NEWFOUNDLAND AND LABRADOR REGULATION 97/25

NLR 35/23
as amended

1. (1) Paragraph 2(1)(f) of the Medical Regulations, 2023 is repealed and the following substituted:

(f) "associate licence" means a medical licence issued to a person who is registered on the associate register under the Act and these regulations;

(2) Paragraph 2(1)(k) of the regulations is repealed and the following substituted:

(k) "clinical assistance licence" means a medical licence issued to a person who is registered on the clinical assistant register under the Act and these regulations;

(3) Paragraph 2(1)(l) of the regulations is repealed.

(4) Paragraph 2(1)(o) of the regulations is repealed.

(5) Paragraph 2(1)(q) of the regulations is repealed and the following substituted:

(q) "full licence" means a medical licence issued to a person who is registered on the medical register under the Act and these regulations;

(6) Paragraph 2(1)(x) of the regulations is repealed and the following substituted:

(x) "provisional licence" means a medical licence issued to a person who is registered on the provisional register under the Act and these regulations;

(7) Subsection 2(1) of the regulations is amended by deleting the word "and" at the end of paragraph (aa), deleting the period at the end of subparagraph (bb)(ii) and substituting a semi-colon and the word "and" and adding immediately after that subparagraph the following:

(cc) "virtual care" means the practice of medicine using any means of communication, where the medical practitioner and the medical practitioner's patient are not in the same location.

2. (1) Clause 3(1)(d)(i)(A) of the regulations is repealed and the following substituted:

(A) the person has obtained certification approved by the council,

(2) Clause 3(1)(d)(ii)(A) of the regulations is repealed and the following substituted:

(A) the person has obtained certification approved by the council,

3. The regulations are amended by adding immediately after section 13 the following:

Physician assistant registration

13.1 (1) In addition to the requirements in paragraph 19.4(a) of the Act, a person applying to be registered on the physician assistant register shall

(a) complete an application in the form approved by the council;

(b) satisfy those requirements in section 14 approved by the council as being applicable to persons applying under this section; and

(i) have completed a physician assistant training program approved by the council and either

(A) holds a certification as a physician assistant as approved by the council, or

(B) is eligible to obtain certification as a physician assistant as approved by the council, or

(ii) holds a physician assistant licence issued by a medical regulatory authority in a Canadian jurisdiction that is a party to the Canadian Free Trade Agreement and the council is satisfied that the licence held is equivalent to a physician assistant licence issued by the college to a person registered on the physician assistant register.

(2) A person registered on the physician assistant register shall only practice physician assisting in the province if the person holds a valid licence under this Act.

Physician assistant licence

13.2 A person is eligible for a physician assistant licence where the person

(a) submits an application in the form approved by the council;

(b) is registered on the physician assistant register;

(c) satisfies the requirements in section 14 approved by the council as being applicable to persons applying under this section;

(d) provides proof satisfactory to the council that, upon receipt of the physician assistant licence, the person has employment in a position where the duties have been approved by the council; and

(e) continues to satisfy one of the requirements in paragraph 13.1(1)(c).

4. Paragraph 14(1)(k) of the regulations is amended by adding immediately after the words "practice of medicine" the words "or the practice of physician assisting".

5. (1) Subsection 15(1) of the regulations is amended by adding immediately after the word "medical" the words "or physician assisting".

(2) Paragraph 15(2)(a) of the regulations is amended by adding immediately after the words "practice medicine" wherever they appear the words "or physician assisting".

6. (1) Subsection 16(1) of the regulations is repealed and the following substituted:

Scope of practice

16. (1) It is a condition of every

(a) medical licence that a medical practitioner shall only engage in the scope of practice specified in the medical practitioner's licence; and

(b) physician assistant licence that a physician assistant shall only engage in the scope of practice specified in the physician assistant's licence.

(2) Subsection 16(2) of the regulations is amended by adding immediately after the words "medical practitioner" the words "or physician assistant".

(3) Subsection 16(3) of the regulations is repealed and the following substituted:

(3) Where the council prescribes a scope of practice that restricts

(a) a medical practitioner from providing direct patient care, the council may exempt the medical practitioner from medical post-graduate education, training, certification, evaluation, examination, assessments, practice experience and continuing professional development requirements and other requirements relating to licensure; or

(b) a physician assistant from providing direct patient care, the council may exempt the physician assistant from training, certification, evaluation, examination, assessments, practice experience and continuing professional development requirements and other requirements relating to licensure.

(4) Section 16 of the regulations is amended by adding immediately after subsection (4) the following:

(5) A physician assistant's scope of practice may only be changed in accordance with these regulations and as approved by the council.

7. Section 17 of the regulations is amended by adding immediately after subsection (4) the following:

(5) In addition to any other terms, conditions or restrictions that may be attached to the licence under subsection (1), a physician assistant licence shall be subject to the following restrictions:

(a) a physician assistant shall only carry out those duties and perform those procedures that are assigned to the physician assistant by and under the supervision of a medical practitioner licensed by the college; and

(b) a physician assistant shall only carry out those duties and perform those procedures in relation to the position in which the physician assistant is employed and of which the college has approved.

