Saskatchewan College of Physicians and Surgeons

Transcription

1 The Medical Profession Act, 1981 The Bylaws pursuant to The Medical Profession Act, 1981 are repealed and replaced by the following: PART I INTERPRETATION 1 In these bylaws, unless there is something in the subject of the context inconsistent therewith, the word: Act means an Act respecting the Medical Profession, commonly referred to as The Medical Profession Act, 1981; Acupuncture means the medical procedure of inserting needles through the skin or mucous membrane, with or without electrical stimulation applied, at one or more specific points, without the injection or withdrawal of any substance, to affect a therapeutic and/or analgesic response in a patient, with the intent to stimulate the neuroendocrine system; Annual Licence Fee means the annual fee paid by physicians to maintain registration as determined annually by resolution of Council; Approved means approved by the Council; Bylaw means the rules and regulations whereby the business of the College is transacted; College means the College of Physicians and Surgeons of Saskatchewan; College of Medicine means the College of Medicine of the University of Saskatchewan; Council means the Council of the College; JURSI (Junior Undergraduate Rotating Student Intern) means an undergraduate in the final year (commonly known elsewhere as a Clinical Clerk) enrolled in an approved teaching program in the Province of Saskatchewan; Locum means a physician authorized under section 31 of the Act to practice in accordance with any terms and conditions that council may prescribe as a substitute for or assistant to a member; Member means a member of the College registered under section 4, 28, 29 or 30 of the Act; Registrar means the Chief Executive Officer of the Council;

2 Resident means a graduate physician entered in an approved residency training program in the Province of Saskatchewan; Resident of Canada means a Canadian Citizen or Landed Immigrant or a person who has been resident in Canada continuously for a minimum of three months; Training Fellow means a graduate physician who is on the Educational Register and has completed the postgraduate requirements for a specialty. PART II ELECTION OF OFFICERS 2 The Council shall each year at its first meeting elect from amongst its members: (1) A President and a Vice-President; and an Executive Committee composed of the President, Vice-President, Past President and two members elected at large from and by Council. One of the members at large shall be a non-medical council member. (2) All officers of the Council shall hold office until their successors are elected or appointed. (3) The Executive Committee shall meet at the call of the Registrar on the direction of the President or person acting in place of the President. Three members of the Executive Committee shall constitute a quorum. (4) The Executive Committee shall have and exercise all the power and direction of the Council, but shall not enact, repeal, or amend bylaws or make regulations inconsistent with existing regulations. Minutes of the meeting of the Executive Committee shall be presented at the next following meeting of Council and when adopted by the Council shall be entered as if they were the minutes of the Council. (5) In the event of death, incapacitation, vacancy from office of a permanent nature, of the President, and/or Vice-President, Council shall elect members to fill the vacancies. (6) The President shall preside at all meetings of the Council, in his absence the Vice-President shall take the Chair, and in the absence of both of these officers, the members of the Council then present shall choose one of their number as Chair. (7) The Vice-President shall be vested with all the powers and shall perform all the duties of the President in the absence of the President. PART III ELECTION OF COUNCIL 3 The nine Medical Electoral Divisions required by subsection 11(1) of The Medical Profession Act, 1981 are: Division No. 1: All that portion of the Province of Saskatchewan north of 53 latitude and east of 107 longitude; Division No. 2: All that portion of the Province of Saskatchewan north of 52 latitude and west of 107 longitude; Division No. 3: All that portion of the Province of Saskatchewan known as the City of Saskatoon; Division No. 4: All that portion of the Province of Saskatchewan between 51 and 53 lines of latitude and east of 104 o longitude; Division No. 5: All that portion of the Province of Saskatchewan south of 52 latitude and west of 107 longitude; Division No. 6: All that portion of the Province of Saskatchewan south of 51 latitude, bordered on the west by 107 longitude and on the east by 104 longitude, excluding the City of Regina; Division No. 7: All that portion of the Province of Saskatchewan known as the City of Regina; Division No. 8: All that portion of the Province of Saskatchewan south of 51 latitude and east of 104 longitude; Division No. 9: All that portion of the Province of Saskatchewan bordered by 51 and 53 lines of latitude and 104 and 105 lines of longitude, excluding the City of Saskatoon. 4 Elections to be held (1) Elections will be held in medical electoral divisions 1, 3, 5, 7 and 9 in year one of the election cycle; and (2) elections will be held in medical electoral divisions 2, 3, 4, 6, 7 and 8 in year two of the election cycle; and (3) there will be no regularly scheduled elections the third year of the election cycle. (4) An election is to be held in the case of the death or resignation of a member of Council as soon as practicable thereafter. (5) The election shall, as far as practicable, be held in December of each election year in accordance with paragraphs 4(1) to 4(3). 5 Nomination and Voting Papers (1) At least six weeks prior to the date fixed for the election, the Registrar shall mail to each member entitled to vote a complete list of all members in his or her medical electoral division who are qualified for election under the Act together with a nomination paper. (2) Each candidate shall be nominated by three other members in his or her Medical Electoral Division who are qualified to vote in the election. (3) Nominations shall be signed by the three nominating members, and each nomination shall be accepted in writing by the candidate. (4) At least three weeks prior to the date of the election, the Registrar shall mail to each member entitled to vote: (a) a ballot listing the candidates nominated in the medical electoral division in which he or she is entitled to vote; (b) an envelope marked place and seal ballot in the envelope to ensure secrecy ; (c) an envelope marked voting paper and having on it a declaration of identification; (d) a self-addressed envelope marked voting paper ; (e) a notice of the date of the election and the place fixed for the counting of votes. (5) Only such members as are duly nominated shall be eligible for election as members of the Council. 