While the Supreme Court of Canada has said in Reference re Pan‑Canadian Securities Regulation, 2018 SCC 48 (CanLII), [2018] 3 SCR 189, that a national regulator of an industry or profession is constitutionally possible, so far, politically, it has been too high a hurdle to leap. Perhaps a more achievable first step is to have a shared national register of registrants. The physician and nursing regulators of Canada are already on the way to having that, although initially the national registers will mostly be for internal regulatory use. One advantage of a national register is to facilitate mobility of registrants while enabling regulators to identify applicants who have “issues” in their original jurisdiction. It would also enable the easier identification of illegal practitioners.
Recently published research has identified another significant benefit to a national register: facilitating evidence-based decisions for serious misconduct: Physician respondents in sexual misconduct concerns in Canada: a comparative case analysis using publicly available information, Kirstie C. Lithgow, Sarah Taylor, Debby Oladimeji and Shannon M. Ruzycki, CMAJ April 20, 2026 198 (15) E581-E591; DOI: https://doi.org/10.1503/cmaj.251179. The authors searched for publicly available information (from media, tribunal decisions, and regulatory websites) for all instances of sex- or gender-based abuse, assault, discrimination, harassment, or violence by physicians in Canada over a five-year period.
The identified practitioners (called respondents) represented about 0.2% of all physicians. However, this is likely an underestimate, as the vast majority of complaints or concerns (of all types) are dismissed or addressed internally by the regulator without creating a public record. In addition, only a small portion of patients who experience sexual misconduct report it (the researchers cited studies suggesting one in five).
The researchers noted that almost 93% of identified physicians were men and just under 85% of victims (the term used by the researchers) were women or girls. About 85% of the reported cases resulted in either a suspension or revocation. Almost 30% of respondents had previous complaints, although many were of a different nature. (The 30% figure is likely an understatement as the data on the topic was incomplete.)
The researchers found evidence that public disclosure of concerns not only helped protect the public (e.g., by enabling patients to make informed choices about their provider) but often led to additional victims coming forward.
On the issue of recidivism, the authors said the following:
The effect of education, practice restrictions, and practice suspensions on physician behaviours, in particular those related to sex- or gender-based harassment and discrimination, is not monitored or transparently reported in Canada. Emerging evidence shows that remedial continuing medical education may reduce recurrent complaints for all disciplinary types, though there is little evidence to support the wide range of educational programs or workshops used to deter, prevent, or remediate sex- or gender-based harassment or discrimination. Though recidivism does not prove that remediation methods are ineffective, it does suggest that additional monitoring of physicians with previous complaints could be justified. [citations omitted]
The main thesis of the research is that greater access to data could assist in better understanding the nature of the conduct and the effectiveness of regulatory initiatives to address it:
The data limitations restrict analysis of how policy and legislative changes across provinces and over time have influenced physician behaviour. Though Quebec, Ontario, Alberta, and Prince Edward Island have introduced laws that mandate periods of licence suspension for physicians who commit select sexual boundary violations, it is not possible to assess whether these laws have deterred these behaviours. Comparison between provinces is further limited by varying definitions, procedures, disciplinary actions, and public reporting of concerns across colleges….
A national repository describing the incidence of physician complaints by category type, the outcomes with explanation (including dismissal without an investigation), and the types of disciplinary actions would facilitate high-quality research to understand types of disciplinary actions that may prevent future offences. Such a registry would address inherent limitations of the databases used in this project, including changes in available records over time and use of nonreproducible search algorithms. A registry would be an opportunity to create formal procedures between law enforcement and medical regulators to ensure that physicians charged with or under investigation for specific crimes are known to the college as a backstop for current self-reporting mechanisms. [citations omitted]
The authors conclude as follows:
This work demonstrates the need for standardized, transparent data collection and reporting of physicians involved in concerns related to sex- and gender-based harassment and discrimination. Improved reporting would facilitate research to better understand prevention and remediation of harassment and discrimination, in particular as provinces implement new legislation addressing this issue. Further, transparent reporting may better protect the general public through clearer messaging on practice restrictions and self-identification of victims, and by promoting accountability for regulators.
This type of research can encourage (and inform the content of) national registers.
