NEWFOUNDLAND AND LABRADOR REGULATION 35/23

Short title

1. These regulations may be cited as the Medical Regulations, 2023.

Interpretation

2. (1) In these regulations

(a) "Act" means the Medical Act, 2011;

(b) "approved by the council" includes set out in by-law or policy or approved by motion passed by the council, and includes as approved by a committee appointed by the council pursuant to section 14 of the Act;

(c) "approved degree" means a medical degree from an approved faculty of medicine or a Doctor of Osteopathic Medicine degree from an approved faculty of osteopathic medicine;

(d) "approved faculty of medicine" means a medical faculty or school approved by the council;

(e) "approved faculty of osteopathic medicine" means a faculty or school granting a Doctor of Osteopathic Medicine degree approved by the council;

(f) "associate licence" means a licence to practise medicine issued to a person under section 24 of the Act where the person is registered on the associate register under the Act and these regulations;

(g) "Canadian Free Trade Agreement" means the Canadian Free Trade Agreement, signed in 2017 by the governments of Canada, the provinces and the territories and includes amendments to the agreement;

(h) "certificate of professional conduct" means a certificate or analogous document issued by a medical regulatory authority that includes information about the person's

(i) registration and licensing history, including any conditions or restrictions affecting the person's practice,

(ii) any outstanding allegations or previous findings of incapacity or disciplinary matters, and

(iii) other matters determined by the medical regulatory authority issuing the certificate;

(i) "CFPC" means the College of Family Physicians of Canada;

(j) "clinical assessment" means an evaluation of a person’s clinical knowledge, competencies and skills approved by the council;

(k) "clinical assistant licence" means a licence to practise medicine issued to a person under section 24 of the Act where the person is registered on the clinical assistant register under the Act and these regulations;

(l) "CMQ" means the College des medecins du Quebec;

(m) "corporate licence" means a licence issued to a professional medical corporation under section 33 of the Act;

(n) "Dean of Medicine" means the Dean of Medicine of Memorial University or any delegate of the Dean of Medicine of Memorial University;

(o) "education registrant" means a person registered on the education register;

(p) "former regulations" means the Medical Regulations, Newfoundland and Labrador Regulations 38/15;

(q) "full licence" means a licence to practise medicine issued to a person under section 24 of the Act where the person is registered on the medical register under the Act and these regulations;

(r) "good standing with the college" means a person

(i) is in compliance with the Act, regulations and by-laws of the college,

(ii) is in compliance with the scope of practice and any terms, conditions or restrictions attached to the person's licence,

(iii) has paid all fees, costs, fines and other monies owed to the college,

(iv) is not subject to an outstanding suspension or surrender of licence, and

(v) where applicable, is in compliance with

(A) a direction, caution or counsel of the complaints authorization committee,

(B) an order of an adjudication tribunal or of the quality assurance committee, or

(s) "medical practitioner providing oversight" means a medical practitioner approved by the council who

(i) monitors another medical practitioner's clinical practice at set intervals, and

(ii) reports to the council on the standard of practice and professionalism of that medical practitioner;

(t) "Memorial University" means the Memorial University of Newfoundland established under the Memorial University Act;

(u) "MINC" means the Medical Identification Number for Canada;

(v) "pre-licensure assessment" means an evaluation of a person's knowledge, competencies and skills approved by the council as a pre-condition to the issuance of a licence;

(w) "provincial health authority" means the Provincial Health Authority established under the Provincial Health Authority Act;

(x) "provisional licence" means a licence to practise medicine issued to a person under section 24 of the Act where the person is registered on the provisional register under the Act and these regulations;

(y) "RCPSC" means the Royal College of Physicians and Surgeons of Canada;

(z) "required by the council" includes required by a committee appointed by the council under section 14 of the Act;

(aa) "satisfactory to the council" includes satisfactory to a committee appointed by the council under section 14 of the Act; and

(bb) "sponsor" means

(i) the Faculty of Medicine of Memorial University, or

(ii) the provincial health authority.

(2) Where the functions of an organization referred to in these regulations have been assumed, in whole or in part, by another organization recognized and approved by the council, or the name of the organization has changed, the reference to the original organization or name in these regulations shall be considered to be a reference to the successor organization or name from the effective date of the recognition and approval by the council.

(3) Where an examination or evaluation tool referred to in these regulations has been succeeded, replaced or supplemented by another examination or evaluation tool recognized and approved by the council, the reference to the original examination or evaluation tool in these regulations shall be considered to be a reference to the successor examination or evaluation tool from the effective date of recognition and approval by the council.

