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Pre-Entry Assessment Period (PEAP)


The Pre-entry Assessment Program (PEAP), a legislative requirement under the Medicine Act (1991), is a period of assessment to determine if the International Medical Graduate (IMG) candidate can function at their appointed level of training prior to full acceptance in the program. An IMG is a candidate who graduated from a non-LCME/CACMs medical school. The PEAP provides an opportunity for the Program Director to:

  • Assess the candidate’s basic skills appropriate for supervised practice in the chosen discipline.
  • Ensure that the candidate is: mentally competent to practice medicine; has the ability to practice with decency, integrity and honesty and in accordance with the law; has sufficient knowledge, skills and judgment to engage in the kind of medical practice authorized by the certificate, can communicate effectively and displays an appropriately professional attitude.

These individuals are not normally intended to be part of a Canadian PG output pool.

The PEAP provides an assessment of the candidate’s general knowledge and competency in the specialty and at the level in which she/he is certified, and appropriate for practice in the discipline in which the candidate is entering resident or fellowship training. The resident PEAP training period cannot be counted towards Royal College or Family Medicine certification. A successful fellowship PEAP training period can be counted.

Licensure and Supervision

The candidate must hold a valid certificate of registration (Pre-Entry Assessment Program Certificate of Registration) from the CPSO to participate in the PEAP. The PEAP candidate may practice medicine only:

(a) in a clinical teaching unit that is formally affiliated with the Ontario medical school and only as part of a system in which postgraduate trainees are regularly assigned by the program to that clinical teaching unit;

(b) to the extent required to complete the pre-entry assessment program to which the holder is appointed; and

(c) under a level of supervision that is determined to be appropriate for the holder and the program of medical education and assessment, by a member of the College designated by the director of the program; and
PG Deans approval May 2014

(d) may not charge a fee for medical services.

Once the PEAP is finished, the PEAP registration certificate expires immediately, and the candidate cannot continue training until the CPSO has reviewed the PEAP final assessment. Efforts and processes should be in place to avoid a break in licensure. If the PEAP is completed successfully, the College will issue a Postgraduate Education Certificate. Candidates must not begin training until the College has officially notified the candidate that the Postgraduate Education Certificate has been issued.

Assessment Format

Program Directors must ensure that candidates are assessed and given written feedback on a regular basis during the PEAP. The PEAP must be a minimum of four and a maximum of twelve weeks in duration (dependent on progress made and at the program directors discretion).

If a candidate is successful after the 12-week mark the final assessment is to be completed by the Program Director on the PEAP form and forwarded to the PG Dean’s Office for authorization and further forwarding to the CPSO.

PEAP extensions must not be for the purpose of remedial training. Extensions of up to 4 weeks training time is acceptable only in circumstances where something happened during the initial 12 weeks (e.g. illness of trainee or temporary unavailability of supervisor) that prevented full and fair opportunity for 12 weeks of assessment. Requests for PEAP extensions (beyond 12 weeks) can be processed at CPSO staff level and we will require an updated letter of appointment and a letter from the Program Director which outlines the reason for extension.

Possible Outcomes

  1. Satisfactory:  If the PEAP is completed successfully, candidates continue in the postgraduate training program.
  2. Unsatisfactory:  If the PEAP is not completed successfully, the PEAP certificate of registration immediately expires and cannot be re-issued. Enrolment in a subsequent PEAP in the same discipline is not permitted.
  3. Withdrawal:  A PEAP candidate may choose to withdraw from the PEAP at any time.
  4. Other:  Candidates should refer to individual school and hospital policy regarding suspension or other potential outcomes.


PEAP candidates may choose to appeal the unsatisfactory assessment based on process issues only. The candidate would refer to the individual school’s policy and procedures regarding appeals.

Vacation Requests during the PEAP

The PEAP is a high stakes assessment over a short timeframe. As such, candidates are discouraged from taking vacation during the PEAP, as it may put their assessment in jeopardy.