Physician Salaries Around the World (2026): How the US Compares to Australia, UK, Canada, UAE, and 8 Other Countries

Why the Salary Number Alone Is Misleading

Before the country-by-country data, three adjustments are necessary to make the comparison meaningful.

With those adjustments in mind, here is the complete country comparison.

The Global Physician Salary Comparison Table (2026)

*All figures USD equivalent. After-tax estimates approximate and vary by specialty, family structure, and specific income level. See CountryTaxCalc for detailed calculations.*

United States — The Baseline

• •Average physician salary: $316,000–$386,000 (all specialties)
• •Specialists: $450,000–$900,000+
• •After-tax income (Texas, no state tax): ~$200,000–$280,000 on $316,000–$386,000
• •Work hours: 50–60 per week

The United States pays physicians more than almost any country on earth — and the structural reasons for this are worth understanding before comparing to other systems, because they explain why the gap is unlikely to close in most international markets.

American physicians earn more because:

• •The fee-for-service private insurance model creates no fixed salary ceiling. A gastroenterologist who owns an ambulatory surgery center, performs premium procedures, and builds ASC equity captures income that no national health system can replicate — because national systems pay fixed rates that prevent the facility-fee accumulation model described in our Gastroenterology Salary guide.
• •Student loan debt justifies premium compensation. The average U.S. medical graduate carries $285,000 in student loan debt — a burden that demands premium income to service. Countries with subsidized or tuition-free medical education (Germany, UK, most of Europe) do not face this structural pressure on physician compensation.
• •Malpractice insurance costs are globally unique. A U.S. neurosurgeon paying $150,000 to $200,000 per year in malpractice premiums needs a correspondingly higher gross income to net the same take-home as an Australian neurosurgeon whose malpractice costs $15,000 to $20,000 annually. The U.S. physician's higher gross salary partially covers a cost that does not exist at the same magnitude in other countries.
• •The physician shortage is severe and accelerating. Physician shortages projected to reach up to 100,000 physicians within the next decade, per industry projections, drive physician compensation above what supply-demand balance would otherwise produce. Shortage markets pay scarcity premiums that other countries — where physician supply is better balanced — do not generate.

The honest disadvantage of U.S. practice: The after-tax income advantage narrows when malpractice insurance, CME costs, licensing fees, and the administrative burden of American healthcare are deducted. A U.S. family physician spending $18,000 per year on malpractice, $5,000 on CME and licensing, and several hundred unpaid hours per year on prior authorizations is not receiving an uncomplicated income premium. For the complete analysis of what U.S. physicians keep after all costs, see our Physician Salary After Taxes guide.

Switzerland — The Highest Gross Salary Outside the United States

• •Average physician salary: $388,623 (CHF 352,018)
• •Specialists: $450,000–$600,000+
• •After-tax income: ~$229,000 (59% retained)
• •Work hours: 45–50 per week

Switzerland tops virtually every global physician salary ranking. The Swiss healthcare system — a regulated multi-payer model with mandatory private insurance, no single-payer national system — creates physician compensation dynamics closer to the U.S. model than to any European national health system. Specialists earn between CHF 300,000 and CHF 500,000 ($330,000 to $550,000) in hospital-based practice; senior consultants (Chefärzte) at major university hospitals can earn CHF 500,000 to CHF 700,000 ($550,000 to $770,000).

The cost of living caveat: Switzerland has one of the highest costs of living of any country on earth. A two-bedroom apartment in Zurich costs CHF 3,000 to CHF 5,000 ($3,300 to $5,500) per month. Groceries, transportation, childcare, and dining out are priced at 30 to 60 percent above U.S. major metropolitan costs. The physician who compares Swiss gross salary to U.S. gross salary is comparing numbers that do not translate directly to lifestyle — the Swiss physician's $388,000 buys meaningfully less than a U.S. physician's $380,000 in most consumption categories.

After-tax Swiss physician income: Switzerland applies cantonal (state), municipal, and federal income taxes that combine to produce effective rates of approximately 35 to 42 percent at specialist income levels. A physician earning CHF 400,000 retains approximately CHF 240,000 to CHF 260,000 after tax — roughly $265,000 to $287,000 — before cost of living adjustments.

