To be eligible for obtaining a notice of compliance with a region’s PREM, a candidate has to undertake to start his practice in that region within 12 months following the receipt of his compliance notice application by the DRMG. 

The physician may, however, ask for his start of practice to be deferred for a maximum of six additional months. It is up to the DRMG whether or not it agrees to the deferral request for reasons it deems fair and equitable.


  • 55%-45% RULE

The doctor must devote at least 55% of his annual billing days to the region or area where he holds his PREM compliance notice. 

A day is considered as soon as the physician has billed at least $523 in the area. A half day is considered as soon as the physician has billed at least $261,50, but less than $523. 

The distribution of the doctor’s practice is evaluated on an annual basis with regard to days worked, from March 1 to February 28-29 of the following year, from the date of issue of the PREM compliance notice. 

If the physician begins during the year, the calculation is prorated, from the date of issue of the compliance notice.

A doctor may therefore devote up to 45% of his billing days to practising outside the area where he holds his compliance notice, either in another RLS in the same region, in one of Quebec’s 17 other regions, or on part-time locums. WARNING: Currently, only the Quebec City (Capitale-Nationale) region (except for the Portneuf and Charlevoix sub-areas) is subject to the following rule: a doctor who has no compliance notice from that region may not perform more than 5% of his billing days there.