March 17, 2013

Labour mobility and equivalent registration classes

Administrative Law
Professional Regulation
Registration and Fitness

To obtain a certificate of registration through interprovincial mobility provisions, an applicant must have an equivalent licence in another jurisdiction, and be deemed fit to practice. The Ontario HPARB decided an “inactive” license in Saskatchewan was not equivalent to a certificate of licensure in Ontario in Bugwandin v College of Physicians and Surgeons of Ontario, 2012 CanLII 60641 (ON HPARB).

Background: Dr. B (the “Applicant”) obtained his medical degree in India in 1998, and interned and practiced in South Africa. In 2005, he obtained a provisional licence in Saskatchewan and began to practice family medicine. He passed several exams – the Medical Council of Canada (MCC) Evaluating Examination (May 2006), the MCC Qualifying Examination (MCCQE) Part 1 (Nov 2006), and the MCCQE Part 2 (May 2008). As of Dec 2007, he was eligible to sit the Certificate Examination in Family Medicine (CEFM) of the College of Family Physicians of Canada (CFPC).

The first application for registration: In June 2007, he applied to the College of Physicians and Surgeons of Ontario (the “College”) for a certificate authorizing independent practice. In October 2008, based on his eligibility to sit the CEFM, the college granted to him a certificate to practice medicine in Windsor, Ontario under supervision. The certificate was to expire in three years, but to automatically expire if his supervisor was no longer able or willing to supervise. But the Applicant failed his CEFM in the fall of 2008 and again in the fall of 2009. And in July 2010, his supervisor, Dr. D reported a concern about his medical practice, leading to the registrar to appoint a medical inspector, Dr. M. In November 2010, Dr. D resigned as supervisor, and the Registration Committee (“RC”) told the Applicant to stop practicing as his certificate had auto­matically expired.

The second application for registration: In May 2010, prior to Dr. D resigning, the Applicant applied to the College for an equivalent certificate of registration as an out-of-province certificate holder. He stated he held a full licence in Saskatchewan, and had not failed an assessment or examination relating to his skills or knowledge in medicine. In December 2010, the RC declined to proceed until the college in Saskatchewan confirmed the Applicant had disclosed his CEFM attempts, and confirmed his registration status.

The College later determined that the Applicant’s licensure status in Saskatchewan for 2011 was “inactive”. Additionally, the medical inspector, Dr. M, reported the Applicant’s charts and level of patient care was inadequate. The Applicant provided another doctor’s review, which identified chart errors, but found his level of care adequate.

Outcome: A panel of the Inquiries, Complaints and Reports Committee (the “IC”) reviewed the inspector’s report, but as the Applicant was not then registered, the IC cautioned him and advised the RC of its “grave” reservations about his ability to practice safely.

In June 2011, the RC decided the Applicant was not eligible for registration as he did not have an active certificate in Saskatchewan, and the College had no equivalent certificate. Additionally, section 22.18(7) of the Code permitted the College to refuse registration if it necessary to protect the public against issues of competence or character. The Applicant applied to the Health Professions Appeal and Review Board (HPARB).

The HPARB acknowledged that while interprovincial mobility provisions prevail in any conflict with a regulation under the Ontario Health Professions Act, the Applicant’s “inactive” licence in Saskatchewan was not equivalent to a certificate of licensure available in Ontario.

Even if the Applicant had an out-of-province certificate equivalent to the certificate for which he was applying, his application was subject to the RC’s discretion to refuse a certificate to protect the public interest.  HPARB confirmed the RC’s refusal, citing the supervisor’s report, the examiner’s report, the IC’s decision and the Applicant’s multiple failed exam sittings.

Bugwandin v College of Physicians and Surgeons of Ontario, 2012 CanLII 60641 (ON HPARB)