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Registration Practices Assessment Report — Summary


In March 2012, Ontario’s Office of the Fairness Commissioner assessed the way the College of Physicians and Surgeons of Ontario   registers people who apply for a licence to practise in Ontario, to ensure that the registration practices are fair and continue to improve.  

This summary of the assessment includes commendable practices that are under way and recommendations for improvement.

The College of Physicians and Surgeons of Ontario is subject to Ontario's fair access law, which amended the law about health professions, the Regulated Health Professions Act, 1991 (RHPA). The law spells out the college’s obligation to have transparent, objective, impartial and fair registration methods and requirements.

The Office of the Fairness Commissioner

To encourage accountability under the fair access law, the Office of the Fairness Commissioner (OFC) works with professions’ regulatory bodies to improve the way they register people who apply for professional licences. As a result of the OFC’s work, qualified people, no matter where they were originally trained, will have faster, fairer access to their licence to practise here.

In its work with regulators so far, the OFC has found that they have succeeded in streamlining their registration processes, but they need to do more. For example, regulators need to be more transparent and hold their assessment agencies more accountable for fairness.

To encourage, and hold regulators accountable for, continuous improvement, the OFC assesses their licensing practices in a two-year cycle. This cycle includes recommending improvements where needed and monitoring the bodies’ action plans that address the OFC’s concerns. This approach benefits applicants, the professions and the province.

You can read more about the OFC’s strategy for continuous improvement and its guide for assessments elsewhere on this site.

For more information about this particular assessment, contact the OFC.

Note: The words license, register and certify all refer to authorizing a person to practise a profession.


Commendable Practices

The College of Physicians and Surgeons of Ontario (CPSO) is demonstrating many commendable practices, in the following areas. (These areas correspond to the sections of the assessment guide, and are derived from the fair access legislation.)

Information for Applicants

  • The CPSO undertook a comprehensive redesign of its website in 2008. The website now has information about all aspects of the registration requirements for each category of certification. This information includes the following:
    • application packages and forms for independent practice, for Canadian and U.S. graduates; graduates from outside of Canada and the U.S.; and out-of-province licence holders in Canada
    • a description of the application review process
    • registration policies
    • information about national examining and certifying bodies

Documentation of Qualifications

  • The CPSO has a registration policy that explicitly allows graduates of medical schools in Iraq and other countries experiencing war or civil disruption to submit alternative documents instead of the usual verification documents from the source organizations.

Assessment of Qualifications

  • For the final stage of the registration process, the CPSO's assessors gather and assess all of an applicant's registration information. This registration information and the assessment are then sent for peer review for confirmation of the assessment, and then to the registration supervisor for final approval. This three-level assessment (triple check) system ensures quality and consistency in the CPSO's assessments. In addition, some files are selected randomly (by computer) for a fourth assessment.
  • The CPSO's registration department sends quarterly reports about the CPSO's adherence to its timelines to the registration committee. These reports help staff to review the CPSO's internal processes.
  • One of the recommendations in the CPSO's Entry-to-Practice Review report is a commitment to service and efficient processes. This commitment has been implemented in the form of a service pledge that reflects service standards, values and expectations. This pledge has been posted on the website in the Registration section.



The OFC recommends improvements in the following areas. (These areas correspond to the sections of the assessment guide, and are derived from the fair access legislation. Recommendations marked "Required" correspond to the practices regulators must demonstrate in order to meet the specific duties in the legislation. Recommendations marked "Good" correspond to the practices the OFC encourages a regulatory body to adopt in order to meet the general duty to provide registration practices that are transparent, objective, impartial and fair.)

Information for Applicants

  • On the home page of the CPSO website, place a short notice in French directing francophones to contact the CPSO by phone, by email or in writing to get registration information in French. [Good]
May 2012
  • Develop an overview of the licensing process in Ontario, similar to the overview developed by the Medical Council of Canada, and place it in the Registration section of the CPSO website. Alternatively, develop a flowchart similar to the one on the website of the Royal College of Physicians and Surgeons of Canada for routes to certification for specialists, and place it in the Registration section. [Good]
May 2012
  • On the CPSO website, inform applicants about the CPSO's document-retention policy. [Good]
November 2012

Internal "Review"

  • Implement the Entry-to-Practice Review report's recommendations related to the registration committee's processes. Two of these recommendations are:
  • Inform applicants and other affected individuals about unscheduled, interim committee meetings. [Good]
June 2012
  • Increase applicants' access to the committee's administrative staff, for submitting inquiries. [Good]
March 2012

Access to Records

  • On the CPSO website, provide policy information related to all aspects of applicants' access to their records. [Good]
October 2012
Blank = Implementation is in progress.
Checked = Recommendation is implemented.
Acceptable alternative = Regulator implements acceptable alternative to this recommendation.