Responsibilities of Supervisors and Physicians Under Supervision

Supervision

Supervision is a process under which a physician (or group of physicians) formally assesses another physician’s practice for the purpose of ensuring that the care provided meets the expected standard. Supervision commonly includes an educational component for the supervised physician.

Examples:

• A physician on a Defined Licence requires supervision as a criteria for licensure.
• Concerns have been raised regarding the standard of care in the physician’s practice.
• A physician is changing their scope of practice or re-entering practice after a prolonged absence.

Supervisor’s Responsibilities

The Supervisor’s specific obligations will be set out in the Terms of Supervision¹ with the College and are also described in the College’s Guidelines for College-directed Supervision.²

Starting Supervision

• Signs a Terms of Supervision¹ agreement with the College
• Reviews the Guidelines for College-directed Supervision²
• Participates in orientation and/or training as required by the College
• Reviews pertinent background material, including the supervised physician’s practice profile

During Supervision

• establishes and maintains a professional relationship with the supervised physician
• provides and documents supervision, using of standardized assessment tools provided by the College
• adheres, as closely as possible, to the established timelines of supervision report submission, to avoid delays in the supervised physician’s licensing decisions

Immediate Reporting to the College

The Supervisor is responsible for immediately reporting to the College in the following situations:

• there are concerns about the Supervised Physician’s practice (i.e. practice below a reasonable standard, or which exposes patients to risk of harm or injury)
• the Physician under Supervision is practicing outside the scope or setting approved by the College
• the Supervised Physician’s conduct presents concern
• the Physician under Supervision is acting in such a manner that suggests that he / she may be impaired or incapacitated
• the Physician under Supervision fails to comply with the terms of supervision, including missing an appointment or meeting with the Supervisor without good reason, or being uncooperative
• the Supervisor is unable to continue in the role, or is unable to fulfill the obligations agreed to in the Terms of Supervision on a permanent or temporary basis (e.g. due to illness, personal emergency, etc.)
• the Supervisor becomes the subject of a complaint to the regulator, either in Nova Scotia or another jurisdiction, or
• the Physician under Supervision ceases to practice within the Health Authority.

Physician Under Supervision’s Responsibilities

• should performance concerns be identified during the course of supervision, acknowledges and provides a plan for practice improvement
• abides by the imposed level of supervision³, as decided by the Registrar or College Committee in accordance to College policy
• gives consent to the College for the release, to the supervisor(s), of any pertinent background information necessary to enable them to carry out duties effectively
• gives consent, where deemed necessary by the Supervisor or College, for the conduct of interviews with colleagues or patients
• is motivated and takes responsibility for improvement;
• is open, honest and collegial with colleagues and the supervisor
• demonstrates meaningful progress towards meeting the expectations of the College
• supports the supervisor in fulfilling their obligations, including the provision of timely reports to the College
• provides notice to the supervisor and College of planned absences or intent to leave practice
• assumes responsibility for the payment of all fees, costs, charges, and expenses arising from the supervision arrangement
• agrees to information sharing amongst all involved Supervisors

Resources

1. Terms of Supervision
2. Guideline for College-directed Supervision
3. Supervision Levels for College-directed Supervision