Registration assessments take many forms. They also have enormous significance to applicants. Where the assessment takes place in a practice setting, applicants may come to view them as training programs where they will be given feedback and further opportunities to improve their performance. So long as the applicant is clearly told that the experience is an assessment, regulators do not need to treat them as training programs: Sandhu v College of Physicians and Surgeons of Alberta, 2021 ABQB 494 (CanLII), https://canlii.ca/t/jgmd8/.
In this case the applicant was an internationally trained physician who was required to satisfactorily complete a required assessment for independent practice. Within a few days of commencing the months-long assessment the assessor indicated to the regulator that the applicant’s performance was unsatisfactory and that the assessor had to withdraw from the role for patient safety reasons. Upon reviewing the information and receiving submissions from the applicant the regulator agreed and required the applicant to complete significant additional training before being assessed again.
The Court dismissed the applicant’s request for judicial review. The Court found that the applicant had been clearly informed that the experience was an assessment, not a training opportunity. As such the applicant was not entitled to immediate notice of concerns, constructive feedback or opportunities to continue the assessment once safety concerns were identified. The Court also found that there was no appearance of bias on the part of the assessor for forming a quick conclusion. The Court also found that safety concerns could be partially based on record keeping and communication issues that placed the safety of patients at risk.
The Court found that the procedural fairness requirements on the regulator were met. On the extent of the duty of procedural fairness, the Court said:
In my view, this statement indicates that determining whether the PRA [assessment] process was fair requires consideration of the statutory and social context. The CPSA [regulator] is charged by statute with responsibility for establishing and enforcing appropriate standards of medical practice in Alberta. It has a duty under the Health Professions Act to protect and serve the public interest. It does this, in part, by designing a PRA process that reflects, to the greatest extent possible, the circumstances a physician will encounter in independent practice and ascertains the applicant’s ability to manage those exigencies without compromising patient safety. Put simply, Dr. Sandhu was not the only one who had a stake in the outcome of his PRA.
The case illustrates the value of regulators being clear as to the purpose and scope of registration assessments where they occur in a practice setting.