Eligibility and Selection Criteria for Referral to PACE Assessment Program 

Pathway to Independent Licensure in Office-based Primary Care

Note: This policy has been reviewed and approved by the College of Physicians and Surgeons Nova Scotia (the College), PACE, and Nova Scotia Health (NSH).

These criteria should be read in conjunction with the PACE Assessment Program Overview.

There are various stages involved in this Pathway to Independent licensure:

1. The Eligibility Stage
   1. Eligibility will only be assessed at times when openings are anticipated to be available at PACE;
   2. A registration agent at the College of Physicians and Surgeons of Nova Scotia (the “College”) will review preliminary eligibility with a candidate, based on the following eligibility requirements:
      1. A recognized medical degree which is defined as a degree from a university listed in the World Directory of Medical Schools with Canadian sponsor notes.
      2. Successful completion of an internship or postgraduate training program in family medicine/general practice that is a minimum of 2 years in duration resulting in certification, recognition or practice in Family Medicine or General Practice.
      3. Currency of clinical practice or training in family medicine/general practice as defined by:
         1. Completion of a minimum of two years of internship or post-graduate training in family medicine/general practice within the last 5 years, or
         2. A minimum of 450 clinical hours of independent practice in family medicine/general practice within the last 5 years. Administrative practice does not satisfy this requirement.
      4. Candidates must satisfy the College’s English language proficiency requirements.
   3. Following this preliminary review, the candidate decides whether to proceed with a formal request for a Review of Qualifications through the Physicians Apply portal, which requires the payment of a fee.
   4. If the candidate completes the Review of Qualifications, the registration agent conveys to the candidate a provisional decision as to the likelihood of success in a licensing application for a Clinical Assessment Licence. This provisional decision is based on a review of the candidate’s credentials only and does not consider at this stage the documents required to assess a candidate’s competence and character. These matters are reviewed if the candidate is selected to participate in an Assessment by Nova Scotia Health, as described in the Selection Stage below.
2. The Selection Stage
   1. If the registration agent makes the provisional decision that a candidate is likely to be granted a Clinical Assessment Licence based on their credentials, the candidate is referred to PACE, which then ranks eligible candidates based on their likelihood of success in the Assessment. This ranking process considers matters such as:
      1. Currency of practice for office-based primary care. 
      2. The relevance of the applicant’s rotations (internship/postgraduate training) to the competencies being assessed through PACE. 
         1. Family Medicine/General Practice (8 weeks)
         2. Internal Medicine (4 weeks)
         3. Surgery (4 weeks)
         4. Psychiatry (4 weeks)
         5. Pediatrics (4 weeks)
         6. Obstetrics and Gynecology (4 weeks)
      3. The candidate’s performance in any standardized examinations, including any Canadian examinations (NAC OSCE, MCCQEI and the TDM examinations).
      4. The recency of continuing professional development relevant to primary care practice.
   2. The selection process is competitive with limited space in the assessment program. As such, only the most qualified candidates will be referred by PACE to Nova Scotia Health for an interview, which is the final stage of the Selection process. 
   3. The final selection for participation in the Assessment is made by Nova Scotia Health following the interview process. The names of the selected candidates are then sent to PACE. The selected candidates are required to sign:
      1. A letter of offer from Nova Scotia Health;
      2. A return of service agreement with the Department of Health and Wellness; and
      3. A contract with PACE respecting their participation in the Assessment. 
   4. Selected physicians may only commence the Assessment upon providing proof of legal authority to work in Canada (such as citizenship, work permit, or permanent residency), and after being issued a Clinical Assessment Licence.
3. The Clinical Assessment Licensing Stage
   1. The selected candidates send all relevant documents to the College for a final decision to be made on granting a Clinical Assessment Licence. The candidate is required to complete all remaining aspects of the licence application process by submitting a fee, references, Certificates of Professional Conduct, Criminal Record Checks, and any other required criteria.
   2. A decision is then made by the Registrar to grant or deny the Clinical Assessment Licence, or to refer the application to the Registration Committee for decision, in accordance with section 14 of the Regulations under the Medical Act.
4. The Assessment Stage 
   1. Space is limited in the Assessment Program, and there is no guarantee that a candidate who is selected will find a space in the Program within any defined period of time.
   2. A candidate who is selected for the Assessment must successfully complete the Welcome Collaborative orientation program prior to the assessment.
   3. Clinical observership may be required prior to the assessment.
   4. Candidates should review the PACE Assessment Program Overview for further details respecting the Assessment process.
   5. If the candidate successfully completes the Assessment, the candidate will be eligible for a Defined licence, Restricted licence, or Clinical Assistant licence based on the competencies demonstrated, and the experience and training of the candidate. See the PACE Assessment Program Overview for further details. 
   6. Whether holding a Defined licence, a Restricted licence or Clinical Assistant licence, physicians are under no obligation to challenge additional licensure or certification examinations.

Resources

Overview of PACE Assessment Program

Physicians Apply

Therapeutic Decision-Making (TDM) Examination of the Medical Council of Canada

World Directory of Medical Schools

CPSNS English Language Proficiency Policy

Sample Candidate Contract

Welcome Collaborative

Competence Committee (Terms of Reference)