POLICY MATTERS
Are you considering changing
your scope of practice?
Make sure you are familiar with College's updated expectations
Y
ou have been practising emer-
gency medicine for three years
when you decide to make your
dream of focusing solely on
sports medicine a reality. Well, before
hanging out a new shingle, you will need to
familiarize yourself with the expectations in
the College’s recently updated policy that
addresses intentions to change scope.
If you plan on changing your scope of
practice, the College needs to be assured
that you will be able to practise safely. The
recently approved policy, entitled Ensuring
Competence: Changing Scope of Practice
and/or Re-entering Practice, states that all
physicians who wish to change their scope of
practice and/or re-enter practice must report
to the College their intent and must partici-
pate in a College review process to demon-
strate their competence in the area in which
they intend to practise.
After the review, the College will decide
whether the physician, in fact, requires
supervision and/or training. Decisions
regarding training and/or supervision will be
informed by a number of factors, including
physician’s prior experience, training already
taken, and continuing professional develop-
ment already taken.
A physician’s scope of practice is deter-
mined by a number of factors, including:
• education, training, and certification;
• the patients the physician cares for;
• the procedures performed;
• the treatments provided;
• the practice environment.
The policy defines a change of scope as oc-
curring when there is a significant change to
any of these specified factors or when physi-
cians wish to return to a scope of practice
in which they have not practised for two
consecutive years or more.
Significant changes in scope of practice
are all determined on a case-by-case basis. A
change in scope of practice has been consid-
ered by the College to be “significant” in the
following circumstances:
i. Physicians completely change their type of
practice (e.g., a surgeon wants to practise in
family medicine); or
ii. Physicians are adding something to their
practice that:
a) t hey have not done before, and
b) i s not something that is considered a
usual part of the discipline (e.g., a pe-
diatrician who wants to start working
in an emergency department caring
for adult patients); or
iii. P
hysicians begin to practise in a location
where the health-care system is sig-
nificantly different from where they had
been practising previously (e.g., an urban
setting versus a rural setting)
This policy does not apply to physicians
who intend to change their scope of practice
or intend to re-enter practice in positions
focused on teaching, research, or administra-
tion, where there is no assessment or treat-
ment of patients.
ISSUE 1, 2018 DIALOGUE
25