Transatlantic pharmacy: what to consider if you want to work in Canada
As a socially progressive nation with universal healthcare, Canada could prove to be that tempting next move for many UK pharmacists. However, there are a number of important considerations before taking such a big leap.
Canada is a country with great opportunities for skilled professionals, which many UK pharmacists might find attractive. Canadian and UK residents share the same level of wellbeing and, generally, pharmacists across Canada can earn between 54,112 Canadian dollars (CAD$) (£31,202) and CAD$144,300 (£83,261) per year.
However, registering as a pharmacist in Canada is expensive and can be an exhausting process. Individuals will need to balance practical placements with attending clinical diploma study days and on-call rotations; and, prior to COVID-19, long flights across the Atlantic to sit five-hour exams at an approved testing centre.
Here are five things those interested should consider when deciding to make the move.
1. The complicated registration process
It can take months or years to become fully registered in Canada, depending on the requirements of the province individuals wish to work in.
Box 1 summarises the general steps involved.
Box 1: The registration process
Part A) Register with Pharmacists’ Gateway Canada
This gateway is the information portal for overseas qualified pharmacists. The portal provides candidates with a cost and time to licensure calculator, a step-by-step guide on how to apply and complete the national registration exams, and guidance on how to then register with a regulatory provincial body in Canada. Each candidate will receive a national identifier number, which is a unique code that will follow the individual through the licensing process and at each stage of the journey.
Part B) Registration assessments
The Pharmacy Examining Board of Canada (PEBC) is the body responsible for setting the qualifying exams for the pharmacy profession across Canada. This body examines every candidate (both home and overseas students), to ensure each prospective registrant is academically fit to practise pharmacy within the country. The process varies depending on whether you are an international/overseas qualified pharmacist or pharmacy graduate. For overseas qualified pharmacists there are three standard stages.
- Stage 1: Document evaluation
All candidates will be required to submit an application form along with the associated fee and certified copies of supporting documents, including identity documents, certificates and registration documents.
Candidates will need to contact their university and request that a copy of their degree and full transcript of results be sent directly to the PEBC. Candidates must also contact the General Pharmaceutical Council to request a letter of good standing — also known as a certificate of current professional status — to be sent directly to the PEBC. It is an official document used as proof of your registration in the UK and states any restrictions on your practice.
It takes approximately six weeks to receive an email from the PEBC acknowledging receipt of the application. Once received, it can take up to eight weeks to process all documentation and, if approved, candidates have up to five years to sit the evaluating exam.
- Stage 2: Evaluating exam
Candidates must sit this preliminary exam, which assesses undergraduate pharmacy knowledge. The exam is four hours and 30 minutes and is designed to test knowledge of A level Chemistry and Biology right up to the fourth year of the MPharm. The exam is a computer-based multiple choice question (MCQ) assessment which traditionally takes place at an approved testing centre; however, owing to COVID-19, candidates now have the option to sit the assessment remotely. Candidates must score at least 60% in order to pass and be eligible to sit the qualifying exam. Examination results are posted on the PEBC website within three weeks.
- Stage 3: Qualifying exam
All prospective pharmacists must sit this exam before qualifying to practice in Canada.
There are two parts to this exam: an MCQ paper and an objective structured clinical examination. Candidates must pass both parts of the exam. Some provincial bodies (e.g. Ontario College of Pharmacists) require international candidates to pass these exams on the first sitting. If an individual does not pass first time, they will be required to re-sit the exam and complete a training course before being able to practice.
The pass mark for the exam will vary depending on the set difficulty level.
- Stage 4: Apply to register with a provisional pharmacy regulatory authority
A formal application to the chosen provisional board of pharmacy needs to be made in order for pharmacists to gain licensure and be able to practice in a specific province.
Each province will have specific requirements, including completion of training in a licensed pharmacy — much like a preregistration placement. The number of structured training hours to be completed will vary between provinces.
Once all requirements have been met, the provisional pharmacy regulatory authority will confirm completion and issue a license to practise.
2. Where you want to work
Each Canadian province has its own provisional Pharmacy Regulatory Authority — equivalent to the General Pharmaceutical Council in the UK.
Each provincial board will have its own set of registration requirements and a licence in one province does not grant an individual automatic licence to work in other provinces.