8. (1) Subsection 19(1) of the regulations is repealed and the following substituted:

Licence renewal

19. (1) The council may renew a licence where the medical practitioner or physician assistant

(a) submits a completed application for renewal in the form approved by the council within 12 months of the expiry of the licence;

(b) satisfies those requirements in section 14 approved by the council as being applicable to persons applying for a renewal of a licence;

(c) provides proof satisfactory to the council that the medical practitioner or physician assistant has complied with the continuing professional development requirements; and

(d) where requested by the council, provides proof satisfactory to the council that the medical practitioner or physician assistant has complied with all terms, conditions and restrictions set out in the licence and in these regulations.

(2) Subsections 19(4) and (5) of the regulations are repealed and the following substituted:

(4) A medical practitioner or physician assistant who applies for a renewal of a licence more than 12 months after the expiry of the licence is not eligible for a renewal and is required to make an application for a licence in accordance with the Act and these regulations.

(5) At any time after the date of expiry of a licence, the registrar may notify any person, entity or organization that the registrar considers appropriate, that

(a) a medical practitioner's licence is expired and that the medical practitioner is not entitled to engage in the practice of medicine; or

(b) a physician assistant's licence is expired and that the physician assistant is not entitled to engage in the practice of physician assisting.

9. The regulations are amended by adding immediately after section 19 the following:

Exemption from requirement to be registered or licensed

19.1 (1) A person who is registered or licensed to practice medicine in another province or territory of Canada is exempt from the requirement to be registered or licensed under the Act to engage in the practice of medicine in the province where one or more of the following apply:

(a) the college is satisfied that

(i) the person's licence in the other province or territory is equivalent to a licence issued under section 4 or 5, and

(ii) the person satisfies the following criteria:

(A) the person is permitted to practise in the intended scope of practice in the province or territory where the person is registered or licensed,

(B) the person carries professional liability insurance which meets the requirements of the college for the person's intended practice of medicine in the province,

(I) limits the person's practice of medicine in the province to virtual care for a maximum of 90 days in a calendar year, and

(II) is not located in the province when providing the virtual care, and

(D) the person has no outstanding disciplinary matters; or

(b) the person

(i) is providing medical care as a member of the Canadian Armed Forces, an employee of the Department of National Defence, or as a person providing medical services under a contract or subcontract with the Canadian Armed Forces,

(ii) limits the person's practice of medicine to the person's responsibilities as a member of the Canadian Armed Forces, an employee of the Department of National Defence, or the duties outlined in the person's contract or sub-contract with the Canadian Armed Forces, and

(ii) satisfies the criteria in clauses (a)(ii)(A) and (B).

(2) A person who is registered or licensed to practice medicine in another jurisdiction is exempt from the requirement to be registered or licensed under the Act to engage in the practice of medicine in the province where one or more of the following apply:

(a) the person is providing medical care to a patient during the transport to a facility operated by the provincial health authority;

(b) the person is

(i) providing or participating in continuing professional development sponsored by the Provincial Health Authority that does not involve direct patient care, and

(ii) satisfies the criteria in clauses (1)(a)(ii)(A) and (B);

(c) the person is providing medical education or training sponsored by, and at the request of, the Faculty of Medicine that does not involve direct patient care; or

(d) the person is providing testimony in a civil, criminal or regulatory matter.

(3) A person who is registered or licensed to practice physician assisting in another province or territory of Canada is exempt from the requirement to be registered or licensed under the Act to engage in the practice of physician assisting in the province where the person

(a) is providing care as a member of the Canadian Armed Forces, an employee of the Department of National Defence or as a person providing physician assisting services under a contract or subcontract with the Canadian Armed Forces,

(b) limits the person's practice of physician assisting to the person's responsibilities as a member of the Canadian Armed Forces, an employee of the Department of National Defence or the duties outlined in the person's contract or sub-contract with the Canadian Armed Forces, and

(i) the person is permitted to practise in the intended scope of practice in the province or territory where the person is registered or licensed, and

(ii) the person carries professional liability insurance which meets the requirements of the college for the person's intended practice of physician assisting in the province.

(4) A person who is registered or licensed to practice physician assisting in another jurisdiction is exempt from the requirement to be registered or licensed under the Act to engage in the practice of physician assisting in the province where the person is providing care to a patient during the transport to a facility operated by the provincial health authority.

10. Section 20 of the regulations is repealed and the following substituted:

Undergraduate learners

20. A person applying to be registered on the education register under paragraph 20(1)(a) of the Act for the purpose of engaging in undergraduate education and training at the Faculty of Medicine of Memorial University shall

(a) submit a completed application in the form satisfactory to the council;

(b) provide written confirmation that the person is either enrolled

(i) in an undergraduate program at the Faculty of Medicine of Memorial University, or

(ii) in the visiting elective placement program at the Faculty of Medicine of Memorial University;

(i) a recommendation that the person be registered on the education register as an undergraduate learner, and

(ii) the start date and the anticipated end date for the registration; and

(d) satisfy those requirements in section 14 approved by the council as being applicable to persons applying under this section.

