Pathway to conditional licensure for internationally trained physicians via a practice ready assessment – office-based primary care

Preamble

The criteria for registration on the Conditional Register are laid out in section 39 of the Medical Act Regulations.¹ Physicians who are not eligible for a Full licence² may be eligible for licensure on the Conditional Register.

Physicians registered on the Conditional Register are permitted to practise medicine in accordance with the conditions and restrictions outlined in their licensing agreement with the College of Physicians and Surgeons of Nova Scotia (the College).

For the purposes of this policy, conditional licensure means either a Defined licence, a Restricted licence, or a Clinical Assistant licence.

A practice ready assessment (PRA) is a practice-based assessment to determine whether the physician is ready for practice as the most responsible physician in Nova Scotia. Unless otherwise approved by the Registrar, all PRAs in office-based primary care are conducted by the Physician Assessment Centre of Excellent (PACE).³

Purpose

This policy outlines the College’s eligibility requirements for a PRA in office-based primary care and the licensing decisions available to the Registrar at the conclusion of the assessment.

Scope

This policy applies to all applicants for a PRA in office-based primary care who completed their family medicine or general practice training in an international jurisdiction that is not recognized by the College of Family Physicians of Canada (CFPC).

Policy

All PRAs for office-based primary care must be conducted in accordance with this policy and with the agreement of the College, Nova Scotia Health, and PACE, where appropriate. All PRAs must be approved by the College in advance.

Minimum eligibility criteria

In addition to the following criteria, candidates must have fewer than two previous unsuccessful attempts in a Canadian practice ready assessment program.

All credentials must be source-verified by physiciansapply.ca⁵. Candidates must have all of the following credentials:

* If the applicant has a gap in any of the listed rotations, the College may accept practice experience in lieu of training as follows:

• Each 1 year of independent practice as a family physician/general practitioner that includes the gap in practice experience rotation will be considered as equivalent to 4 weeks of postgraduate training in that area. For up to 3 rotation deficiencies. AND
• Applicants must provide an acceptable attestation to prove practice experience in the area(s) of postgraduate rotation gap.

** At the discretion of the Registrar, candidates for practice ready assessment in office-based primary care, may be excused the requirement for 4 weeks of postgraduate training in psychiatry and/or obstetrics/ gynecology, provided they have the equivalent amount of extra training in family medicine.

Licensing decisions following PACE assessment

The Registrar of the College will make a licensing decision upon consideration of all reports or recommendations of the PACE Competence Committee, specifically determining whether:

1. The physician has demonstrated the competencies necessary for Restricted licensure without supervision, restricted to the scope of practice and location(s) outlined in the physician’s return of service agreement with the Department of Health and Wellness. OR
2. The physician has demonstrated the competencies necessary for Defined licensure with supervision, with or without additional conditions and/or restrictions beyond those typically applied to a Defined licence. The physician will be restricted to the scope of practice and location(s) outlined in their return of service agreement with the Department of Health and Wellness. OR
3. The physician has demonstrated the competencies necessary for a Clinical Assistant licence for practise as an associate physician within an approved associate physician program. A letter of offer for employment as an associate physician in an approved program from Nova Scotia Health or the IWK Health Centre is a requirement for a Clinical Assistant licence. OR
4. The physician has not demonstrated the competencies necessary for any form of licensure and the application is denied. This denial must be disclosed to other Medical Regulatory Authorities if asked about a history of being denied licensure.

In the event the Registrar is not prepared to make a licensing decision based on concerns related to the physician’s capacity, competence, or character to safely and ethically practise medicine, the Registrar will refer the physician to the Registration Committee for consideration.

At any time after the conclusion of the assessment, the candidate has the option to withdraw their application for licensure. In this case, there will be no licensing decision rendered.

Appealing a licensing decision

All licensing decisions have an appeals process depending on the circumstances. The internal review and appeal processes are laid out in the policy for Appealing a Licensing Decision.⁸

Resources

1. Medical Act Regulations
2. Full Licensure: Requirements and Criteria for Physicians
3. Physician Assessment Centre of Excellence
4. physiciansapply.ca
5. World Directory of Medical Schools
6. Currency of Practice Experience
7. English Language Proficiency
8. Appealing a Licensing Decision