Fair Registration Practices Report

Physicians and Surgeons (2018)

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.

At the end of 2018, the Registration Committee issued the Registrar a set of directives which provide that, if an applicant has satisfied all other requirements for registration, the Registrar no longer forms reasonable grounds to refer these applications to the Committee for approval.

What this means is that a number of policies no longer require review and approval by the Registration Committee, provided the applicants 1) meet all other requirements for issuance of a certificate of registration and 2) have no additional issues presenting.

The policies that directives were issued for are as follows:

  • Alternatives to Degrees in Medicine from Schools Listed in the World Directory of Medical Schools Published by the World Health Organization (WHO policy);
  • Restricted Registration for Residents (Moonlighting);
  • Postgraduate Term for Clinical Fellows (Fellow Extensions);
  • Pre-Entry Assessment Program Exemption (PEAP) (Advanced Trainees);
  • Haiti/Uganda/Guyana McMaster Exchange Program;
  • Doctors of Osteopathic Medicine;
  • One Year of Canadian Practice Experience Exemption;
  • Canadian Citizenship/Permanent Resident Status Exemption;
  • Recognition of Certification without Examination Issued by the CFPC– Candidates for an Independent Practice Certificate only;
  • For details of these policies please access our website

 

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

We anticipate this change will result in a quicker processing time for qualified applicants as their applications will no longer require review and approval by the Registration Committee.

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

We anticipate a 20% reduction in matters going to the Committee with the implementation of these directives, and a faster processing time for applicants and better customer service experience.

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

Letters of Eligibility (LOEs) are now completed by Assessors.

Letters of Eligibility (LOEs) are issued for postgraduate trainees who are not Canadian Citizens or Permanent Residents and require a valid employment authorization (work permit) from Citizenship and Immigration Canada in order to obtain a certificate of registration to engage in residency, clinical fellowship or elective training at an Ontario medical school.  In order to ensure timely issuance of an LOE, it is the responsibility of the postgraduate medical education office to ensure that the applicant is eligible for the appointment to which s/he is being appointed and that all supporting documents are being submitted.

To facilitate this we have created an applicant screening document submission checklist for the postgraduate medical education offices.

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

This further solidifies our approach of one point of contact for applicants, and ensures consistency in our approach.

Additionally, publishing our submission checklist has provided increased transparency to the process.

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

A case management model has been further enforced using this approach, whereby the individual assessing/processing the file is now determining eligibility.

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

Orders with Reasons of the Registration Committee have been centralized with the Committee Support Department, and are now being drafted by Decision Administrators who complete this activity for a variety of College Committees.

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

A consistent approach, service standards and timelines across College Committees and a reduction in timelines has been achieved.

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

As above

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

No changes this year

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

No changes this year

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

No changes this year

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

No changes this year

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

No changes this year

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

No changes this year

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

As previously mentioned, at the end of 2018, the Registration Committee issued the Registrar a set of directives which provide that, if an applicant has satisfied all other requirements for registration, the Registrar no longer forms reasonable grounds to refer these applications to the Committee for approval.

What this means is that a number of policies no longer require review and approval by the Registration Committee, provided the applicants 1) meet all other requirements for issuance of a certificate of registration and 2) have no additional (Section 2) issues presenting.

In addition, Council approved the revised policy “Ensuring Competence: Changing Scope and/or Re-entering Practice”, which combines 2 previously distinct policies into one comprehensive policy, and provides clarity around timelines.

We also published a new Framework “Rural Emergency Medicine” which sets out the College’s expectations and minimum training requirements for physicians wishing to practice in this area.  The College also published a helpful Frequently Asked Questions (FAQ) document to support this framework.

Additionally, a framework pertaining to physicians wishing to practise medicine in Skin Disorders was also published and the minimum training guidelines for non-obstetricians looking to include caesarean sections was updated.

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

Directives: We anticipate a 20% reduction in matters going to the Committee with the implementation of these directives, and a faster processing time for applicants and better customer service experience.

Frameworks: Increased transparency/clarity regarding the College’s expectations and protocols relating to Change of Scope/Re-Entry.

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

Reduction in administrative phone calls and queries seeking operational understanding of our processes.

Reduction in queries regarding the College’s expectations in the identified areas.

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

This year, we have updated the following published application resources:

  • Comprehensive fee guidelines;
  • Guide to Acceptable Criminal Records Checks;
  • Study Plan Guidelines and Corresponding Resources/Courses;
  • Application General Guidelines/FAQ document;
  • Schedule of Requirements for applications ;

As it relates to the Change of Scope/Re-Entry policy, updates have been made to the following resources:

  • Change of Scope Application
  • Re-Entering Practice Application;
  • Interventional Pain Management Application;

With respect to the assessment processes, registration specific assessment tools were added to the CPSO website relevant to Registration Assessments specifically to less commonly encountered disciplines (e.g., diagnostic imaging).

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

Increased transparency regarding requirements/process and protocols.

The availability of additional Registration assessment tools makes the assessment process more transparent.

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

A reduction in inquiries seeking clarification on the applicable documents.

Hosting new and/or additional tools enables the CPSO to make the information easily accessible to assessors, applicants and members. 

