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

Preamble

At the Registrar’s discretion, physicians issued a Defined licence may request authorization to undergo 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.

This policy does not apply to physicians following the Pathway to Long-Term Licensure via a Defined Licence¹.

Whereas a Defined licence is time-limited, a Restricted licence may be renewed annually without a time limit. Successful completion of a CCAP leads to a Restricted licence.

Purpose

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

Scope

This policy applies to physicians who meet the listed eligibility criteria for a CCAP and who were issued a Defined licence to practise medicine in accordance with the policy for Defined Licence: Requirements and Conditions for Independent Practice in effect for physicians issued a licence prior to September 1, 2022, who remained on their original licensing pathway.

This policy does not apply to physicians who were issued a Defined licence to practise medicine in accordance with the policy for Defined Licence: Requirements and Conditions for Supervised Practice as the Most Responsible Physician².

Policy

A. Eligibility

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

1. currently holds a Defined licence* with the College; and
2. has demonstrated supervised practice in Nova Scotia satisfactory to the Registrar for at least 24 months practising 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; 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 should they have eligibility to remain on a Defined 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 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.

* Physician must have been issued a Defined licence prior to September 1, 2022, and be on their original licensing pathway.

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 Registrar’s decision may include:

1. Restricted licensure, including specific conditions and/or restrictions regarding the scope of practice and practice location and any other conditions and/or restrictions the Registrar deems necessary to support safe and effective practice; or
2. Continued Defined licensure to the end date outlined in the Licensing Agreement; or
3. Eligibility for a Clinical Assistant licence; 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 Defined licence physician 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. Defined Licence: Requirements and Conditions for Supervised Practice as the Most Responsible Physician