(4) Where these regulations refer to education, training or experience or to a course, assessment, program, examination or other requirement to be undertaken, completed, satisfied or obtained by a person, the education, training, experience, course, assessment, program, examination or other requirement shall be undertaken, completed, satisfied and obtained in a manner approved by and satisfactory to the council and the score or other standard of achievement in that education, training, experience, course, assessment, program, examination or other requirement shall be satisfactory to the council.

PART I
REGISTRATION AND LICENSING

Medical registration

3. (1) In addition to the requirements in paragraphs 18(a) and (b) of the Act, a person applying to be registered on the medical register shall

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

(b) provide proof satisfactory to the council that the person has obtained a score satisfactory to the council in any examination required and approved by the council;

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

(d) either

(i) satisfy one of the following requirements:

(A) the person has obtained certification in family medicine from the CFPC or the CMQ,

(B) the person

(I) has completed a post-graduate training pro-gram approved by the council and holds certification satisfactory to the council,

(II) is registered on the provisional register and held a provisional licence for a family medicine practice issued under these regulations for a continuous period of at least 3 years,

(III) was subject to monitoring by a medical practitioner providing oversight for the time period referred to in subclause (II), and

(IV) has the requisite knowledge, skills, and competencies to obtain a full licence for a family medicine practice to the satisfaction of the council based on reports of the medical practitioner providing oversight, a clinical assessment, where a clinical assessment is required by the council, and any other information that the council considers applicable,

(C) the person held a full licence for a primary care practice under the former regulations within 5 years before the coming into force of these regulations, or

(D) the person holds a 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 full licence for a family medicine practice issued by the college to a person registered on the medical register, or

(ii) satisfy one of the following requirements:

(A) the person has obtained certification in a primary specialty from the RCPSC,

(B) the person

(I) has completed a post-graduate training pro-gram approved by the council and holds certification satisfactory to the council,

(II) is registered on the provisional register and held a provisional licence for a specialty practice issued under these regulations for a continuous period of at least 3 years,

(III) was subject to monitoring by a medical practitioner providing oversight for the time period referred to in subclause (II), and

(IV) has the requisite knowledge, skills, and competencies to obtain a full licence for a specialty practice to the satisfaction of the council based on reports of the medical practitioner providing oversight, a clinical assessment, where a clinical assessment is required by the council, and any other information that the council considers applicable,

(C) the person held a full licence for a specialty practice under the former regulations within 5 years before the coming into force of these regulations, or

(D) the person holds a 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 full licence for a specialty practice issued by the college to a person registered on the medical register.

(2) A person registered on the medical register shall only practice medicine in the province if the person holds a valid licence under the Act.

Full licence – family medicine practice

4. A person is eligible for a full licence for a family medicine practice where the person

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

(b) is registered on the medical register;

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

(d) continues to satisfy one of the requirements in subparagraph 3(1)(d)(i).

Full licence – specialty practice

5. A person is eligible for a full licence for a specialty practice where the person

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

(b) is registered on the medical register;

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

(d) continues to satisfy one of the requirements in subparagraph 3(1)(d)(ii).

Provisional registration

6. (1) In addition to the requirements in paragraphs 19.1(1)(a) and (b) of the Act, a person applying to be registered on the provisional register shall

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

(b) provide proof satisfactory to the council that the person has obtained a score satisfactory to the council in any examination required and approved by the council;

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

(d) either

(i) satisfy one of the following requirements:

(A) the person is eligible to obtain certification in family medicine from the CFPC,

(B) the person has completed a post-graduate training program approved by the council and holds certification satisfactory to the council,

(I) has completed a post-graduate training program approved by the council that is discipline appropriate to family medicine and that is a minimum of 2 years in duration or another minimum duration as may be approved by the council, and

(II) is registered or recognized as a general practitioner or family physician in another jurisdiction, satisfactory to the council, or

(D) the person held a provisional licence for a primary care practice within 5 years before the coming into force of these regulations, or

(ii) satisfy one of the following requirements:

(A) the person is eligible to obtain certification in a primary specialty from the RCPSC,

(B) the person has completed a post-graduate training program approved by the council and holds certification satisfactory to the council, or

(C) the person held a provisional licence for a specialty practice within 5 years before the coming into force of these regulations.

(2) A person registered on the provisional register shall only practice medicine in the province if the person holds a valid licence under the Act.

Provisional licence – family medicine practice

7. A person is eligible for a provisional licence for a family medicine practice where the person

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

(b) is registered on the provisional register;

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

(d) continues to satisfy one of the requirements in subparagraph 6(1)(d)(i); and

(e) has a sponsor approved by the council.