6 Voting Every member voting shall: (1) mark an X on the ballot provided opposite or in the space containing the name of the candidate for whom he or she intends to vote; (2) place the ballot in the envelope marked place and seal ballot in the envelope to ensure secrecy ; (3) place the enveloped ballot in the envelope marked voting paper and containing the declaration of identification; (4) after sealing the envelope, complete and sign the declaration contained on the envelope; and (5) return the envelope to the Registrar in a sealed self-addressed envelope marked voting paper so as to be received by the Registrar on or before the day of the election. 7 Counting of Ballots At the hour of one o clock in the afternoon of the day following the election, the Registrar (or his designate), in the view of the scrutineers present, shall, in respect of each Medical Electoral Division: (1) open the declaration envelopes; (2) open the envelopes marked place and seal ballot in envelope to ensure secrecy ; (3) count the votes cast for each candidate and record the results in a book provided by the Council. The Registrar shall inform each member of the College of the results of the election in his or her Medical Electoral Division. PART IV MEETINGS OF THE COLLEGE, COUNCIL AND ITS COMMITTEES 8 Meetings of the Council and the Committees of Council shall be conducted in accordance with the Sturgis Standard Code of Parliamentary Procedure, unless otherwise specified herein. 9 Annual General Meeting (1) There shall be an annual general meeting of the members of the College to: (a) receive the reports of the Council; and

3 (b) consider the matters of general interest to the members of the profession; and (c) provide a forum for individual members to express concerns; and (d) to adopt a Code of Ethics. (2) A formally proposed Notice of Motion to be considered at the annual general meeting shall be submitted to the Registrar s office at least 10 days before the date of the annual general meeting. (3) The annual general meeting shall be held at a time and place to be determined by the Council. At least 21 day s notice of such meetings shall be given to all members resident in the province by the Registrar. (4) The order of proceedings at annual general meetings shall so far as is practicable follow an agenda or program prepared by Council. 10 Special General Meetings A special general meeting can be called by Council under the provisions laid down for an annual general meeting. 11 Council Meetings (1) At least two (2) regular meetings shall be held in each year. The first meeting shall be called by the Registrar within 60 days of a General Election after consultation with the President. (2) At least seven (7) day s notice shall be given to all Councillors of all regular meetings of Council. (3) The Registrar shall make reasonable efforts to provide notice of meetings to all members of Council. All meetings of the Council are validly constituted, and all business conducted by the Council shall be validly conducted, notwithstanding the inadvertent failure to provide the required notice of Council meetings to Councillors or the lack of receipt of notice by any Councillors. 12 The members of the Council or the Executive Committee may participate in meetings by means of conference telephone or similar communications equipment, whereby all Councillors participating in the meeting can hear each other at the same time, and participation in any meetings shall constitute presence in person by such Councillor at such meeting. 13 If, in the opinion of the President (or where the President is not available, the Registrar), a situation arises which requires immediate attention by the Council, then the President, or the Registrar, may convene a meeting of the Council on such notice as the convenor sees fit. Such meeting shall be comprised of as many members of Council as are available in person or by telephone, provided a quorum of the Council is present. 14 A copy of the notice of meeting held under paragraphs 12 and 13 shall be included in the minutes of the meeting. 15 A majority of the members of the Council constitutes a quorum. 16 Voting At all meetings of the College at all levels, an affirmative vote is by a simple majority of those members present. 17 Committee Meetings (1) The Legislated Committees shall meet as required by Council and function in accordance with the provisions of the Act and bylaws. Legislated Committees: 1 Competency Committee 2 Competency Hearing Committee 3 Discipline Committee 4 Discipline Hearing Committee 5 Investigating Committee (Mental Health Committee) 6 Preliminary Inquiry Committee (2) The Standing Committees meet under the terms of reference specified in the bylaws. Standing Committees: 1 Advisory Committee on Medical Imaging 2 Anaesthetic and Operative Deaths Study Committee 3 Committee on Family Practitioner Interpretation of Electrocardiograms 4 Complaints Committee 5 Finance Committee 6 Health Care Facility Credentials Committee 7 Perinatal and Maternal Mortality Study Committee 8 Practice Enhancement Committee 18 Standing Committees Terms of Reference (1) Fifty percent plus one of committee members shall constitute a quorum. (2) Advisory Committee on Medical Imaging (a) Composition The Chair and members of the committee shall be appointed annually by Council. The committee shall include representatives from Radiology, Ultrasonography, Nuclear Medicine, representatives from the Department of Health, and may include others. (b) Objectives (i) Study and advise upon the best possible, safe and required medical imaging services. (ii) Consideration of the appropriate economic implications involved in the provision of such services. (iii) Advise Saskatchewan Health on medical imaging equipment. (c) Methods (i) The establishment and maintenance of standards of quality of the medical imaging services. (ii) The establishment and maintenance of standards for the appropriate and proper use of medical imaging equipment. (iii) The inspection and evaluation of the existing medical imaging services and facilities as required. (iv) A review of manpower and equipment needs with respect to the provision of medical imaging services and facilities. (v) A study and recommendations on mechanisms which might control the