REGISTRATION

Medicine Act, 1991

ONTARIO REGULATION 865/93

REGISTRATION

Consolidation Period: From June 4, 2024 to the e-Laws currency date.

Last amendment: 220/24.

Legislative History: 56/94, 123/03, 498/07, 93/12, 510/22, 286/23, 220/24.

This is the English version of a bilingual regulation.

Definitions and General Requirements

definitions

1. In this Regulation,

“accredited medical school” means a medical school accredited by the Committee on Accreditation of Canadian Medical Schools or by the Liaison Committee on Medical Education; (“école de médecine agréée”)

“degree in medicine” means,

(a)  an M. D. or equivalent basic degree in medicine from a medical school that was, at the time of graduation, an accredited medical school, based upon successful completion of an undergraduate program of medical education that included a clerkship of at least forty weeks taken as part of the second half of the undergraduate program of medical education that includes,

(i)  clinical education of at least,

(A)  eight weeks in internal medicine,

(B)  eight weeks in surgery,

(C)  four weeks in obstetrics and gynaecology,

(D)  four weeks in paediatrics, and

(E)  four weeks in psychiatry,

(ii)  clinical education of at least four weeks in family medicine or an alternative program to develop the knowledge, skills, attitudes and behaviours necessary to enter postgraduate education in family medicine or primary medical care,

(iii)  instruction and experience in both ambulatory and hospital settings, and

(iv)  the major aspects of acute, chronic, continuing, preventive and rehabilitative care, or

(b)  an M. D. or equivalent basic degree in medicine, based upon successful completion of a conventional undergraduate program of education in allopathic medicine that,

(i)  teaches medical principles, knowledge and skills similar to those taught in undergraduate programs of medical education at accredited medical schools,

(ii)  includes at least 130 weeks of instruction over a minimum of thirty-six months, and

(iii)  was, at the time of graduation, listed in the World Directory of Medical Schools published by the World Health Organization. (“grade en médecine”) O. Reg. 865/93, s. 1.

general requirements

2. (1) It is a non-exemptible standard and qualification for a certificate of registration that the applicant’s past and present conduct afford reasonable grounds for belief that the applicant,

(a)  is mentally competent to practise medicine;

(b)  will practise medicine with decency, integrity and honesty and in accordance with the law;

(c)  has sufficient knowledge, skill and judgment to engage in the kind of medical practice authorized by the certificate; and

(d)  can communicate effectively and will display an appropriately professional attitude.  O. Reg. 865/93, s. 2 (1).

(2) It is a standard and qualification for a certificate of registration that the applicant,

(a)  submit to the College a completed application for the class of certificate for which application is made, in a form provided by the College;

(b)  has one of the following:

(i)  for a certificate of registration authorizing independent practice, Canadian citizenship or permanent resident status,

(ii)  for a certificate of registration authorizing academic practice, Canadian citizenship, permanent resident status or a work permit issued under the Immigration and Refugee Protection Act (Canada) consistent with the practice for which the certificate is issued, or

(iii)  for a certificate of registration authorizing postgraduate education by reason of section 11, 12, 13 or 15, Canadian citizenship, permanent resident status or a work permit issued under the Immigration and Refugee Protection Act (Canada) for the program of postgraduate medical education in which the applicant is appointed;

(c)  pay the relevant application fee and annual membership fee;

(d)  establish his or her identity, provide documentation relating to the registration requirements and attend in person at the College for those purposes if requested; and

(e)  have professional liability protection that extends to all areas of practice in compliance with the by-laws.  O. Reg. 865/93, s. 2 (2); O. Reg. 498/07, s. 1 (1); O. Reg. 93/12, s. 1.

(3) It is a term, condition and limitation of a certificate of registration that the certificate expires when the holder,

(a)  no longer has the standards and qualifications required by clause (2) (b); or

(b)  no longer has the professional liability protection required by clause (2) (e).  O. Reg. 498/07, s. 1 (2).

(4) Despite any other provision in this Regulation, an applicant who makes any false or misleading representation or declaration on or in connection with an application, by commission or omission, shall be deemed thereafter not to have, and not to have had, the standards and qualifications for a certificate of any class.  O. Reg. 865/93, s. 2 (4).

(5) It is a term, condition and limitation of a certificate of registration that the holder practise only in the areas of medicine in which the holder is educated and experienced.  O. Reg. 865/93, s. 2 (5).

(6) If a member fails to provide to the College information about the member or a declaration required under the by-laws, in the form and manner required under the by-laws, the Registrar may give the member notice of intention to suspend the member and may suspend the member’s certificate of registration for failure to provide the information or declaration 60 days after notice is given.  O. Reg. 498/07, s. 1 (3).

(7) If a member fails to provide to the College evidence that the member holds professional liability protection in compliance with the by-laws when the College requests it, the Registrar shall immediately give the member notice of intention to suspend the member and may suspend the member’s certificate of registration for failure to provide the evidence 15 days after notice is given.  O. Reg. 498/07, s. 1 (3).

Classes of Certificates of Registration Authorizing Practice

independent practice

3. (1) The standards and qualifications for a certificate of registration authorizing independent practice are as follows:

1.  The applicant must have a degree in medicine.

2.  The applicant must have successfully completed Part 1 and Part 2 of the Medical Council of Canada Qualifying Examination.

