Fair Registration Practices Report

Physicians and Surgeons (2017)

The answers seen below were submitted to the OFC by the regulated professions.

This Fair Registration Practices Report was produced as required by:

  • the Fair Access to Regulated Professions and Compulsory Trades Act (FARPACTA) s. 20 and 23(1), for regulated professions named in Schedule 1 of FARPACTA
  • the Health Professions Procedural Code set out in Schedule 2 of the Regulated Health Professions Act (RHPA) s. 22.7 (1) and 22.9(1), for health colleges.

Index

  1. Qualitative Information
  2. Quantitative Information
  3. Submission

1. Qualitative Information

a) Requirements for registration, including acceptable alternatives
i. Describe any improvements / changes implemented in the last year.

Removal Of EPP requirement on the Application

Incoming Residents were no longer required to answer whether they performed Exposure Prone Procedures. (EPP's)
The position was taken that all residents perform EPP's in their various rotations. 

Harmonization of Application form and Base Requirements

Supplementary forms for Medical Identification Number and Professional Liability and Declarations for breaks, were incorporated into the base applications.

Practice Ready Assessments

Finalization and Approval of Practice ready Assessments in Family medicine was completed early in the year. Currently this project is awaiting Ministry of Health to launch it.  

Approval of the New Member Orientation Module 

Council approved the creation of an educational support tool for all first time incoming physicians to the profession. 

  • An orientation/education activity that will focus on ensuring applicants understand the laws, regulations and policies that govern professional regulation of physicians, and could include information about important and emerging content areas such as maintaining appropriate boundaries, the CPD regulatory requirement, medical record keeping, safe opioid prescribing etc.

Update to Changing Scope of Practice and Re-entry policy "COSRE" (currently outside with the membership for consulation) 

The two policies were combined into one to create clarity. The time out practice requirement was reduced from 36 months to 24, also eliminating the mathematical equation requiried to calculate this timeline. For example old language was " less than 6 months in the preceeding 5 years."  36 months was deemed too long to ensure phyiscian competency. 

 

 

 

 

 

ii. Describe the impact of the improvements / changes on applicants.

The application question on EPP's caused multiple queries and the Application Harmonization reduced the number of requirement submissions. 

New Member Orientation ensured that Applicants were given fair access to expectations within the Profession. Practice ready assessments in 
Ontario Family medicine would open a new route to compency based assessment for IMG's without traditional residency training. 

The removal of the mathematical equation requirement in COSRE clarifies the policy using plain and accessible language. 

 

 

 

 

 

iii. Describe the impact of the improvements / changes on your organization.

 Reduction in Requirement submissions for tracking and matching purposes within a paper based process.

Reduction in administrative phone calls and queries seeking operational understanding.

Reduction in queries regarding the requirement to self report when out of practice. 

 

 

 

b) Assessment of qualifications
i. Describe any improvements / changes implemented in the last year.

Discretionary Guidelines which provide assessors with standardized criteria for common credentialing requirements was updated.

Each previous guideline was scrutinized by the team and agreement was made on what the bell curve would be to satisfy basic credentialing requirements.

Supporting Application schedules which itemize the requirements for licensure were crossreferenced for standardized language, using less acronyms.   

Applications requiring Registration Committee exemptions (citizenship, one year practice in Ontario, PEAP exemptions) were fast tracked and submitted in Memo formated vs Case writeup.  

The Assessor Resources webpage, referencing tools are now available to assessors, including EMR Training Videos, along with the Assessor Governance Framework and supporting online documents.  As well, following is the Assessor: Bring Your Skills to the Table webpage outlining an overview of the assessor roles, along with the requirements, qualifications, expectations, time commitment and contact information.

 

 

 

 

 

 

 

 

 

 

 

ii. Describe the impact of the improvements / changes on applicants.

Discretionary Guidelines ensure  that applicants will receive the same case analysis regardless of the assessor assigned to the file.

CPSO will accept a custom reference letter in lieu of the CPSO standard form providing that all relevant canmeds comptencies are spoken to.

This greatly reduced the need for updated forms to be sent to various parties. The memo decreased timelines and ensured committee approval on a "no discussion list".

Assessor Resources and training ensure quality and consistency within the assessment process. Applicants are ensured a fair and equitable process.