elements of possible over-servicing and over-utilization of medical imaging services in relation to overall medical imaging costs. (vi) The continuing education of the medical and allied professions and workers with respect to medical imaging usage, procedure, hazards and safety. (vii) Offering advice on credentialling of physicians in imaging services. (viii) Any other matter related to the above areas which appear pertinent to the committee within the broad framework listed above. (d) Reporting (i) The Chair reports the findings and recommendations of the committee to the Council for Council s consideration. (ii) The Chair reports to the annual meeting of the College. (e) Meetings The committee will meet at the call of the Chair. (3) Anaesthetic and Operative Deaths Study Committee (a) Composition The Chair and members of the committee shall be appointed annually by Council. The membership shall include General Practitioners and Specialists from the following disciplines: Internal Medicine, General Surgery, Orthopaedics, Obstetrics and Gynaecology, Urology, Pathology, Anaesthesia, and may include others. (b) Objectives The committee reviews all deaths occurring within 10 days of surgery and/or anaesthesia in the Province of Saskatchewan for purposes of assuring quality care. The cases are categorized using the following classifications:

4 Classification of Death Contributing Factors (1) Preventable (A) Patient failure of compliance (2) Non-Preventable (B) Family failure of compliance (3) Humane (C) Physician error in (3) Non-Intervention judgment (4) Non-Assessable (D) Physician error in technique (E) Nursing error (F) Equipment failure (G) Inadequate facilities (c) Method (i) The Director of Vital Statistics of the Saskatchewan Health Department forwards to the Registrar copies of the Death Certificates of all patients dying within 10 days of an operative procedure or anaesthetic. (ii) Under the authority of regulations of The Hospital Standards Act, the following information is released to the committee when a patient dies in the hospital during the administration of the anaesthetic or within 10 days thereafter, or during the surgical operation or within 10 days thereafter as the case may be: 1 the admission history and physical examination; 2 consultation reports; 3 the operative record or records; 4 the anaesthetic record or records; 5 the laboratory, tissue and autopsy reports; 6 postoperative notes; 7 statements completed by the attending anaesthetists and surgeon on the form prescribed (Clinical Summary of Death within 10 days of Surgery) (Appendix I) (iii) If the initial documents obtained from the hospital are not complete, the Registrar contacts the hospital and/or physician(s) concerned requesting the further documentation required. (d) Reporting (i) The Chair reports the findings and recommendations of the committee to Council for Council s consideration. (ii) Following the Chair s report to Council, letters are sent to the physicians involved, informing them of the committee s conclusions. (iii) The Chair reports to the annual meeting of the College. (e) Meetings The committee will meet at the call of the Chair. (4) Committee on Family Practitioner Interpretation of Electrocardiograms (a) Composition (i) The Chair and members of the committee shall be appointed annually by Council. (ii) The committee shall include Internists and General Practitioners, and may include others. (b) Objectives To assess members who wish to demonstrate their competence to interpret electrocardiograms. (c) Method (i) The committee is responsible for the development, review, and grading of the E.C.G. Examination. (ii) The pass mark is determined by resolution of Council. (d) Reporting (i) The Chair reports the finding and recommendations to Council for Council s consideration. (ii) Following the Chair s report to Council, letters are sent to the physicians tested informing them of the committee s conclusions. (iii) The Chair reports to the annual meeting of the College. (e) Meetings The committee will meet at the call of the Chair. (5) Complaints Committee (a) Composition The Complaints Committee Chair and members are appointed by Council annually. The committee shall be composed of: (i) three members of the College; (ii) three persons who are not members of the College. (iii) The Council may fill a vacancy in the committee by appointing any person to the committee that the Council thinks appropriate. (b) Objectives To receive, investigate and, if possible, resolve complaints regarding the conduct of physicians. (c) Method Complaints are received by the Registrar. By personal or telephone interview, complainants are informed of the role of the College in protecting the public interest, including the working of the Complaints Committee. The complainant is asked to submit the complaint in writing. An authorization for release of information (preferably from the patient) is obtained before the investigation proceeds. Complaints may be resolved by the Registrar. Unresolved complaints are forwarded to the committee. Physicians comments are requested and hospital records are obtained. The committee may resolve the complaint from the information available or request the complainant and/or the physician(s) to attend for interview. Consultants may be asked to review certain aspects of the case and give a written opinion. The written decision of the committee shall be forwarded to the complainant and physician(s) upon resolution of the complaint. (d) Reporting The Chair reports the findings and recommendations of the committee to Council for Council s consideration. (e) Meetings The Committee will meet at the call of the Chair. (6) Finance Committee (a) Composition The Chair and members of the committee shall be appointed annually by Council. The committee shall be composed of five or more members of the College with working knowledge of finance. (b) Objective To ensure responsible management of the affairs and finances of the College. (c) Method (i) By preparation of an annual budget through the Administrative Officers of the College. (ii) By preparation of a meaningful annual financial statement of the College operation through the Administrative Officers of the College. (iii) By recommending to Council the amount of the annual fee for membership in the College. (iv) By acting as a resource body and advising Council on major expenditures and acquisitions. (v) By acting as a resource body and advising Council on matters relating to staffing of the College office. (vi) By performing other duties which, from time to time, Council may require.

