Skip to main content

Main menu

  • Home
  • Content
    • Current issue
    • Past issues
    • Early releases
    • Collections
    • Sections
    • Blog
    • Infographics & illustrations
    • Podcasts
    • COVID-19 Articles
    • Obituary notices
  • Authors & Reviewers
    • Overview for authors
    • Submission guidelines
    • Submit a manuscript
    • Forms
    • Editorial process
    • Editorial policies
    • Peer review process
    • Publication fees
    • Reprint requests
    • Open access
    • Patient engagement
  • Members & Subscribers
    • Benefits for CMA Members
    • CPD Credits for Members
    • Subscribe to CMAJ Print
    • Subscription Prices
    • Obituary notices
  • Alerts
    • Email alerts
    • RSS
  • JAMC
    • À propos
    • Numéro en cours
    • Archives
    • Sections
    • Abonnement
    • Alertes
    • Trousse média 2023
    • Avis de décès
  • CMAJ JOURNALS
    • CMAJ Open
    • CJS
    • JAMC
    • JPN

User menu

Search

  • Advanced search
CMAJ
  • CMAJ JOURNALS
    • CMAJ Open
    • CJS
    • JAMC
    • JPN
CMAJ

Advanced Search

  • Home
  • Content
    • Current issue
    • Past issues
    • Early releases
    • Collections
    • Sections
    • Blog
    • Infographics & illustrations
    • Podcasts
    • COVID-19 Articles
    • Obituary notices
  • Authors & Reviewers
    • Overview for authors
    • Submission guidelines
    • Submit a manuscript
    • Forms
    • Editorial process
    • Editorial policies
    • Peer review process
    • Publication fees
    • Reprint requests
    • Open access
    • Patient engagement
  • Members & Subscribers
    • Benefits for CMA Members
    • CPD Credits for Members
    • Subscribe to CMAJ Print
    • Subscription Prices
    • Obituary notices
  • Alerts
    • Email alerts
    • RSS
  • JAMC
    • À propos
    • Numéro en cours
    • Archives
    • Sections
    • Abonnement
    • Alertes
    • Trousse média 2023
    • Avis de décès
  • Visit CMAJ on Facebook
  • Follow CMAJ on Twitter
  • Follow CMAJ on Pinterest
  • Follow CMAJ on Youtube
  • Follow CMAJ on Instagram
News

What’s the holdup on national licensing for doctors?

Lauren Vogel
CMAJ November 18, 2019 191 (46) E1287-E1288; DOI: https://doi.org/10.1503/cmaj.1095833
Lauren Vogel
CMAJ
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Figures & Tables
  • Responses
  • Metrics
  • PDF
Loading

Canada has more doctors than ever, but medical licensing rules pose a barrier to them working wherever they are most needed. Nine in 10 physicians support national licensure that would enable them to practise anywhere in the country, according to a survey of nearly 7000 doctors conducted by the Canadian Medical Association (CMA).

“It would be common sense that if I’m safe to practise in Ontario, then I should be safe to practise in British Columbia,” says CMA President Dr. Sandy Buchman. However, that’s not the way it works.

Although doctors undergo similar training across Canada, all 13 provinces and territories have separate licensing requirements and fees. This means that a doctor licensed in Ontario can’t back up colleagues in Manitoba without repeating onerous and costly licensing processes there.

The requirement for separate licenses also limits the reach of telemedicine programs, Buchman explains. “As a palliative care physician, for example, I’d love to be able to provide virtual consultation and support to people in remote and rural Canada,” he says. “Seventy percent of Canadians don’t get access to palliative care.”

However, like more than half of physicians surveyed by CMA, Buchman has never applied for licensure in other provinces and territories because “the barriers are great.”

More than three in five doctors surveyed by the CMA said the overall complexity of the licensing process was a major obstacle to practising in other jurisdictions. More than half also cited the length of the process and the cost of getting licensed as key barriers. The fees associated with licensure can total “several thousand dollars each time they make the application,” Buchman notes.

Without these barriers, “we’re seeing that a lot of physicians would be willing to help out to provide virtual care and access to areas of the country in which they’re not licensed,” Buchman says.

Three-quarters of doctors surveyed agreed that national licensure would improve access to care. With more flexible licensing, many said they would be somewhat or highly likely to provide virtual care (38.7%), temporarily practise in remote areas (41.5%), and seek out locum opportunities in other jurisdictions (45.3%).

