad.”

The injunction application was led by two international medical graduates, who intend to secure residency spots in vascular surgery and in the field of obstetrics and gynecology, respectively. Both came to Canada as permanent residents.

Earlier Thursday, officials with CaRMS, the administrator of the residency matching, the Association of Faculties of Medicine of Canada (AFMC) and the Council of Ontario Faculties of Medicine — none of which are a party in the case — appeared in court to respond to questions by the judge about potential consequences of another extension.

The application period was closed initially on Nov. 27, but the Divisional Court extended the deadline to Thursday, which has now been put off until Monday. It’s meant to allow time for people initially excluded by the new rule to submit an application for consideration.

Officials with those bodies told the judge that any further extension could cause “domino effects” and delay processing, putting tremendous pressure on medical school faculties in selecting candidates, who start residencies July 1. Concerns were also raised over the jurisdiction of the provincial court and the application extension’s implications on medical schools in other provinces.

“We recognize this situation has been potentially disruptive to you as an applicant,” AFMC, which represents Canada’s 18 faculties of medicine, said in a statement.

“CaRMS has been working to ensure that the information you are provided with is both timely and accurate, while trying to navigate the same uncertainties you may have been experiencing. We are optimistic that the Match process will return to the usual function now that the judicial proceedings have concluded.”

Earlier this week, the applicants’ lawyers said completing a medical residency program is generally the only way for international medical graduates to gain access to the profession in Canada and the two-year Ontario high school requirement is “unreasonable, procedurally unfair, unintelligible,” and a violation of the Charter.

More than 92 per cent of the spots are filled in the first iteration of the matching, and being excluded from round one of the process could cause irreparable harm to IMGs who don’t meet the new rule and can’t make up for it, they argued. High school attendance in Ontario in this case is a proxy for national and ethnic origin as well as place of upbringing, they said.

“They’re not foreign nationals,” lawyer Warda Shazadi Meighen, who represents the affected applicants with co-counsel Allan Rock, told the court. The policy “immediately extinguished a one-time career-defining opportunity for both of these applicants.”

The new policy is meant to ensure Ontario residency positions are occupied by people who have a demonstrated and long-standing connection to the province, so they will remain here throughout their careers, given the enormous provincial public expense of funding residency programs, the provincial government contended.

There will be applicants who benefit from the change and those who don’t. “The court should not be picking winners and losers,” its lawyer Zachary Green argued.

While governments always face difficult policy choices, these decisions are subject to court scrutiny, said Rock, a former federal justice minister and attorney general. Many of the affected IMGs have made plans, invested in the process and followed the rules to practise medicine in Ontario, only to be upended at the last minute.

“That’s irreparable harm to say to that person, ‘You cannot practise your profession. We have closed the door,’” Rock said in closing.

Nicholas Keung is a Toronto-based reporter covering immigration for the Star.  Megan Ogilvie is a Toronto-based health reporter for the Star. 

https://www.thestar.com/news/canada/international-medical-graduates/article_6ad75e1e-b3e9-4935-964b-99a237ba8ad6.html

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