5 (d) Reporting The Chair or designate shall present the annual budget and the committee s recommendations to Council. The Chair or designate shall present the report, the approved annual budget and the annual financial statement to the annual meeting of the College. (e) Meetings The committee will meet at the call of the Chair. (7) Health Care Facility Credentials Committee (a) Composition The Chair and members of the committee shall be appointed annually by Council. The membership shall consist of: (i) a Specialist from each of the following disciplines: General Surgery; Obstetrics and Gynaecology; Internal Medicine and Anaesthesia; (ii) three General Practitioners; (iii) one Chief Executive Officer of a Health District; and (iv) additional members as required. (b) Objectives (i) For the purpose of making recommendations to the District Board, the committee shall assess the qualifications, training and experience of: 1 new registrants of the College of Physicians and Surgeons of Saskatchewan applying for privileges in health care facilities of 100 beds or less; 2 registered practitioners moving from one location to another and applying for privileges in a health care facility; 3 members of the Medical Staff of a health care facility as part of a Health Care Facility Assessment; 4 members of the Medical Staff of any health care facility, upon request by the District Board. 5 any physicians requesting this service for self-assessment or reassessment. (ii) Carry out Health Care Facility Assessments upon receipt of a request from a District Board. (c) Method (i) Physicians Privileges The committee in making recommendations shall take the following factors into consideration: 1 the qualifications, training and medical experience of the physicians; 2 the physical facilities available; 3 the backup personnel available, i.e. physicians, nurses, laboratory and x-ray technicians, physiotherapists, and others; 4 location of the health care facility; and 5 transport facilities available. The committee makes recommendations for privileges as they apply to elective procedures only. The applicants and District Boards are advised physicians must be given every opportunity to deal with an emergency to the best of his or her knowledge, training and ability. Applicant-physicians are required to complete the prescribed application in a form approved by Council and present it to the Registrar. A provisional list of recommended privileges (to Level I only) is forwarded to the District Board and physician based on the documented postgraduate training and experience presented by the applicant. When applicants request privileges beyond Level I, and appropriate documentation of formal training and experience is available, provisional privileges up to Level II may be recommended by the committee via a telephone conference call. Applicants applying for privileges beyond the Level II category, or privileges that are not consistent with the guidelines, may be required to meet with the committee to review their requests for privileges. The provisional lists of recommendations are presented to the next regular meeting of the Health Care Facility Credentials Committee for review, modification, and/or ratification, and therefore, to Council for review, modification and/or ratification. The final recommendation of Council shall be communicated to the District Boards and the physicians involved. (ii) Health Care Facility Assessments Health Care Facility Assessments are carried out by a subcommittee of the Health Care Facility Credentials Committee. The Health Care Facility Assessment Team may include members who are not members of the Health Care Facility Credentials Committee. Health Care Facility Assessments will be carried out at the request of a District Board. District Boards requesting assessments will be required to complete documentation relating to facilities, personnel, and any other relevant matter. The Assessment Team appointed to carry out the assessment may make recommendations with respect to: 1 privileges of individual physicians; 2 medical staff changes; 3 facility improvements; 4 ancillary staff; 5 equipment, etc.; 6 any other relevant matter. The Assessment Team reports to the Health Care Facility Credentials Committee and subsequently to Council. The final written assessment report is communicated to the District Board after approval of Council. (d) Reporting (i) The Chair reports the findings and recommendations of the committee to Council for Council s consideration. (ii) Following the Chair s report to Council, letters are sent to the District Boards and physicians involved advising them of the committee s conclusions. (iii) The Chair reports to the annual meeting of the College. (e) Meetings The committee will meet at the call of the Chair. (8) Perinatal and Maternal Mortality Study Committee (a) Composition The Chair and membership of the committee shall be appointed annually by Council. The membership of the committee shall consist of Obstetricians, Paediatricians and/or Neonatologists, General Practitioners, and may include others. (b) Objectives (i) Study of matters which pertain to the quality of obstetrical practice and neonatal care identified by the committee through review of medical records. (ii) The committee will review the medical records of: 1 Perinatal Deaths: (A) Stillborn: all infants, weighing 500 grams or more at birth, who show no sign of life at or after birth. (B) Early Neonatal Deaths: all infants, weighing 500 grams or more at birth, who die before they have completed seven full days of life (168 hours). 2 Maternal Deaths: occurring in the province either during pregnancy or within 42 days following termination of pregnancy.

