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Overview for Supervisors Regarding the New Licensing Pathway for Physicians Trained Outside of Canada

Physicians issued a Defined licence in Nova Scotia are required to have oversight from both a supervisor and a sponsor for the duration of that licence.

Supervisor Role & Responsibilities

The role of a supervisor is to monitor, assess, and support the supervised physician as they work towards long-term licensure. Supervisors play an important part in ensuring access to high-quality patient care for Nova Scotians.

The Supervision Handbook provides guidance to supervisors.

Supervisors must:

  • Assess a physician’s practice
  • Ensure the practice meets care expectations
  • Establish and maintain a professional relationship with the Defined licensee
  • Act as an agent of the College
  • Be familiar with the supervised physician’s Licensing Agreement
  • Advise the College of concerns
  • Report on the supervised physician’s performance to the College
  • Immediately notify the College Registrar if there are imminent patient safety concerns
  • Advise the Registrar if the supervised physician stops practicing in a Health Zone
  • Inform the College in advance if intending to withdraw from supervision

The College will notify the Supervisor if there is a College complaint regarding the supervised physician.


To be eligible to be a Supervisor, a physician must:

  • Have a Full licence, Academic licence, or Defined licence on sponsor-only oversight
  • Have a minimum of two years in practice
  • Be approved by the Sponsor
  • Be approved by the College
  • Be engaged in a similar scope of practice as the Supervised physician
  • Practice in the same geographic area as the Supervised physician unless otherwise approved by the Registrar

New Pathway to Long-term Licensure for Physicians Trained Outside of Canada

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The College has developed a streamlined approach to long-term licensure for physicians on a Defined licence.

The Medical Act requires physicians trained outside of Canada to practise under a Defined licence and undergo supervision. Physicians must meet the requirements and conditions required to obtain a Defined licence. There is no change to the qualification requirements.

Shorter Supervision Period

Shorter Supervision Period

The new licensing pathway reduces the required time physicians on a Defined licence must practise under supervision by 60%.

Physicians issued a Defined licence will have a minimum of six months of supervision to a maximum of 24 months.

Based on our data, we anticipate that 80% of physicians on the new pathway will be issued a Restricted licence after six months. A smaller cohort may require up to 24 months of supervision.

Focus on Demonstrated Competency Not Certification

Focus on Demonstrated Competency Not Certification

The new licensing pathway enables faster decisions regarding long-term licensure based on demonstrated competency.

There is no longer a focus on passing the certification exam from the certifying bodies.

Physicians on a Defined Licence must be deemed eligible by their certifying body to challenge certification, but they do not have to challenge the Royal College or College of Family Physicians of Canada (CFPC) exams. They can choose to challenge the exams to obtain a Full Licence but it is no longer a licensing requirement.

The goal of supervision is to understand the physician’s competence within six months. There will be direct observation of practice monthly. Colleague interviews will occur twice in the first six months with the opportunity to respond to and integrate feedback. Chart reviews will continue to play a role in supervision. There will always be the option of providing more supervision tools as needed.