The licensing pathway: Switzerland requires either an EU-recognized medical degree or credential recognition through the MedReg system. German language proficiency at C1 or B2 level is required in the German-speaking cantons (Zurich, Bern, Basel — the major medical markets). Swiss medical residency or specialty recognition may be required for non-EU trained physicians. The process is structured but not impossible for English-speaking physicians willing to invest in German language acquisition.

Australia — The Best Lifestyle-to-Income Ratio Among English-Speaking Countries

• •Specialist salary: AUD $250,000–$400,000+ ($160,000–$260,000 USD)
• •After-tax income: ~$100,000–$170,000 USD (65% retained)
• •Work hours: 40–44 per week
• •Superannuation (pension): 11.5% employer contribution in addition to salary

Australia leads on salary-to-quality-of-life ratio, with specialists earning AUD $250,000–$400,000 and a clear AMC pathway to registration.

The gross salary comparison between Australia and the U.S. does not favor Australia — a U.S. cardiologist earning $650,000 substantially out-earns an Australian cardiologist earning AUD $380,000 ($245,000 USD). But the comparison that actually matters for physician quality of life is different when work hours, malpractice costs, administrative burden, and superannuation are factored in.

The superannuation advantage: Australian employers are legally required to contribute 11.5 percent of physician salary into a superannuation (retirement) account annually. On AUD $300,000 salary: AUD $34,500 ($22,200 USD) in annual mandatory retirement contributions from the employer — a benefit that no U.S. employed physician receives at this scale and that significantly improves the total compensation picture over a career.

The malpractice cost advantage: Australian medical indemnity premiums are a fraction of U.S. costs. An Australian general practitioner pays approximately AUD $3,000 to $8,000 annually in indemnity premiums. An Australian surgeon pays AUD $15,000 to $40,000. The U.S. equivalent costs $15,000 to $200,000 depending on specialty — creating a gross income premium for U.S. physicians that is partially consumed by this cost differential.

The work environment: Australia has strong industrial agreements that enforce working hour limits more strictly than U.S. employment contracts typically do. A 44-hour workweek for an Australian hospitalist is a genuine 44 hours — not 44 hours plus undocumented administrative time. The culture of medicine in Australia includes genuine respect for physician lifestyle in a way that many U.S. physicians report their employment environment does not.

The demand driver: Australia faces a persistent doctor shortage, particularly in regional, rural, and remote areas. Approximately 30 percent of Australia's practising doctors are international medical graduates. The Australian Medical Council (AMC) pathway provides a structured route to registration: AMC MCQ examination followed by the AMC Clinical Examination for standard pathway applicants, with a specialist pathway available for experienced specialists seeking direct assessment by the relevant specialist college.

Key advantage: Australia is the only major destination where experienced specialists can potentially bypass the residency requirement entirely through specialist college assessment. A board-certified U.S. cardiologist may qualify for direct specialist recognition through the Royal Australasian College of Physicians (RACP) without repeating fellowship training.

United Arab Emirates — The Tax-Free Opportunity With Important Caveats

• •Physician salary: $150,000–$250,000 USD
• •After-tax income: $150,000–$250,000 (100% retained — zero income tax)
• •Work hours: 44–50 per week
• •Term: Typically contract-based, 2–3 year renewable

The UAE stands out globally for one reason: zero personal income tax. A physician earning $200,000 in the UAE keeps every dollar of it. The equivalent income in Australia nets approximately $130,000. The equivalent in Ontario, Canada nets approximately $118,000. The tax-free advantage is real, substantial, and the primary reason physicians from Canada, UK, Australia, and other high-tax countries choose UAE practice over their home country.

Gulf countries such as the UAE, Saudi Arabia, and Qatar are attractive for physicians seeking high salaries and tax-free income. These countries often offer competitive compensation packages, housing allowances, and relocation benefits.

The complete UAE compensation package typically includes:

• •Base salary: $120,000 to $200,000 depending on specialty and institution
• •Housing allowance: $18,000 to $36,000 annually (or employer-provided accommodation)
• •School fee allowance: $10,000 to $25,000 for children's private school tuition
• •Annual flights home: $3,000 to $6,000
• •Health insurance for family: included
• •End of service gratuity: equivalent to 21 to 30 days of basic salary per year of service

When these benefits are included, total compensation packages for specialist physicians in the UAE reach $180,000 to $310,000 — all of which is retained without income tax.