6 3 Other matters pertaining to quality control that are presented to the committee by Council for study. (c) Method (i) Copies of Certificates of Neonatal Deaths, Stillbirths and Maternal Deaths are forwarded to the Registrar from the Division of Vital Statistics, Saskatchewan Department of Health. (ii) Under the authority of regulations of The Hospital Standards Act, copies of the hospital records of all stillbirths weighing 500 grams and over, and live births who die before they have completed seven full days of life (168 hours) are obtained by the College. The records are sent to members of the committee in advance of the committee meeting for their review and completion of a review form. The review forms are photocopied and provided to each committee member in attendance. Each case is discussed at the committee meetings in order that the death may be classified using the categories listed in paragraph (8)(c)(iv). If additional information is required, the committee may request the mother s hospital record and/or further reports from the physicians involved with the care of either the mother or baby. (iii) Under the authority of regulations of The Hospital Standards Act, copies of the hospital records of patients dying either during pregnancy or within 42 days following termination of pregnancy may be obtained for the committee s assessment. (iv) Deaths and contributing factors are classified as follows: Classification of Death Contributing Factors (a) Preventable (i) Patient failure of compliance (b) Non-Preventable (ii) Family failure of compliance (c) Ideally Preventable (iii) Physician error in judgment (d) Non-Assessable (iv) Physician error in technique (v) Nursing error (vi) Equipment failure (vii) Inadequate facilities (viii) Difficult diagnostic problem (ix) Unavoidable medical or surgical complications (x) Other (specify) (d) Reporting (i) The Chair reports the findings and recommendations of the committee to Council for Council s consideration. (ii) Following the Chair s report to Council, letters are sent to the physicians involved, informing them of the committee s conclusions. (iii) The Chair reports to the annual meeting of the College. (e) Meetings The committee will meet at the call of the Chair. (9) Ad Hoc Committee (a) Composition (i) Council may appoint an Ad Hoc Committee to investigate and report to Council upon any matter. (ii) These Ad Hoc Committees may consist of such number of members and other persons as the Council deems advisable. All members shall be duly registered and in good standing with the College. One of the members shall be named by the Council to be the Chair of the committee. (b) Method The Council will set out, in writing, to the members of the committee the matter to be dealt with in such detail as it deems necessary. (i) The Ad Hoc Committee may, subject to The Medical Profession Act, 1981 and the bylaws, regulate its own manner of proceeding, with due regard for time and costs. (ii) No statement or answer given before the Ad Hoc Committee is to be used in evidence in a proceeding before a Discipline Committee appointed under the Act but is to be used only for the purpose of the Ad Hoc Committee. (iii) Upon the completion of its assigned task, the Ad Hoc Committee shall prepare for Council a written report of its activities, findings, conclusions, and recommendations, to be signed by each member of the committee concurring. A minority report may be submitted. Council may require the presence of the Chair at a meeting to present the report and to answer questions. PART V THE REGISTER 19 The Register The Registrar shall keep a Register in which shall be entered the name of every person entitled to be registered according to the provisions of the Act. 20 Admission to the Register A person desiring to register shall comply with the provisions for registration and licensing under the Act and the bylaws thereunder. 21 Categories of Membership (1) There shall be the following categories of membership in the College of Physicians and Surgeons: (a) Regular Member (Active); (b) Regular Member (Inactive); (c) Provisional Member (Active); (d) Provisional Member (Inactive); (e) Special Member; (f) Senior Life-Member (Active); (g) Senior Life-Member (Inactive). (2) Regular Member (Active) (a) A regular member (active) is a member registered under section 4 or 28 of the Act, other than a member who is a regular member (inactive). (b) A regular member (active) shall have the right to practise medicine in Saskatchewan, subject to any limitations imposed by the Council in accordance with the provisions of the bylaws and the Act, to hold office and to vote as may be provided for in the Act or the bylaws. (c) For the purpose of registration under section 28 of The Medical Profession Act, 1981, the following shall constitute evidence of satisfactory postgraduate training: (i) For applicants who shall practise as a consultant specialist and restrict practice to one of the disciplines recognized by the Royal College of Physicians and Surgeons of Canada (R.C.P.S.C.) certification in that specialty by the R.C.P.S.C. shall be required. (ii) For applicants who shall practise primary care medicine, the following shall satisfy postgraduate training requirements: 1 Certification by the College of Family Physicians of Canada (C.F.P.C.); or 2 Satisfactory completion of a C.F.P.C. accredited residency in family medicine and eligibility to undertake the C.F.P.C. certification examination; or 3 Satisfactory completion of 24 months of postgraduate training in programs affiliated with an L.C.M.E./ C.A.C.M.S. accredited medical school and accredited by the R.C.P.S.C. or C.F.P.C. which shall include the following elements: Mandatory Educational Elements The mandatory portion of the 24-month pre-registration training period shall consist of 60 weeks of training to be made up of the following rotations: (A) twelve weeks of supervised training in an approved family medicine program;

