Site Search
Skip to main content

Comprehensive Clinical Assessment of Practice: Criteria and Outcomes for Physicians on a Defined Licence

Download PDF


The Registration Committee of the College has the discretion to authorize a Comprehensive Clinical Assessment of Practice (CCAP) for the purpose of ongoing licensure in Nova Scotia. Specifically, a physician holding a Defined licence may be eligible to undergo a CCAP as a route to a Restricted licence.

Whereas a Defined licence is time-limited, a Restricted licence may be renewed annually without a time limit.

In this circumstance, a Restricted licence may be issued to a physician holding a Defined licence if they have:

  1. A Medical Degree from a school listed in the World Directory of Medical Schools1; and
  2. A satisfactory Comprehensive Clinical Assessment of Practice (CCAP).


This policy describes the eligibility criteria, associated costs and possible outcomes for a CCAP.


This policy applies to physicians on a Defined licence with the listed eligibility criteria2.


a) Eligibility

At the discretion of the Registration Committee, a CCAP may be offered to a physician who:

    1. currently holds a Defined Licence with the College and:
      1. has lost their eligibility from their respective Canadian certifying College, the Royal College of Physicians and Surgeons of Canada (RCPSC)3 or the College of Family Physicians of Canada (CFPC)4 or,
      2. holds eligibility for certification from the RCPSC3 of CFPC4 and demonstrates that their scope of practice is narrower than the full scope of the discipline assessed by the certification examination; and
    2. has practised to a satisfactory standard under sponsorship for at least 24 consecutive months immediately prior to the Registration Committee’s decision in this regard; and
    3. provides a letter from their current Sponsor indicating support for the assessment and planned continued sponsorship if a Restricted licence is not achieved achieved should they have eligibility  to remain on a Defined licence; and
    4. provides a letter from their Clinical Department Head indicating departmental support for the assessment and a willingness to maintain the candidate’s position within the department; and
    5. meets all other conditions set by the College for a Restricted licence.

A CCAP will not be offered to candidates in disciplines for which a rigorous and unbiased process is not available or cannot reasonably be established. It will be for the Registration Committee to determine whether a CCAP is feasible and appropriate for any given candidate.

With no exceptions, candidates will be offered only one attempt at the Comprehensive Clinical Assessment of Practice.

b) Costs

The exact nature, duration and cost of the CCAP will be determined by the College in consultation with experts in the discipline. All costs associated with the assessment, including administrative costs of the College, will be borne by the candidate.

c) Outcomes

The Registration Committee will consider the results of the CCAP along with any other relevant information including, but not limited to, supervision reports and examination results when making a decision on further licensure.

Registration Committee decisions may include:

    1. Restricted licensure, including specific conditions and/or restrictions regarding scope of practice or professional development; or
    2. No further licensure for independent practice after the expiration date of the physician’s current Licensing Agreement; or
    3. When there is further eligibility from the RCPSC or the CFPC, continue on a Defined licence.


As with all Registration Committee decisions, the decision of the Registration Committee may be appealed through the College’s Registration Appeal Committee. 

The physician must notify the Registrar of their intent to appeal the decision of the Registration Committee within 30 days from the date of the Committee’s initial decision.

Once the Registrar receives the candidate’s request for an appeal, they will give the Registration Appeal Committee all the information required to conduct a thorough and fair review of the candidate’s file, including but not limited to:

  • all of the information provided to the Registration Committee;
  • the decision of the Registration Committee; and
  • any supporting documentation provided by the candidate.

The Registration Appeal Committee is comprised of three physicians and at least one representative of the public. All decisions of the Registration Appeal Committee are final.


  1. World Directory of Medical Schools
  2. Defined Licence: Requirements and Conditions
  3. Royal College of Physicians and Surgeons of Canada
  4. College of Family Physicians of Canada

Applicable Legislation: Regulations 15 (3a)

Approved By: Registration Policy Committee & Council

Approval Dates: May 20, 2021 & May 28, 2021

Review Date: May 2023