For example, in Alberta, each candidate must undertake a jurisprudence learning module, which covers laws on pharmacy practice, dispensing drugs and the ethics of professional practice; sit an exam on this; and complete a minimum of 1,000 hours of an online structured practical training course. In contrast, the province of Quebec operates in a different way to most other provinces in Canada. French is an official language in Quebec; therefore, pharmacists working in this province should be able to speak French fluently and must complete their examinations in French.
3. The expense
There is considerable expense associated with registering in Canada. Some of the costs are shown in Box 2, but it is important to be aware of others. For example, costs for provincial applications and jurisprudence examinations which vary between provinces. There is also the cost of postage for documents, notary public signings, flights and accommodation to sit exams, letter of good standing (£81), acquiring police records (up to £40) as well as visa processing (from CAD$153 [£88]).
When registering with any pharmacy regulatory authority in Canada, all candidates will be expected to have liability or indemnity insurance, as is expected of pharmacists in the UK – an additional cost of approximately CAD$150–200 (£86–115).
Box 2: Estimated costs associated with the Canadian pharmacist registration process
- Pharmacists’ Gateway Canada enrolment fee: 340 Canadian dollars (CAD$) plus tax = £195
- Document evaluation: CAD$675 = £387
- Evaluating exam: CAD$870 = £498 (please note there is an additional charge if you choose to sit the exam in the UK)
- Qualifying exam: CAD$2,620 = £1,506
4. Visa requirements for pharmacists
Registering and moving to Canada will require a work visa. For British nationals aged up to and including 30 years, there is an International Experience Canada visa that is valid for up to two years.
Individuals aged over 30 years and those who are not British nationals may still apply for this visa, as individuals are selected from a pool depending on work skills, age and other factors.
Alternatively, some individuals decide to apply for a permanent residency visa. This is a more thorough process and requires a lot of documentation. It also takes longer to approve, but is a viable option for pharmacists considering living and working in Canada long term.
Individuals should check their visa eligibility and requirements via the Canadian Immigration and Citizenship website.
5. The differences in pharmacy practice
I currently work as a community pharmacist in the Greater Toronto Area, and there are several noticeable differences in how community pharmacies operate compared to the UK.
For example, Canadian physicians or GPs are mostly privatised so, essentially, there is no associated clinical commissioning group or local GP team. This means that there are no regulations on which drugs are prescribed in specific areas, or which specific policies are followed in certain boroughs. Most physician offices operate as independent entities. There are also no specific prescription forms (e.g. the FP10s as we have in the UK). The range of clinical pharmacy services offered will also vary depending on where pharmacists work.
Fax systems are commonly used in Canada to transfer prescriptions between pharmacies and from physician offices. Pharmacies are also allowed to transfer remaining amounts of a drug on a prescription to another pharmacy for dispensing. For example, a doctor can prescribe 60 tablets of atenolol for a patient, who can decide to have 30 tablets dispensed at one pharmacy and then request to have the rest dispensed at another pharmacy the following month.
A very important difference from community pharmacy practice in the UK is how medicines are paid for. Most individuals in Canada — those aged over 21 and under 65 years — have insurance coverage for their medicines. Some other individuals, especially seniors, have what is called government coverage. Understanding how the insurance payments work can take a while and it requires some practice to get used to.
One final difference to point out is drug packaging in Canada. In the UK, most of our medicines come in standard 30- or 28-day pill boxes for monthly supplies. However, manufacturers in Canada produce medicines differently; for example, medicines rarely come in bulk packages. Dispensing can therefore be more time consuming as each drug needs to be counted and dispensed in 30- or 90-day pill bottles.
For more information on registering as a pharmacist in Canada visit:
- Pharmacy Examining Board of Canada
- Pharmacists’ Gateway Canada
- Government of Canada Immigration and Citizenship
- The General Pharmaceutical Council advice on working abroad
All pharmacists should take the opportunity to work overseas, if possible. Individuals will be exposed to a different way of practising pharmacy, advance their skills and add diversity to their resume. It will come with its challenges, but it is definitely a worthwhile experience.
About the author:
Mary Adegboyega is a community pharmacist in Ontario, Canada. She registered as a pharmacist in the UK in 2014 and gained licensure in Canada in 2019. Mary is happy to provide additional information and support to pharmacists interested in moving to Canada and is contactable via her Instagram and Twitter accounts: @OreSupasta.
Citation: The Pharmaceutical Journal DOI: 10.1211/PJ.2020.20208374
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