7 (B) eight weeks emergency medicine/critical care; (C) eight weeks internal medicine with an ambulatory component; (D) eight weeks general surgery with an ambulatory component; (E) eight weeks obstetrics and gynaecology with an ambulatory component; (F) eight weeks paediatrics with an ambulatory component; (G) eight weeks psychiatry with an ambulatory component. Elective Educational Elements The elective portion of the 24-month pre-registration training period shall consist of 36 weeks of training, to be made up of one to three of the following rotations (each rotation to be a minimum of 12 weeks duration): (A) twelve, 24, or 36 weeks of medicine and/or its sub-specialties; or (B) twelve, 24, or 36 weeks of surgery and/or its sub-specialties; or (C) twelve, 24, or 36 weeks of obstetrics and gynaecology and/or its sub-specialties; or (D) twelve, 24, or 36 weeks of paediatrics and/or its sub-specialties; or (E) twelve, 24, or 36 weeks of psychiatry and/or its sub-specialties; or (F) twelve, 24, or 36 weeks of family medicine; or (G) twelve, 24, or 36 weeks of anaesthesia. Note: One 12-week block (one rotation) of this 36 weeks of elective training may be taken in a R.C.P.S.C. recognized discipline which is not listed above. And a recommendation for licensure from the Assistant Dean for Postgraduate Studies of the medical school in which the major portion of this postgraduate training has been completed, or 4 Satisfactory completion of 24 months of postgraduate training in programs affiliated with a university outside of Canada or the United States which is approved by the Council of the College where such training is directed towards the education of primary care physicians and is under the supervision of a program director, and includes all of the educational elements listed in paragraph 21(2)(c)(ii)3. 5 The council will accept as evidence of satisfactory postgraduate clinical training proof that applicants have demonstrated satisfactory skills and knowledge by an assessment, undertaken at their own expense; such assessment to be in a form approved by the Council. (3) Regular Member (Inactive) (a) A regular member (active) may apply for membership as an inactive member. (b) In order to be eligible for membership as an inactive member, a member shall withdraw from the active practice of medicine in Saskatchewan. (c) A regular member (inactive) shall pay the fee for inactive status established by the Council. (d) A regular member (inactive) shall not practise medicine in Saskatchewan, hold office, or vote. (e) In order for an inactive member to become an active member, an inactive member shall: (i) produce a Certificate of Good Standing of recent origin from each jurisdiction in which the member has practised in since ceasing to be a regular member (active) in Saskatchewan; (ii) produce evidence of good character to the satisfaction of the Council in a form and in a manner that may be prescribed by the Council; (iii) if the member has not actively practised medicine for a period of 24 months, or intends to or has changed his or her field of practice, provide proof to the Council of successful completion of training as set out in bylaw 24; (iv) pay the annual fee for an active member established by the Council. (4) Provisional Member (Active) (a) A provisional member is a member registered under section 29 of the Act. (b) The Council may register and issue a provisional licence to a person who produces evidence in a form and manner that may be prescribed by Council that the person: (i) is a graduate of an approved university medical school; and (ii) has passed the MCCEE and holds a valid letter from The Medical Council of Canada; and (iii) has met the postgraduate training requirements established in paragraph 21(4)(e) of these bylaws; and (iv) is of good character; and (v) has established good standing as a practitioner if at any time that person was entitled to practise medicine; and (vi) pays the fee prescribed by Council for licensure; and (vii) has signed a commitment to practise in the community for which they are registered for a period of three years and has agreed that any licence issued to the applicant may be revoked in the event that the applicant ceases to practice in the community for which they are registered. Such commitment shall continue after the applicant obtains registration under section 28 of The Medical Profession Act, (c) If the provisional member (active), without the permission of the Council, ceases to practice in the community for which the member was registered, or relocates without the permission of the Council, the Registrar shall strike the member s name from the provisional register and that person s licence shall automatically terminate. (d) A provisional member who leaves the province with the permission of the Council may remain registered for the remainder of that current licence year. (e) For purpose of registration under section 29 of The Medical Profession Act, 1981 the following shall constitute evidence of satisfactory postgraduate training: (i) Physicians who have completed a Royal College specialty training program in Canada or a specialty training program in the U.S.A. and are eligible to sit the exam of the Royal College of Physicians and Surgeons of Canada and who are recommended for licensure by the Dean of Postgraduate Studies who oversees their program may be provisionally registered, with practice restricted to the discipline in which they have satisfactorily completed postgraduate training. (ii) Physicians who hold a specialty qualification from the United Kingdom of Great Britain and Northern Ireland, Ireland, Australia, New Zealand, or the Republic of South Africa or the United States of America and who are eligible to sit the examination of the Royal College of Physicians and Surgeons of Canada may be provisionally registered with practice restricted to the discipline in which they have satisfactorily completed postgraduate training. (iii) Physicians who are graduates from medical schools in the United Kingdom of Great Britain and Northern Ireland, Ireland, Australia, New Zealand, or the Republic of South Africa, who meet the postgraduate training requirements for section 28 and who have passed the MCCEE may be provisionally registered. (iv) Physicians who are graduates of other approved university medical schools who are fully registered with The General Medical Council, or the South African Medical and Dental Council or the Irish Medical Council or the New Zealand Medical Council or the Medical Council of Australia