Figure

Canada’s medical licensing rules require doctors to undergo onerous, costly applications to work in other provinces or territories.

Image courtesy of iStock.com/Drazen Zigic

Whether national licensure is possible remains to be seen. According to Dr. Linda Inkpen, president of the Federation of Medical Regulatory Authorities of Canada, the hands of medical regulators are tied by Canada’s constitution.

Professional regulation is a provincial responsibility, even if the standards are roughly the same in every province and territory, she explained at the CMA Health Summit in August. “We need other partners to deal with the national licensing issue.”

In the meantime, Canadian medical regulatory colleges are considering an expedited clearance for temporary work in other jurisdictions that would function like a NEXUS card does for travel between Canada and the United States. They are also working on agreements that would allow doctors to provide occasional virtual care to patients outside their home province or territory without obtaining additional licenses.

Some physicians feel that regulatory colleges have resisted better solutions in order to protect their income from fees. These can add up quickly. For example, the College of Physicians and Surgeons of Nova Scotia has an annual fee of $1950, plus $975 for fees paid after July 1. A temporary license costs an additional $850. There are also fees for documentation, to review qualifications, to copy a diploma and to confirm if a physician is a member of the college.

According to Buchman, a CMA taskforce will report on next steps to national licensure in the new year.

Footnotes

  • Posted on cmajnews.com on October 29, 2019

PreviousNext
Back to top

In this issue

Canadian Medical Association Journal: 191 (46)
CMAJ
Vol. 191, Issue 46
18 Nov 2019
  • Table of Contents
  • Index by author

Article tools

Respond to this article
Print
Download PDF
Article Alerts
To sign up for email alerts or to access your current email alerts, enter your email address below:
Email Article

Thank you for your interest in spreading the word on CMAJ.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
What’s the holdup on national licensing for doctors?
(Your Name) has sent you a message from CMAJ
(Your Name) thought you would like to see the CMAJ web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Citation Tools
What’s the holdup on national licensing for doctors?
Lauren Vogel
CMAJ Nov 2019, 191 (46) E1287-E1288; DOI: 10.1503/cmaj.1095833

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
‍ Request Permissions
Share
What’s the holdup on national licensing for doctors?
Lauren Vogel
CMAJ Nov 2019, 191 (46) E1287-E1288; DOI: 10.1503/cmaj.1095833
Digg logo Reddit logo Twitter logo Facebook logo Google logo Mendeley logo
  • Tweet Widget
  • Facebook Like

Jump to section

  • Article
    • Footnotes
  • Figures & Tables
  • Responses
  • Metrics
  • PDF

Related Articles

  • No related articles found.
  • PubMed
  • Google Scholar

Cited By...

  • No citing articles found.
  • Google Scholar

More in this TOC Section

  • Resignations at Canada’s drug pricing panel raise independence questions
  • Provinces accept federal health funding deal
  • Feds propose $196B health funding deal with few strings attached
Show more News

Similar Articles

Collections

  • Topics
    • Health technology
    • Professional conduct & regulation

 

View Latest Classified Ads

Content

  • Current issue
  • Past issues
  • Collections
  • Sections
  • Blog
  • Podcasts
  • Alerts
  • RSS
  • Early releases

Information for

  • Advertisers
  • Authors
  • Reviewers
  • CMA Members
  • CPD credits
  • Media
  • Reprint requests
  • Subscribers

About

  • General Information
  • Journal staff
  • Editorial Board
  • Advisory Panels
  • Governance Council
  • Journal Oversight
  • Careers
  • Contact
  • Copyright and Permissions
  • Accessibiity
  • CMA Civility Standards
CMAJ Group

Copyright 2023, CMA Impact Inc. or its licensors. All rights reserved. ISSN 1488-2329 (e) 0820-3946 (p)

All editorial matter in CMAJ represents the opinions of the authors and not necessarily those of the Canadian Medical Association or its subsidiaries.

To receive any of these resources in an accessible format, please contact us at CMAJ Group, 500-1410 Blair Towers Place, Ottawa ON, K1J 9B9; p: 1-888-855-2555; e: cmajgroup@cmaj.ca

Powered by HighWire