Provisional licence – specialty practice

8. A person is eligible for a provisional licence for a specialty practice where the person

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

(b) is registered on the provisional register;

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

(d) continues to satisfy one of the requirements in subparagraph 6(1)(d)(ii); and

(e) has a sponsor approved by the council.

Associate registration

9. (1) In addition to the requirements in paragraphs 19.2(a) and (b) of the Act, a person applying to be registered on the associate register shall

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

(b) provide proof satisfactory to the council that the person has obtained a score satisfactory to the council in any examination required and approved by the council;

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

(d) where required by the council, complete a clinical assessment;

(e) where a deficiency is identified in the clinical assessment, complete any training course or program approved by the council; and

(f) have a sponsor approved by the council.

(2) A person registered on the associate register shall only practice medicine in the province if the person holds a valid licence under the Act.

Associate licence

10. (1) A person is eligible for an associate licence where the person

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

(b) is registered on the associate register; and

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

(2) Notwithstanding subsection (1), where a person who is applying for an associate licence previously held an associate licence that has expired or been revoked, the person shall, in addition to the requirements in subsection (1),

(a) complete a clinical assessment where required by the council;

(b) where a deficiency is identified in the clinical assessment, complete any training course or program approved by the council; and

Clinical assistant registration

11. (1) In addition to the requirements in paragraphs 19.3(a) and (b) of the Act, a person applying to be registered on the clinical assistant register shall

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

(b) provide proof satisfactory to the council that the person has obtained a score satisfactory to the council in any examination required and approved by the council;

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

(d) where required by the council, complete a clinical assessment;

(e) where a deficiency is identified in the clinical assessment, complete any training course or program approved by the council;

(f) have a sponsor approved by the council; and

(g) provide proof satisfactory to the council that, upon registration on the clinical assistant register and receipt of a clinical assistant licence, the person has employment in a position where the duties have been approved by the council.

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

Clinical assistant licence

12. (1) A person is eligible for a clinical assistant licence where the person

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

(b) is registered on the clinical assistant register; and

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

(2) Notwithstanding subsection (1), where a person who is applying for a clinical assistant licence previously held a clinical assistant licence that has expired or been revoked, the person shall, in addition to the requirements in subsection (1),

(a) complete a clinical assessment where required by the council;

(b) where a deficiency is identified in the clinical assessment, complete any training course or program approved by the council;

(d) provide proof satisfactory to the council that, upon receipt of a clinical assistant licence, the person has employment in a position where the duties have been approved by the council.

Clinical assessment

13. (1) Notwithstanding section 6, the council may register a person on the provisional register who does not satisfy one or both of the requirements in paragraphs 6(1)(b) or (d) where

(a) the person has satisfied the other requirements in section 6;

(b) the council is of the opinion that the failure to satisfy one or both of the requirements in paragraphs 6(1)(b) or (d) may be addressed by a clinical assessment and, where necessary, completion of a training course or program;

(d) either

(i) the council is of the opinion that the person's performance in the clinical assessment demonstrates that the person has the knowledge, skills and competence to practise, or

(ii) the council is of the opinion that the person's performance in the clinical assessment demonstrated a deficiency in clinical competence which has been remediated by the completion of a training course or program approved by the council.

(2) Notwithstanding paragraph 7(d), a person registered on the provisional register in accordance with subsection (1) who is applying for a provisional licence for a family medicine practice is not required to satisfy the requirement in paragraph 7(d).

(3) Notwithstanding paragraph 8(d), a person registered on the provisional register in accordance with subsection (1) who is applying for a provisional licence for a specialty practice is not required to satisfy the requirement in paragraph 8(d).

Application requirements

14. (1) In addition to the other requirements in the Act and these regulations, the council may require one or more of the following to be included with an application for registration or licensure:

(a) payment of the fees approved by the council;

(b) identification documents, including photo identification, satisfactory to the council;

(c) proof satisfactory to the council of the person's reasonable fluency in the English language, which may include a requirement to complete an examination, approved by the council, to test fluency in the English language;

(d) proof satisfactory to the council that the person has not had a significant interruption in practice as determined by the council;

(e) proof satisfactory to the council that the person is in good standing with the college;

(f) certificates of professional conduct from one or more of the medical regulatory authorities with which the person has been or is currently registered or licensed, certifying that the person is in good standing with the medical regulatory authority equivalent to good standing with the college;

(g) letters of reference from one or more persons who the registrar, a committee or an employee of the college appointed by the council, is satisfied are sufficiently familiar with the person's professional practice and conduct;

(h) proof satisfactory to the council of the person's good character, fitness to practise and competency to practise;

(i) the person's MINC;

(j) proof satisfactory to the council that the person has completed an examination or a pre-licensure assessment appropriate for entry into practice or medical training, as required and approved by the council; and

(k) proof satisfactory to the council that the person has completed the courses on the laws, regulations, by-laws, standards, policies, guidelines and code of ethics applicable to the practice of medicine in the province as approved by the council as a requirement for registration or licensure.