8 and who have met the postgraduate training requirements of paragraph 21(2)(c) and have passed the MCCEE may be provisionally registered. (v) The Council will accept as evidence of satisfactory postgraduate clinical training proof that applicants have demonstrated satisfactory skills and knowledge by an assessment, undertaken at their own expense; such assessment to be in a form approved by the Council. (f) Provisionally registered physicians must comply with the following conditions of registration: (i) The registrant must qualify for licensure under section 28 within three years of the date of registration if a family physician, and five years from the date of registration if a specialist. Failure to become registered under section 28 will result in revocation of the licence. (ii) The registrant, if a family physician, will practise in a community with a population of 10,000 or less. (iii) The registrant must practise in the community for which they are registered for three years, and can only move before that time with the permission of Council. (5) Provisional Member (Inactive) (a) A provisional member (active) who leaves the province with the permission of the Council may, upon payment of the fee for inactive status, remain a provisional member (inactive) for the remainder of the three years of the provisional licence. (b) A provisional member (active) who has left the province and has paid the fee for inactive status as set out in the previous subparagraph of this bylaw shall not be entitled to practise medicine in Saskatchewan, nor to have become a provisional member (active) until the member: (i) produces a Certificate of Good Standing of recent origin from each jurisdiction the member has practised in since ceasing to be a regular member (active) in Saskatchewan; (ii) produces evidence of good character to the satisfaction of the Council in a form and in a manner that may be prescribed by the Council; (iii) pays the annual fee for a provisional member (active) established by the Council. (6) Special Member (a) A special member is a member registered under section 30 of the Act. (b) An applicant for a special licence shall produce proof of the applicant s: (i) good character to the satisfaction of the Council; and (ii) good standing as a practitioner. (c) (i) An applicant for a special licence under subsection 30(1) of The Medical Profession Act, 1981 shall prove to the satisfaction of the Council that: 1 the applicant is a graduate in medicine of a university approved by the Council; and 2 the applicant holds certification from the Royal College of Physicians and Surgeons of Canada; and/or 3 the applicant holds a specialty qualification acceptable to the Council from the United States, the United Kingdom of Great Britain and Northern Ireland, Ireland, Australia, New Zealand, or South Africa; and 4 there is a need for the applicant s medical skills in the community in which the applicant will work which cannot reasonably be met by a physician registered in accordance with section 28 or 29 of The Medical Profession Act, 1981 ; and 5 the applicant is certification eligible by the Royal College of Physicians and Surgeons of Canada (if not already certified by the Royal College of Physcians and Surgeons of Canada); and 6 if the applicant intends to confine his practice to a subspecialty of medicine or surgery, he has training in that sub-specialty of such kind as may be approved by the Council; and 7 the applicant has signed a five-year commitment and has agreed that any licence issued to the applicant may be revoked in the event that the applicant ceases to practise in the community in which the applicant has applied to work. Such commitment shall continue after the applicant obtains certification with the Royal College of Physicians and Surgeons of Canada and after the physician becomes licensed under section 28 or 29 of the Act. (ii) If the applicant is not certification eligible by the Royal College of Physicians and Surgeons of Canada, the Council may issue a special licence if the applicant meets the requirements of paragraphs (6)(c)(i)1, 3, 4 and 6, is a physician of renowned reputation and will be receiving an academic appointment. (iii) The special licence issued under this bylaw shall be automatically revoked and shall cease to be valid if: 1 the holder of the special licence ceases to practise in the community in which he or she applied to work, unless he or she has applied to Council to practise in another community, and has satisfied the Council that his or her practice in that community complies with paragraph (6)(c)(i)4 above; or 2 the holder of the special licence ceases to be employed by the employer for whom he or she applied to work, unless he or she has received the approval of the Council to work for another employer; or 3 the holder of a special licence who has applied to practise in a sub-specialty ceases to confine his or her practice to that sub-specialty; or 4 the holder of a special licence who has applied because of an academic appointment ceases to hold that academic appointment; or 5 the holder of a special licence fails to obtain certification from the Royal College of Physicians and Surgeons of Canada within the period of eligibility with the Royal College of Physicians and Surgeons; or 6 the holder of a special licence fails to become registered under section 28 within five years of the date of initial registration. (d) A physician for whom a request for a special licence is made by the minister under subsection 30(2) of The Medical Profession Act, 1981 shall practise Psychiatry in a branch of the public service of Saskatchewan or for a District Health Board. The applicant registered under subsection 30(2) shall sign a five-year commitment and agree that the licence issued may be revoked in the event that the applicant ceases to practise in the community in which the applicant has applied to work. Such commitment shall continue after the applicant obtains certification from the Royal College of Physicians and Surgeons of Canada or after the applicant becomes licensed under section 28 or 29 of the Act. (e) A physician for whom a request for a special licence is made by the minister under subsection 30(3) of The Medical Profession Act, 1981 shall prove to the satisfaction of the Council that: (i) the physician has received training in public health in such form as may be approved by the Council, if the physician is to serve as a public health officer; (ii) the physician meets the requirements for postgraduate training required of an applicant for registration under section 28 of The Medical Profession Act, 1981 if the physician intends to practise as a general practitioner in a hospital or other institution. (f) (i) A person who signs a commitment to practise in a community in accordance with this section, and who, during the period of that commitment practises in a community other than the community to which the commitment applies, shall be guilty of unbecoming, improper, unprofessional or discreditable conduct. (ii) Paragraph (6)(f)(i) does not apply if the person has received the permission of the Council to practise in the other community and practises in accordance with the terms of the permission given by the Council.