3.  The applicant must have completed one of the following:

i.  A clerkship at an accredited medical school in Canada which meets the criteria of a clerkship in clause (a) of the definition of “degree in medicine” in section 1.

ii.  A year of postgraduate medical education at an accredited medical school in Canada.

iii.  A year of active medical practice in Canada which includes significant clinical experience pertinent to the applicant’s area of medical practice.

4.  The applicant must have certification by examination by the Royal College of Physicians and Surgeons of Canada or by the College of Family Physicians of Canada.  O. Reg. 865/93, s. 3 (1).

(2) An applicant who holds a certificate of registration authorizing academic practice and an appointment described in paragraph 2 of subsection 4 (1) is exempt from the standards and qualifications required under paragraphs 2, 3 and 4 of subsection (1) if the applicant satisfies the following standards and qualifications:

1.  The applicant must have held the certificate and the appointment continuously for the three years immediately preceding the application.

2.  The applicant must have, for the three years immediately preceding the application, continuously maintained an active medical practice in a clinical teaching unit formally affiliated with the medical school department in which he or she holds the professorial appointment.

3.  The applicant must have permanent certification or certification by examination by the Royal College of Physicians and Surgeons of Canada or by the College of Family Physicians of Canada.  O. Reg. 865/93, s. 3 (2).

(3) An applicant is exempt from the requirement of successfully completing Part 1 and Part 2 of the Medical Council of Canada Qualifying Examination under paragraph 2 of subsection (1), if,

(a)  on or before December 31, 1991, the applicant had,

(i)  successfully completed the qualifying examination of the Medical Council of Canada,

(ii)  successfully completed the examinations for the diploma of the National Board of Medical Examiners of the United States of America, or

(iii)  obtained one of the following scores on the Licensing Examination of the Federation of State Medical Boards of the United States of America:

(A)  if the examination was taken before July 1, 1985, a weighted score average of seventy-five using the weighting formula of 1/6 for Part 1 of Component 1, 2/6 for Part 2 of Component 1 and 3/6 for Component 2, or

(B)  if the examination was taken after July 1, 1985, a score of seventy-five on each of Component 1 and Component 2; or

(b)  on or before December 31, 1993, the applicant had applied for registration and successfully completed Part 1 of the Medical Council of Canada Qualifying Examination.  O. Reg. 865/93, s. 3 (3); O. Reg. 56/94, s. 1.

(4) An applicant described in subsection (5) is exempt from the standards and qualifications required under paragraphs 2, 3 and 4 of subsection (1) if the applicant satisfies the following standards and qualifications:

1.  The applicant must have certification by the Royal College of Physicians and Surgeons of Canada by examination passed ten years prior to application.

2.  The applicant must have maintained an active medical practice while holding an academic or hospital practice licence, or a certificate of registration authorizing academic practice or hospital practice, continuously for the ten years immediately preceding the application.  O. Reg. 865/93, s. 3 (4).

(5) Subsection (4) applies to an applicant who, on October 31, 1992, held an academic practice licence or a hospital practice licence under a predecessor of the Act.  O. Reg. 865/93, s. 3 (5).

(6) A former member whose certificate of registration authorizing independent practice has expired under clause 16 (1) (a), (b) or (c) shall, upon application for reinstatement, be deemed to have met the standards and qualifications in this section if he or she,

(a)  held the certificate for a continuous period of at least one year; and

(b)  submits the application form required by clause 2 (2) (a) within one year after the expiry under clause 16 (1) (a), (b) or (c).  O. Reg. 498/07, s. 2.

(7) Subject to section 10 (restricted certificates), a person who, on the day this Regulation comes into force, holds an independent practice licence issued under a predecessor of the Act is deemed to be the holder of a certificate of registration authorizing independent practice under the Act.  O. Reg. 865/93, s. 3 (7).

3.1 (1) Where section 22.18 of the Health Professions Procedural Code applies to an applicant for a certificate of registration authorizing independent practice, the applicant is deemed to have met the requirements of subsection 3 (1).  O. Reg. 93/12, s. 2.

(2) Where an applicant to whom subsection (1) applies is unable to satisfy the Registrar or a panel of the Registration Committee that the applicant practised the profession of medicine to the extent that would be permitted by a certificate of registration authorizing independent practice at any time in the three years immediately preceding the date of that applicant’s application, the applicant must meet any further requirement to undertake, obtain or undergo material additional training, experience, examinations or assessments that may be specified by a panel of the Registration Committee.  O. Reg. 93/12, s. 2.

(3) Despite subsection (1), an applicant is not deemed to have met a requirement if that requirement is described in subsection 22.18 (3) of the Health Professions Procedural Code.  O. Reg. 93/12, s. 2.

3.2 (1) An applicant who, in the year immediately preceding their application for a certificate of registration authorizing independent practice, has held a certificate of registration issued by the College authorizing practice in emergency circumstances, is exempt from the standards and qualifications required under paragraphs 3 and 4 of subsection 3 (1) if the applicant has a certification issued by the Royal College of Physicians and Surgeons of Canada or by the College of Family Physicians of Canada. O. Reg. 286/23, s. 1.

(2) An applicant who, in the year immediately preceding their application for a certificate of registration authorizing independent practice, has held a certificate of registration issued by the College authorizing practice in emergency circumstances, is exempt from the standards and qualifications required under clause 2 (2) (c) in respect of payment of the relevant application fee but not in respect of payment of the annual membership fee. O. Reg. 286/23, s. 1.

academic practice

4. (1) The standards and qualifications for a certificate of registration authorizing academic practice are as follows:

1.  The applicant must have a degree in medicine.

2.  The applicant must have a geographical full-time teaching appointment or a geographical full-time research appointment to the academic staff of an accredited medical school in Ontario at the rank of full or associate professor.

