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Defined Licence Supervision

Frequently Asked Questions Expand All

Why is supervision being introduced now?

Supervision is not new.

Under the previous Medical Act and Regulations, all physicians issued a Defined Licence were required to have supervision for a minimum of 12 months. Following this, they remained under the more arms-length oversight of a sponsor for the duration of the licence. Sponsors were responsible for submitting an annual report to the College, but in many cases had little concrete information about a physician’s performance in practice on which to base their report and recommendations.

The new Medical Act and Regulations demand a greater degree of oversight than before. Physicians holding a Defined Licence must now have both a supervisor and a sponsor for the duration of the licence. These requirements can only be lifted when the physician meets the requirements for Full Licensure.

The supervisor will be responsible for overseeing the supervised physician’s practice and providing periodic reports to the supervised physician, their sponsor and to the College. These reports will provide concrete support to decisions made regarding ongoing sponsorship and licensure. Where appropriate, they will provide the supervised physician with recommendations for practice improvement.

Why do I require supervision at all?

Defined Licence physicians on the Conditional Register are, by definition, lacking one or more of the requirements for Full Licensure in Canada. In the interest of patient safety, the Medical Act and Regulations require supervision until the requirements for Full Licensure are met.

I am enrolled in a Clinical Fellowship and already work under supervision. What does this mean for me?

Physicians who have been issued a Defined Licence for the purpose of participating in a clinical fellowship, will not be required to have additional clinical supervision while enrolled in fellowship training. As such, there will be no additional requirements or costs. Should a physician wish to practice independently on a Defined Licence following the completion of fellowship training, the requirement and costs of supervision would then apply.

I've been practicing in Nova Scotia for years, with only a sponsor. Will I need a supervisor now, too?

All physicians holding a Defined Licence will now require a supervisor, in addition to a sponsor, regardless of their time in practice.

What will supervision mean for me in terms of my practice?

The degree of supervision required will depend on a number of factors. For many physicians holding a Defined Licence, supervision will entail a periodic review of their practice. This may include a review of patient records, clinical outcomes, CPD history and/or interviews with colleagues. For some, there may be a requirement for periodic observation of actual clinical care.

Who decides how much and what kind of supervision I require?

The College will assign an initial level of supervision based on such factors as a physician’s time in practice, past supervision / sponsorship reports and any history of College-related disciplinary action. The level and nature of supervision may be adjusted over time in response to the reports received from the supervisor and sponsor.

Do I get to choose my own Supervisor?

No. Supervisors will be chosen in consultation between the College and the senior leadership of the Nova Scotia Health Authority and IWK Health Centre. Wherever possible, supervisors will have a scope of practice that closely matches that of the physician they are working with. All supervisors will receive training and support to ensure that they are providing consistent and accurate information about a physician’s practice.

Why do I have to pay for supervision?

The College’s Council, a body made up of practising Nova Scotia physicians and public representatives, has determined that the supervision program should run on a cost-recovery basis. Supervision is now a necessary and ongoing condition of Defined Licensure, without which many physicians who lack the qualifications for a Full Licence would be unable to work as a physician in the province. In the interest of fairness, Council has directed that the cost of supervision be borne by the physicians who most directly benefit from this route to licensure, rather than by all Nova Scotia physicians licenced by the College.

So what is this going to cost me?

Supervision costs will vary, primarily depending on the level of supervision required. For most physicians we anticipate the annual cost to be in the range of $1,800 – $3,000. Higher levels of supervision, although much less common, will cost more.

When will I find out about my own Supervision?

Supervision will be phased in over the 2016 calendar year. Those physicians most recently licensed in Nova Scotia and those requiring higher levels of supervision will be addressed first. You will receive information about your specific supervision prior to it being implemented.

When will supervision end for me?

Supervision for Defined Licence physicians will be renewed each year at the time of licensure. Once a physician is successful in obtaining Full Licensure, supervision will end. If you have questions about the steps you are required to take to obtain Full Licensure please contact Registration at: