Emergency Physician

What emergency physicians make

CIHI (Canadian Institute for Health Information) does not break out emergency medicine, but its average gross payment across all medical specialties is about $405,000 a year (2023 to 2024), and Job Bank lists a median of about $310,000 for emergency physicians. There is no office to pay for, so nearly all of it is take-home. Pay varies by province and by whether the department pays hourly, per patient, or a blend.

During residency

Paid employees with benefits and a union contract. Quebec pays the least, Alberta and Ontario the most.

Paid by the hour, often

Nights, weekends and holidays pay more. Rural departments that struggle to fill shifts offer premiums and sometimes travel and housing.

What it costs to get there

Undergrad degree (3 to 4 years)

$7,000 to $10,000 a year

Medical school, the MD (doctor of medicine), 3 to 4 years

$15,000 to $28,000 a year

MCAT (medical school admission test), applications, interviews

$2,000 to $5,000

Licensing and certification exams: the MCCQE (national medical exam), then either the CCFP (family medicine) exam plus the CCFP-EM (family medicine emergency) exam, or the Royal College exam

$6,000 to $12,000 depending on route

Roughly, all in

$74,000 to $169,000

Tuition, fees, exams and kit. Not rent, food or travel

The low end is a three year undergraduate degree at cheaper tuition, a medical school at the low end of Canadian fees, and the shorter family medicine route into emergency work. The high end is four years of undergraduate study, four years at an expensive medical school, and the longer Royal College of Physicians and Surgeons route. Residency is paid, so the training years after medical school are income rather than cost. Typical debt at the end of medical school is $80,000 to $150,000, and the admission test, applications and interviews alone run $2,000 to $5,000.

Typical debt at the end of medical school is $80,000 to $150,000. The shorter family medicine route gets you earning sooner. In 2026 the MCCQE costs $1,500, the family medicine exam about $4,500 and the emergency add-on exam about $6,300.

Benefits

• Pension only if salaried

  Most emergency doctors are self-employed contractors. Ontario residents are in HOOPP (the Healthcare of Ontario Pension Plan) during training.

• Union contract during residency

  Provincial residents' associations negotiate pay, call limits and leave.

• Malpractice coverage

  Through the CMPA (Canadian Medical Protective Association), mostly reimbursed by the province.

• No call, no charts at home

  You work your shifts and leave. Time off is real time off.

The path

Two routes end in the same emergency department.

1. 1

   High school

   Grades 11 and 12

   Top marks in biology, chemistry, math and English. You need a very high average for a science undergrad.

2. 2

   Bachelor's degree

   3 to 4 years

   Any major works. Keep a GPA (grade point average) above 3.8, volunteer, do research. Write the MCAT (medical school admission test).

3. 3

   Medical school, the MD (doctor of medicine)

   3 to 4 years

   Acceptance rates are 5% to 15%. Classes, then clinical rotations including emergency shifts.

4. 4

   Residency, route A: Royal College emergency medicine

   5 years

   Matched through CaRMS (the residency matching service). Trauma, critical care, pediatrics, toxicology. Leads to FRCPC (Fellow of the Royal College of Physicians of Canada) and most academic trauma centre jobs.

5. 5

   Residency, route B: family medicine plus CCFP-EM (the family medicine emergency year)

   3 years

   2 years of family medicine, then 1 competitive extra year. Most community and rural emergency doctors in Canada took this route.

High school courses that help

• Biology and chemistry

  Required for nearly every pre-med path.

• Calculus and functions

• Physics

  Tested on the MCAT (medical school admission test).

• English

  You will explain bad news clearly, fast, to strangers.

Time and money, at a glance

Years after high school

9 to 13, depending on route

Med school acceptance rate

Roughly 5% to 15%

Residency match

Both routes are competitive

Total tuition

$90,000 to $150,000

Paid while training?

Only during residency

Heavily regulated

You need a licence from your provincial College of Physicians and Surgeons to practise. Emergency doctors hold either Royal College certification or CCFP-EM (the family medicine emergency certificate). Both are national credentials, so moving provinces is mostly paperwork. Family doctors without either can still staff small rural emergency departments, and many do.

Extra training that changes the job

• Trauma or critical care

  Run the resuscitation bay at a trauma centre, or split time with the ICU (intensive care unit).

• Pediatric emergency medicine

  Shifts at a children's hospital emergency department.

• Transport medicine

  Air ambulance and critical care transport, common in the North.

• Point-of-care ultrasound

  Scan at the bedside to find bleeding or heart problems in minutes.

Nice-to-haves before med school

• First response experience

  Lifeguard, ski patrol, first aid volunteer. Shows you can act under stress.

• Research experience

  Helps at some schools.

• French

  Opens Ottawa, New Brunswick and Quebec programs.

• A rural background

  Rural emergency departments are the ones most desperate for doctors.

A typical shift

Eight to ten hours. You pick up the next chart: chest pain, a broken wrist, a toddler with a fever, an overdose, a car crash, all in the same hour. Order tests, sew cuts, reset bones, decide who goes home and who gets admitted. Twenty to forty patients a shift in a busy department. Handover to the next doctor, then home, sometimes at 3 a.m.

The honest trade-offs

Work life

Typical hours

12 to 16 shifts a month, 8 to 10 hours each

Remote work

None

Physical demand

Moderate, on your feet all shift

Unionized

Residents yes, attending doctors no

Similar paths

• ParamedicTwo years of college, then the front line of emergency medicine.
• Family DoctorThe longest path on this site, and one of the highest paid. Ten years, then a job for life.
• AnesthesiologistThe doctor who puts you to sleep for surgery and keeps you alive through it. Five years of residency, high pay, no clinic to run.

More than 15 million visits a year

CIHI (Canadian Institute for Health Information) counted more than 15.6 million unscheduled emergency department visits in the year to March 2026, in a country of about 41 million people. Not every province reports every visit, so the real number is higher. Most are not true emergencies, which is part of why waits are long.

Most emergency doctors are family doctors

Outside the big city trauma centres, the majority of emergency care in Canada is delivered by family physicians, many with the extra CCFP-EM (family medicine emergency) year. CIHI (Canadian Institute for Health Information) counted about 2,250 family doctors with emergency training in 2024, against about 1,450 Royal College emergency specialists.

Rural emergency rooms are closing

Since 2022, small hospitals across Canada have had to close their emergency departments overnight or for whole weekends because no doctor was available. Show up trained and you can name your town.