3.  The applicant must have certification by the Royal College of Physicians and Surgeons of Canada or by the College of Family Physicians of Canada.  O. Reg. 865/93, s. 4 (1).

(2) Subject to section 10 (restricted certificates), a person who, on the day this Regulation comes into force, holds an academic licence issued under a predecessor of the Act is deemed to be the holder of a certificate of registration authorizing academic practice under this Act.  O. Reg. 865/93, s. 4 (2).

(3) It is a term, condition and limitation of a certificate of registration authorizing academic practice that,

(a)  the holder practise medicine only,

(i)  in a clinical teaching unit formally affiliated with the medical school department in which he or she holds the professorial appointment, and

(ii)  to the extent required by the teaching or research requirements of that appointment; and

(b)  the certificate terminates when the holder no longer holds an appointment in accordance with paragraph 2 of subsection (1) or is no longer certified in accordance with paragraph 3 of subsection (1).  O. Reg. 865/93, s. 4 (3).

4.1 (1) Where section 22.18 of the Health Professions Procedural Code applies to an applicant for a certificate of registration authorizing academic practice, the applicant is deemed to have met the requirements of paragraphs 1 and 3 of subsection 4 (1).  O. Reg. 93/12, s. 3.

(2) Where an applicant to whom subsection (1) applies is unable to satisfy the Registrar or a panel of the Registration Committee that the applicant practised the profession of medicine to the extent that would be permitted by a certificate of registration authorizing academic practice at any time in the three years immediately preceding the date of that applicant’s application, the applicant must meet any further requirement to undertake, obtain or undergo material additional training, experience, examinations or assessments that may be specified by a panel of the Registration Committee.  O. Reg. 93/12, s. 3.

(3) Despite subsection (1), an applicant is not deemed to have met a requirement if that requirement is described in subsection 22.18 (3) of the Health Professions Procedural Code.  O. Reg. 93/12, s. 3.

academic visitor

5. (1) The standards and qualifications for a certificate of registration authorizing academic practice by a visitor are as follows:

1.  The applicant must have a degree in medicine.

2.  The applicant must have an established scholarly career in medical teaching or research at a medical school outside Ontario, and a permanent appointment to the academic staff of the medical school primarily for the purpose of teaching or research.

3.  The applicant must give an undertaking to fulfill the medical school’s expectation that the applicant will return to the appointment referred to in paragraph 2 upon the expiry of the certificate.

4.  The applicant must have a qualification as a medical specialist that is recognized by the medical licensing authority in the jurisdiction where the applicant holds his or her medical school appointment.

5.  The applicant must hold an appointment by the dean of an accredited medical school in Ontario primarily to provide undergraduate or postgraduate medical education, or medical research, or both, for a specified period of time which does not exceed twelve months.  O. Reg. 865/93, s. 5 (1).

(2) It is a non-exemptible standard and qualification for a certificate of registration authorizing academic practice by a visitor that twelve months have elapsed since the expiry of the last of any previously issued such certificates to the applicant.  O. Reg. 865/93, s. 5 (2).

(3) It is a term, condition and limitation of a certificate of registration authorizing academic practice by a visitor that,

(a)  the holder practise medicine only,

(i)  in a clinical teaching unit formally affiliated with the medical school department in which he or she holds his or her appointment as a visitor, and

(ii)  to the extent required by the teaching or research requirements of that appointment:

(b)  the holder not charge a fee for medical services; and

(c)  the certificate expires on the earlier of the following days:

(i)  the day the holder no longer holds an appointment in accordance with paragraph 5 of subsection (1), or

(ii)  the day the period specified under paragraph 5 of subsection (1) ends, unless the Registration Committee extends the period by a period not exceeding three months.  O. Reg. 865/93, s. 5 (3).

5.1 (1) Where section 22.18 of the Health Professions Procedural Code applies to an applicant for a certificate of registration authorizing academic practice by a visitor, the applicant is deemed to have met the requirements of paragraphs 1 and 4 of subsection 5 (1) as well as the requirement that the applicant have an established scholarly career in medical teaching or research at a medical school outside Ontario as that requirement is set out in paragraph 2 of that subsection.  O. Reg. 93/12, s. 5.

(2) Where an applicant to whom subsection (1) applies is unable to satisfy the Registrar or a panel of the Registration Committee that the applicant practised the profession of medicine to the extent that would be permitted by a certificate of registration authorizing academic practice by a visitor at any time in the three years immediately preceding the date of that applicant’s application, the applicant must meet any further requirement to undertake, obtain or undergo material additional training, experience, examinations or assessments that may be specified by a panel of the Registration Committee.  O. Reg. 93/12, s. 5.

(3) Despite subsection (1), an applicant is not deemed to have met a requirement if that requirement is described in subsection 22.18 (3) of the Health Professions Procedural Code.  O. Reg. 93/12, s. 5.

supervised practice of short duration

6. (1) The standards and qualifications for a certificate of registration authorizing supervised practice of a short duration are as follows:

1.  The applicant must have a degree in medicine.

2.  The applicant must hold an appointment by,

i.  an accredited medical school in Ontario,

ii.  a hospital approved under the Public Hospitals Act or an institution designated as a psychiatric facility by the regulations made under the Mental Health Act, or

iii.  the Crown in right of Canada or of Ontario or an agency of the Crown.

3.  The applicant’s appointment must be solely for the purpose of providing,

i.  assistance that would otherwise not be available promptly for an individual’s medical problem in Ontario that requires remedy on an urgent basis,

ii.  medical services for a short interval that would otherwise be unavailable because of a lack of persons to provide them, or

iii.  a brief continuing medical education program primarily for the benefit of members holding a certificate of registration authorizing independent or academic practice.

4.  A member holding a certificate of registration authorizing independent practice must give an undertaking to supervise the applicant and be responsible for providing continuing care for patients attended by the applicant in Ontario.  O. Reg. 865/93, s. 6 (1).

(2) The terms, conditions and limitations of a certificate of registration authorizing supervised practice of a short duration are that,

(a)  the holder practise medicine only to the extent required by the holder’s appointment and under the supervision of the member who gave the undertaking; and

(b)  the certificate expires on the earliest of the following days:

(i)  the day of the expiry of the holder’s appointment,

(ii)  the day when the holder leaves Ontario, or

(iii)  the thirtieth day after the certificate is issued.  O. Reg. 865/93, s. 6 (2).

temporary independent practice

6.1 (1) The standards and qualifications for a certificate of registration authorizing temporary independent practice are as follows:

1.  The applicant must hold a full, unrestricted licence or a certificate of practice authorizing independent practice in a Canadian jurisdiction other than Ontario, which may include an indication of the specific areas of practice in which the applicant is authorized to practice independently, based on education, qualifications and experience.

2.  The applicant must have an agreement with, hold an appointment by, or have an offer from a sponsor, including a sponsor listed in paragraph 4, that is approved by the Registrar.

3.  The agreement, appointment or offer must be approved by the Registrar and be solely for the purpose of providing medical services on a temporary basis.

4.  The sponsors referred to in paragraph 2 are:

i.  A hospital within the meaning of the Public Hospitals Act or a private hospital within the meaning of the Private Hospitals Act.

ii.  An organization, other than a hospital or private hospital referred to in subparagraph i, that facilitates the provision of medical services.

iii.  A member. O. Reg. 510/22, s. 1.

(2) The terms, conditions and limitations of a certificate of registration authorizing temporary independent practice are that,

(a)  the holder practise medicine only to the extent,

(i)  required by the holder’s agreement, appointment or offer, and

(ii)  authorized by the holder’s licence or certificate of practice referred to in paragraph 1 of subsection (1); and

(b)  the certificate expires on the earlier of,

(i)  the ninetieth day after the certificate is issued, or

(ii)  the day after the holder’s agreement, appointment or offer expires. O. Reg. 510/22, s. 1.

Emergency Circumstances Practice

6.2 (1) The standards and qualifications for a certificate of registration authorizing practice in emergency circumstances are as follows:

1.  The Minister must have requested that the College initiate registrations under this class based on the Minister’s opinion that emergency circumstances call for it, or the Council must have determined, after taking into account all of the relevant circumstances that impact the ability of applicants to meet the ordinary registration requirements, that there are emergency circumstances, and that it is in the public interest that the College issue emergency certificates of registration.

2.  The applicant must have a degree in medicine.

3.  The applicant must have completed one year of postgraduate medical education at an accredited medical school.

4.  A member who is a physician holding a certificate of registration authorizing independent practice must give an undertaking to supervise the applicant and be responsible for providing continuing care for patients attended by the applicant in Ontario.

5.  The applicant must have any other standard or qualification that the Council has identified as necessary in order for holders of emergency certificates of registration to assist in addressing the determined emergency circumstances. O. Reg. 286/23, s. 2.

(2) The requirements of paragraphs 1, 2, 3, 4, and 5 of subsection (1) are non-exemptible. O. Reg. 286/23, s. 2.

(3) It is a term, condition and limitation of a certificate of registration authorizing practice in emergency circumstances that,

(a)  the holder practise under the supervision of a member who is a physician;

(b)  the certificate expires on the earlier of,

(i)  one year from the date the certificate was issued or renewed, and

(ii)  the 90th day after the Council declares that the emergency circumstances have ended; and

(c)  the holder must adhere to any other terms, conditions and limitations that the Council has identified as necessary in order for holders of emergency certificates of registration to assist in addressing the determined emergency circumstances. O. Reg. 286/23, s. 2.

(4) The Registrar may renew a certificate of registration authorizing practice in emergency circumstances for one or more periods, each of which is not to exceed one year, if the Council has not declared that the emergency circumstances have ended. O. Reg. 286/23, s. 2.

public service practice

7. (1) Subject to section 10 (restricted certificates), a person who, on December 31, 1993, holds or is deemed to hold a Public Service licence under a predecessor of the Act and is employed by the Crown in right of Canada or of Ontario, an agency of the Crown or a board of health within the meaning of the Health Protection and Promotion Act, is deemed to be the holder of a certificate of registration authorizing public service practice under the Act.  O. Reg. 865/93, s. 7 (1).

(2) The terms, conditions and limitations of a certificate of registration authorizing public service practice are that,

(a)  the holder practise medicine only to the extent required by the holder’s employment by the Crown, agency or board of health that employed the holder on December 31, 1993; and

(b)  the certificate expires when the Crown, agency or board of health that employed the holder on December 31, 1993 ceases to employ the holder.  O. Reg. 865/93, s. 7 (2).

practice in an underserviced area

8. (1) Subject to section 10 (restricted certificates), a person who, on December 31, 1993, is deemed to hold an Underserviced Area licence under a predecessor of the Act is deemed to be the holder of a certificate of registration authorizing practice in an underserviced area under the Act.  O. Reg. 865/93, s. 8 (1).