The UAE caveats physicians must understand:

• •Job security is contract-based. UAE employment is typically 2 to 3 year contracts with employer-sponsored residency visas. If the employer terminates the contract, the physician and family must either find a new employer-sponsored position or leave the country within 30 days. There is no unemployment insurance, no severance beyond gratuity entitlement, and no equivalent to the U.S. COBRA health insurance bridge. The structural insecurity of contract employment is the most significant UAE disadvantage for physicians building long-term financial security.
• •Permanent residency is limited. The UAE's Golden Visa program provides 10-year renewable residency for professionals meeting specific criteria — including physicians with specialist qualifications and sufficient income. However, UAE citizenship is not available to foreign nationals except in extraordinary circumstances. Long-term residents can accumulate wealth in the UAE but must plan for the possibility of eventual departure regardless of how long they have practiced there.
• •The practice environment is private sector. UAE medical practice is primarily private hospital and clinic based. The regulatory environment through the Dubai Health Authority (DHA) and the Health Authority Abu Dhabi (HAAD) is structured, but the patient population is international (approximately 89 percent of UAE residents are expatriates) and the medical culture is different from Western practice in ways that require adjustment.

Licensing: UAE licensing requires credential verification, primary source verification, licensure in country of training, English language proficiency, and typically a credentials review committee evaluation. Most specialty-trained physicians from recognized institutions are eligible with processing times of 3 to 6 months.

Canada — The Closest to the U.S. With Dramatically Lower After-Tax Income

• •Specialist salary: CAD $250,000–$400,000 ($180,000–$290,000 USD)
• •After-tax income (Ontario): ~$90,000–$165,000 (59% retained)
• •Work hours: 45–55 per week

Canada appears on every "best country for physician immigration" list, and the cultural and geographic proximity to the U.S. makes it a natural comparison. The financial reality is significantly less favorable than most Canadian physician salary articles suggest.

The billing model: Most Canadian physicians bill under provincial fee-for-service schedules. An Ontario specialist physician billing under OHIP (Ontario Health Insurance Plan) earns income equivalent to CAD $250,000 to $400,000 after practice expenses — but this represents gross billings above $350,000 to $550,000 minus overhead. The physician is self-employed for tax purposes, meaning both employer and employee CPP contributions fall to the physician, and no employer pension or health benefits exist.

The tax reality in Ontario: At CAD $280,000 in net income, combined federal ($80,000) and Ontario provincial ($35,000) taxes approach $115,000 — a 41 percent effective tax rate. The after-tax income of approximately CAD $165,000 ($120,000 USD) is substantially below what a comparable U.S. employed physician retains.

Canada offers the fastest permanent residency pathway (6 to 12 months via Express Entry) but requires the longest licensing journey through MCC exams and CaRMS residency matching. The Medical Council of Canada qualification examinations (MCCQE Part I and II, NAC Examination for IMGs) are the pathway to Canadian medical licensure, followed by CaRMS residency matching — a process that can take 3 to 5 years from initial exam registration to independent practice.

The quality of life advantage: Canadian physicians practice in a single-payer environment that eliminates much of the insurance-related administrative burden of U.S. practice. Prior authorizations, claims denials, and billing complexity are dramatically reduced compared to the U.S. multi-payer system. Many Canadian physicians report higher professional satisfaction despite lower nominal income precisely because the non-clinical administrative burden is lower.

United Kingdom — The Most Accessible Entry Point, The Lowest Compensation

• •Junior doctor salary: £40,000–£65,000 ($51,000–$83,000 USD)
• •Consultant salary: £90,000–£120,000 ($115,000–$153,000 USD)
• •After-tax income: ~$35,000–$95,000 (58–62% retained)
• •Work hours: 40–50 per week
• •NHS pension: Defined benefit, extremely valuable

The UK offers the most accessible entry point for IMGs through the PLAB exam and Health & Care Worker visa, with consultant salaries of £90,000–£120,000+ and processing times of 8–12 weeks for GMC registration.

The UK's physician compensation is the most widely misunderstood of any major destination because the NHS pension benefit is so valuable that it fundamentally changes the financial comparison — and almost no physician salary article accounts for it correctly.

