Ontario Return of Service in 2026: 7,200 Hours Explained

The IMG Return of Service Program Guidelines put the change this way:

“Beginning 2026, IMGs who sign the ROS Agreement have a commitment to provide a total of 7,200 hours of clinical practice hours (with a minimum requirement of 120 hours per month) in an eligible community or multiple eligible communities, after graduation of training. This is a change from the prior 5 years, allow greater flexibility / counting of hours.”

The rules at a glance

Topic	What the guidelines say
Who	IMGs who sign the ROS Agreement “beginning 2026”
Total	7,200 clinical practice hours
Monthly minimum	120 hours
Where	An eligible community or multiple eligible communities
What an hour includes	“documenting, evaluating, consultation, diagnosing, and treating patients”
What counts	“OHIP-insured services” and “OHIP-covered virtual care services,” with separate rules for patient catchment, provincial needs-based specialties and academic appointments (minimum 4,800 hours in an eligible community)
Reporting	An annual attestation at the end of each calendar year

What the numbers mean

At the minimum, 7,200 hours divided by 120 hours a month is 60 months, or exactly 5 years. That arithmetic matters: the hours measure is not automatically shorter. Its effect depends on how many eligible hours you work each month.

120 hours a month is about 27.7 hours a week across a year (120 x 12 / 52). The table below shows how long 7,200 hours takes at different monthly totals, if every hour counts. The guidelines do not state whether hours above 120 in a month carry forward, so treat the shorter timelines as questions to raise with the ministry.

Eligible hours a month	Months to reach 7,200	Years
120	60	5.0
130	55.4	4.6
150	48	4.0
170	42.4	3.5

Where ministry wording differs

Agreements from 2026 use hours per the October 2025 guidelines, and earlier agreements were written as 5 years, so check your own agreement. Other ministry documents still use the older wording in places, so we set them side by side here.

Topic	Program guidelines	Health human resources page
Length	7,200 hours, “a change from the prior 5 years”	“must execute a 5-year Return of Service (ROS) Agreement”
Pace	Minimum of 120 hours a month	“full time requirement of 30 hours per week”
Part-time	Not addressed	“The ROS is a full time commitment”
Partial credit on repayment	Not addressed	The ministry “will consider” a proportional reduction on request

An April 2026 government briefing also says “No changes are being made to the 5-year ROS obligations for IMGs (both Ontario IMGs and others).” We have not found a ministry explanation of that wording, which is one more reason to read your own agreement.

What the guidelines leave open

These points are not stated in the sources we read:

What happens to agreements signed before 2026
What happens if a month falls below 120 hours
Whether there is an outer deadline for finishing the 7,200 hours
Whether hours above the minimum shorten the term
How the ministry verifies hours

We could not find the agreement published, and it is what binds you. The guidelines also changed between editions: the earlier October 2025 file said “A minimum of 40%” on virtual care, and the current file, posted at a December 2025 URL and still dated October 2025 on its face, says “Up to 40%.” Check that you are reading the edition the ministry page links to.

Confirm how this applies to your agreement with the Ministry of Health.

Common questions

Is the 2026 return of service shorter than 5 years?

Not necessarily. At exactly the 120-hour monthly minimum, 7,200 hours takes 60 months, which is 5 years. Working more hours each month could finish it sooner if the extra hours count, and the guidelines describe the change as allowing greater flexibility and counting of hours.

Do the 7,200-hour terms apply to agreements signed before 2026?

The guidelines do not say. They apply the hours measure to IMGs who sign the agreement beginning in 2026 and give no transition rule for earlier signers. Ask the ministry in writing.

How are return of service hours reported?

The guidelines require an annual attestation at the end of each calendar year. They do not publish the form, its due date or how hours are verified.

Sources

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.

Return of Service Repayment Calculator (Ontario 2026)

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.

What changed in Ontario return of service for 2026?