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Home > Forms > Pre-Screening Questions

Pre-Screening Questions for PRA Candidates

Please fully complete all steps to apply.

Links in form:

Health Careers Manitoba Job Search
See if you may be a Canadian Citizen
Understanding Permanent Resident Status
Physician Apply Portal
College of Physicians & Surgeons Manitoba – International Medical Graduate Resources

Pre-Screening Questions for PRA Candidates

Step 1 of 5

20%

PERSONAL INFORMATION

Name

First Middle Last

Gender

Female

Male

other

Are you a Canadian Citizen or Permanent Resident?

Yes

No

(see link #3 at top of page for more information)

What is your country of citizenship?

Are you a Canadian Studying Abroad?

Yes

No

(see link #2 at top of page for more information)

What is your Home address?

Street Address City Province

Email Address

Primary Phone

Mobile Phone

Upload your Resume / CV including medical practice experience

Accepted file types: doc, docx, txt, rtf, pdf, Max. file size: 5 MB.

MEDICAL EDUCATION

Undergraduate Medical Education:

Country where Medical Education Obtained

Name of Medical School

Length of Program

Date of Graduation (dd-mm-yyyy)

DD dash MM dash YYYY

Postgraduate Medical Education / Residency Training:

Residency Training Completed?

Yes

No

Specialty

Country of Residency Training?

Length of Training

Date Training Completed (dd-mm-yyyy)

DD dash MM dash YYYY

PROFESSIONAL REGISTRATION / EXAMINATION

I have submitted my documents to Physicianapply.ca

Yes

No

(see link #4 at top of page for more information)

I have applied to the College of Physicians and Surgeons of Manitoba

Yes

No

(see link #5 at top of page for more information)

I have completed the Medical Council of Canada Evaluating (MCCEE) Exam

Yes

No

MCCEE Score

I have completed the National Assessment Collaboration (NAC) Exam

Yes

No

I have passed the Medical Council of Canada Qualifying Examination (MCCQE) Part 1

Yes

No

I have passed the Medical Council of Canada Qualifying Examination (MCCQE) Part 2

Yes

No

I have passed the Therapeutic Decision-Making (TDM) Exam

Yes

No

My Overall English Language Proficiency Test Score is…

PRACTICE EXPERIENCE

Certifications outside of Canada

Date (dd-mm-yyyy)

Certification

Independent practice experience Outside of Canada

Date (dd-mm-yyyy)

Scope of practice

Virtual or in-person

Last date of practice (dd-mm-yyyy)

DD dash MM dash YYYY

Current or past licensures

Date (dd-mm-yyyy)

Location

License

CAREERS in MANITOBA

Do you currently have a job offer to work as medical staff within Manitoba?

Yes

No

(see link #1 at top of page for more information)

Please confirm?

Who offered the position?

Job title

Location

Was the position is posted on the Health Careers website under Job Opportunities?

Yes

No

(see link #5 at top of page for more information)

Have you reviewed the Health Careers Manitoba Website to find any jobs that you may be eligible to apply for?

Yes

No

(see link #5 at top of page for more information)

Please review the Health Careers Manitoba Website for current job opportunities.

Consent

Important note: This intake form must be fully completed for a candidate to be reviewed for PRA training in Manitoba. By completing and submitting this intake form, the candidate (or any agent filling out the form for the candidate) acknowledges and consents to the use, disclosure and collection of the information and documents referenced within the intake form for the purpose of the candidate being assessed for PRA training in Manitoba, or any alternate route to medical staff licensure or employment within the health system in Manitoba.

The above-noted consent may be revoked at any time by the PRA candidate by sending in such request to [email protected], attention: IMG Navigator. In doing so, the PRA candidate’s request for PRA intake will be deleted, along with any documents that were submitted in support of the candidate’s PRA intake request.

I agree with the above statement.

Email

This field is for validation purposes and should be left unchanged.

Land Acknowledgement

We acknowledge that Manitoba is located on the Treaty Territories and ancestral lands of the Anishinaabeg, Anishininewuk, Dakota Oyate, Denesuline and Nehethowuk Nations. We acknowledge Manitoba is located on the National Homeland of the Red River Métis. We acknowledge northern Manitoba includes lands that were and are the ancestral lands of the Inuit.

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