 

 

 

 

 

 

 

 

 

 

iii. Describe the impact of the improvements / changes on your organization.

Assessors spend less time in consultation during the verification process and no longer require manager review for decisions.

Memo cases to committee decreased co-ordinator workload. Committee members felt a decrease to case prep.

 

 

 

 

 

 

c) Provision of timely decisions, responses, and reasons
i. Describe any improvements / changes implemented in the last year.

Secure mail transfer of Orders upon completion to committee members was used to finalize and approve draft Orders, instead of scheduling face to face meetings for approval.

All Certificates of Registration are issued 3 months prior to the start date of practice.

Standard Certificates of Registration by request may be processed in less than 3 weeks.

 

 

 

 

 

 

 

 

 

 

ii. Describe the impact of the improvements / changes on applicants.

Orders are released sooner. Applicants may request subsequent Certificates of Professional Conduct sooner for potential employers. Allows physicians to register sooner with their Post Graduate Medical Educational Office and obtain their professional liabilty protection. Reduces the probablity of credentialing documents expiring and requring further funds and efforts to replace them.

Expedited review identifies files which require immediate attention reducing the stress to staff and ensuring the ability to organize workflow.

 

 

 

 

 

iii. Describe the impact of the improvements / changes on your organization.

Less money and resources are spent needlessly to approve the order. Less followup and duplication of file assessment allows assessors to complete the file in one review.

 

 

 

 

 

 

d) Fees
i. Describe any improvements / changes implemented in the last year.

Implementation of  a new Service - expedited review. For straight forward Certificates of Registration not requiring committee review, applicants were given the option to have their assessment guaranteed under 3 weeks.

 

 

 

 

 

 

ii. Describe the impact of the improvements / changes on applicants.

Applicants were thrilled to have an option which secured start dates even after they missed deadlines for submission. This was most beneficial during peak periods of registration when appication fatigue is at its highest.

 

 

 

 

 

 

iii. Describe the impact of the improvements / changes on your organization.

Peak periods in previous years were spent negotiating deadlines or disappointing applicants with their own delays. This was a fair and transparent mechanism for staff to coordinate and communicate with applicant and process.

 

 

 

 

 

 

e) Timelines
i. Describe any improvements / changes implemented in the last year.

Timelines for initial assessment for cases not requiring committee review were decreased to 3 weeks, or less than with expedited review option.

Registration Committee initial assessment for cases is 5 weeks and decisions not requiring orders are 5-7 business days.

 

 

 

 

 

 

ii. Describe the impact of the improvements / changes on applicants.

Quicker responses to applicants enable them to make earlier commitments to employers and patients.

 

 

 

 

 

 

iii. Describe the impact of the improvements / changes on your organization.

 

No change

 

 

 

f) Policies, procedures and/or processes, including by-laws
i. Describe any improvements / changes implemented in the last year.

Letters of Appointment information for incoming residents were received in a single spreadsheet as a Pilot for one school to test the process.

 The procedure requesting third parties to access applicant file/data was streamlined to include a standard form by request.

The program assistants "PA" role is to make applicant files ready for assessment. In the past, each PA was attached to two assessors. In 2017 we created a program assistant pool whereby all PA's are on a uplist, processing all types of applications by date of submission.

All completed files require verification for quality check and final approval for issuance prior to licensure. This process requiries a minimum of 5 days and creates anxiety in the applicant. The tracking tool or online view of the application process stays in a holding pattern during the final approval stage. Applicants this year were given standard messaging during this timeline. 

 

 

 

 

 

 

 

 

 

 

ii. Describe the impact of the improvements / changes on applicants.

The electronic spreadsheet cut down the need for individual submissions.

The PA pool ensured consistency within the process, delivering faster services with a balanced workflow.

The standard messaging alleviated anxiety and informed applicants in a simple and transparent fashion.

 

 

 

 

 

 

 

 

iii. Describe the impact of the improvements / changes on your organization.

This reduced the paper but also reduced the need to match each requirement with over 1000 files, during peak season.

The PA pool reduced down time and ensured equal levels of processing, liberating a resource to be better utilized elsewhere in the team.

The standard messaging decreased phone calls to the Inquiries team.

 

 

 

 

 

 

 

 

g) Resources for applicants
i. Describe any improvements / changes implemented in the last year.

