Comprehensive Clinical Assessment of Practice: Criteria and Outcomes

Preamble

At the Registrar’s discretion, physicians meeting certain criteria may request authorization to undergo a Comprehensive Clinical Assessment of Practice (CCAP) for the purpose of attaining long-term, renewable licensure in Nova Scotia. Depending on the licence type prior to the assessment, successful completion of a CCAP leads to a Full or Restricted licence.

Purpose

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

Scope

This policy applies to physicians who meet the listed eligibility criteria for a CCAP.

Policy

A. Eligibility

At the discretion of the Registrar, a CCAP may be offered to a physician who, at the time of request:

1. Holds a Defined licence, and
   1. has been under supervision for at least two years, and
   2. provides a letter from their current Sponsor indicating support for the assessment.

OR

2. Holds a Restricted licence issued via one of the following licensing pathways:
   1. Pathway to Long-Term Licensure via a Defined Licence*^,1
   2. Pathway to Restricted Licensure for Defined Licence Physicians on Sponsor-Only Oversight²
   3. Pathway to Restricted Licensure for Academic Licence Physicians³

Eligible physicians on a Restricted licence must provide a letter from their Department Head indicating support for the assessment.

* Physicians issued a Restricted licence via the Pathway to Long-Term Licensure via a Defined Licence must practise under Restricted licensure in Nova Scotia for a minimum of 24 months. This practice must be at least 0.5 Full Time Equivalent (FTE) at a minimum of 900 hours annually immediately prior to the Registrar’s decision in this regard.

A CCAP will only be offered to candidates in disciplines for which a rigorous and unbiased process is available and can reasonably be established. It will be for the Registrar 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 CCAP.

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

When making a decision regarding further licensure, the Registrar will consider the results of the CCAP along with any other relevant information including, but not limited to supervision reports and examination results.

The licensing decisions available include:

1. Full licensure; or
2. Restricted licensure, including specific conditions and/or restrictions regarding scope of practice and any other conditions and/or restrictions the Registrar deems necessary to support safe and effective practice; or
3. For those on a Defined license immediately prior to the CCAP, continued Defined licensure to the end date outlined in the Licensing Agreement; or
4. Referral to the Registration Committee if there are concerns of capacity, competence, and/or character to safely and ethically practise medicine.

Appeal of the Registrar’s Decision

The physician who undergoes a CCAP has the option to appeal the decision of the Registrar through the College’s Registration Committee.

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

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

• all of the information reviewed by the Registrar in making their decision;
• the decision of the Registrar; and
• any supporting documentation provided by the candidate.

The Registration Committee is comprised of three physicians and at least one representative of the public. All decisions of the Registration Committee can be appealed to the Registration Appeal Committee.

Appeal of the Registration Committee’s Decision

The physician has the option to appeal the decision of the Registration Committee 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 physician’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 physician’s file, including but not limited to:

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.

Resources

1. Pathway to Long-Term Licensure via a Defined Licence
2. Pathway to Restricted Licensure for Defined Licence Physicians on Sponsor-Only Oversight
3. Pathway to Restricted Licensure for Academic Licence Physicians