Prince Edward Island: the associate physician and clinical assistant licences

Prince Edward Island (PEI) is the only province that offers both clinical assistant and associate physician licences, with each having distinct roles and scopes of practice. Other provinces typically offer only one of these roles, which generally have similar responsibilities across jurisdictions. In British Columbia, there is a single associate physician licence, with setting-specific eligibility requirements for acute care, community primary care, and surgical assisting. Unlike other regions, PEI clearly differentiates between clinical assistant and associate physician licences, and the terms are not interchangeable. In Nova Scotia, both terms refer to a single licence: physicians holding a clinical assistant licence are referred to as associate physicians. In PEI they are two separate licences with separate requirements.

PEI and British Columbia are currently the only provinces that issue a limited-role licence without the requirement that an applicant (1) be a Licentiate of the Medical Council of Canada (LMCC), (2) have a pass result on the National Assessment Collaboration (NAC) Examination, or (3) have an acceptable alternative to the LMCC as per the corresponding provincial medical regulatory authority policies. In both provinces, however, postgraduate training remains a requirement: in PEI, applicants must have successfully completed a postgraduate medical training program or hold qualifications, experience, and training that CPSPEI considers substantially equivalent to the successful completion of such a program; in British Columbia, applicants must have completed a minimum of one year of accredited postgraduate training appropriate to the intended practice setting.

The associate physician class of registration with the College of Physicians & Surgeons of PEI (CPSPEI) allows internationally trained physicians who have completed postgraduate training to apply for a licence to practise in PEI as associate physicians. This class does not require the completion of a jurisdictional examination before registration.

Common areas of practice for associate physicians include primary care, emergency medicine, long-term care, surgery, and obstetrics and gynecology, and other care settings on the basis of their training and experience.

An applicant for associate physician registration shall:

• Have a medical degree from a medical school or faculty of medicine that is accredited at the time the degree is granted

• Have one of the following:

  • Option 1: Have successfully completed a postgraduate medical training program

  • Option 2: Have qualifications, experience, and training that, in CPSPEI’s opinion, are substantially equivalent to the successful completion of a postgraduate medical training program

• Demonstrate currency of professional knowledge and skills by having done one of the following within the five years immediately preceding the application:

  • Successfully completed the training requirement described above

  • Actively practised medicine in the province or in another jurisdiction recognized by CPSPEI to an extent that is acceptable to the Council of CPSPEI

  • Successfully completed a refresher program approved by the CPSPEI

• Be certified by an organization, recognized by the Council of CPSPEI, governing family medicine (for registration on the family medicine register) or the relevant specific discipline of medicine (for registration on the specific disciplines register) in another jurisdiction

For licensure as an associate physician, individuals must have been engaged in clinical practice for at least 450 hours within the last five years.

A medical practitioner with associate registration shall not practise medicine except under the supervision of a designated supervisor.

The clinical assistant registration is intended to allow physicians with postgraduate medical training acceptable to the CPSPEI, who are not otherwise eligible for registration in PEI, to work under supervision in a team-based care setting to increase capacity and service delivery.

An applicant for clinical assistant shall:

• Have a medical degree from a medical school or faculty of medicine that is accredited at the time the degree is granted

• Have successfully completed one of:

  • Option 1: The Medical Council of Canada Qualifying Examination (MCCQE)

  • Option 2: An examination administered in another jurisdiction that, in the opinion of the Council of CPSPEI, is substantially equivalent

• Training, one of:

  • Option 1: Have successfully completed a postgraduate medical training program

  • Option 2: Have qualifications, experience and training that, in the opinion of the Council of CPSPEI, are substantially equivalent to the successful completion of a postgraduate medical training program

• Demonstrate currency of professional knowledge and skills by having done one of the following within the five years immediately preceding the application:

  • Successfully completed the training requirement described above

  • Actively practised medicine in the province or in another jurisdiction recognized by CPSPEI to an extent that is acceptable to the Council of CPSPEI

  • Successfully completed a refresher program approved by the Council of CPSPEI

• Be enrolled in the Canadian Medical Register as a Licentiate of the Medical Council of Canada or have qualifications that CPSPEI accepts as an alternative

For licensure as clinical assistants, individuals must have been engaged in clinical practice for at least 450 hours within the last five years.

Training requirements

One of the following:

• 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

• Option 3: Qualifications, experience, and training that the Council of CPSPEI considers equivalent to successful completion of a postgraduate medical training program

The clinical assistant shall not practise medicine except under the supervision of a supervisor approved by the Council of CPSPEI with signed supervision agreements in place.