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Information for Dr. Emmanuel Rivera’s Patients

Dr. Emmanuel Rivera is in the process of implementing changes to his practice which were mandated by the College. This is part of a rigorous process undertaken by the College to define an appropriate scope of practice for Dr. Rivera who has not yet achieved the necessary credentials for full licensure in Nova Scotia. This posting is intended to explain the College’s process.

Dr. Rivera’s Licence

Dr. Emmanuel Rivera presently holds a Restricted Licence – a form of long-term, renewable licensure granted to physicians who do not qualify for full licensure. In addition to having evidence of good health and good character, the national standards for full licensure require that a physician:

  • hold an appropriate MD;
  • be a licentiate of the Medical Council of Canada; and
  • be certified by either the Royal College (for specialists) or the College of Family Physicians of Canada.

Dr. Rivera was initially licensed in 2014 with a Defined (conditional) Licence. The purpose of conditional licensure is to allow a physician to work towards full licensure – which, in most cases, means practicing under College supervision and oversight while preparing for certification exams. When first granted a provisional licence, physicians sign a Licensing Agreement, setting out the timeline and pathway for the physician to attain full licensure.

The Medical Act, together with College policy, requires that conditional licensure be time-limited. Dr. Rivera’s initial agreement allotted up to five years to fulfill the requirements set out in his licensing agreement. At the conclusion of this time period, Dr. Rivera requested that his Defined Licence be extended and converted to a Restricted Licence on appropriate conditions. This led the College’s Registration Committee to conduct a full assessment of his practice.

Practice Restrictions

When a physician’s provisional licence ends, an independent Registration Committee, comprised of physicians and public members makes a determination as to whether the physician’s competencies support some form of restricted licensure. These decisions are made after a Comprehensive Clinical Assessment of Practice – essentially a deep dive by independent assessors into the practice of the physician.

Dr. Rivera went through this process, resulting in the Registration Committee concluding that Dr. Rivera is fit and competent to practice in the scope of Family Medicine with certain restrictions and conditions. The Registration Committee directed the Registrar to grant a Restricted Licence to Dr. Rivera. Details of these decisions are not in the public domain. Dr. Rivera is owed a measure of privacy, and as such the details of that decision including the reasons remain confidential.

However, the restrictions imposed are in the public domain and are available on our website. These include the requirement that he limit his practice to 1500 patients which Dr. Rivera has now done using a method in keeping with the College’s Professional Standards and Guidelines Regarding Reducing the Size of a Medical Practice.

The other conditions applied by the Registration Committee were:

  • Must practice under supervision
  • Must not practice inpatient care (hospitalist work)
  • Cannot provide intra-partum obstetrical care
  • Cannot practice in an Emergency Department or in a Collaborative Emergency Centre

Decisions of the College are anchored in a commitment to public safety and to the integrity of the profession.