(2) The terms, conditions and limitations of a certificate of registration authorizing practice in an underserviced area are that,

(a)  the holder practise medicine only in the underserviced area for which the holder was licensed on December 31, 1993; and

(b)  the certificate expires when the holder ceases practising medicine in that underserviced area.  O. Reg. 865/93, s. 8 (2).

hospital practice

9. (1) Subject to section 10 (restricted certificates), a person who, on December 31, 1993, is deemed to hold a Hospital Practice licence under a predecessor of the Act is deemed to be the holder of a certificate of registration authorizing hospital practice under the Act.  O. Reg. 865/93, s. 9 (1).

(2) The terms, conditions and limitations of a certificate of registration authorizing hospital practice are that,

(a)  the holder practise medicine only in,

(i)  the specialty in which he or she is certified by the Royal College of Physicians and Surgeons of Canada, and

(ii)  the institution where he or she is practising medicine on December 31, 1993; and

(b)  the certificate expires if the holder ceases,

(i)  being certified by the Royal College of Physicians and Surgeons of Canada, or

(ii)  practising in the institution where he or she is practising medicine on December 31, 1993.  O. Reg. 865/93, s. 9 (2).

Note: On April 1, 2025, the day section 1 of Schedule 3 to the Advancing Oversight and Planning in Ontario’s Health System Act, 2021 comes into force, the Regulation is amended by adding the following sections: (See: O. Reg. 220/24, s. 1)

Physician Assistants – General

9.1 (1) The standards and qualifications for a certificate of registration authorizing practice as a physician assistant are as follows:

1.  The applicant must have a minimum of a baccalaureate degree evidencing the successful completion of a program designed to educate and train persons to be practising physician assistants which was,

i.  accredited by the Canadian Medical Association or Accreditation Canada at the time the applicant graduated,

ii.  accredited by the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA) at the time the applicant graduated,

iii.  accredited by another accrediting body approved by the Council at the time the applicant graduated, or

iv.  otherwise approved by the Council.

2.  The applicant must hold at least one of the following certifications as a physician assistant:

i.  Canadian Certified Physician Assistant (CCPA) certification by the Physician Assistant Certification Council of Canada (PACCC).

ii.  Physician Assistant-Certified (PA-C) by the National Commission on Certification of Physician Assistants (NCCPA) (US).

iii.  Another certification approved by the Council. O. Reg. 220/24, s. 1.

(2) During the 24 months following the day this section comes into force, paragraph 1 of subsection (1) does not apply in respect of an application for a certificate of registration authorizing practice as a physician assistant where,

(a)  the applicant successfully completed the Canadian Armed Forces Health Training Centre Physician Assistant Program or the Ontario Physician Assistant Integration Program by the Centre for the Evaluation of Health Professionals Educated Abroad; and

(b)  the applicant is able to satisfy the Registrar or a panel of the Registration Committee that the applicant engaged in practice in Canada within the scope of a physician assistant during the two-year period that immediately preceded the date that the applicant submitted their application. O. Reg. 220/24, s. 1.

9.2 (1) Where section 22.18 of the Health Professions Procedural Code applies to an applicant for a certificate of registration authorizing practice as a physician assistant, the applicant is deemed to have met the requirements of subsection 9.1 (1). O. Reg. 220/24, s. 1.

(2) Where an applicant to whom subsection (1) applies is unable to satisfy the Registrar or a panel of the Registration Committee that the applicant practised the profession of medicine to the extent that would be permitted by a certificate of registration authorizing practice as a physician assistant at any time in the three years immediately preceding the date of that applicant’s application, the applicant must meet any further requirement to undertake, obtain or undergo material additional training, experience, examinations or assessments that may be specified by a panel of the Registration Committee. O. Reg. 220/24, s. 1.

(3) Despite subsection (1), an applicant is not deemed to have met a requirement if that requirement is described in subsection 22.18 (3) of the Health Professions Procedural Code. O. Reg. 220/24, s. 1.

Emergency Circumstances Practice – Physician Assistants

9.3 (1) The standards and qualifications for a certificate of registration authorizing practice in emergency circumstances for physician assistants are as follows:

1.  The Minister must have requested that the College initiate registrations under this class based on the Minister’s opinion that emergency circumstances call for it, or the Council must have determined, after taking into account all of the relevant circumstances that impact the ability of applicants to meet the ordinary registration requirements, that there are emergency circumstances, and that it is in the public interest that the College issue emergency certificates of registration.

2.  The applicant must have a minimum of a baccalaureate degree evidencing the successful completion of a program designed to educate and train persons to be practising physician assistants which was,

i.  accredited by the Canadian Medical Association or Accreditation Canada at the time the applicant graduated,

ii.  accredited by the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA) at the time the applicant graduated,

iii.  accredited by another accrediting body approved by the Council at the time the applicant graduated, or

iv.  otherwise approved by the Council.

3.  The applicant must have any other standard or qualification that the Council has identified as necessary in order for holders of emergency certificates of registration for physician assistants to assist in addressing the determined emergency circumstances. O. Reg. 220/24, s. 1.

(2) The requirements of paragraphs 1, 2, and 3 of subsection (1) are non-exemptible. O. Reg. 220/24, s. 1.

