Practicing while on a Leave of Absence
Only registrants with a valid certificate of practice are permitted to practice medicine.
If you plan to continue to engage in practice in some way, even when that does not include direct or personal involvement with patients, you must maintain your certificate of practice for that purpose, including by ensuring it is renewed on schedule.
This is most often relevant during the transition period when the registrant is overseeing follow-up to outstanding consultations and diagnostic requisitions, prescription renewals, or catching up on clinical documentation. It would also be relevant if you intend to remain available to address some aspects of your practice, for example, clinical administrative work.
CPSM's interpretation of the following terms will be important to consider if practicing while on a leave of absence:
Section 3 of the Practice of Medicine Regulation defines the "scope of practice of medicine" for the purposes of the RHPA:
The scope of practice of medicine is the application of medical knowledge, skill and judgment for
(a) the assessment and management of a physical, mental or psycho-social disease, disorder, injury or condition of an individual or group of individuals at any stage of the biological life cycle, including the prenatal and post-mortem periods;
(b) the prevention and treatment of physical, mental or psycho-social diseases, disorders, injuries and conditions; and
(c) the promotion of good health.
A valid certificate of practice issued by CPSM is required to engage in the practice of medicine.
For CPSM's purposes, registrants who do not have a valid certificate of practice are defined as non-practicing. These registrants are placed in a non-practicing class.
Registrants taking a leave of absence who maintain their certificate of practice are not defined as non-practicing for CPSM registration purposes.
Examples of non-practicing registrants:
- Full registrants who have failed to renew their certificate of practice may be converted to the Full (Non-Practicing) Class.
- The Retired (Physician) Class is a non-practicing class.
- Provisional registrants who have ceased practice or lost their supervisor or practice location are converted to the Provisional (Non-Practicing) Class.
- Educational registrants may be converted to the Educational (Non-Practicing) Class if there are on leave from their program.
Administrative Tasks, Research, and Teaching
Administrative tasks, including paperwork, may be clinical or non-clinical. Clinical activities are those which involve participating directly or indirectly in actual patient care.
- Clinical administrative work requires a valid certificate of practice. This includes important components of continuity of care such as documentation of care, preparing referrals, monitoring consultant, laboratory and diagnostic reports, and oversight of prescribing. Monitoring reports may require follow-up directly with the patient to make sure they are aware and can seek care.
- Non-clinical administrative work includes billing, maintenance of patient records, monitoring phone, mail, email and other communications, and other day-to-day administrative and clerical tasks that are part of operating a medical practice. It can also include organizing coverage and alternate care arrangements. When this work relates to the registrant's professional practice, numerous regulatory, ethical, and professional requirements apply, for example, managing conflicts, advertising requirements, and CPSM notice and reporting requirements. However, non-clinical administrative work can generally be done by a non-practicing registrant who does not hold a valid certificate of practice.
- Other non-clinical medical administrative work requiring a valid certificate of practice includes responsibilities for ensuring that a practice environment or setting is safe, appropriate, and sanitary respecting medical care delivered in the practice setting. In group settings, carrying out the responsibilities of the Medical Director, who must be a duly qualified medical practitioner in good standing, would be considered active practice necessitating a valid certificate of practice. This category would also include the practice of independent medical examiners, the Medical Director of a facility, public health physicians not directly involved in patient care, medical administrative aspects of the professional practice of the Dean of the Manitoba Faculty, and other similar practice areas.
- Clinical teaching and research that involves patient care requires a valid certificate of practice.