11. Subsection 21(1) of the regulations is repealed and the following substituted:

Post-graduate learners

21. (1) A person applying to be registered on the education register under paragraph 20(1)(b) of the Act for the purpose of engaging in a post-graduate training program at the Faculty of Medicine of Memorial University shall

(a) submit a completed application in the form satisfactory to the council;

(b) provide written documentation from the Dean of Medicine containing the following:

(i) confirmation that the person has been accepted into a post-graduate training program at the Faculty of Medicine of Memorial University,

(ii) a recommendation that the person be registered on the education register as a post-graduate learner, and

(iii) the start date and the anticipated end date for the registration;

(i) the Faculty of Medicine of Memorial University or of a faculty of medicine accredited by the Committee for Accreditation of Canadian Medical Schools or the Liaison Committee on Medical Education of the American Medical Association, or

(ii) an approved faculty of medicine other than one referred to in subparagraph (i) or an approved faculty of osteopathic medicine and the person

(A) has obtained a score satisfactory to the council in any examination required and approved by the council, or

(B) held immediately preceding the person's application for registration a provisional licence from the college;

(d) be sponsored by the Faculty of Medicine of Memorial University;

(e) satisfy those requirements in section 14 approved by the council as being applicable to persons applying under this section; and

(f) satisfy those other requirements that may be approved by the council.

12. Paragraph 22(a) of the regulations is amended by deleting the words "education registrant" and substituting the word "learner".

13. Subparagraph 23(1)(c)(ii) of the regulations is amended by deleting the word "student" and substituting the word "learner".

14. Section 25 of the regulations is repealed and the following substituted:

Restrictions on learners

25. A learner shall only

(a) carry out those duties and perform those procedures that are assigned to the learner by and under the supervision of a medical practitioner licensed by the college and only in relation to the training or assessment program in which the learner is enrolled and of which the college has been notified; and

(b) be entered on the education register for the duration of the learner's enrolment in the undergraduate training program, post-graduate training program, clinical training program or other training or assessment program of which the college has been notified under the applicable section.

15. (1) Subsection 26(1) of the regulations is amended by

(a) deleting the words "an education registrant" and substituting the words "a learner"; and

(b) deleting the words "the education registrant" and substituting the words "the learner".

(2) Subsection 26(2) of the regulations is amended by

(a) deleting the words "education registrant" wherever they appear and substituting the word "learner"; and

(b) deleting the words "education registrant's" and substituting the word "learner's".

(3) Subsection 26(5) of the regulations is amended by

(a) deleting the words "an education registrant's" and substituting the word "a learner's"; and

(b) deleting the words "education registrant" and substituting the word "learner".

16. Section 27 of the regulations is amended by

(a) deleting the words "an education registrant" and substituting the words "a learner";

(b) deleting the words "the education registrant" wherever they appear and substituting the word "the learner"; and

17. Subsection 28(1) of the regulations is amended by

(a) deleting the words "an education registrant" and substituting the words "a learner";

(b) deleting the words "the education registrant" wherever they appear and substituting the words "the learner"; and

18. Section 29 of the regulations is amended by deleting the words "education registrant" and substituting the word "learner".

19. Paragraph 30(1)(a) of the regulations is repealed and the following substituted:

(a) is registered on the medical register, provisional register, associate register, clinical assistant register or physician assistant register;

20. (1) Subsection 31(1) of the regulations is amended by adding immediately after the words "medical practitioner" the words "or physician assistant".

(2) Subsection 31(2) of the regulations is amended by adding immediately after the words "medical practitioner" the words "or physician assistant".

(3) Subsection 31(3) of the regulations is amended by adding immediately after the words "medical practitioner" the words "or physician assistant".

(4) Subsection 31(5) of the regulations is repealed and the following substituted:

(5) The council may revoke

(a) a medical practitioner's licence where the medical practitioner fails to comply with a program of continuing professional development required by the council; or

(b) a physician assistant's licence where the physician assistant fails to comply with a program of continuing professional development required by the council.

21. (1) Subsection 32(1) of the regulations is amended by adding immediately after the words "medical practitioner" wherever they appear the words "or physician assistant".

(2) Subsection 32(2) of the regulations is amended by adding immediately after the words "medical practitioner" the words "or physician assistant".

22. (1) Subsection 44(1) of the regulations is amended by

(a) deleting the words "medical practitioner" wherever they appear and substituting the words "medical practitioner, physician assistant or learner"; and

(b) deleting the words "medical practitioner's attorney for service" and substituting the words "attorney for service by the medical practitioner, physician assistant or learner".

(2) Subsection 44(2) of the regulations is amended by

(a) deleting the words "medical practitioner" wherever they appear and substituting the words "medical practitioner, physician assistant or learner"; and

(b) deleting the words "medical practitioner's attorney for service" and substituting the words "attorney for service by the medical practitioner, physician assistant or learner".

(3) Subsection 44(3) of the regulations is amended by deleting the words "medical practitioner" and substituting the words "medical practitioner, physician assistant or learner".

Commencement

23. These regulations come into force the day an Act to Amend the Medical Act, 2011, No.2, SNL2024 c.22 comes into force.