(3) It is a term, condition and limitation of a certificate of registration authorizing practice in emergency circumstances for physician assistants that,

(a)  the certificate expires the earlier of,

(i)  one year from the date the certificate was issued or renewed, and

(ii)  the 90th day after the Council declares that the emergency circumstances have ended; and

(b)  the holder must adhere to any other terms, conditions and limitations that the Council has identified as necessary in order for holders of emergency certificates of registration for physician assistants to assist in addressing the determined emergency circumstances. O. Reg. 220/24, s. 1.

(4) The Registrar may renew a certificate of registration authorizing practice in emergency circumstances for one or more periods, each of which is not to exceed one year, if the Council has not declared that the emergency circumstances have ended. O. Reg. 220/24, s. 1.

9.4 An applicant who, in the year immediately preceding their application for a certificate of registration authorizing practice as a physician assistant, has held a certificate of registration issued by the College authorizing practice in emergency circumstances for physician assistants, is exempt from the standards and qualifications required under clause 2 (2) (c), but only in respect of payment of the relevant application fee, not in respect of payment of the annual membership fee. O. Reg. 220/24, s. 1.

restricted certificate

10. (1) A licence that is in effect on the day this Regulation comes into force and which is subject to terms, conditions or limitations imposed by a committee under a predecessor of the Act is deemed to be a restricted certificate of registration under the Act subject to the imposed terms, conditions and limitations.  O. Reg. 865/93, s. 10 (1).

(2) A certificate of registration of any class upon which a committee imposes terms, conditions or limitations is deemed to be a restricted certificate of registration under the Act subject to the imposed terms, conditions and limitations.  O. Reg. 865/93, s. 10 (2).

(3) A certificate of registration of any class issued by reason of an order of the Registration Committee directing the Registrar to impose terms, conditions or limitations on the certificate is deemed to be a restricted certificate of registration under the Act subject to the imposed terms, conditions and limitations.  O. Reg. 865/93, s. 10 (3).

(4) A holder of a restricted certificate of registration may practise medicine only in accordance with the terms, conditions and limitations of the certificate.  O. Reg. 865/93, s. 10 (4).

Certificates Authorizing Postgraduate Education

general

11. (1) The standards and qualifications for a certificate of registration authorizing postgraduate education are that an applicant receive an appointment in a program of postgraduate medical education at an accredited medical school in Ontario after,

(a)  obtaining a degree in medicine described in clause (a) of the definition of “degree in medicine” in section 1; or

(b)  attaining all of the following:

(i)  a degree in medicine described in clause (b) of the definition of “degree in medicine” in section 1,

(ii)  successful completion of,

(A)  the Medical Council of Canada Evaluating Examination, or

(B)  Part 1 of the Medical Council of Canada Qualifying Examination or, if the qualifying examination was written before December 31, 1991, the Medical Council of Canada Qualifying Examination,

(iii)  reasonable fluency in English or French, and

(iv)  selection for appointment to the program of postgraduate medical education on the basis of performance in a pre-entry assessment program.  O. Reg. 865/93, s. 11 (1).

(2) For the purposes of subclause (1) (b) (iii), an applicant is reasonably fluent in English or French if the applicant,

(a)  obtains a score of 220 on the Test of Spoken English and a score of 580 on the Test of English as a Foreign Language of the Educational Testing Service;

(b)  obtains a score of 60 per cent on each part of the test of French as a second language used by the Office de la langue française of the Government of Quebec for applicants to the Corporation professionnelle des médicins du Québec;

(c)  undergoes both primary and secondary education in English or French or both;

(d)  obtains a degree in medicine from a medical school where the language of instruction, including the language used in patient care, was English or French or both;

(e)  completes, with performance acceptable to the College, four years of postgraduate education in clinical medicine in North America in which the language used is English or French or both; or

(f)  holds continuously, for the four years immediately preceding application, a senior teaching appointment at an accredited medical school in which the language of instruction, including the language used in patient care, is English or French or both.  O. Reg. 865/93, s. 11 (2).

(3) A member who applies for a certificate of registration authorizing postgraduate education is exempt from the requirement of being reasonably fluent in English or French under subclause (3) (b) (iii) if the member,

(a)  was issued a certificate of registration of any class by the College at a time when language tests were not required; or

(b)  was exempted from the requirement by the College before the day this Regulation comes into force.  O. Reg. 865/93, s. 11 (3).

(4) The pre-entry assessment program referred to in subclause (1) (b) (iv) is a program provided by an accredited medical school in Ontario, the duration, form and content of which is acceptable to the College and which,

(a)  assesses the applicant’s clinical skills in, among other things, internal medicine, obstetrics and gynaecology, paediatrics, psychiatry and general surgery; and

(b)  evaluates the candidate with respect to the standards and qualifications mentioned in subsection 2 (1).  O. Reg. 865/93, s. 11 (4).

(5) It is a standard and qualification for a certificate of registration authorizing postgraduate education that the applicant not have previously held, or currently be the holder of, a certificate of registration authorizing postgraduate education as a clinical or research fellow under section 12 unless the applicant has received the express permission of the Registration Committee and complies with any terms, conditions or limitations imposed by the Registration Committee.  O. Reg. 865/93, s. 11 (5).

