Council has approved a proposed regulation to create a new temporary class of registration designed to support mobility within Canada.
Government approval is required for this regulation to go forward. We are, however, circulating the proposed bylaw now to expedite implementation should government approval be granted.
The ongoing health care system crisis, health human resource shortages and Emergency Department closures have garnered significant attention, and government is under pressure to take steps to rectify both the underlying systemic issues and provide immediate relief.
The intent of the proposed regulation is to provide a more flexible option that supports potential applicants who wish to assist with system needs on a temporary basis, enabling them to practice at full scope and reducing the administrative burden for all involved.
In early August, the Ontario Minister of Health issued a letter directing CPSO to “make every effort to register out of province and internationally educated physicians to the College as expeditiously as possible.”
The College, in response, noted the medical regulator was but one part of the broader solution, and put forward a range of options to address the current crisis and underlying issues. Among the options outlined in the response, one proposal sought to better support temporary mobility between provinces and territories to help address temporary resource challenges. Regulatory amendments enabling the creation of a new class of registration would fill a gap between existing classes, and support a more timely and robust mechanism for movement within Canada. This new class of registration would offer benefits over the College’s current 30-day license — the Supervised Practice of Short Duration certificate — in important ways:
- Not requiring supervision, enabling physicians to practice independently;
- Extending the duration of a license (3 months), enabling greater flexibility;
- Allowing a broader range of system sponsors, including community-based settings;
- Reducing administrative burden on the sponsor, the physician and CPSO.
In response to our proposal, government specifically requested that we work to implement the regulatory amendment and to do so as quickly as possible.
Throughout the pandemic and continuing, the Short Duration certificate has been used to help hospitals address immediate and temporary physician shortages. Notably, this class has been used 18 times since May to provide urgent coverage in hospitals, including temporarily licensing Manitoba physicians providing coverage in Northern Ontario. This new class of registration seeks to offer a more comprehensive and flexible alternative for physicians in these kinds of instances.
Due to the urgent system need, notification of other medical regulatory authorities of this proposal occurred in advance of the Council meeting to allow for feedback prior to submission to government. Additionally, an exemption from the standard 60-day consultation period required by the Health Professions Procedural Code has been made, with approval from the Minister.
Should the government approve the regulatory amendments, CPSO by-laws will need to be updated to operationalize this new class of registration. Reflecting the term of the proposed class of registration, it is proposed that application fees be set at 25 percent of the annual fee.
The Council of the College of Physicians and Surgeons of Ontario amends the motion titled By-law Amendments for Fees for Temporary Services Certificate of Registration by replacing the proposed By-law No. 153 with the following:
By-law No. 153
1. Section 1 of the Fees and Remuneration By-law (By-law No. 2) is revoked and substituted with the following:
Application Fees
1. A person who submits an application for a certificate of registration or authorization shall pay an application fee. The application fees are as follows:
(a) For a certificate of registration authorizing postgraduate education, 25% of the annual fee specified in section 4(a);
(b) For a certificate of registration authorizing supervised practice of a short duration, 20% of the annual fee specified in Section 4(a);
(b.1) For a certificate of registration authorizing temporary independent practice, 25% of the annual fee specified in section 4(a);
(c) For an application for reinstatement of a certificate of registration, 60% of the annual fee specified in s. 4(a);
(d) For any other certificate of registration, 60% of the annual fee specified in Section 4(a);
(e) [repealed]: May 31, 2019]
(f) For a certificate of authorization, $400.00;
(g) For an application to the Registration Committee for an order directing the Registrar to modify or remove terms, conditions or limitations imposed on the member’s certificate of registration by the Registration Committee, 25% of the annual fee specified in section 4(a);
(h) If the person:
(i)
meets the registration requirements applicable to the class of certificate of registration applied for, as prescribed in the Registration Regulation, Ontario Regulation 865/93 under the Medicine Act, 1991; and
(ii)
requests the College to conduct the initial assessment of the application within three weeks after receipt by the College of the application,
an additional fee equal to 50% of the application fee applicable to such person under subsection 1(a), (b), (b.1) or (d).
2. Section 3 of the Fees and Remuneration By-law (By-law No. 2) is revoked and substituted with the following:
Annual Fees
3. Every holder of a certificate of authorization, other than a holder of a certificate of registration authorizing supervised practice of a short duration or authorizing postgraduate education for an elective appointment or authorizing temporary independent practice, shall pay an annual fee.
3. Subsection 4(a) of the Fees and Remuneration By-law (By-law No. 2) is revoked and substituted with the following:
(a) $1725 for holders of a certificate of registration other than a certificate of registration authorizing postgraduate education, a certificate of registration authorizing supervised practice of a short duration, or a certificate of registration authorizing temporary independent practice;
