So then, for a person matched for internal medicine, will it be an acceptable action plan to mention the fellowship in USA (since internal is 3 years is USA).

so
3 years Internal medicine residency
2 or 3 years fellowship
(MCC QE2 not required for me resident in ontario, QE1 already passed)
request extension of statement of need in PGY3
RCPSC assessment in internal medicine, i.e., by april 30 of PGY3
write RCPSC exam in spring of PGY4

hmmm.. but then what about fellowship sub-specialty license... for that need to apply for RCPSC assessment again and take board exams etc!!

im confused... I wanna do fellowship so that i dont have to do one year extra when i come back to ontario.

You could also do a Chief Resident or a one year geriatric medicine fellowship in the US.

"one year extra" are you referring to the CPSO requirement to have done one year of clinical practice in Canada? If so, that can be waived by the CPSO licensing committee. If you are referring to another year of internal medicine, no worry, since the first year of a 2 or 3 year fellowship is counted as the fourth year of IM.

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PMs accepted.

by "one extra year" i meant the fourth year of internal medicine. I would like to do fellowship instead of chief resident.

However, if i do fellowship, then do I have to assessment/exam again for Royal College after the fellowship is complete?

The preliminary assessment is done first, and only if you do a subspecialty and you want to work as a subspecialist (e.g., Infectious Diseases), do you have to ask for additional assessment and then write the ID exam.
If you do a one year fellowship, you will have to notify the RCPSC so they know you have done the fourth year. Then you will be allowed to write the IM exam.

__________________
Not an M.D.
PMs accepted.

Thanks ValuableCanadian !