POLICY MATTERS Change in Scope or Evolution of Practice? EXTERNAL CONSULTATION Examples of changes in scope of practice When there is a change to one of the factors that have been considered significant by set out in the definition of scope of practice the College include but are not limited to: but the change is not significant, the College considers this to be an evolution in practice. A family physician who wishes to An evolution in practice is characterized by perform cosmetic surgical procedures; the gradual development or progression primarily practise and receive referrals for psychotherapy, disorders of the skin, or palliative care; area in keeping with the direction of the specialty. An evolution in practice may include narrowing or limiting a practice, # OF RESPONDENTS: performance of innovative techniques or A family physician who wishes to procedures or prescribing new medications practise components of fertility 40 within the context of a specialty. medicine; A physician who practises in chronic pain management but who wishes to practise in interventional pain Examples include: A family physician who, within their general area of training, decides to management; BREAKDOWN OF RESPONDENTS: narrow the focus of their practice to A psychiatrist who wishes to practise in women’s health issues; sleep medicine; An emergency medicine physician who A neurosurgeon who wishes to practise is incorporating bedside ultrasound into in palliative care; their practice; or An orthopedic surgeon who wishes to The transition from a solo practice to a practise in family medicine; Family Health Team. An emergency medicine physician who wishes to practise in sports medicine; A physician who has been working in primary care in a developing country wishes to return to Ontario; 80% PHYSICIANS 12% ORGANIZATIONS 8% PUBLIC If physicians are uncertain about whether they are required to report an intention to change their scope of practice or an CHANGES MADE IN RESPONSE TO FEEDBACK: intention to re-enter practice, they should contact the Inquiries Section in the A physician who wishes to relocate Applications and Credentials Department of from an urban, academic practice to a the College for further guidance at 416-967- rural, underserviced area. 2617 or by email at email@example.com. YES NO MD Three things to know about the Ensuring Competence Policy Physicians must report an intention to change their scope of practice and/or to re-enter practice after an absence of two years or more. 26 September 14th, 2017 – December 4th, 2017 of a physician’s practice within a certain A family physician who wishes to 1 DATES HELD: DIALOGUE ISSUE 1, 2018 2 All physicians who wish to change their scope of practice and/or re-enter practice must participate in a College review process to demonstrate their competence in the area in which they intend to practise. 3 Physicians must not practise in a new scope of practice or re-enter practice unless the College has approved their request.