(2) In addition to the requirements in subsection (1), the Act and these regulations, an application for licensure shall include proof satisfactory to the council that the person has sufficient liability protection or insurance coverage.

(3) All documents submitted to the college shall be

(a) legible and in English or translated into English by a person satisfactory to the council; and

(b) where required by the council, verified by a third party agency approved by the council.

(4) A person shall respond to any questions forming part of the application with completeness and candour and consent to any follow-up enquiries of the registrar, a committee or an employee of the college appointed by the council to confirm or obtain further information regarding the questionnaire responses.

(5) The college is not liable for a person's costs for complying with the requirements of registration or licensure under the Act or these regulations.

(6) In addition to the requirements for registration and licensure in the Act and these regulations, a person may be required to attend a personal interview with the registrar, a committee or an employee of the college appointed by the council.

(7) The college's fees for applications shall reflect the costs of the college to review the application and where the costs of the college materially increase due to the person providing incorrect or incomplete information, the council may require the person to pay an additional fee as a condition of a further review of the application.

Emergency licence

15. (1) Where the registrar or the council determines that there is an immediate need for medical services due to an actual or potential threat to public safety, health or welfare or where the minister or the federal Minister of Health makes a request, the registrar may issue an emergency licence.

(2) A person may be issued an emergency licence where the person

(a) provides proof satisfactory to the registrar or the council that the person

(i) is licensed to practise medicine in another jurisdiction in Canada or in another jurisdiction outside Canada satisfactory to the registrar or the council, or

(ii) was previously licensed to practise medicine in the province;

(b) provides proof satisfactory to the registrar or the council that the person's licence has not been revoked, suspended or restricted by reasons of disciplinary or other regulatory measures;

(d) satisfies the other requirements of a licence as the registrar or the council may determine are necessary and practicable in the circumstances.

(3) The registrar or the council may accept the declaration of a person as proof that the person satisfies one or more of the requirements in subsection (2).

(4) A licence issued under subsection (2) shall not be issued for a period exceeding 12 months.

(5) The registrar or the council may terminate a licence issued under subsection (2) at any time.

Scope of practice

16. (1) It is a condition of every licence that a medical practitioner shall only engage in the scope of practice specified in the medical practitioner's licence.

(2) The council may prescribe a scope of practice that restricts a medical practitioner from providing direct patient care.

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

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

Conditions and restrictions on a licence

17. (1) The council may attach terms, conditions or restrictions to a licence upon issuance or renewal of the licence.

(2) The council may consider the following factors in determining the terms, conditions or restrictions to attach to a licence:

(a) terms, conditions or restrictions attached to a registration or licence issued to the person by another medical regulatory authority;

(b) an illness or condition of the person which may affect the person's fitness to practice;

(d) other matters approved by the council.

(3) In addition to any other terms, conditions or restrictions that may be attached to the licence under subsection (1), an associate licence shall be subject to the condition that the medical practitioner be monitored by a medical practitioner providing oversight.

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

(a) the condition that the medical practitioner shall carry out the medical practitioner's duties under the supervision of a medical practitioner licensed by the college; and

(b) the restriction that the medical practitioner shall not have overall responsibility for directing and coordinating the care and management of a patient at a specific point in time.

Sponsor's undertaking

18. (1) Upon the issuance or renewal of a provisional licence, an associate licence or a clinical assistant licence, the council may require the undertaking of the sponsor to provide one or more of the following:

(a) orientation of the sponsored person into the practice environment and practice expectation, both before and after entry or re-entry into practice under the sponsor;

(b) supervision of the sponsored person during the period of licensure;

(d) assessment of the clinical competence of the sponsored person, both before and after entry or re-entry into practice under the sponsor;

(e) other supports as required and approved by the council; and

(f) reports to the college, periodically and at the request of the council, in relation to matters set out in paragraphs (a) to (e).

(2) A sponsored person shall cooperate and comply with the sponsor's undertakings in subsection (1).

