Building Your Medical Practice in Ontario – Jobs, Clinics & the Right Fit
From License to Livelihood: What Happens Next Is What Happens First
Your first practice environment can make or break your Ontario practice habit-forming, it’s even more important to choose wisely because they may well be an integral part of your immigration and licensing process.
This part of the series helps you find the right environment, choose a clinic aligned with your values, and avoid burnout from day one.
Step 1: Understand the Landscape – Where Can You Work?
Ontario’s healthcare system allows you to practice:
In OHIP-funded clinics
In private, non-OHIP clinics (e.g., cosmetics, lifestyle medicine)
In hospitals
Through locum tenens (temporary short-term placements)
In our experience, many U.S.-trained specialists choose community, OHIP-funded clinics and locum work, which provides:
Flexibility
Faster income
Broad exposure to how clinics and hospitals operate in Ontario
Explore Jobs Here:
Specialty associations can also be great resources for find positions. Here are just a few…
Step 2: Consider Starting with a Locum Role
Locum work - especially in rural Ontario - is ideal for new-to-Ontario doctors. It offers:
Minimal overhead and often generous compensation
Pre-built patient base
Trial-run flexibility before full commitment
What You Need (depending on the locum, they can help facilitate your application):
CPSO license
OHIP billing number
MC EDT + billing software (we can help with this)
Malpractice insurance (CMPA or equivalent)
Step 3: Evaluate a Clinic or Hospital Opportunity
Don’t rush. Vet every opportunity based on:
Red Flags:
No clear billing split or profit model, or if the billing split sounds too good to be true, ask to see actual income statements
“Too good to be true” promises on income without showing you proof
No admin/billing support that you can see / meet / understand quickly
No existing patient base
No smiles on the reception or the team
Green Flags:
Transparent overhead & billing model
Tools for efficiency (EMR, admin staff)
Existing demand or referral streams they are happy to show you
Culture aligned with your values
Smiling team who feel well aligned
Step 4: Build for Long-Term Success
Ask yourself:
Do I want to build a private clinic?
Do I prefer flexibility over ownership?
Am I a specialist who can align with an existing surgical or hospital group? Should I align with a primary care practice and allied health services?
If you’re not sure—PFF can help match you to aligned clinics that are hiring or building capacity for specialists.
Step 5: Know the Financial Model
In Ontario, most clinics operate under:
Fee-for-service (FFS) via OHIP billing
Split-revenue models (e.g., 70/30 or 80/20)
Some Family Health Teams (FHTs) or Alternative Funding Plans (AFPs) for salaried roles can be beneficial depending on your lifestyle and practice preferences
Understand your gross income potential, but more importantly: what net income will land in your bank account after expenses and support.
Questions + Answers
1. What is the best way to start working as a doctor in Ontario?
Most U.S.-trained doctors begin with locum work or join an established OHIP-billing clinic to gain experience and income quickly.
2. Can I work as a locum in Ontario after getting my license?
Yes. With a CPSO license, OHIP billing number, and malpractice coverage, you're ready to work locum shifts.
3. How do I find a job as a new physician in Ontario?
Use sites like HealthForceOntario, Ontario Health careers, or contact PFF for direct introductions to hiring clinics.
4. What is locum work for physicians?
Locum tenens positions are temporary jobs that let doctors fill in at clinics or hospitals without long-term commitment.
5. What is a fair billing split at an Ontario clinic?
Typical splits range from 70/30 to 85/15 (physician/clinic), depending on overhead, admin support, and location.
6. Should I open a clinic right away in Ontario?
Not unless you have a strong patient base and support team. Most doctors build experience first, then consider clinic ownership.
7. Can I do private medicine instead of OHIP work?
Yes, but it must be non-insured services (e.g., cosmetic, executive health). Most specialists combine OHIP + private offerings.
8. What insurance do I need to practice in Ontario?
All doctors need malpractice insurance—most commonly from the CMPA (Canadian Medical Protective Association).
9. Can I work in multiple clinics in Ontario?
Yes. You can practice at several locations as long as they’re registered with your OHIP profile and MOH.
10. How do I know if a clinic is a good fit for me?
Look for transparency, existing demand, fair splits, and a team culture aligned with your values.
11. Can I change clinics after starting in Ontario?
Absolutely. Most contracts are flexible and allow you to relocate or renegotiate once you're established.
12. Do specialists get paid more in private or OHIP-funded work?
It depends. OHIP is stable but capped. Private services can yield more revenue but are market-dependent and less predictable.
13. Are there physician recruiters in Ontario?
Yes. PFF offers a concierge matching service for U.S.-trained doctors and connects you to clinics seeking your specialty.
14. Is hospital work better than clinic work in Ontario?
That depends on your goals. Hospitals offer stability; clinics often offer more flexibility and income potential.
15. Can I own a clinic in Ontario as a foreign-trained physician?
Yes, once you’re licensed and registered. Many specialists build or buy clinics after establishing themselves.
16. What are overhead costs like in an Ontario clinic?
Expect to pay 15%–30% of gross billings, depending on support staff, equipment, and location.
17. Can I negotiate my billing split with a clinic?
Yes. Everything is negotiable—especially if you bring a niche specialty or strong referral network.
18. What support should a good clinic provide?
Billing admin, EMR tools, referral management, reception, and practice development support are key.
19. Is there a shortage of specialists in Ontario?
Yes. Many areas, especially outside Toronto, urgently need radiologists, psychiatrists, anesthesiologists, and internists.
20. Who can help me choose the right clinic?
PFF works with both doctors and clinics to align values, income goals, and long-term success strategies.