The NHS pension: The NHS defined benefit pension (career average 1/54 scheme) accrues approximately 1/54 of pensionable pay per year of service. A consultant earning £110,000 annually accrues approximately £2,037 per year in guaranteed inflation-linked retirement income. After 20 years of consultant practice: approximately £40,740 per year in NHS pension income — guaranteed, inflation-linked, for life. The actuarial value of this benefit is equivalent to several hundred thousand pounds over a retirement. The nominal UK take-home cash figure understates total compensation significantly compared to countries with defined contribution systems only.

The junior doctor compensation crisis: The UK's junior doctor compensation has been the subject of sustained industrial action since 2023. Junior doctors — the UK term for doctors in training, equivalent to residents through fellows — earn £40,000 to £65,000 in a healthcare system where London housing costs consume a disproportionate share of income. The British Medical Association (BMA) has documented that junior doctor real pay has fallen approximately 26 percent in inflation-adjusted terms since 2008 — a decline that drove significant strike action and continues to drive physician emigration from the UK.

The PLAB pathway for IMGs: The Professional and Linguistic Assessments Board (PLAB) examination is the most accessible IMG licensing route globally. PLAB 1 is a 180-question written exam available at Pearson VUE centres worldwide. PLAB 2 is a clinical skills assessment at the General Medical Council (GMC) in Manchester. After PLAB success, GMC registration typically processes in 8 to 12 weeks. The Health & Care Worker visa for registered doctors processes in weeks. The total time from exam registration to UK practice for an IMG is typically 6 to 18 months — shorter than almost any other major destination.

Why physicians leave the UK: The combination of compressed real pay growth, high workload, and the perception that the NHS is systematically underfunded has driven significant physician emigration. Australia is the most common destination for UK-trained physician emigrants — specifically because the Australian salary is substantially higher, the work hours are better regulated, and the cultural adjustment is minimal for English-speaking physicians.

Germany — High Standards, Lower Pay, Excellent Quality of Life

• •Specialist salary: €100,000–€160,000 ($107,000–$172,000 USD)
• •Senior consultants (Chefarzt): €200,000–€350,000 ($215,000–$376,000 USD)
• •After-tax income: €57,000–€96,000 ($61,000–$103,000 USD) at specialist level
• •Work hours: 45–50 per week

Germany represents the sophisticated medical practice environment of a major European healthcare system — with an important financial trade-off. Physician salaries are competitive by European standards but dramatically below U.S. or Australian equivalents, and the German tax and social contribution system retains approximately 40 to 47 percent of physician income at specialist salary levels.

At €140,000 gross: all-in deductions (income tax + health insurance + pension + nursing care + unemployment): approximately €60,000 to €65,000. Take-home: approximately €75,000 to €80,000 (57 percent). The German physician working in a hospital environment retains 57 cents of every gross euro earned.

The Chefarzt exception: Senior department chiefs (Chefarzte) at German university hospitals operate under different compensation structures that include significant private patient billing privileges. A Chefarzt who treats Privatpatienten (privately insured patients) supplements their base hospital salary — which might be €180,000 — with private patient fee income that can add €50,000 to €150,000 annually. Total Chefarzt compensation at major German university hospitals reaches €250,000 to €400,000+ — making this career stage genuinely competitive internationally.

The language requirement: German language proficiency at C1 medical level is the primary barrier for most international physicians considering Germany. The licensing process — Approbation — requires Anerkennung (credential recognition) by the state medical association (Ärztekammer), which is generally straightforward for EU-trained physicians and requires additional assessment for non-EU physicians. The language requirement is non-negotiable and typically requires 12 to 24 months of dedicated German study for physicians starting from zero.

The advantage Germany offers: Germany's Arbeitszeitgesetz (Working Hours Act) limits weekly physician working hours more strictly than in the U.S., Australia, or Canada. Work-life balance in German hospital medicine is structurally better protected than in American medicine — a significant quality of life advantage for physicians who value predictable schedules, protected rest periods, and genuine vacation time (German physicians typically receive 30 days of paid annual leave).

New Zealand — The Surprise in the Income-Per-Hour Calculation

• •Specialist salary: NZD $200,000–$350,000 ($120,000–$210,000 USD)
• •After-tax income: ~$97,000–$170,000 (81% retained)
• •Work hours: 40–44 per week
• •ACC levy: Replaces tort liability for personal injury

New Zealand produces the highest after-tax physician retention rate of any English-speaking country — 81 percent of gross income retained — because New Zealand income tax is genuinely lower than comparable countries at physician salary levels, and the ACC (Accident Compensation Corporation) levy replaces personal injury tort liability, substantially reducing malpractice exposure.