(3) Where a sponsored person or a sponsor does not or is not able to comply with the undertakings in subsection (1) in a manner satisfactory to the council, the council may

(a) require the temporary withdrawal of the sponsored person from practice or restrict the sponsored person's practice until the sponsored person or the sponsor complies with the undertakings in a manner satisfactory to the council; or

(b) suspend or revoke the sponsored person's licence.

(4) Where a sponsor terminates its sponsorship after a provisional licence, associate licence or clinical assistant licence has been issued to a sponsored person, the provisional licence, associate licence or clinical assistant licence shall be revoked.

(5) The college is not liable for any costs relating to compliance with the undertakings referred to in subsection (1).

(6) The college is not responsible for providing the orientation, supervision, mentoring, assessment of clinical competence or supports required by the undertakings referred to in subsection (1).

(7) The college's fees for a licence and a renewal of a licence shall reflect the costs of the college of ensuring compliance with the undertakings referred to in subsection (1).

Licence renewal

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

(a) submits a completed application for renewal in the form approved by the council within 12 months of the expiry of the medical practitioner's 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 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 has complied with all terms, conditions and restrictions set out in the licence and in these regulations.

(2) Upon renewal of a licence, the council may attach or amend the terms, conditions or restrictions and the scope of practice of a licence.

(3) Upon renewal of a provisional licence, associate licence or clinical assistant licence, the council may amend the requirements of the undertakings and require the undertaking of the sponsor and the sponsored person that they will comply with the amended requirements.

(4) A medical practitioner who applies for a renewal of the medical practitioner's 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 medical practitioner's licence is expired and that the medical practitioner is not entitled to engage in the practice of medicine.

PART II
EDUCATION REGISTER

Undergraduate students

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) as an undergraduate student at the Faculty of Medicine of Memorial University, or

(ii) in the visiting student 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 student, 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.

Post-graduate students

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 student, and

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

(i) is a graduate of 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) is a graduate of 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.

(2) A person registered on the educational register in accordance with subsection (1) shall only practice medicine in the province if the person holds a valid licence under the Act.

Dean of Medicine to notify college

22. The Dean of Medicine shall notify the college when a person who is registered on the education register in accordance with section 20 or 21

(a) completes the education or training program in which the education registrant was enrolled; or

(b) ceases to be enrolled in the education or training program.

Visiting post-graduate elective placement

23. (1) A person applying to be registered on the education register under paragraph 20(1)(b) of the Act for the purpose of a visiting post-graduate elective placement 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 a copy or other proof satisfactory to the council of an approved degree;

(i) confirmation that the person has been accepted for a visiting post-graduate elective placement in 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 student, and

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

(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.

(2) A person registered on the educational register in accordance with subsection (1) shall only practice medicine in the province if the person holds a valid licence under the Act.

Assessment or training program

24. A person may be registered on the education register under paragraph 20(1)(c) of the Act for the purposes of participating in an assessment or training program at the Faculty of Medicine of Memorial University or affiliated with that faculty where

(a) the registrar has determined that the person is eligible to participate in the applicable assessment or training program, in accordance with policy approved by the council;

(b) the person has been accepted into the applicable assessment or training program;

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

(d) the person satisfies those other requirements that may be approved by the council.

Restrictions on education registrants

25. An education registrant shall only

(a) carry out those duties and perform those procedures that are assigned to the education registrant 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 education registrant is enrolled and of which the college has been notified; and

(b) be entered on the education register for the duration of the education registrant'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.

Post-graduate training program licence

26. (1) The council may issue a post-graduate training program licence to an education registrant registered under section 21 or 23 where the education registrant

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

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

(2) A licence issued under subsection (1) is restricted to clinical training and the practice of medicine

(a) for which the education registrant has the competence and experience to perform;

(b) that is permitted by the education registrant's post-graduate training program; and

(c) while the education registrant is under the supervision of a supervisor approved by the Faculty of Medicine of Memorial University.

(3) A licence issued under this section does not authorize the holder to issue or sign prescriptions, certificates, statements or other documents which the Act or another Act authorizes a medical practitioner to issue or sign unless the holder has received approval from the Faculty of Medicine of Memorial University to perform these activities as part of their post-graduate training program.

(4) A licence issued under this section expires on the date set out in the licence unless it is revoked on an earlier date in accordance with subsection (5).

(5) The council shall revoke an education registrant's licence where the education registrant

(a) is no longer enrolled in the post-graduate training program; or

(b) is suspended from the post-graduate training program.