(6) An applicant who previously held a certificate of registration authorizing postgraduate education for a continuous period of at least one year and who applies for another certificate of registration authorizing postgraduate education shall be deemed to have the standards and qualifications in subsection (1) if,

(a)  the previous certificate terminated merely by reason of the applicant’s satisfactory completion of a program of postgraduate medical education in Ontario to which the applicant was appointed; and

(b)  the applicant has either,

(i)  been continuously enrolled in postgraduate medical education outside Ontario since the termination of the certificate, or

(ii)  submitted the application form required by clause 2 (2) (a) within six months after the termination of the certificate.  O. Reg. 865/93, s. 11 (6).

(7) A person who, on December 31, 1993, holds an educational licence issued under a predecessor of the Act is deemed to be the holder of a certificate of registration authorizing postgraduate education under the Act subject to any terms, conditions, limitations or restrictions to which the licence was subject.  O. Reg. 865/93, s. 11 (7).

(8) The following are terms, conditions and limitations of a certificate of registration authorizing postgraduate education:

1.  The holder shall,

i.  practise medicine only as required by the program in which the holder is enrolled,

ii.  prescribe drugs only for in-patients or out-patients of a clinical teaching unit that is formally affiliated with the department where he or she is properly practising medicine and to which postgraduate trainees are regularly assigned by the department as part of its program of postgraduate medical education, and

iii.  not charge a fee for medical services.

2.  The certificate terminates on one of the following times:

i.  The day the holder ceases to be enrolled in a program of postgraduate medical education provided by an accredited medical school in Ontario.

ii.  For a holder who was exempted from a standard or qualification set out in subsection (1) in accordance with section 12, 13, 14 or 15 or by the Registration Committee under subsection 18 (3) of the Health Professions Procedural Code, on the earlier of the following times:

A.  the day the holder ceases to be enrolled in a program of postgraduate medical education provided by an accredited medical school in Ontario,

B.  the day the certificate terminates according to the terms, conditions and limitations of the certificate.  O. Reg. 865/93, s. 11 (8).

(9) Despite subparagraph iii of paragraph 1 of subsection (8), the holder of a certificate of registration authorizing postgraduate education may receive remuneration for medical services only in the form of a fixed salary.  O. Reg. 865/93, s. 11 (9).

11.1 (1) Where section 22.18 of the Health Professions Procedural Code applies to an applicant for a certificate of registration authorizing postgraduate education, the applicant is deemed to have met the requirements of clause 11 (1) (a) and subclauses 11 (1) (b) (i), (ii) and (iv).  O. Reg. 93/12, s. 5.

(2) An applicant referred to in subsection (1) is deemed to have met the requirement of subclause 11 (1) (b) (iii) if the requirements for the issuance of the out-of-province certificate included language proficiency requirements equivalent to those required by that subclause.  O. Reg. 93/12, s. 5.

(3) Despite subsection (1), an applicant is not deemed to have met a requirement if that requirement is described in subsection 22.18 (3) of the Health Professions Procedural Code.  O. Reg. 93/12, s. 5.

fellows

12. (1) Subject to subsection (2), if an applicant’s appointment to a program of postgraduate medical education is as a clinical or research fellow, the applicant for a certificate of registration authorizing postgraduate education is exempted from,

(a)  the Medical Council of Canada Evaluating Examination and Part 1 of the Medical Council of Canada Qualifying Examination required by subclause 11 (1) (b) (ii); and

(b)  the pre-entry assessment program required by subclause 11 (1) (b) (iv).  O. Reg. 865/93, s. 12 (1).

(2) An applicant referred to in subsection (1) must meet the following standards and qualifications:

1.  The applicant must,

i.  satisfy the educational requirements for certification as a specialist by,

A.  the Royal College of Physicians and Surgeons of Canada or the College of Family Physicians of Canada, or

B.  a board in the United States of America that is a regular member board of the American Board of Medical Specialties, or

ii.  be recognized as a medical specialist in the jurisdiction where the applicant practises medicine immediately before the appointment as a clinical or research fellow by an organization outside of North America that recognizes medical specialists.

2.  The applicant must have an appointment to a program of postgraduate medical education as a clinical or research fellow to gain further education in the same discipline as, or a subdiscipline of, the discipline in which the applicant has satisfied the educational requirements for certification or is recognized as a medical specialist.  O. Reg. 865/93, s. 12 (2).

(3) For an applicant who has not satisfied the educational requirements for certification as a specialist under subparagraph i of paragraph 1 of subsection (2), the exemption only applies if the dean of the medical school where the applicant is appointed provides the College with information acceptable to the College indicating that,

(a)  the applicant has completed all the requirements for recognition as a medical specialist in the jurisdiction where the applicant practises medicine immediately before his or her appointment;

(b)  the organization which recognized the applicant as a medical specialist did so using standards that are substantially similar to the standards of the Royal College of Physicians and Surgeons of Canada or the College of Family Physicians of Canada; and

(c)  the applicant’s appointment to a program of postgraduate medical education is in a discipline which is the same discipline as, or a subdiscipline of, the discipline in which the applicant is recognized as a medical specialist.  O. Reg. 865/93, s. 12 (3).

(4) It is a term, condition and limitation of a certificate of registration issued under this section that the certificate terminates on the earlier of the following times:

1.  The day the holder no longer holds the appointment as a clinical or research fellow for which the certificate was issued.

