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Moonlighting (PGY3s/Fellows)

First, speak to your program director

  • Talk to your program director (ideally before PGY3 starts) about policies on moonlighting. For example, most will want to ensure you follow Professional Association of Residents of Ontario (PARO) guidelines for duty hours, breaks between shifts, educational activities, etc.
  • If your school or program allows moonlighting and you are interested, discuss it with your program director, who can help clarify your goals and readiness for a moonlighting job. The director will also help structure your curriculum to prepare you and to accommodate your moonlighting position. Here are a few considerations:
    • While moonlighting can be financially rewarding, bear in mind that PGY3 programs are busy and, in themselves, offer significant learning opportunities. Be careful not to over commit.
    • Practising at a position with higher risk could hinder you in the long run. For example, you may encounter challenges you are not trained for that can put you at medico-legal risk and cause significant stress during PGY3 training.
    • Moonlighting may undermine your confidence as a growing independent practitioner. Your program director may be able to provide important insight on locations, including feedback from previous graduates.
    • You are responsible for connecting with the CMPA and CPSO with respect to any moonlighting activities you plan to participate in during PGY3.
    • Many positions require references when you apply. Your program director can assist you with obtaining these as well.

Start seeking opportunities

  • Approach your search for moonlighting opportunities as you would any job search, while understanding that your ability to search may be limited by your academic commitments.
  • Speak with colleagues, previous grads, program directors, leaders at locations where you previously enjoyed training, rural hospital recruiters, etc. This is the best way to make connections.
  • Make sure you are ready to take on the role you are signing up for. You will have the responsibility of an independent practitioner, practising with your own CCFP license.

Ensure your paperwork is complete

  • If you want to moonlight, you must be set up for independent practice, similar to colleagues who graduate after PGY2.
  • You must have obtained your CCFP licence/number and your OHIP billing number.
  • Change your CMPA coverage to Code 14.
  • Obtain hospital privileges as needed.

Consider these additional tips

  • Ensure you are prepared for and comfortable with the role! Know your comfort level and be prepared to turn down opportunities where you would not be able to practise safely.
  • Before stepping into a moonlighting role, you can always take additional courses and complete rotations in the areas of medicine where you would benefit from more training.
  • Because you will be remunerated as a staff physician, you will likely need to do your own billing. Practising this task during PGY1/2 may help ease the transition.

Rural Family Medicine Incentives

Canada Student Loan Forgiveness for Family Doctors and Nurses

What’s available:

  • Forgiveness of up to $8,000 per year, to a maximum of $40,000 (at time of writing, may be subject to change), over five years toward the national portion of your OSAP loans


  • Be a family doctor or family medicine resident in Canada
  • Have outstanding Canada Student Loans, on which payments are up to date
  • Have been employed for 12 months in a designated community (does not apply to family medicine residents) and provided in-person services for 400 hours (or 50 days); see information page for details on “designated communities” 


  • CPSO registration number
  • Signature of immediate supervisor to verify time employed/period of service


  • Apply after completing 12 months of employment

For details and to apply:

Northern and Rural Recruitment and Retention Initiative (NRRRI)

What’s available

  • Grants from $80,000, up to $117,600 (may be subject to change), with amounts paid quarterly over a four-year period; amount determined by the Rurality Index for Ontario (RIO) score of the intended community of practice (RIO score is a measure of how rural a location is to ensure appropriate funding.).


  • A community is eligible if its RIO score is 40 or greater or if it is in one of five urban referral centres: North Bay, Sault Ste. Marie, Sudbury, Thunder Bay or Timmins.
  • Physician must commit to a full-time family practice in a primary care model (i.e., minimum 40 hours per week).
  • Physician must agree to provide ER coverage, unless exempted by community or hospital.
  • You cannot receive the NRRRI and NPRI financial incentives concomitantly.


  • CPSO number and certificate of registration.
  • CFPC certificate of registration.
  • Proof of CMPA coverage.
  • Letter of acceptance from the community for full-time practice establishment.
  • Proof of hospital privileges in the eligible community.


  • Application must be received and approved before establishing practice within the community.

For details and to apply

Northern Physician Retention Initiative (NPRI) 

What’s available

  • $7,000 taxable incentive distributed at the end of the fiscal year (may be subject to change).


  • Physician must have completed at least four years of family practice in Northern Ontario and must continue to provide care until the end of that fiscal year.
  • Communities in Northern Ontario are eligible: districts of Algoma, Cochrane, Kenora, Manitoulin, Nipissing, Parry Sound, Muskoka, Rainy River, Sudbury, Thunder Bay and Temiskaming.
  • You cannot receive the NRRRI and NPRI financial incentives concomitantly.


  • CPSO number and certificate or registration.
  • CFPC certificate of registration.
  • OHIP billing number with billing privileges.
  • Proof of active hospital privileges within the community.


  • Applications are usually due before the end of the fiscal year; deadlines can be found on the MOHLTC website.

 For details and to apply

Family Physician Outreach Program

  • This program offers compensation for physicians willing to provide either
    • Primary care clinics in outlying communities with Underserviced Area Program–funded clinics or nursing stations, or
    • Physician telephone back-up to RNs or NPs working in Underserviced Area Program–funded clinics or nursing stations.
  • For details visit the Outreach Program information page.

Rural Family Medicine Locum Program

  • Locums in rural Ontario are available through the Rural Family Medicine Locum Program.
  • Accommodation, travel expenses and course reimbursement (ATLS & ACLS within 12 months) are usually covered for locum physicians.
  • Visit the Health Force Ontario website to learn more about this program.

Hospital Privileges

Please note that you should speak with the hospital(s) where you will be applying to get specific guidance regarding the application process.

In general, you must apply to a hospital to secure an appointment as professional staff before you can provide patient care there. In addition to a completed application form, requirements include the following:

  • Proof of registration with the CPSO
  • Proof of professional liability protection/malpractice insurance (e.g., through the CMPA)
  • Medical education and training certificates
  • Up-to-date CV
  • Vulnerable sector or criminal record check
  • Current photograph
  • Banking information
  • Evidence of current immunization status
  • Copy of work visa and proof of landed immigrant status, if applicable

Reference Letters

Professional references are generally required for each hospital you apply to. In most, but not all, circumstances, a hospital’s application process will require you to provide at least one reference from all hospitals where you have held or hold privileges.

If you intend to work in multiple hospitals, it can become cumbersome to sequentially apply as you will generally be required to obtain a new reference at each hospital for application to the next one. You can reduce your administrative burden by instead applying at the same time to all hospitals where you intend to work. Doing so allows you to use the same references for each application.

Finding a Job

  • Check with your supervisors, department and university for available locums and job opportunities.
  • For regularly updated locum and permanent job postings, visit Health Force Ontario.
    • Check physician-centred Facebook groups for possible locum opportunities; for example, Ontario/Canada First 5 Years of Practice group, Physician Locums Canada group
  • OMA Legal Services will review employment contracts for free for OMA members. Contact your regional OMA representative for details.