Post-graduate on-call duties licence

27. (1) The council may issue a post-graduate on-call duties licence to an education registrant where

(a) the education registrant submits a completed application in the form satisfactory to the council;

(b) the education registrant is enrolled in a post-graduate training program in family medicine or in another speciality of medicine at the Faculty of Medicine of Memorial University;

(c) the Dean of Medicine submitted a written request that the education registrant be issued a post-graduate on-call duties licence and confirming that the education registrant

(i) is in good standing in the education registrant's post-graduate training program,

(ii) satisfactorily completed a period of post-graduate training satisfactory to the council, including satisfactory completion of the rotation in respect of which the education registrant intends to perform the specified on-call duties, and

(iii) has the knowledge, skill and judgment to perform the specified on-call duties;

(d) the education registrant is sponsored by the provincial health authority;

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

(f) the education registrant satisfies the other requirements as may be approved by the council.

(2) A licence issued under subsection (1) is restricted to those specified on-call duties which the education registrant has the training and experience to perform, provided those duties are

(a) approved by the Faculty of Medicine of Memorial University;

(b) assigned to the education registrant by a medical practitioner licensed by the college; and

(i) under the supervision of a medical practitioner licensed by the college, and

(ii) in accordance with any conditions attached to the licence.

Provisional post-graduate licence-specialty locum

28. (1) The council may issue a provisional post-graduate licence for a specialty locum to an education registrant where

(a) the education registrant submits a completed application in the form satisfactory to the council;

(b) the Dean of Medicine submitted a written request that the education registrant be issued a provisional post-graduate licence for a specialty locum and confirming that the education registrant

(i) is in the final stage of and in good standing in the education registrant's post-graduate specialty training program, and

(ii) has the knowledge, skill and judgment to perform a locum in the education registrant's specialty of training;

(d) the education registrant's specialty locum has been approved by the council;

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

(f) the education registrant satisfies the other requirements as may be approved by the council.

(2) A licence issued under subsection (1) is restricted to performing only those duties and procedures relating to the specialty locum approved by the council and in accordance with any terms, conditions or restrictions attached to the licence.

Expiry and renewal of licence

29. A licence issued under this Part shall expire in accordance with its terms and may be renewed on application to the college only for the purpose for which it was originally issued and only for the period in which the education registrant is enrolled and in good standing in the post-graduate training program.

Restrictions on medical practitioners

30. (1) A medical practitioner shall not allow a person to shadow or observe a medical practitioner in practice unless the person

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

(b) is registered on the education register and the shadowing or observing is approved by the Faculty of Medicine of Memorial University; or

(2) Notwithstanding subsection (1), the council may allow a person who does not meet the requirements of subsection (1) to shadow or observe a medical practitioner where

(a) the Dean of Medicine makes a written request to the council seeking a waiver of the requirements of subsection (1) for the purpose of an educational opportunity sponsored by the Faculty of Medicine of Memorial University;

(b) the council is satisfied that the educational opportunity will not involve the person providing or advising on patient care; and

(3) Permission under this section for a person to shadow or observe a medical practitioner does not allow the person to engage in the practice of medicine unless the person is registered on a register and holds a licence under these regulations that permits the person to engage in the intended practice of medicine.

PART III
CONTINUING PROFESSIONAL DEVELOPMENT REQUIREMENTS

Continuing professional development

31. (1) A medical practitioner shall participate in and satisfy the requirements of a program of continuing professional development established by the council.

(2) A medical practitioner shall

(a) maintain a record of participation in a program of continuing professional development in the form and manner approved by the council; and

(b) retain the record for a minimum of 10 years from the date of participation in the program.

(3) A medical practitioner shall submit a record of participation in a program of continuing professional development to the council where requested by

(a) the council;

(b) a committee appointed by the council or person appointed by that committee; or

(4) A record of participation shall be submitted to the council within the time period specified in the request or within 30 days of the request, where no time period is specified.

(5) The council may revoke a medical practitioner's licence where the medical practitioner fails to comply with a program of continuing professional development required by the council.

Deferral from continuing professional development requirements

32. (1) A medical practitioner may be granted a deferral from the continuing professional development requirements in whole or in part where the medical practitioner applies to the quality assurance committee or a committee appointed by the council to authorize deferrals.

(2) The quality assurance committee, or the other committee appointed by the council, may require a medical practitioner applying for a deferral under subsection (1) to provide further information and documentation and may refuse to consider the application until the information is provided.

