Change in Clinical Scope of Practice: Requirements

Preamble

All registrants have a professional responsibility to practise within a clinical scope for which they are appropriately trained and competent. Breach of this responsibility may be considered professional misconduct.

In accordance with section 16(2) of the Medical Act Regulations¹, a person must notify the Registrar in writing of their intention to change the scope of their clinical practice to an area in which they have not practised for the 3 years immediately preceding.

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.

A registrant’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.

Distinct from this incremental evolution in scope, a registrant may 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 registrant changing their scope to include an area:

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

* For more information about a significant change in clinical scope of practice, please refer to the Guidance to Physicians Contemplating a Change in Clinical Scope of Practice.²

Purpose

This policy describes the Registrar’s requirements for a registrant to make a significant change to their clinical scope of practice, including to an area in which they have not practised for the 3 years immediately preceding.

Scope

This policy applies to registrants applying to make a significant change to their clinical scope of practice.

Policy

Current registrants are required to adhere to the College’s Currency of Practice Experience requirements.³

All registrants must report to the College if they wish to make any significant changes to their scope of practice. They will be required to complete the appropriate application form before significantly changing their scope of practice.

Upon receipt of the application, the College will determine whether the registrant requires an assessment and/or training to safely change their scope of practice. All costs associated with the application and assessment for changes to scope of practice are the responsibility of the registrant.

Resources

1. Medical Act Regulations
2. Guidance to Physicians Contemplating a Change in Clinical Scope of Practice
3. Currency of Practice Experience