2.  Two years after the certificate is issued.  O. Reg. 865/93, s. 12 (4).

advanced standing

13. An applicant for a certificate of registration authorizing postgraduate education who has successfully completed Parts 1 and 2 of the Medical Council of Canada Qualifying Examination is exempted from the pre-entry assessment program required in subclause 11 (1) (b) (iv) if,

(a)  the applicant has completed at an accredited medical school in Canada, within one year before application, with performance acceptable to the College, two years of a residency program accredited, and leading to certification, by the Royal College of Physicians and Surgeons of Canada and is entering a subsequent year of the residency program in the same discipline or a subdiscipline as the completed residency; or

(b)  the applicant has satisfied the educational requirements for certification by the College of Family Physicians of Canada, within one year before application, and the applicant is entering a program to obtain recognition in a related discipline by that College.  O. Reg. 865/93, s. 13.

electives

14. (1) Subject to subsection (2), an applicant for a certificate of registration authorizing postgraduate education who is enrolled in an accredited medical school outside Ontario and has applied to complete an elective of postgraduate medical education in an accredited medical school in Ontario is exempted from the standards and qualifications in,

(a)  subclause 11 (1) (b) (iii) (language fluency); and

(b)  subclause 11 (1) (b) (iv) (the pre-entry assessment program).  O. Reg. 865/93, s. 14 (1).

(2) An applicant under subsection (1) must satisfy the following standards and qualifications:

1.  The applicant must be enrolled in a postgraduate program of medical education at an accredited medical school outside Ontario and have completed one year of the program with performance acceptable to the College.

2.  The applicant must have the approval of the head of the program outside Ontario in which he or she is enrolled allowing the applicant to undertake a specified part of the program at a particular accredited medical school in Ontario.

3.  The applicant must have the approval from the head of postgraduate medical education at the accredited medical school in Ontario at which the applicant will complete the specified part of the postgraduate program.

4.  The applicant must undertake to spend no more than fifteen weeks at the accredited medical school in Ontario.  O. Reg. 865/93, s. 14 (2).

(3) It is a term, condition and limitation of a certificate issued to a holder exempted by this section that the certificate terminates fifteen weeks after it is issued or at the end of the specified part of the holder’s program, whichever occurs first.  O. Reg. 865/93, s. 14 (3).

exchange resident

15. (1) Subject to subsection (2), an applicant for a certificate of registration authorizing postgraduate education who is seeking admission to postgraduate training at an accredited medical school in Ontario as part of an exchange program in which the applicant is enrolled in a program of postgraduate medical education outside Ontario and is exchanging places with a member of the College is exempted from,

(a)  the Medical Council of Canada Evaluating Examination and Part 1 of the Medical Council of Canada Qualifying Examination required by subclause 11 (1) (b) (ii); and

(b)  the pre-entry assessment program required by subclause 11 (1) (b) (iv).  O. Reg. 865/93, s. 15 (1).

(2) The exemption under subsection (1) only applies if,

(a)  the member of the College with whom the applicant is exchanging places,

(i)  is enrolled in a program of postgraduate medical education at the medical school in Ontario,

(ii)  is in the second or a higher year of a residency program leading to certification by the Royal College of Physicians and Surgeons of Canada, and

(iii)  will be obtaining elective education in the postgraduate training program in which the applicant is enrolled;

(b)  the Associate Dean for Postgraduate Medical Education of the medical school in Ontario,

(i)  approves, and identifies to the College, the educational program which the applicant will undertake,

(ii)  issues a certificate of appointment of the applicant as an “elective resident — exchange program”, including the start and end dates of the appointment,

(iii)  identifies to the College the member who will be directly responsible for the supervision of the applicant’s educational experience in Ontario,

(iv)  identifies to the College the member who is being exchanged with the applicant,

(v)  indicates to the College his or her satisfaction that the exchange is appropriate, having regard to the prior education of the applicant and the similarity in educational standards of the programs involved in the exchange; and

(c)  the person responsible for postgraduate medical education at the medical school with which the exchange is being made,

(i)  confirms to the College the school’s approval for the applicant to undertake postgraduate medical education at the medical school in Ontario,

(ii)  outlines to the College the educational experience that he or she expects the applicant to receive at the medical school in Ontario,

(iii)  confirms to the College the expected start and end dates of the appointment,

(iv)  confirms to the College the identity of the member who is being exchanged with the applicant, and

(v)  undertakes to the College to provide to the Ontario medical school in-training evaluation reports on the performance of the member who is being exchanged with the applicant in the form supplied by the Ontario medical school.  O. Reg. 865/93, s. 15 (2).

(3) It is a term, condition and limitation of a certificate issued to a holder exempted by this section that the certificate terminates twenty-six weeks after it is issued or at the end of the holder’s exchange program, whichever occurs first.  O. Reg. 865/93, s. 15 (3).

expiry and retirement

16. (1) A certificate of registration expires upon,

(a)  the suspension of the certificate under section 24 of the Health Professions Procedural Code;

(b)  the suspension of the certificate under subsection 2 (6) or (7); or

(c)  the resignation of the member.  O. Reg. 498/07, s. 3.

(2) Subject to subsections 3 (6) and 11 (5) and to an exemption granted by the Registration Committee under subsection 18 (3) of the Health Professions Procedural Code, if a certificate of registration expires under subsection (1), and the person who held the certificate applies for another certificate of registration, the applicant is required to meet the standards and qualifications for the certificate in effect at the time of application.  O. Reg. 865/93, s. 16 (2).

17., 18. Revoked:  O. Reg. 123/03, s. 1.

date of certificate

19. No certificate of registration shall be dated earlier than the day it was issued.  O. Reg. 865/93, s. 19.

20. Omitted (provides for coming into force of provisions of this Regulation).  O. Reg. 865/93, s. 20.