Clinical Observer

Registration as a clinical observer can provide an important and rewarding educational experience for international medical graduates who are hoping to enter a postgraduate training program in British Columbia. Registration as a clinical observer may be granted for a limited time for a maximum of three years.

Clinical observers are not authorized to practise independently. A clinical observer functions at the level of a fourth-year medical student in the practice setting, not at the level of a postgraduate resident or physician assistant. This is an unpaid position.


To be granted registration as a clinical observer, an applicant must:

  • have a medical degree from a medical school listed in the World Directory of Medical Schools which includes the Canada sponsor note
  • have successfully completed Part 1 of the Medical Council of Canada's Qualifying Examination (MCCQE), or have completed medical licensing examinations in the United States of America that are acceptable to the Registration Committee
  • obtain a written request from a supervising physician to be submitted with the application
  • have Canadian citizenship or permanent resident status, or be legally entitled to live and work in British Columbia
  • meet the College’s English language proficiency requirements

Application Process

Please allow six weeks for the application to be processed.

  1. The applicant’s supervising physician must submit a formal written request to the College with an enclosed copy of the applicant’s CV. (These documents must be sent together.)
  2. The written request must come from a registrant in the full class who is in good standing and who:
  • agrees to supervise and be responsible for all clinical contact the applicant may have with patients and will ensure the applicant’s compliance with the College’s professional standards and guidelines; 
  • details the duration, parameters, responsibilities, benefits and goals; and
  • explains the nature and extent of the intended supervision.
  1. If a portion of the educational activity is to take place in a hospital, a letter from the chief of staff in support of the applicant’s registration as a clinical observer must also be included.
  2. Once the written request and the applicant’s CV have been reviewed by the College, an application package will be sent to the supervising physician. The application package includes:
  • approval letter
  • application form
  • CMA Code of Ethics and Professionalism
  • Code of Ethics undertaking
  • consent to a criminal record check form
  • note to applicant
  • information letter
  • clinical observership agreement
  1. The approval letter (found in the application package) must be reviewed by both the supervisor and the applicant as it contains important information about registering as a clinical observer.
  2. The application form should be completed by the clinical observer.
  3. The clinical observership agreement must be completed by the supervisor and co-signed by the applicant. If more than one physician agrees to act as a supervisor, all must sign the form.
  4. The clinical observership agreement form and application form must then be forwarded to the registration department.
  5. The applicant is required to arrange for certificates of professional conduct from all previous jurisdictions in which s/he has trained/worked. It is essential that the certificate of professional conduct is mailed directly to the College before the applicant participates in an interview with College staff. Registration as a clinical observer will not be granted without this documentation.
  6. The applicant's medical degree, identification and MCCQE Part 1 results must be verified by prior to scheduling a registration appointment with the College.
  7. Once all the above steps have been completed, the applicant must contact the College to arrange for a registration appointment. The applicant will be advised which original documents must be brought to this appointment. Registration will be granted at that time.


  1. A non-refundable fee of C$140 is required to complete the application process. The fee must be paid at the time of the interview. A portion of this fee ($40) is required to complete a criminal record check.
  2. A renewal fee of C$150 (effective July 1, 2018) is required each year that registration as a clinical observer is maintained (up to a maximum of three years).

Important Information for Supervising Physicians

Supervising physicians must confirm in writing that they will be responsible for the supervision of any clinical contact by the clinical observer with patients and will:

  • inform the patient that the clinical observer is an IMG participating in an educational experience under their supervision;
  • obtain verbal consent from the patient to allow the clinical observer to participate in the care situation; and
  • provide direct supervision of all interactions between the clinical observer and the patient.

In situations where the clinical observer has demonstrated an appropriate level of competence and performance, the supervising physician may allow him/her to interact alone with the patient, provided that the clinical observer-patient interview is followed by direct interaction between the supervising physician and the patient to confirm the findings, diagnosis and suggested investigations or treatment.
Any activities based on clinical judgement, such as procedures or activities, must be directly overseen by the supervising physician or his/her designate.
If a portion of the educational activity is to take place in a hospital, a letter from the chief of staff supporting the registration of the applicant as a clinical observer must be submitted with the application.
If a clinical observer leaves the observership before the expiration date of his/her registration, the College must be informed immediately. This includes clinical observers who take time away from their observership to study.
During the period of the clinical observership, the supervising physician is responsible for ensuring that the clinical observer is complying with the ethical responsibilities set out in the Canadian Medical Association's Code of Ethics and Professionalism.

It is College policy that there should be no more than two clinical observers under the supervision of a physician, or physicians, in any one office location at one time. If the supervising physician practises in more than one clinic, s/he cannot supervise more than two clinical observers. A colleague can agree to act as the supervisor at alternate practice locations.

More information regarding the eligibility requirements for supervisors can be found here.

Please contact the registration department at for more information on supervising clinical observers.