The clinical assistant licence in Nova Scotia

A clinical assistant licence in Nova Scotia is a conditional licence issued by the College of Physicians & Surgeons of Nova Scotia (CPSNS) to internationally trained physicians who have obtained a letter of offer in an approved physician extender program. In Nova Scotia, physicians holding a clinical assistant licence are referred to as associate physicians. They practise under the supervision of a fully licensed physician and are never the most responsible physician (MRP).

All candidates must:

• Have a medical degree from a school listed in the World Directory of Medical Schools with Canadian sponsor notes

• Meet the criteria for a clinical assistant licence as set out in Section 49 of the Medical Practitioners Regulations;

• Have acquired one of:

  • Option 1: two years of postgraduate training and one year of licensed, independent, unsupervised practice experience

  • Option 2: one year of postgraduate training and two years of licensed, independent, unsupervised practice experience

• Be a Licentiate of the Medical Council of Canada (LMCC) or have an acceptable alternative to the LMCC, one of:

  • United States Medical Licensing Examination (USMLE) Steps 1, 2, and 3

  • Federation Licensing Examination (FLEX) Components 1 and 2

  • National Board of Medical Examiners (NBME) Parts I, II, and III

  • Comprehensive Osteopathic Licensing Examination (COMLEX-USA) Levels 1, 2, and 3

  • A minimum of five years of recent postgraduate training and/or practice experience

• Meet the CPSNS English language proficiency requirements. Applicants are exempt from ELP testing if they completed the MCCQE, the certification examinations of the College of Family Physicians of Canada, or the certification examinations of the Royal College of Physicians and Surgeons of Canada in English, or if their postgraduate training was conducted in English with English as the primary language of patient care and was completed within the last five years. Otherwise, a pass result on an ELP test taken within the 24 months before applying is required.
  
  NOTE: The CPSNS will accept the IELTS Academic and the CELPIP General only until January 1, 2027. Test results dated before January 1, 2027, will still be considered when determining an applicant's English language proficiency.

• Have practised medicine independently and unsupervised, and/or acquired postgraduate training, within the last five years

To be considered current in clinical practice, a physician must have completed at least 450 hours of clinical practice, in the scope they intend to practise in Nova Scotia, within the five years preceding their proposed practice start date as an associate physician.

Candidates must not have been out of independent practice for more than five years.

• Practice experience as an associate physician in another Canadian jurisdiction where such a program exists and is sanctioned by the provincial or territorial medical regulatory authority may be considered in lieu of independent, unsupervised practice for determination of currency at the discretion of the CPSNS.

• Verifiable postgraduate training may be considered in lieu of independent, unsupervised practice for determination of currency at the discretion of the CPSNS.

The CPSNS must approve your credentials before you can accept a job offer.

Before CPSNS issues you a licence, you must send proof of an offer of employment as a clinical assistant with either Nova Scotia Health or IWK Health.

If you are approved for licensure and secure a job offer, you will be issued a clinical assistant licence to practise medicine in Nova Scotia.

The licensure application has two parts: a review of qualifications and the balance of the application.

Step 1: Review of Qualifications

1. Submit an application for medical registration through MCC's physiciansapply.ca and have your credentials source verified. The application is separate from document verification through the same portal.

2. A registration agent will be assigned to your file and will provide a list of documents to complete your review.

3. Once all required documents are received and your eligibility is confirmed, you will receive a letter confirming your eligibility for licensure, which can be presented when securing a letter of offer.

Step 2: Letter of Offer

1. Secure a letter of offer in an approved physician extender program with Nova Scotia Health or IWK Health. Nova Scotia Health notifies the CPSNS, and your registration agent will contact you about completing your application.

Step 3: Completing your application

1. Complete your application on physiciansapply.ca and submit the required documents, which demonstrate your character, competence, and ability to practise medicine in Nova Scotia.

2. Once all required documents are received, your file can be approved and your licence issued within one to three business days. Plan to obtain your licence at least two weeks before your first shift to allow time for credentialing and privileging, obtaining a billing number, and information technology setup.

For more information, contact the CPSNS at 902-422-5823.

Step 4: You receive your licence to practise

1. If you are approved for a licence, CPSNS issues your licence to practise medicine in Nova Scotia. You will receive a notification by email outlining your responsibilities.

2. If you do not meet the requirements set out in the Medical Act and Medical Practitioners Regulations, your application will be referred to the registrar.

3. The registrar may:

   1. Approve your application and grant a licence, with or without conditions;

   2. Deny your application and give you information about how to appeal this decision;

   3. Order a competency assessment; and/or

   4. Refer your application to the Registration Committee.