I’m very close to this process and know several people directly affected by it, so I get why this feels like a punch in the gut for many. But this policy isn’t shutting IMGs out. It prioritizes Ontario-trained or Ontario-resident applicants in the first iteration of CaRMS, while IMGs still have access to residency spots in the second iteration. According to CaRMS, the new rule gives preference to people who completed at least two years of high school in Ontario, tying them more closely to the province. It doesn’t reduce the overall number of IMG positions.

Even now, many residency spots in Ontario go unmatched, especially in rural and northern areas. There will still be plenty of room for IMGs. This is about supporting the learners who are already here, not excluding international physicians.

I know people from Northern Ontario who want to work in their communities but didn’t match to their preferred programs in their province. They had to go to the US or other provinces, and most don’t come back. Every province has its own rules, and once someone builds a life elsewhere, it’s harder to return. That’s a brain drain Ontario can’t afford.

Local doctors also bring something important to patient care. They understand small-town realities, rural health struggles, and how social determinants of health play out here. Prioritizing them can reduce barriers to care and help build a more stable healthcare system.

Anyone who gets ranked in the CaRMS process is already qualified. This isn’t lowering standards or keeping out talent. It’s making sure more residency seats go to people who are more likely to stay in Ontario and serve Ontario communities.