Internal medicine
In brief
Compare two residencies- 516 spots, the second-most in Canada. 16.9% ranked it first.
- 4-year residency. Stay a general internist, or move into 1 of 17 subspecialties after the Core stage.
- Adult cardiology needs internal medicine first: Royal College certification or its Core stage.
- Cardiology adds 3 years. Gastroenterology, critical care medicine, palliative medicine and clinical pharmacology and toxicology are each planned as 2.
- Average billing $517,131 before expenses, including cardiology and other subspecialties. Highest province Ontario $580,205, lowest Nova Scotia $370,803. Overhead 21% (2017). Cardiology alone $893,554.
Full breakdown
The 2026 match
- Spots for Canadian grads
- 516516 spots for Canadian gradsFirst-round spots in the 2026 match set aside for grads of Canadian med schools. International grads have their own stream.Source: CaRMS
- Spots per person who ranked it first
- 0.990.99 spots per person who ranked it firstUnder 1.00: more people put it first than there were spots. It compares specialties. It isn’t anyone’s odds, because people rank several programs and programs rank people.Our math516 spots ÷ 0.99 = about 521 people ranked it first. That’s 1.0 people for every spot.Source: CaRMS
- Rank, 1 = hardest
- 20 of 3320 of 33, 1 = hardestOur mathAll 33 match streams sorted by spots per person who ranked it first, lowest first.Source: CaRMS
- People who ranked it first
- About 521About 521 ranked it firstCanadian grads who put it first on their rank list. CaRMS publishes the ratio, not the count, so this is our estimate.Our math516 spots ÷ 0.99 = 521. CaRMS rounds the ratio, so the real count is between 519 and 523.Source: CaRMS
- Empty after the first round (all streams)
- 14Empty after the first round, all streamsSource: CaRMS
- Empty after both rounds (all streams)
- 22 spots still emptyEmpty after the first round: 14. Still empty after the second round: 2. Counts every stream, including international grads, so it is a bigger pool than the Canadian-grad spots.Source: CaRMS
- Applications offered an interview (2025 match)
- 64%64% of applications got an interviewIn the 2025 match, Canadian grads sent 7,245 applications to internal medicine programs and 4,655 got an interview offer. Counts applications, not people: one person usually applies to several programs. 2026 is not published yet.Source: CaRMS
- Filled in round 1 + round 2 (all streams)
- 575 + 17Filled in each round, 2026First round: 575 of 589 spots filled. Second round: 17 of 19 filled, 2 left empty. All streams, including international grads.Source: CaRMS
- Ranked it first and had no residency after both rounds
- 16Ranked it first, no residencyCanadian grads only.Our math6 who took part in the second round and did not match + 10 who did not match in the first round and skipped the second = 16Source: CaRMS
- Ranked it first, matched to family medicine (first round)
- 39Matched to family medicine insteadSource: CaRMS
Ranked it first, by yearRanked it first, 2022 to 2026Source: CaRMS
Billing, 2024-25
Canadian average $517,131$517,131 average billing, 2024-25Average gross clinical payments per physician across Canada, before expenses like staff, rent and insurance. Not take-home pay. Every physician counts once, full time or not. Includes cardiology and other subspecialties.Source: CIHI before expenses. Not take-home pay. Highest province Ontario $580,205, lowest Nova Scotia $370,803.
Includes cardiology and other subspecialties. Cardiology alone averages $893,554 and gastroenterology $620,207.Internal medicine subspecialtiesCIHI notes that gastroenterology and cardiology sit inside internal medicine, which includes 11 other subspecialties.Source: CIHI
- Canada$517,131
- British Columbia$512,180 -$4,951
- Alberta$507,270 -$9,861
- SaskatchewanNot available
- Manitoba$442,702 -$74,429
- Ontario$580,205 +$63,074
- Quebec$414,129 -$103,002
- New Brunswick*$426,534 -$90,597
- Nova Scotia$370,803 -$146,328
- Prince Edward Island*$473,009 -$44,122
- Newfoundland and Labrador*$411,040 -$106,091
- Yukon*$143,129 -$374,002
* A small number of doctors can swing this. Hidden: CIHI suppresses groups too small to keep anonymous. Not available: CIHI marks it n/a. Neither is zero. Gap shown against Canada.Source: CIHI
Overhead 21%21% overhead, 2017Average overhead doctors in this specialty reported for running their practice, in the CMA’s 2017 survey. Old, so we never subtract it from 2024-25 billing.Source: CMA, reported in 2017. A dated survey figure, so we do not subtract it from 2024-25 billing.
Training
4-year residency. Planned as a 4-year residency.Residency lengthSource: Royal College
Subspecialty training starts once you complete the Core stage of internal medicine. The Royal College sets no fixed length for that stage. The Royal College lists 17 subspecialties that can overlap with internal medicine training.
| Adult cardiology | Planned as 3 years.Adult cardiologySource: Royal College |
|---|---|
| Gastroenterology | Planned as 2 years.GastroenterologySource: Royal College |
| Adult critical care medicine | Planned as 2 years.Adult critical care medicineSource: Royal College |
| Adult palliative medicine | Planned as 2 years.Adult palliative medicineSource: Royal College |
| Clinical pharmacology and toxicology | Planned as 2 years.Clinical pharmacology and toxicologySource: Royal College |
Entry to adult cardiology needs Royal College certification in internal medicine or completion of its Core stage.Source: Royal College
39 grads who ranked it first matched into family medicine in the first round, more than from any other specialty CaRMS lists.