The College Website was redesigned for better transparency and clarity to the user.

  • The CPSO website was redesigned to be more streamlined and user friendly. Membership information now appears all on one screen rather than tabs, restrictions are flagged, tabs reworded and language simplified . Some of the linked language has been enhanced as a “call to action” for users – e.g. Make a Complaint, Find a Doctor, Participate in Consultations, etc. There is a brand new section to the site, called Public Information & Services which gathers links to all of the relevant sections to the public audience for the website, including Find a Doctor and Submit a Complaint. 
  • Updated Education study plan guide available on website to exam eligible candidates preparing for exams.

 

 

 

ii. Describe the impact of the improvements / changes on applicants.

The new website redesign is transparent, easier to navigate and find information. The new study plan as a resource is used regularly by applicants.

 

 

 

iii. Describe the impact of the improvements / changes on your organization.

This allows us to communicate more effectively to applicants and members.

 

 

 

h) Review or appeal processes
i. Describe any improvements / changes implemented in the last year.

No changes this year

ii. Describe the impact of the improvements / changes on applicants.

 

 

 

 

 

 

 

iii. Describe the impact of the improvements / changes on your organization.

 

 

 

 

 

 

 

i) Access to applicant records
i. Describe any improvements / changes implemented in the last year.

No changes this year

ii. Describe the impact of the improvements / changes on applicants.

 

 

 

 

iii. Describe the impact of the improvements / changes on your organization.

 

 

 

 

j) Training and resources for registration staff, Council, and committee members
i. Describe any improvements / changes implemented in the last year.

Training and Resources for Council, committee members and staff included:

Ontario Worker Health & Safety Awareness

Essentials of Supervision and Coordination

Having Difficult Conversations

Mental Health in the Workplace

Policy sign offs

  • Code of Conduct
  • Harassment and Discrimination
  • Protection against Workplace Violence
  • AODA
  • Social media

 

 

 

 

 

ii. Describe the impact of the improvements / changes on applicants.

Better qualitiy of service through:

Awareness of  rising mental health issues. 

Awareness to diversity and appropriate communication.

Awareness to esclation processes.

 

 

 

iii. Describe the impact of the improvements / changes on your organization.

 

Consistency to the delivery of our mandate.

 

 

 

k) Mutual recognition agreements
i. Describe any improvements / changes implemented in the last year.

Electronic receipt of Certificates of Good Standing from Quebec was added to the existing list of approved jurisdictions.

 

 

 

 

 

 

ii. Describe the impact of the improvements / changes on applicants.

Timelier receipt of credentialling.

 

 

 

iii. Describe the impact of the improvements / changes on your organization.

Centralized documentation.

 

 

 

 

 

 

l) Other (include as many items as applicable)
i. Describe any improvements / changes implemented in the last year.

Please be advised that there is a new section on the CPSO website that is aimed at recruiting Clinical Supervisors:

 http://www.cpso.on.ca/Member-Information/Member-Engagement/Clinical-Supervisor

Electronic book marking of Committee material was implemented to expedite the review.

Supervisor orientation.  In 2016, a third party vendor was retained to aid in the development of a performance framework and curriculum design map for supervisor training. These were completed in 2017 and may inform future training content and structure which may be applied to new applicants under supervision. Development of supervisor training is ongoing.

 

CPSO website. A section dedicated to information about supervision and the recruitment of supervisors was posted in 2017, http://www.cpso.on.ca/Member-Information/Member-Engagement/Clinical-Supervisor

 

ii. Describe the impact of the improvements / changes on applicants.

Supervision guidelines/training and recruiting ensures the applicant is aware at the onset of the the requirement and rigour of the process and expectations.

 

 

 

 

 

 

iii. Describe the impact of the improvements / changes on your organization.