At NZD $230,000 (approximately $138,000 USD): income tax at 33-39 percent produces approximately $36,760 in total income tax; ACC earners' levy approximately $1,500 total. Take-home: approximately NZD $191,740 ($115,000 USD) — 81 percent of gross.

The gross salary is below Australia, Canada, or the U.S. But the after-tax retention rate and the absence of significant malpractice insurance costs create a net financial position that is better than its nominal salary ranking suggests.

The ACC malpractice structure: New Zealand's Accident Compensation Corporation provides a no-fault compensation scheme that eliminates most personal injury tort litigation — including most medical malpractice claims. Physicians practicing in New Zealand face dramatically lower malpractice insurance costs than U.S. or Australian counterparts. The professional indemnity that New Zealand physicians carry is primarily for disciplinary proceedings and international practice, not for personal injury claims — a meaningful structural difference that reduces physician financial anxiety and practice overhead simultaneously.

Licensing: The Medical Council of New Zealand (MCNZ) recognizes medical degrees from Australia, UK, Ireland, Canada, and the U.S. without an additional qualifying examination in most cases. The pathway is among the most straightforward of any major destination for physicians trained in recognized programs. Time from application to vocational registration (the equivalent of specialty certification): 3 to 6 months for most applicants from recognized training countries.

The Nordic Countries — The Work-Life Balance Leaders

• •Average physician salary (Norway, Denmark, Sweden, Finland): $110,000–$170,000 USD
• •After-tax income: ~$58,000–$90,000 (52–57% retained)
• •Work hours: 37.5 to 42 per week
• •Vacation: 5 to 6 weeks annually

Norway and Denmark consistently appear in physician satisfaction surveys as some of the best countries to practice medicine — not because of income, but because of working conditions, physician respect, and the genuine implementation of work-life balance that Scandinavian labor culture protects.

Norwegian physicians work 37.5 contracted hours per week. Danish physicians receive 6 weeks of paid annual leave as a standard employment right. Swedish physicians working in hospital settings receive protected rest periods between shifts that are legally enforced — not just contractually stated. The physician who values these conditions over income maximization finds the Nordic countries genuinely compelling.

The financial trade-off is stark: Norwegian physician after-tax income of approximately $58,000 to $90,000 USD is dramatically below U.S., Australian, or even New Zealand equivalents. The country pays for universal healthcare, generous social services, and physician work-life protection through tax rates that make the gross-to-net conversion unfavorable for high earners. Physicians in Norway are well-compensated relative to other Norwegian professionals — but not relative to physicians in English-speaking countries.

The language and integration challenge: Practice in Norway, Denmark, Sweden, or Finland requires native or near-native proficiency in the relevant Scandinavian language. Medical education is conducted in the local language; patient interaction is conducted in the local language; and professional integration requires cultural fluency that takes years rather than months to develop. This is the primary barrier for most English-speaking physicians considering Scandinavian practice.

Singapore — The Asian Tiger Option for High Earners

• •Physician salary: $100,000–$200,000 USD
• •After-tax income: ~$78,000–$164,000 (79% retained)
• •Work hours: 50–60 per week
• •Tax structure: 17–24% effective rate at physician income levels

Singapore combines Asia's work culture with some of the lowest effective income tax rates available to high-earning physicians outside the Gulf states. At a $200,000 USD equivalent gross salary, a Singapore physician retains approximately $157,000 (79 percent) — better than the United States at comparable income and dramatically better than the UK or Canada.

Singapore's Singapore Medical Council (SMC) maintains structured pathways for physicians from recognized training countries. Public hospital employment is primarily through the National University Health System or the Singapore Health Services, with private sector employment available through private hospitals (Gleneagles, Mount Elizabeth, Raffles Medical).

The work culture caveat: Singapore's working hours — 50 to 60 per week for hospital-employed physicians — are among the longest outside the United States. The efficiency that Singapore's economy is globally recognized for applies to its healthcare workforce expectations as well. Physicians who choose Singapore for its favorable tax environment accept a work culture that is closer to American medicine in intensity than to Australian or European medicine.