PART IV
PROFESSIONAL MEDICAL CORPORATIONS

Corporate licence

33. Registration and a corporate licence to provide the services of one or more medical practitioners shall be granted to a corporation that

(a) satisfies the requirements in subsection 33(1) of the Act;

(b) submits a completed application in the form approved by the council, and complies with the undertakings and authorizations contained in it;

(d) satisfies the council that the corporation complies with the requirements of the Act and these regulations relating to professional medical corporations.

Expiry and renewal

34. A corporate licence shall be renewed by the registrar where the professional medical corporation

(a) is in good standing with the college;

(b) submits a completed application for renewal in the form approved by the council, and complies with the undertakings and authorizations contained in it;

(c) satisfies the council that the corporation continues to comply with the requirements of the Act and these regulations relating to professional medical corporations; and

(d) pays the fees set by the council.

Notice of change

35. A professional medical corporation shall advise the registrar of a change in the information provided in an application for a corporate licence or an application for renewal of a corporate licence, in the form of notice approved by the council, within 15 days of the change, and shall pay the fee set by the council.

Certification of documents

36. All applications, notices and other documents submitted to the registrar on behalf of a professional medical corporation shall be certified by all of the licensed medical practitioners who are directors or shareholders of the corporation.

Maintenance of records

37. The registrar shall maintain a record of the following information with respect to each professional medical corporation:

(a) the name, registered office, medical offices and corporate number of the professional medical corporation;

(b) the names and residential addresses of all medical practitioners holding voting shares in the corporation, the number and class of voting shares held by each medical practitioner and the terms, conditions and restrictions applicable to the voting shares;

(c) the name and residential address of all persons holding non-voting shares in the corporation, the number and class of non-voting shares held by each person, and the terms and conditions applicable to the non-voting shares;

(d) the names and residential addresses of the directors of the professional medical corporation;

(e) the names and residential addresses of all licensed medical practitioners practising medicine as employees or on behalf of the corporation;

(f) the date of issuance of the original corporate licence to the professional medical corporation;

(g) each date of renewal of the corporate licence of the professional medical corporation; and

(h) the other particulars that may be directed by the council or that the registrar considers appropriate.

Corporate records

38. A professional medical corporation shall

(a) prepare and maintain current financial records in accordance with generally accepted accounting principles;

(b) prepare a financial statement at the end of each fiscal year;

(d) maintain, in accordance with generally accepted business standards, records with respect to its employees.

Corporate name

39. (1) The name of a professional medical corporation shall contain

(a) the surnames, or the surnames and a combination of the given names or initials and professional designation, of one or more licensed medical practitioners who hold voting shares in the corporation or who are practising medicine as employees or on behalf of the corporation;

(b) the words "Medical Clinic" or words with a similar meaning together with the names referenced in paragraph (a) or together with words establishing a geographic location or area of practice; or

(c) other words that indicate in a manner satisfactory to the council that the corporation is engaged in the practice of medicine,

followed by the words "Professional Medical Corporation" or "Prof. Med. Corp." or the initials "P.M.C."

(2) The council may refuse to accept articles of incorporation or continuation for a corporation or to register articles amending the name of a professional medical corporation where, in the opinion of the council,

(a) the name is inaccurate or may be misleading;

(b) the name expresses or implies superiority of qualifications, experience or education over that of other medical practitioners; or

(c) the name would tend to bring the medical profession into disrepute or otherwise is objectionable in light of professional standards of practice and ethics.

Expiry or revocation of licence

40. (1) Where a corporate licence expires without renewal or is revoked under section 34 of the Act, the registrar shall promptly

(a) enter on the corporate registry a memorandum with respect to the expiry or revocation of the corporate licence; and

(b) notify the professional medical corporation, all licensed medical practitioners practising medicine as employees or on behalf of the professional medical corporation, and the other parties that the registrar considers appropriate that the corporate licence of the professional medical corporation has expired or has been revoked.

(2) Upon expiry of a corporate licence without renewal, or the revocation of a corporate licence under section 34 of the Act, the council shall determine whether the professional medical corporation is entitled to apply for a new corporate licence and may impose conditions under which the corporate licence shall be issued.

(3) A new corporate licence shall not be issued unless an application for a corporate licence is made in accordance with the Act and these regulations and the council is satisfied that the corporation has complied with all the conditions applicable to the corporate licence.

Liability for payment of fees

41. (1) A professional medical corporation is jointly liable for the payment of the annual licensing fee of each medical practitioner holding voting shares in the professional medical corporation and each medical practitioner practising medicine as an employee or on behalf of the corporation.

