Site Search
Skip to main content

Supervision Levels for College-Directed Supervision

Download PDF

Background

The College, through the Medical Act (2011) and Medical Practitioners Regulations1, or its Committees and Policies, may require that a physician’s practice be supervised. The College’s general expectations and processes for physicians engaged in College-Directed supervision are administered under the Guidelines for College-Directed Supervision 2.

The intensity or level of Supervision required is administered according to the College’s six-level supervision framework: College-Directed Supervision Framework – Responsibilities and Outline by Level 3. The framework outlines the indications for the various levels, as well as the supervision activities and reporting responsibilities of the Supervisor.

Purpose

This policy outlines the reasons why supervision may be required or imposed for a physician licensed to practice medicine in Nova Scotia and also provides indications as to when supervision levels may change.

Policy

  1. Under the Medical Act (2011)4and Medical Practitioners Regulations1, physicians granted a Defined licence (DL) under the Conditional Register are required to have a sponsor and supervisor for the duration of that licence.

    Physicians issued a Defined licence:

    1. will be subject to a minimum of 24 months of Standard Level Supervision, unless referred to a College Committee or the Registrar for further review and consideration.
    2. Low Level Supervision may be permitted in the following circumstances:
        1. 24 months of Standard Level supervision has been completed and deemed satisfactory to the Registrar, including all required supervision reports and activities;
          AND
        2. The Defined licensed physician’s Sponsor and the College agree that no outstanding concerns exist preventing Low Level supervision.
    3. Basic Level Supervision may be permitted in the following circumstances:
        1. 24 months of Standard Level supervision has been completed and deemed satisfactory to the Registrar, including all required supervision reports and activities;
          AND
        2. The Defined licensed physician has achieved certification with their relevant certifying body.5,6
          AND
        3. The Defined licensed physician’s Sponsor and the College agree that no outstanding concerns exist preventing Basic Level supervision.
    4. Sponsor-only oversight may be appropriate for physicians whose Defined licence was first issued prior to January 1, 2015 and in accordance to the College’s Sponsor-only Oversight for Defined Licence Physicians7.
  2. Notwithstanding the above, supervision may be imposed at any level, including Intermediate and High level, for a physician on either a Defined licence or Restricted licence in any of the following circumstances:
    • As an interim sanction/condition imposed by an Investigations Committee;
    • As imposed by or agreed to in the resolution of an Investigation or hearing matter;
    • As ordered by the Registration Committee or the Registration Appeal Committee in response to a concern regarding a physician’s competence, capacity or character;
    • Where recommended by the physician’s Sponsor, after providing reasons to the Registrar and the physician for the change.

Under article 2(d), the Registrar may change the supervision level. Under Section 14(3) of the Medical Practitioners Regulations1, if the Registrar imposes conditions or restrictions on the licence, the Registrar must notify the physician with a written decision with reasons and inform the physician of the appeal process. The decision may be appealed to the Registration Committee. It is also open to the Sponsor to withdraw sponsorship if the physician is not willing to participate in the recommended level of supervision, where the Sponsor has complied with the provisions of subsection 44(3) of the Regulations.1

3. When the decision of supervision level is made by the Registration Committee, the physician may appeal the decision to the Registration Appeal Committee. A decision of the Registration Appeal Committee is not subject to further review under the Medical Act.

Resources

  1. Medical Practitioners Regulations
  2. Guidelines for College-Directed Supervision
  3. College-Directed Supervision Framework – Responsibilities and Outline by Level
  4. Medical Act 2011
  5. Royal College of Physicians and Surgeons of Canada (RCPSC)
  6. The College of Family Physicians of Canada (CFPC)
  7. Sponsor-only Oversight of a Defined Licence Physician

Approved By: Registration Policy Committee; Council

Approval Date: September 3, 2020; October 9, 2020

Review Date: September 2022