The housing cost consideration: Singapore has some of the world's most expensive real estate. A two-bedroom apartment in central Singapore costs SGD $5,000 to $8,000 ($3,700 to $5,900 USD) per month. Public housing (HDB flats) is available at lower cost but typically requires permanent resident status to access at favorable terms. The net financial position of a Singapore physician improves substantially once the housing cost is accounted for alongside the favorable tax rate.

The After-Tax Income-Per-Hour Comparison: The Ranking That Changes Everything

The most honest physician compensation comparison incorporates both after-tax income and hours worked — producing an income-per-hour figure that reflects what each hour of physician time actually produces in retained wealth.

After-tax income per hour worked (specialist physician):

Switzerland's $92 per hour represents the highest after-tax income per hour of any country on this list — but against a cost of living so elevated that it is largely consumed by basic living expenses. The UAE's $82 per hour in a tax-free environment against a lower cost of living than Switzerland produces the best real wealth accumulation per hour worked of any country on the list for physicians who can accept the contract-based employment structure.

The U.S. at $70 per hour after tax — at the Texas no-state-tax level — represents genuinely strong income per hour of work even after the high malpractice costs and student loan burden are considered. The gap between the U.S. and the best non-U.S. alternatives is real but narrower than the gross salary comparison suggests.

For U.S. Physicians Considering International Practice

The financial case for staying in the U.S. is strongest for physicians who:

• •Are in high-income procedural specialties (cardiology, orthopedics, GI, ophthalmology) where the ASC ownership model creates income that no national health system replicates
• •Are still actively building practice equity and net worth
• •Are pursuing PSLF — which requires qualifying U.S. employer status and immediately loses its value if the physician leaves to international practice
• •Have significant U.S. medical school debt that is specifically addressed by U.S. income levels and repayment programs

For physicians with federal student loans pursuing PSLF, international practice is particularly complex. PSLF requires qualifying employment at a U.S. 501(c)(3) nonprofit, government agency, or tribal organization. Practice at an international hospital does not generate qualifying PSLF payments — meaning any physician who has accumulated PSLF qualifying payments and then leaves the U.S. forfeits the forgiveness value of those accumulated payments. See our PSLF vs. Refinancing guide for the complete dollar analysis of this decision.

The case for international practice is compelling for physicians who:

• •Are experiencing the clinical and administrative burnout that U.S. medicine disproportionately produces
• •Have no medical school debt (international physicians who trained outside the U.S.) or have already paid off their debt
• •Value work-life balance over income maximization
• •Are in specialties where U.S. private practice ownership models are not accessible or relevant to their situation
• •Have genuine interest in living and practicing in a specific international location for personal or family reasons

The physician burnout research is clear: the U.S. healthcare system produces physician burnout at higher rates than comparable developed country healthcare systems. The combination of administrative burden, malpractice liability culture, prior authorization requirements, and the productivity-over-relationship clinical culture creates a practice environment that many physicians find unsustainable regardless of the compensation it produces. For the complete analysis of how burnout affects physician finances, see our Physician Burnout and Finances guide.

For International Medical Graduates Choosing Where to Practice

The best country for an IMG depends on three factors that vary by individual circumstance: licensing pathway feasibility, language capacity, and income-lifestyle priority.

• •If maximum income is the priority: United States — but the USMLE pathway, residency matching, and credentialing timeline is 3 to 7 years from exam registration to independent U.S. practice. The income premium is real and substantial for those who complete it.
• •If fastest licensing is the priority: United Kingdom — PLAB exam available globally, GMC registration in 8 to 12 weeks for eligible candidates, Health & Care Worker visa processes in weeks. Full practice possible within 6 to 18 months of beginning the process.
• •If best income-lifestyle balance in English-speaking country is the priority: Australia — AMC pathway is structured and clear, specialist college recognition may bypass additional residency for experienced specialists, working hours are protected by industrial agreements, and superannuation provides retirement benefits that enhance total compensation above nominal salary.
• •If tax-free income is the priority and contract employment is acceptable: UAE — zero income tax, comprehensive benefit packages, professional practice environment, and licensing through DHA or HAAD for Dubai and Abu Dhabi respectively.
• •If permanent residency speed is the priority: Canada — 6 to 12 month Express Entry pathway to permanent residency, culturally similar to the U.S. for North American physicians, but requires MCC examination pathway and CaRMS residency matching.