(2) Where a professional medical corporation has paid an annual licensing fee of a medical practitioner, the medical practitioner is not liable to pay an annual licensing fee for the year for which the professional medical corporation has paid the medical practitioner's annual licensing fee.

(3) Where a medical practitioner has paid an annual licensing fee before acquiring voting shares in the professional medical corporation, or before practising medicine as an employee or on behalf of the corporation, the professional medical corporation is not liable to pay the medical practitioner's annual licensing fee for the year for which the medical practitioner has paid the fee.

Notice to medical corporation

42. A notice required to be given to a professional medical corporation, or to a director, shareholder or employee of a medical corporation, under the Act or these regulations shall be by personal service or by registered mail to the last address filed with the registrar in relation to an application for corporate licence, an application for renewal of a corporate licence or a notice of change.

PART V
GENERAL

Alternative dispute resolution

43. (1) Where the complaints authorization committee refers an allegation to the registrar for alternative dispute resolution, the alternative dispute resolution shall be conducted in accordance with the policy established by the council.

(2) Alternative dispute resolution shall not be conducted unless the complainant and respondent consent to it in writing.

(3) The registrar may appoint those other persons the registrar considers necessary to assist in the alternative dispute resolution process.

(4) Where an allegation is not resolved through alternative dispute resolution or where, in the opinion of the registrar, the allegation is unsuitable for alternative dispute resolution, the registrar shall refer the allegation back to the complaints authorization committee.

Notice

44. (1) Where notice is to be provided to a medical practitioner under the Act or these regulations it shall be

(a) personally served on the medical practitioner;

(b) delivered to the legal counsel designated as the medical practitioner's attorney for service; or

(2) Where a medical practitioner is absent from the address referred to in paragraph (1)(c), the medical practitioner shall be responsible to ensure that there is a reliable mechanism to accept receipt of registered mail sent to that address and to promptly forward to the medical practitioner the college's correspondence mailed to that address, or to notify the college of the street address and mailing address of legal counsel designated as the medical practitioner's attorney for service.

(3) Notice sent by registered mail shall be considered to be delivered to the medical practitioner on the earlier of

(a) the date of actual receipt at that address as reported by Canada Post; or

(b) on the fifth day after the college mailed the notice.

(4) Paragraph (3)(b) applies notwithstanding that Canada Post reports the mail to be undeliverable or not accepted for receipt at the address.

Not obligated to provide programs

45. Nothing in these regulations shall be considered to have placed an obligation on the college or the council to establish or make available

(a) an undergraduate training program;

(b) a post-graduate training program;

(d) a pre-licensure assessment;

(e) a clinical assessment; or

(f) a medical practitioner providing oversight.

Transitional - registration

46. On the coming into force of these regulations

(a) a person who was registered on the medical register immediately before the coming into force of these regulations shall continue to be registered on the medical register;

(b) a person who was registered on the specialist register immediately before the coming into force of these regulations shall be registered on the medical register;

(c) a person who was registered on the education register immediately before the coming into force of these regulations shall continue to be registered on the education register; and

(d) a person who held a provisional licence under Part I of the former regulations immediately before the coming into force of these regulations shall be registered on the provisional register.

Transitional - licences

47. On the coming into force of these regulations

(a) a full licence for a primary care practice that was held by a person immediately before the coming into force of these regulations shall be considered to be a full licence for a family medicine practice and the licence shall be valid until it expires in accordance with the terms on which the full licence for a primary care practice was issued under the former regulations;

(b) a provisional licence for a primary care practice that was held by a person immediately before the coming into force of these regulations shall be considered to be a provisional licence for a family medicine practice and the licence shall be valid until it expires in accordance with the terms on which provisional licence for a primary care practice was issued under the former regulations;

(c) a full or provisional licence for a specialty practice that was held by a person immediately before the coming into force of these regulations shall continue to be valid until the licence expires in accordance with the terms on which it was issued under the former regulations;

(d) a provisional licence held by an education registrant immediately before the coming into force of these regulations continues to be valid as if the former regulations were still in force until the earlier of

(i) July 1, 2023; or

(ii) the date the licence expires in accordance with the terms on which it was issued under the former regulations; and

(e) a corporate licence held by a professional medical corporation immediately before the coming into force of these regulations shall continue to be valid until the licence expires in accordance with the terms on which it was issued under the former regulations.

Repeal

48. The Medical Regulations, Newfoundland and Labrador Regulation 38/15, are repealed.

Commencement

49. These regulations come into force on the date An Act to Amend the Medical Act, 2011, SNL 2022 c. 22 comes into force.