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Re-Entry into Practice and/or Change in Clinical Scope of Practice

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A physician’s clinical scope of practice can be broadly defined by the patient population served, the range of clinical conditions managed, the medical procedures performed and the clinical environment in which care is provided.

It is accepted that clinical scope of practice will evolve incrementally over the course of a physician’s career through the influence of changing patient demographics, the emergence of new diseases or conditions, the development of novel diagnostic or treatment modalities, and through changes in practice environment.

Distinct from this incremental evolution in scope, a physician may from time to time contemplate making a significant or abrupt change to their clinical scope of practice. Such transitions may pose a particularly high risk to practice quality and patient safety, particularly when they involve a physician changing their scope to include an area:

  1. which is not part of the usual and accepted scope for physicians in their discipline or specialty; or
  2. for which they have limited or no recent experience or training.


  1. Physicians have a professional responsibility to only practise within a clinical scope for which
    they are appropriately trained and competent. Breach of this responsibility may be considered
    professional misconduct.
  2. Physicians must report to the College when they:
    1. wish to re-enter practice and have not been engaged in practice for at least 450 hours over the last three years; and/or
    2. are contemplating a significant or abrupt change in their scope of practice or wish to return to a scope of practice in which they have not practised in the last three years.

For further information regarding re-entry into practice, refer to: Guideline to the Conduct of Return to Practice Assessments.

For further information regarding changes to clinical scope of practice, refer to: Guidance to Physicians Contemplating a Change in Clinical Scope of Practice.

  1. Physicians must complete the appropriate application form. The College will review the
    application and consider whether the physician requires an assessment, supervision and/or
  2. Physicians who wish to re-enter practice or change their scope of practice must pay for all costs
    associated with assessment, supervision and training.

Applicable Legislation

Medical Practitioners Regulations pursuant to the Medical Act – Section 16 (1)

Approved By

Registration Committee, Executive Committee

Approval Date

October 30, 2019

December 12, 2019

Review Date

June 2020