Until 1981, concerns about competency were addressed through
discipline hearings. If it was thought that a physician was not
competent, the physician was charged with unbecoming, improper,
unprofessional or discreditable conduct which was defined by the Act to
include conducting a medical practice in a matter showing lack of
competence or judgment. The Discipline Committee would hear the evidence
and determine whether the physician was, or was not, guilty of medical
mismanagement in their treatment of patients.
This process proved to be unsatisfactory. There was no method for an
independent assessment of the physician's skills and knowledge. There
was no method at that time to obtain and review a physician's files.
Competency was not adequately assessed.
In 1981, the current method of competency assessments was introduced. The steps are:
If the Council has reasonable grounds to believe a physician may
not be competent, it may appoint a Competency Committee under Section
45(1) of The Medical Profession Act, 1981. The Committee could consist
of one or more members whose training and experience lie within the same
field of medicine as the member being assessed.
The Competency Committee meets with the physician. Methods used to
evaluate the physician's skill and knowledge include one or more of the
- case discussion;
- observation of the physician in a practice or hospital setting;
- written examinations;
- use of evaluation forms prepared for the evaluation of physicians;
- a medical examination to determine the physician's health; or
- any other method deemed appropriate by the Committee
Following the evaluation, the Committee prepares a report
expressing its opinion with respect to the physician's competency. If in
its report, it concludes that the physician is not competent in all or a
part of that physician's practice, a Competency Hearing Committee is
constituted from members of Council to determine whether the physician
is or is not competent. The hearing also allows the physician to present
information which may offset the findings of the Competency Committee.
If the Competency Hearing Committee concludes that the physician is
not competent, the matter is referred to the Council of the College for
disposition. The Council will then impose some form of remedial action.
The more common dispostions are to:
- prohibit a physician from performing certain procedures or practising a certain branch of medicine;
- require a specific form of retraining;
- require a physician to practice only under supervision; or
- suspend the physician's right to practise unless specified conditions are met.