 

 

 

 

 

 

 

 

 

 

 

 

Describe any registration-related improvements/changes to your enabling legislation and/or regulations in the last year

No changes this year

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2. Quantitative Information

a) Languages
Indicate the languages in which application information materials were available in the reporting year.
Language Yes/No
English Yes
French No
Other (please specify)
Additional comments:

Our written application information materials are not available in French, but CPSO's Registration inquiries area does offer French language telephone service for applicants wishing to converse in French.   

b) Gender of applicants
Indicate the number of applicants in each category as applicable.
Gender Number of Applicants
Male 2589
Female 2422
None of the above 0
Additional comments:
 
c) Gender of members
Indicate the number of members in each category as applicable. Select the option that best corresponds to the terminology used by your organization.
Gender Number of Members
Male 24265
Female 17654
None of the above 0
Additional comments:
 
d) Jurisdiction where applicants obtained their initial education
Indicate the number of applicants by the jurisdiction where they obtained their initial education1 in the profession or trade.
Ontario Other Canadian Provinces USA Other International Unknown Total
1754 1137 126
OTHER
1994
Total
1994
0
5011

1 Recognizing that applicants may receive their education in multiple jurisdictions, for the purpose of this question, include only the jurisdiction in which an entry-level degree, diploma or other certification required to practice the profession or trade was obtained.

Additional comments:

Note regarding Table (d):
The counts provided above includes only those applicants who actually obtained registration.  There were a relatively small number of applications (approx. 75) that were still in process at year end, incomplete, or withdrew their applications in 2017. These are not counted in Table (d).  

e) Jurisdiction where applicants who became registered members obtained their initial education
Indicate the number of applicants who became registered members in the reporting year by the jurisdiction where they obtained their initial education1 in the profession or trade.
Ontario Other Canadian Provinces USA Other International Unknown Total
1754 1137 126
OTHER
1994
Total
1994
0
5011

1 Recognizing that applicants may receive their education in multiple jurisdictions, for the purpose of this question, include only the jurisdiction in which an entry-level degree, diploma or other certification required to practice the profession or trade was obtained.

Additional comments:
 
f) Jurisdiction where members were initially trained
Indicate the total number of registered members by jurisdiction where they obtained their initial education1 in the profession or trade.
Ontario Other Canadian Provinces USA Other International Unknown Total
21835 7363 630
OTHER
12092
Total
12092
0
41920

1 Recognizing that applicants may receive their education in multiple jurisdictions, for the purpose of this question, include only the jurisdiction in which an entry-level degree, diploma or other certification required to practice the profession or trade was obtained.

Additional comments:
 
g) Applications processed
Indicate the number of applications your organization processed in the reporting year:
Jurisdiction where applicants were initially trained in the profession (before they were granted use of the protected title or professional designation in Ontario)
from January 1st to December 31st of the reporting year Ontario Other Canadian Provinces USA Other International Unknown Total
New applications received 1754 1137 126 1994 0
5011
Applicants actively pursuing licensing (applicants who had some contact with your organization in the reporting year) 1794 1157 131 2044 0
5126
Inactive applicants (applicants who had no contact with your organization in the reporting year) 25 5 5 50 0
85
Applicants who met all requirements and were authorized to become members but did not become members 0 0 0 0 0
0
Applicants who became FULLY registered members 1754 1137 126 1994 0
5011
Applicants who were authorized to receive an alternative class of licence3 but were not issued a licence 0 0 0 0 0
0
Applicants who were issued an alternative class of licence3 975 769 95 1501 0
3340

1 An alternative class of licence enables its holder to practice with limitations, but additional requirements must be met in order for the member to be fully licensed.

Additional comments:

Notes regarding Table G:

  • The counts provided for "New Applications Received" includes only those new applications in 2017 that resulted in issuance of a certificate of registration.
  • The counts provided for "Applicants Actively Pursuing Licensure" combines all the new issuances in 2017 plus estimates of the remaining number of applications submitted in 2017 that were still in process at 2017 year end.
  • The counts provided for "Applicants who met all requirements and were authorized to become members but did not become members" are recorded as zero.  Our registration process is such that every applicant who is authorized to become a member (i.e. has completed all  application requirements) is immediately granted membership.  Fully authorized applicants are not permitted to defer their membership.  
  • The counts provided for "Applicants who became Fully Registered Members" includes only those new applications in 2017 that resulted in issuance of a certificate of registration. Therefore, the counts here are the same as those in "New Applications Received."
  • The counts for "Applicants who were authorized to receive an alternative class of licence but were not issued a licence" are recorded as zero.  The CPSO does not officially track these numbers, but the actual number would be very small, i.e. less than 25 in total.
  • For "Applicants who were issued an alternative class of licence" we are including all classes except the Independent Practice class.  Accordingly, "alternative classes of licence" includes the Postgraduate Education, Restricted, Academic Practice, Academic Visitor and Short Duration classes. 
h) Classes of certificate/license
Inidcate and provide a description of the classes of certificate/license offered by your organization.