9 (7) Senior Life-Member (Active) (a) A regular member (active), registered under section 4 or 28 of the Act, shall become entitled to become a senior life-member (active) if the member: (i) has been fully registered in Saskatchewan for 40 consecutive years (service with the Canadian and/or Allied forces after registration shall be included in this period of time); and (ii) pays the annual fee established by the Council. (b) A senior life-member (active) shall be entitled to practise medicine in Saskatchewan, to hold office, and vote in the same manner as a regular member (active). (8) Senior Life-Member (Inactive) (a) A regular member (active), registered under section 4 or 28 of the Act, or a senior life-member (active), shall become entitled to become a senior life-member (inactive) if the member: (i) has been fully registered in Saskatchewan for 40 consecutive years (service with the Canadian and/or Allied forces after registration shall be included in this period of time); and (ii) voluntarily withdraws from the active practice of medicine. (b) A senior life-member (inactive) is not entitled to practise medicine in Saskatchewan. (c) In order for a senior life-member (inactive) to become a senior life-member (active) the member shall: (i) produce a Certificate of Good Standing of recent origin from each jurisdiction the member has practised in since ceasing to be a regular member (active); (ii) produce evidence of good character to the satisfaction of the Council in a form and in a manner that may be prescribed by the Council; (iii) produce evidence that the member has met the requirements of bylaw section 24; (iv) pay the annual fee for a senior life-member (active) established by the Council. (d) A senior life-member (inactive) is not required to pay an annual fee. (9) Locum Tenens Permits (a) There shall be four classes of locum tenens permits which may be issued by the Council. The Council may issue a supervised locum tenens permit, an unsupervised locum tenens permit, a conditional locum tenens permit and a special locum tenens permit. (b) The Council may issue a supervised locum tenens permit to a physician who: (i) produces documentation that he or she is a graduate in medicine from: 1 a university approved by the Council, and has obtained the L.M.C.C., F.L.E.X., N.B.M.E. or U.S.M.L.E. qualification; or 2 a medical school approved by the Council in the United Kingdom of Great Britain and Northern Ireland, Ireland, Australia, New Zealand or South Africa and has, at the time of application, full registration with the Licensing Body in the United Kingdom of Great Britain and Northern Ireland, Ireland, Australia, New Zealand or South Africa; or 3 a medical school approved by the Council and holds full registration with a Licensing Body in the United Kingdom of Great Britain and Northern Ireland, Ireland, Australia, New Zealand or South Africa; and (ii) produces evidence, in a form and manner that may be prescribed by the Council that he or she has either: 1 a minimum of one-year postgraduate training approved by the Council including eight weeks in each of Medicine, General Surgery, Obstetrics and Gynaecology, and Paediatrics in order to carry out a general practice locum; or 2 appropriate specialty training approved by the Council in order to carry out a locum in a specialty; and (iii) provides proof, to the satisfaction of the Council, that he or she is the person named in the documentation and is of good character; and (iv) satisfies the Council that he or she will practise under the supervision of another physician who practises in the vicinity. (c) The Council may issue a supervised locum tenens permit to a physician who: (i) produces documentation that he or she is a graduate of a Canadian medical school; (ii) is in a postgraduate II, III, IV, or V training year approved by Council; (iii) provides proof, to the satisfaction of Council, that he or she is the person named in the documentation and is of good character; and (iv) will practise under the supervision of another physician who practises in the vicinity. (d) A physician who receives a supervised locum tenens permit shall only be entitled to practise medicine in a location where another physician is available in the vicinity to supervise and consult. (e) The Council may issue an unsupervised locum tenens permit if the physician: (i) meets the requirements of paragraphs (9)(b)(i) and (9)(b)(iii); and (ii) meets the requirements for satisfactory postgraduate training established in paragraph 21(2)(c) or 21(4)(e). (f) The Council may issue an unsupervised locum tenens permit to a physician who: (i) produces documentation that he or she is a graduate of a Canadian medical school; (ii) is in a postgraduate III, IV, or V training year approved by Council; and (iii) provides proof, to the satisfaction of Council that he or she is the person named in the documentation and is of good character. (g) A supervised or unsupervised locum tenens permit may authorize the person named in the permit to practise for a period up to one year as a substitute for, deputy to or assistant to a member. (h) Unless the holder of a locum tenens permit is employed through the S.M.A. Locum Service, a locum who will practise with a medical staff appointment at a health care facility must be employed by or under contract to a member of the College who holds a staff appointment at the same health care facility. (i) The Council may issue a conditional locum tenens permit to a physician who: (i) meets the requirements of paragraphs (9)(b)(i) and (9)(b)(iii); (ii) is sponsored by a member of the College of Physicians and Surgeons who holds a medical staff appointment at a health care facility and undertakes to be responsible to acquaint the holder of the locum tenens permit with the Saskatchewan health care system; (iii) signs a five-year commitment to work in the community in which he or she is registered. This commitment shall continue after the physician becomes licensed under section 28 or 29 of the Act; (iv) meets the requirements for postgraduate training contained in paragraph 21(2)(c) or 21(4)(e); and (v) signs a commitment that he or she will take The Medical Council of Canada Evaluating Examination at the first opportunity. (j) A conditional locum tenens permit shall terminate: (i) thirty days after the first meeting of Council following the date of the first available Medical Council of Canada Evaluating Examination if the holder of the conditional locum tenens permit fails to take the exam, or