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Continuing Professional Development: Requirements

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Preamble

The Medical Act1 describes the purpose and duties of the College of Physicians and Surgeons of Nova Scotia (the College) are to serve and protect the public interest in the practice of medicine and to preserve the integrity of the medical profession and maintain confidence of the public and the profession in the ability of the College to regulate the practice of medicine.

Lack of participation in Continuing Professional Development (CPD) is a known risk factor for poor physician performance. Continuing Professional Development programs mitigate this risk while helping physicians maintain and enhance their competence throughout their careers.

The Nova Scotia Medical Practitioners Regulations2 requires that all physicians on the Full and Conditional Registers must participate in Continuing Professional Development.

Scope

This policy applies to physicians practising under the following licence types:

  • Full licence
  • Defined licence (except Defined licence for Fellowship)
  • Temporary licence
  • Clinical Assistant licence
  • Academic licence
  • Restricted licence

This policy does not apply to physicians on the Education Register, which includes the Clinical Assessment license, and Postgraduate Training licence and Postgraduate Practising licence.

Policy

Enrolment and Participation in CPD

  1. Except for those holding a Clinical Assistant licence or a Defined licence for Clinical Fellowship, all physicians licensed on the Full or Conditional Register must:
  • enroll with and meet the requirements of the Maintenance of Proficiency (Mainpro+) program3 of the College of Family Physicians of Canada (CFPC); or
  • enroll with and meet the requirements of the Maintenance of Certification (MOC) program4 of the Royal College of Physicians and Surgeons of Canada (RCPSC);or
  • Physicians on a Full licence who are currently American Board-certified with the American Board of Medical Specialties (ABMS)5 and satisfactorily participating in ‘Continuing Certification’ with their relevant Board may choose to enroll in one of the relevant Canadian programs outlined above or maintain their CPD through the relevant Member Board of the ABMS.

    If physicians choose to enroll in an ABMS continuing certification process, they must provide the College with annual confirmation of their certification status and satisfactory participation in CPD.

    American Board-certified physicians found to be unsatisfactorily participating in the CPD program requirements of the respective Member Board of the ABMS may be required to enroll and participate in the CPD program of the relevant Canadian certifying College (Mainpro+ or MOC).  If the physician is no longer American Board-certified or no longer participating in ‘Continuing Certification’, then they must enroll in the relevant Canadian program listed above.

    Physicians enrolled in one of the above programs must meet both minimum annual requirements (adherence) and cumulative requirements (compliance) for Continuing Professional Development for their program.
  1.  All Clinical Assistants must meet the Continuing Professional Development requirements of their respective Clinical Assistant Program at Nova Scotia Health (NSH) or the Izaak Walton Killam (IWK) Health Centre, as laid out in the College’s policy Physician Extender Program6.
  2. Reporting completed CPD credits on an annual basis to the designated program is a requirement of satisfactory participation in a CPD program.
  3. The College does not accept direct reports from physicians regarding CPD activity to determine satisfactory participation.

Reporting CPD to the College

  1. All physicians must report whether they have met the requirements of their designated CPD program on the College’s annual licence renewal form.

    Note that the College is notified by the RCPSC and the CFPC regarding physicians who have not participated satisfactorily in their required CPD cycle.

    The College will confirm satisfactory participation for American Board-certified physicians with the relevant American Board via the Federation of State Medical Boards7 database.

    The NSH and the IWK Health Centre report annually regarding Clinical Assistants who are not participating satisfactorily in their programs.

Preliminary Approach to Unsatisfactory Participation in CPD

  1. Physicians who fail to enroll or participate satisfactorily in their designated program will be subject to the following:
    1. The College will contact the physician in writing, with direction about next steps.  Direction could include, and may not be limited to, providing a written explanation for unsatisfactory participation, providing evidence of enrollment in a program, contacting the program for support in a CPD plan, and undergoing a practice assessment.
    2. The physician must respond in writing to the College regarding all directives within 30 days from the date of the letter from the College.

Requirements for Clinical Assistants with Unsatisfactory CPD

  1. Clinical Assistants who are not participating satisfactorily in their relevant CPD program, will be required to provide a written explanation for the lack of participation and the College will liaise with their Program Director to develop a remediation plan.

Requirements for Physicians with Unsatisfactory CPD

  1. The following table outlines the College’s requirements for physicians either not enrolled or not participating satisfactorily in their CPD program.
CPD Concern for Physicians Enrolled in Mainpro+ or MOC or Continuing Certification Through ABMSRequirement
Lack of enrollment at time of initial licensureLicence is not issued until the physician provides evidence of enrollment.
Lack of enrollment at renewalLicence may not be renewed.
Not meeting the minimum annual requirements for the programThe physician may be required to work with their program to develop a CPD plan for the coming year.

At next licence renewal, the physician must provide the College with confirmation from their designated program that they are adherent with the CPD requirements for the past year.
Not meeting the required CPD cycle with certifying bodyThe physician will be required to comply with their program’s CPD remediation process.

At next licence renewal, the physician must provide the College with confirmation from their designated program that they are compliant with the cycle for the past year.
Not meeting the requirements of the CPD remediation processThe physician must undergo a customized assessment with a Quality Improvement lens, with a 6-12 month follow up review by a College-approved assessor.  The assessment will be linked to a CPD learning plan. 

All costs of the assessment will be borne by the physician.

Depending on the results of the assessment, the College may refer the physician to the Registration Committee to determine whether any conditions and/or restrictions need to be imposed on the licence, or whether the licence type should be changed.

Physicians holding a Full licence will have their licence converted to a Restricted licence for the duration of the assessment and until all conditions and restrictions relating to CPD are met.

For all other licence types, conditions and restrictions related to CPD would be added to the licence.  The licence type does not change.

Exemptions

  1. In certain circumstances, the physician may request an exemption in writing from the Registrar.  Examples of such circumstance may include leaves of absence for parental or medical reasons, retirement, or exclusive work in an administrative role.

Appeal Process

  1. If the physician disagrees with the imposed requirements, they may request the decision be referred to the Registration Committee.  The request must be done within 30 days after the Registrar’s decision.

Resources

  1. Medical Act
  2. Medical Practitioners Regulations
  3. CFPC Mainpro+ Overview
  4. Royal College Maintenance of Certification Program
  5. American Board of Medical Specialties Continuing Certification Directory
  6. Physician Extender Programs
  7. Federation of State Medical Boards
Applicable Legislation: Section 17(1), 19(3)(f) & 39(1)(g) of the Medical Practitioners Regulations & Section 2(g) & 11(1)(h), Section 5(c)(iv) of the Medical Act
Approved by: Registration Policy Committee, Council
Approval Date(s):April 13, 2023 & May 26, 2023
Review Date:April 2026