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

As previously mentioned, Orders with Reasons of the Registration Committee have been centralized with the Committee Support Department, and are now being drafted by Decision Administrators who complete this activity for a variety of College Committees.

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

A consistent approach, service standards and timelines across College Committees and a reduction in timelines has been achieved.

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

As above.

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.

No changes this year

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

No changes this year

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

The Registration Department Staff underwent training in “Simple Language”, and additionally attended two webinars on pathways to permanent residency in Canada and student retention in Canada.

 

Training for new Assessors is now done via webex (before it was being done over the phone and we would ask them to make sure they have their assessor orientation package with them as we would briefly go over the material in the package. Now the trainees shares their computer screen and goes over the report templates to illustrate where they can download them from the website; we also go over a sample report in the training).

 

The 2018 Assessor Meeting was held in April 2018 for assessors, applicable staff and Committee members to provide workshops and updates pertaining to assessments. Related topics included assessment tools, report writing, giving effective feedback, assessing EMRs, use of assessor, role of supervision, interviewing and discipline specific discussions pertaining to assessment.

New eLearning tools, interactive PDFs and other resources for assessors were publicly made available on the Assessor Resources webpage.  Topics covered included Report Writing and Preparing for and Conducting Interviews. 

The AssessorMailbox was created to improve response times during staff absences relating to availability of assessor information and/or resources, changes in policy and/or updates relevant to assessments.  

 

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

Better quality of service standards and appropriate communication.

Assessor engagement, updates, workshops and eLearning relevant to assessments facilitate a more consistent and fair approach for applicants undergoing the assessment process.  

An optional contact mechanism for assessors during staff absences ensures that assessment questions are dealt with more quickly thus also promoting a more timely assessment experience for the applicant.

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

Consistency to the delivery of our customer service mandate.

The 2018 Assessor Meeting enables the CPSO to engage assessors and through such events, along with additional eLearning tools and resources, promotes consistency among assessors, thus translating into more consistent, transparent and fair approaches to assessments. 

Assessors are able to receive responses to questions and/or concerns more decreasing chances of missed messages and lengthened assessment processes.

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

No changes this year

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

No changes this year

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

No changes this year

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

Efforts were made to increase outreach for the Clinical Supervisor role.  This included promotion at conferences, internal member events (e.g., Future Leaders’ Day), as well notifications in CPSO newsletters and other communication.

Training materials were produced with the help of a vendor to create learning tools for supervisors to assist in their role and to help promote consistency in clinical supervision.  An update to the supervision guidelines was also conducted and is in the process of being finalized for implementation. 

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

Increased transparency

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

Supervision guidelines/training and recruitment ensures more consistency in the retaining and support of supervisors.

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 registration forms and materials are not available in French, but we offer French language telephone service for applicants wishing to converse in French about registration with CPSO.   

b) Gender of applicants
Indicate the number of applicants in each category as applicable.
Gender Number of Applicants
Male 2745
Female 2536
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 24549
Female 18266
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
1919 1127 123
OTHER
2112
Total
2112
0
5281

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:  The figures provided in Table (d) include only those applicants who obtained registration and became members in 2018.  Figures are not available for the applicants who did not fully complete the registration requirements or were still in process at year end.   

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
1919 1127 123
OTHER
2112
Total
2112
0
5281

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:  The figures provided in Table (e) include only those applicants who obtained registration and became members in 2018. 

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
22197 7406 659
OTHER
12553
Total
12553
0
42815

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 1919 1127 123 2112 0
5281
Applicants actively pursuing licensing (applicants who had some contact with your organization in the reporting year) 1969 1147 125 2162 0
5403
Inactive applicants (applicants who had no contact with your organization in the reporting year) 25 5 2 50 0
82
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 1919 1127 123 2112 0
5281
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 1081 719 93 1574 0
3467

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 2018 that resulted in the issuance of a certificate of registration.
  • The counts provided for "Applicants Actively Pursuing Licensure" combines all new issuances in 2018 plus estimates of the remaining number of applications submitted in 2018 that were still in process at 2018 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 for "Applicants who became Fully Registered Members" includes only those new applications in 2018 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 license but were not issued a license" are recorded as zero.  The CPSO does not officially track these numbers, but the actual number would be very small, ie. less than 25 in total.
  • For "Applicants who were issued an alternative class of license" we are including all classes except the Independent class.  Accordingly, "alternative classes of license" includes all 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 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 limiations.

b) Postgraduate 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 postgraduate training appointment and may not charge fees for services.  This certificate expires when the trainee ceases enrollment in their 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 Registration Committee approves issuance of a certificate 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 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 125 100 5 895 0
1125
Applicants who initiated an appeal of a registration decision 1 2 0 13 0
16
Appeals heard 0 1 0 1 0
2
Registration decisions changed following an appeal 0 0 0 0 0
0
Additional comments:

Note: The total count of 1125 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 2018.  However, exact counts for the jurisdiction sub-totals are not availlable.  The sub-totals shown for the jurisdictions are estimates based on previous years and observed trends in 2018.  

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 403
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:
2019/03/01

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