FAQ – For Program Directors
What is Restricted Registration?
“Restricted Registration” is a certificate of Restricted Registration offered by the College of Physicians and Surgeons of Ontario (CPSO) to Residents who meet agreed upon criteria. Residents who hold an RR certificate are eligible to provide clinical services for remuneration outside of their residency training program.
What are the objectives of the Restricted Registration Program for Residents?
The various stakeholders involved in the RR Program have identified several , including:
- Providing Residents with opportunities for additional practice, collaborative, and managerial experiences that support and develop CanMEDS roles;
- Supporting Ontario’s Health Human Resource needs (including after hours on call and on weekends) in both academic and community settings;
- Improving the financial well-being of Residents
Why are only particular Universities and Programs participating?
Participation in the RR Program is voluntary for both Faculties of Medicine and for the various postgraduate programs within each School. Please visit our Participating Programs page for further information. If your Program would like further information on participating in Restricted Registration, please contact our office.
What are the eligibility criteria for resident participation in Restricted Registration?
Each University and program determines their own specific criteria for participation in RR.
At minimum, Residents must:
- Have successfully completed and passed the MCCQE Parts I and II
- Have completed 18 months of residency training
- Be in good academic standing
- Be actively engaged in their residency training program (i.e. not on leave).
Please note that due to specific arrangements regarding income tax and personal revenue, Pool C Residents/Visa Trainees are not eligible to participate in Restricted Registration.
Residents wishing to work in Emergency Departments must have successfully completed training in Advanced Trauma Life Support and Advanced Cardiac Life Support. Residents wishing to work in Intensive/Critical Care Units must have successfully completed training in Advanced Cardiac Life Support. Those working in comparable pediatric settings must have completed training in Pediatric Advanced Life Support and in Neonatal Advanced Life Support.
Program Directors, in conjunction with their education committees, determine the guidelines specific to the individual postgraduate program. To participate in the RR Program, the program must submit all required documents, including guidelines specific to the postgraduate program in question, and a copy or link to the program’s rotation goals and objectives. Templates of guidelines are available from the Restricted Registration Program office.
All Programs and Postgraduate Deans reserve the right to choose not to approve an application if a Resident is not meeting the required standards in their program.
What are the Resident’s responsibilities?
Once a Restricted Registration opportunity has been found and an offer has been made by the healthcare site, the Resident is responsible for completing the RR Program academic application (found on the website) accurately. They must agree to abide by the following conditions:
- To work in accordance with the terms and conditions of the PARO-CAHO Collective Agreement (including all duty hour stipulations related to on-call maximums and/or shift work as appropriate)
- To obtain the necessary CMPA coverage for Restricted Registration activities (CMPA Code 14 – Residents for Moonlighting)
- To restrict activities to the scope of services and sites indicated by the registration
- To practice only within the scope of training received to date
- Not allow the Restricted Registration activities to interfere with the requirements and responsibilities of his/her training program (including ensuring that RR activities do not take place during residency work hours, including scheduled call periods)
- To provide information and data for the purposes of tracking and evaluating the Restricted Registration Program.
What are possible repercussions for a Resident failing to meet one or more of the responsibilities listed above?
Failure to comply with any of the terms of the agreement listed above may constitute unprofessional conduct and may warrant further action by the CPSO under the Act or Rules.
If the Resident does not maintain good academic standing or if the Restricted Registration activities negatively impact on their academic and/or clinical obligations in their residency program, the Program Director and Postgraduate Dean (or delegate) reserves the right to withdraw their approval for the Restricted Registration, and/or inform the College requesting that the Restricted Registration be terminated by the CPSO.
What are the Program Director’s responsibilities?
The Program Director must attest that the information provided by the Resident regarding their training and academic standing in the application is correct. Furthermore, the Program Director must confirm and attest that the Resident has fulfilled the eligibility criteria set by the Program for each service type and site. If the Resident fulfills these criteria, the Program Director attests to this fact.
Should the Resident fail to maintain their academic standing, the Program Director will notify the RR Program office and the Postgraduate Dean of these concerns and recommend cessation of the registration. This will be effective immediately may not be appealed.
What are the Post Graduate Medical Education (PGME) Dean’s responsibilities?
The PGME Dean reviews the application and provides approval for the Resident to apply for a Restricted Registration to provide clinical services outside their program.
What are the Healthcare Site/Supervisor’s responsibilities?
The responsibilities of the healthcare site/supervisor are to:
- recruit potential Resident applicants for a position;
- confirm and attest that the Resident’s training and experience meets the requirements of the Restricted Registration activities;
- make a tentative offer to the Resident pending the issuance of a Restricted Registration by the CPSO;
- complete the Supervisor portion of the RR academic application indicating:
- the service type and location of the activities
- the potential duties of the Resident
- the name of the supervising physician
- confirmation that the employer will abide by the PARO-CAHO Collective Agreement
- confirmation that the Resident’s activities will be restricted to the scope of services and sites listed on the registration issued by the CPSO
- understanding that they must inform the CPSO and the Resident’s Program Director of any unprofessional conduct or failure to abide by the terms of the Restricted Registration on the part of the Resident
- that they will provide information and data as required by the RR Program for the purposes of tracking and evaluation
What are the steps for obtaining a Restricted Registration Certificate?
- The Resident must find and be offered a contract for work, pending receipt of a RR certificate.
- The Resident must then complete the academic application form found on the website for the Restricted Registration Program at www.rrapp.ca.
- The Resident must ensure that they comply with the eligibility criteria of both the RR Program and their training program
- When the Resident has completed their section of the application, it will be electronically forwarded (in the following order) to the potential supervisor, the Program Director and the PGME Dean for completion.
- The resident completes the CPSO Application and submits it directly to the College along with the registration fee.
- Once all documentation is received, the CPSO will review the application at a scheduled Registration Committee meeting.
- The Resident and the Supervising Physician will be notified by the CPSO when the application has been approved.
How often and what data and information will I have to provide to the RR Program?
From time to time, program participants are asked to provide feedback through online or telephone surveys. All information that is collected is completely anonymous and data will only be used in the aggregate.
Does the Restricted Registration Program pay Residents for RR activities, or provide funding to healthcare sites where RR activities are taking place?
There is no funding provided by the Restricted Registration Program for remuneration for a Resident engaged in RR activities. The Restricted Registration Program funds administration, infrastructure (i.e. the online application and the website), and the evaluation of the Program. This funding enables Residents and healthcare sites to participate in the Program. Remuneration for Residents is determined directly between the Resident and the employer. If physicians will be billing for services provided by RR Residents, they will need to observe the requirements in the OHIP fee schedule guide.