How much does it cost to buy out return of service in Ontario?
The repayment is your training cost per year multiplied by your years or days of postgraduate training, plus a $4,000 administrative cost and any interest. The guidelines describe repayment on breach and under extenuating circumstances, and do not say it can simply be chosen. The guidelines and ministry page give no per-year cost, so your own figure has to come from the ministry.
Researched by Button Health. Last checked .
Physicians usually call this a buyout. The ministry calls it repayment. The formula is in the program guidelines:
“Repayment amount is calculated by (The training cost per year multiply by the total number of years or days of postgraduate medical training) + $4,000 administrative cost.”
Participants who breach are also required to repay “plus interest charges if applicable.”
The parts of the formula
| Part | What we know | Source |
|---|---|---|
| Training cost per year | Not published in the sources we read | Ask the ministry |
| Years of training | Family medicine residencies are 2 years | Ministry page |
| “Years or days” | Days are allowed for, conversion method not stated | Guidelines |
| Administrative cost | $4,000 | Guidelines |
| Interest | “if applicable,” compound, at a rate set by the Province | Guidelines |
| Credit for service | Considered on request, proportional | Ministry page |
Worked examples
Because the guidelines and ministry page give no training cost, the per-year figures below are illustrations only. They show how the formula behaves for a 2-year family medicine residency. They are not ministry figures.
| Illustrative cost per year | x 2 years | + $4,000 | Total |
|---|---|---|---|
| $50,000 | $100,000 | $4,000 | $104,000 |
| $100,000 | $200,000 | $4,000 | $204,000 |
| $150,000 | $300,000 | $4,000 | $304,000 |
A figure you hear may be a per-year number rather than a total. The formula multiplies by years of training, so check which one any figure you hear refers to.
If you have already served part of it
The guidelines formula contains no credit for hours served. The ministry page adds:
“If an individual has partially completed their ROS, upon request, the ministry will consider reducing the repayment amount in proportion to the length of service completed.”
Here is how a proportional reduction would work if the ministry granted it and measured it in hours, using the $204,000 illustration. We assume the $4,000 stays in full, since no source says whether it is reduced.
| Hours served | Share of 7,200 | Training cost remaining | With $4,000 |
|---|---|---|---|
| 0 | 0% | $200,000 | $204,000 |
| 1,800 | 25% | $150,000 | $154,000 |
| 3,600 | 50% | $100,000 | $104,000 |
| 5,400 | 75% | $50,000 | $54,000 |
The ministry also says it “is unable to waive physicians of their financial obligations incurred under the ROS agreement.”
How to get your real number
The guidelines say the ministry issues a notice stating the amount owing. For planning before that point, write to the Return of Service Program Officer at PPUProgramOfficer@ontario.ca and ask:
- What is the training cost per year that applies to my agreement?
- How many years or days of training does it use?
- Would a reduction apply for hours already served, and how is it measured?
- Is the $4,000 reduced in the same way?
Rules differ between provinces. British Columbia’s family medicine contract template, for example, states a repayment of $660,000 for a breach from the second year of residency through completion of service, plus compound interest, not pro-rated. Do not apply one province’s figure to another. See moving to Ontario with return of service from another province.
Confirm how this applies to your agreement with the Ministry of Health.
Common questions
What is the training cost per year for family medicine in Ontario?
The guidelines and ministry page we read do not publish a figure. Ask the ministry for yours, and treat figures on forums as unverified.
Is the repayment reduced if I already served part of my return of service?
The ministry page says that upon request, the ministry "will consider reducing the repayment amount in proportion to the length of service completed." It is not automatic, and the guidelines formula itself contains no credit.
Can I simply choose to buy out my return of service?
The guidelines describe repayment as an option when extenuating circumstances arise and as a requirement on breach. They do not state whether someone can elect repayment without extenuating circumstances, and the word buyout does not appear.
Related questions
- How do you pay back return of service in Ontario?
- What happens if you breach your return of service agreement?
- How long would $38,000 a year take to cover a return of service repayment?
Sources
- Ontario Ministry of Health, IMG ROS Program Guidelines (dated October 2025, posted at a December 2, 2025 URL)
- Ontario, Health human resources (updated November 2, 2026)
- BC family medicine ROS contract template, 2027 cohort, for comparison
The offer
Family physician, Bay and College, Toronto.
Compensation
Fee-for-service Family Health Group (FHG), applying for FHO+ next year.
Overhead: 0% for your first one and a half OHIP billing cycles. Then 20% of your OHIP billings (plus HST) at four or more clinical days a week or $30,000 a month in billings. Below that, 25%.
Estimated earnings: $32,000 to $43,000 a month in billings. $25,000 to $35,000 a month after overhead, from OHIP and private fees.
Attachment bonus: OHIP pays you $100 to $120 for each patient you attach who has no family doctor.
Profit share: Builds by about $3,200 a month, up to $38,000 a year, scaled to days worked. Paid by the clinic in June and December, no overhead. Can go toward your annual HOOPP pension contribution.
Paid leave: six weeks a year, building from your first day. A locum sees your patients while you’re away, so nothing piles up.
Professional allowance: up to $5,000 a year for CME, dues and licensing.
Gym membership: paid by the clinic.
About this research
Button Health researched these rules directly from ministry, regulator and other primary sources, and links each one so you can read it yourself. Button Health is a family practice at Bay and College in Toronto that recruits family physicians, so we have an interest in this topic.
This page is general information, not legal or financial advice. Rules change, and your agreement is what binds you.