Assessment programs

The College of Physicians and Surgeons of Nova Scotia (the College) uses a variety of assessment programs to help ensure physicians are ready to provide safe, effective care in Nova Scotia. These assessments are designed to assess a physician’s skills in real clinical settings — whether they’re new to the province, returning to practice, or expanding their scope of work.

Below is an overview of the main assessment programs and what they involve.

Comprehensive Clinical Assessment of Practice (CCAP)

The CCAP is a short-term, in-depth review of a physician’s clinical work. It’s typically used for physicians who already hold a provisional licence and who need to prove their competence to gain a long-term (Full or independent) licence in Nova Scotia. In plain terms, it’s like a short “on-site audit” of a physician’s work to ensure they meet the required standards.

• How it works: Assessors visit the physician’s workplace for 3 to 5 days. They observe patient care, review medical charts, speak with colleagues, and may use simulation to evaluate performance.
• Goal: To confirm that the physician meets Canadian standards for safe, competent practice.
• Outcome: If successful, the physician may be granted either a Full licence with no conditions or a Restricted licence with certain scope limitations, depending on circumstances. If the results are borderline or concerning, the College might impose specific conditions (such as additional training or ongoing supervision) or even deny further independent practice.

Practice Ready Assessment Specialists

Practice Ready Assessments are designed for internationally trained physicians who want to practise in Nova Scotia but don’t yet qualify for Full licensure. It may be required when a physician is new to practising in Nova Scotia and needs to demonstrate they can safely function as the most responsible physician (MRP). In simpler terms, it’s a two- to three-month trial period where the physician works under observation to demonstrate they are “practice-ready.”

• Who it’s for: Specialists other than family medicine who have completed training outside Canada and are endorsed by Nova Scotia Health.
• How it works: The physician receives a short-term Clinical Assessment licence and completes an 8- to 12-week supervised workplace-based assessment. This includes orientation, coaching, and formal assessment in a Nova Scotia clinical setting.
• Outcome: If the physician demonstrates the required competencies, they may transition to a Defined licence and begin supervised practise in Nova Scotia.

Other Workplace-Based Assessments

The College also uses several other assessment formats depending on the physician’s situation:

• Supervised Practice (Defined licence supervision)
  Physicians with a Defined licence work under the supervision of an approved physician for 6 to 24 months. Supervisors submit regular reports to the College. This ongoing assessment helps determine if the physician is ready for an independent licence.
• One-Day Practice Assessment
  This is a brief, focused assessment — usually one day — used when a quick check of clinical skills is needed. It may apply to physicians returning after a short absence or those needing targeted assessment.
• Advanced Scope Assessments
  If a physician wants to expand their scope of practice, beyond what is included on their current licence, they may undergo an assessment to confirm their competence in that area. These are tailored to the specific circumstances of the physician and scope of practice requested to be assessed.
• Re-entry or Returning-to-Practice Assessment
  Physicians who have been away from practice for several years or are changing specialties may need to complete an assessment to re-establish their readiness. This could range from a few weeks of supervised practice to a structured eight-week assessment.