Continuing Competence

PREAMBLE
The Health Professions Act (HPA) requires CPSA to establish a Continuing Competence Program requiring participation from regulated members to maintain their competence and enhance the provision of professional services¹ throughout their careers. The HPA authorizes CPSA’s Competence Committee to conduct practice visits, examinations, interviews or other competence assessments of regulated members².

The Competence Committee governs and provides direction for CPSA’s Continuing Competence Program. The Continuing Competence Program has two objectives: to establish a program requiring participation from all regulated members, to maintain their competence and enhance the provision of professional services throughout their careers (e.g., quality improvement), and to identify members whose competence may require further assessment and support (e.g., practice changes, quality assurance, education and remediation). The Continuing Competence standard of practice addresses the requirement for regulated members to participate in CPSA’s Continuing Competence Programs.

The Continuing Competence Program is comprised of three components:

• Continuing Professional Development
• General Assessment
• Competence Assessment

Information related to participation in a Continuing Competence Program is confidential under part 3 of the HPA, unless the Competence Committee feels a referral to the Complaints Director is necessary based on information obtained through the Continuing Competence Program that:

• the regulated member has intentionally provided false or misleading information;
• the regulated member displays a lack of competence that has not been remedied by participating in a Continuing Competence Program;
• the regulated member may be incapacitated; or
• the conduct of the regulated member constitutes unprofessional conduct that cannot be readily remedied by means of a Continuing Competence Program³.

Failure or refusal to comply with Continuing Competence Program requirements is considered unprofessional conduct and may result in sanctions.

CONTINUING COMPETENCE PROGRAM

Continuing Professional Development (CPD)

Regulated members are required to continue acquiring knowledge and skills throughout their careers. Details on how to fulfill the requirements below can be found in the Continuing Competence Program Manual.

1. A regulated member on a general register, provisional register, telemedicine register or limited practice register with an active practice permit must undertake CPD by participating in and complying with the requirements of one of⁴:
   1. the Maintenance of Proficiency (Mainpro+) of the College of Family Physicians of Canada; or
   2. the Maintenance of Certification (MoC) of the Royal College of Physicians & Surgeons of Canada.
2. A regulated member must keep records, in a form satisfactory to the Registrar, of any activities undertaken for the purpose of CPD for a period of six (6) years⁵.
3. A regulated member must, on the request of and in accordance with the directions of the Registrar, provide copies of the records referred to in clause (2).
4. A regulated member must submit a copy of the certification of completion of an applicable CPD program to CPSA upon request.
5. A regulated member’s failure or refusal to comply with clauses (2)-(4) is considered unprofessional conduct and may result in sanctions.

General Assessment

General Assessment includes, but is not limited to, CPSA’s Physician Practice Improvement Program (PPIP) and Physician Prescribing Practices (PPP) program.

Physician Practice Improvement Program (PPIP)⁶

6. A regulated member on a general register must participate in PPIP over a continuous five-year cycle, in accordance with requirements outlined in the Continuing Competence Program Manual⁷.
7. A regulated member on a provisional, limited, telemedicine or physician assistant register may be required to participate in PPIP over a continuous five-year cycle, in accordance with requirements outlined in the Continuing Competence Program Manual⁸.
8. Notwithstanding clauses (6) and (7), a regulated member required to participate in PPIP may, if extenuating circumstances exist, submit a request in writing to the Registrar and Continuing Competence Committee to vary the period in which the physician practice improvement activity must be completed.
9. In accordance with the Continuing Competence Program Manual, a regulated member required to participate in PPIP must complete each of the following separate activities at least once over a five-year continuous cycle:
   1. a practice-driven quality improvement activity;
   2. a CPSA Standards of Practice quality improvement activity; and
   3. a personal development activity.
10. A regulated member must retain all documentation related to PPIP activities for a period of six (6) years.

11. Upon request, a regulated member must provide documentation of PPIP activities to CPSA.
12. A regulated member’s failure or refusal to comply with clauses (10) and (11) is considered unprofessional conduct and may result in sanctions.

Physician Prescribing Practices (PPP)⁶

The PPP program establishes parameters to identify at-risk prescribing and monitors the prescribing of certain medications by regulated members.

13. A regulated member may be required to participate in an educational intervention in accordance with the Continuing Competence Program Manual.

Competence Assessment
Competence assessments include, but are not limited to, Individual Practice Review (IPR), Physician Assessment and Feedback (PAF) and the Health & Practice Conditions Monitoring (HPCM). Details on how to fulfill the requirements below can be found in the Continuing Competence Program Manual.

14. When directed, a regulated member must participate in a competence assessment (e.g., IPR, PAF, PHMP) in accordance with the requirements outlined in the Continuing Competence Program Manual, for the purpose of evaluating the regulated member’s competence:
    1. competence assessments may require evaluations, including:
       1. practice visits;
       2. examinations;
       3. an individualized assessment of professional competence, which may include (but is not limited to) assessments of:
          1. professional knowledge or skills;
          2. communication skills;
          3. mental and physical health; professional ethics; or
          4. practice management;
       4. interviews; or
       5. any other type of evaluation as required by the Competence Committee.

 Actions to be taken

15. If the results of a general assessment or competence assessment are unsatisfactory, a regulated member must undertake any remedial action directed by the Competence Committee or Registrar, including, but not limited to:
    1. successful completion of Continuing Competence Program requirements or professional development activities;
    2. successful completion of any examinations, testing, assessment, training, education or treatment to enhance competence in specified areas;
    3. practising^G under the supervision of another regulated member;
    4. practice restrictions or limitations;
    5. participation in HPCM;
    6. reporting on specified matters on specified dates, to the Competence Committee or Registrar;
    7. correction of any problems identified in the practice visit; or
    8. demonstration of competence gained in a specific area.

Regulated members’ responsibility for costs

16. A regulated member must pay the costs as directed by CPSA of:
    1. a competence assessment; and
    2. any action that the regulated member must undertake in response to a direction by the Competence Committee or Registrar under clause (14).

GLOSSARY

Practising: the action of providing medical care—what a regulated member does (verb); “practice” refers to a regulated member’s business (noun). For example, a doctor with a private practice practises privately.

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1 Per Section 50(1) of the HPA.

2 Per Section 50(2) of the HPA.

3 In accordance with Section 51.1(1) of the HPA.

4 Refers to regulated members registered on both physicians, surgeons, osteopaths and physician assistants registers, where these exist.

5 In accordance with CFPC’s Mainpro+ User’s Manual (2019).

6 While titled “Physician Practice Improvement Program” and “Physician Prescribing Practices Program,” these assessments would apply to physician assistants when identified.

7 Refers to regulated members registered on both physicians, surgeons, osteopaths and physician assistants registers, where these exist.

8 Refers to regulated members registered on both physicians, surgeons, osteopaths and physician assistants
registers, where these exist.