You must specify and describe at least one class of certificate/license (on line a) in order for this step to be complete.

# Certification Description
a) Independent Practice Description (a)

This is the class of certificate held by 80% of the College's membership. It is the equivalent of the "full license" in other provinces. It is issued to those who meet the standards and qualifications for independent practice in Ontario. It carries a standard term, condition and limitation permitting the holder to practise only in the area of medicine in which the holder is educated and experienced. Other than this standard one, it carries no other terms, conditions and limitations.

b) Post Gradutate Education Description (b)

This class of certificate is issued only to physicians formally enrolled as a postgraduate medical trainee (e.g. medical residents, clinical fellows or electives) at an Ontario medical school. Holders may practise only within their post graduate training appointment and may not charge fees for services. The certificate expires when the trainee ceases enrollment in the training program.

c) Restricted Description (c)

This class of certificate carries specified terms, conditions and limitations as ordered by the Registration Committee or by certain other CPSO committees, e.g. Discipline Committee.  Every  application approved by the Registration Committee where the Committee imposes specific terms, conditions and limitations is deemed to be a Restricted certificate.  The Restricted certificate holder must practise in accordance with the imposed terms, conditions and limitations

Note: A person cannot apply directly for a Restricted certificate. Instead, the person must apply for one of the regular classes (e.g. Independent Practice). If the person does not meet the qualifications for that class, his or her application is referred to the Registration Committee. If the Regisration Committee approves issuance of a certicate of registration and imposes specified terms, conditions and limitations on the certificate, it is deemed to be a Restricted certificate.

d) Academic Visitor Description (d)

This class of certificate is issued only to visiting academic physicians from medical schools outside Ontario who have a short-term clinical or teaching appointment at an Ontario medical school. They are limited to practising only to the extent of their short-term academic appointment at the medical school, and their certificate automatically expires after twelve months.

e) Supervised Short Duration Description (e)

This class of certificate is issued for a maximum 30-day term, and only for appointments requiring emergency care or to provide a brief educational program or clinical demonstration to Ontario physicians. The short duration appointment must be based at an Ontario medical school or public hospital. The certificate holder must practice under supervision of an Ontario physician holding an Independent Practice certificate.  The certificate automatically expires after 30 days or when the appointment ceases, whichever comes first.

Additional comments:
 
i) Reviews and appeals processed
State the number of reviews and appeals your organization processed in the reporting year (use only whole numbers; do not enter commas or decimals).
Jurisdiction where applicants were initially trained in the profession (before they were granted use of the protected title or professional designation in Ontario)
from January 1st to December 31st of the reporting year Ontario Other Canadian Provinces USA Other International Unknown Total
Applications that were subject to an internal review or that were referred to a statutory committee of your governing council, such as a Registration Committee 150 75 3 1045 0
1273
Applicants who initiated an appeal of a registration decision 1 0 0 6 1
8
Appeals heard 0 1 0 2 0
3
Registration decisions changed following an appeal 1 0 0 0 0
1
Additional comments:

The total count of 1273 shown for "Applications that were subject to an internal review or that were referred to a statutory committee of your governing council, such as a Registration Committee" is the exact total for 2017.  However, exact counts for the jurisdiction sub-totals are not available.  The sub-totals shown for the jurisdictions are estimates based on previous years figures and observed trends in 2017.

j) Paid staff
In the table below, enter the number of paid staff employed by your organization in the categories shown, on December 31 of the reporting year.

When providing information for each of the categories in this section, you may want to use decimals if you count your staff using half units. For example, one full-time employee and one part-time employee might be equivalent to 1.5 employees.

You can enter decimals to the tenths position only. For example, you can enter 1.5 or 7.5 but not 1.55 or 7.52.

Category Staff
Total staff employed by the regulatory body 405
Staff involved in appeals process 18
Staff involved in registration process 25
Additional comments:
 

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3. Submission

Submission
I hereby certify that:
Name of individual with authority to sign on behalf of the organization:
Daniel Faulkner
Title:
Deputy Registrar
Date:
2018/02/28

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