Your Role as a Physician
A physician may or may not be supervised depending on their licence type. Supervised physician may or may not be the Most Responsible Physician (MRP). Physicians that do not require supervision are always the most responsible physician.
Known as general practitioners in many countries, Family Physicians in Nova Scotia are the central primary care providers. Some family physicians, with proper training, can work as hospitalists or emergency physicians.
In many countries, graduation from medical schools is enough to get a general practice licence. This is not the case in Nova Scotia. A physician, whether an IMG or CMG, needs to obtain certification from CFPC or successfully complete a Practice Ready Assessment to qualify for a licence to practice Family Medicine.
Nurse Practitioners (NP) are registered nurses who have gone through training and certification that enables them to provide specified healthcare services. The role of nurse practitioners is defined by separate legislation than physicians.
Specialists are physicians who are licensed to practice medicine in a specialty. The Royal College of Physicians & Surgeons of Canada (RCPSC) determines eligibility to challenge the certification examination - they offer the exam and the grant certification. An IMG in Nova Scotia can become a specialist by joining a residency program, usually followed by a fellowship in that specialty. Other pathways would be to go through the Practice Readiness Assessment (PRA) or the Practice Eligibilty Route (PER) for specialists.
Clinical Assistants act as physician extenders and are not the MRP. They work under supervision within a Health Authority’s Clinical Assistant Program. Generally, Clinical Assistants are IMGs licensed in another country and do not meet the requirements of a full license in Nova Scotia. A job offer is required and the division or the department defines the responsibilities.
Clinical Assistants are licensed physicians, who act as physician extenders and must have a job offer from a health authority to apply for a clinical assistant license.
This is the most common pathway for IMGs to become fully licensed physicians. IMGs who meet the criteria can apply via CaRMS. Dalhousie University provides accredited clinical training while the resident works under the supervision of a fully licensed physician. Depending on the specialty, this can last from two to five or more years and may include fellowship. Previous residency training in another country is generally not transferable to Dalhousie University.
After completing a residency program, a resident may join a fellowship in a subspecialty. Sometimes Fellows can practice as the MRP within their Fellowship program. Once they have successfully completed their Fellowship training, Royal College certification examination and LMCC or Acceptable alternative, they may be eligible for a Full license.