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Professional Staff

​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​Hospitals employ a variety of health professions to deliver competent, ethical and professional services. It is essential that all professions work in an integrated fashion to deliver quality patient-centred care.

Ontario hospitals rely on a diverse team of health care professionals, each with a defined scope of practice regulated by their respective professional colleges. Understanding and staying up to date with these scopes, along with recent legislative and regulatory changes, are critical for legal compliance, patient care, and operational efficiency.

While most health care professionals are regulated under the Regulated Health Professions Act (RHPA) framework and each profession has their respective college, exceptions exist.

This resource page was designed to support health care professionals in understanding the relevant legal and regulatory requirements that can impact their scope of practice. Key information, ​regulatory changes and resources related to specific health care professions and their scope of practice are highlighted below.​

Audiology and Speech-Language Path​ology​​

Dentistry 

Dietetics​​

Medical Laboratory Technology​

Medical Radiation and Imaging Technology​​

Medicine - Physician Assistants

Midwifery

Nursing

Occupational Therapy 

Personal Support Work​

Pharmacy

Physiotherapy

Social Work and Social Services


Audiology and Speech Language Pathology

​​​Definition

Audiologists an​d speech-language pathologists (SLPs) diagnose and treat hearing, balance, speech, language, and swallowing disorders. Audiologists focus on hearing and balance, while SLPs address communication and swallowing issues.​

Regulatory Body

The College of Audiologists and Speech-Language Pathologists of Ontario (CASLPO) governs the professions of audiology and speech language pathology in Ontario. CASLPO has the authority to make regulations on a variety of subject matters, including standards and qualifications for certificates of registration.​

There is also a public registry for audiologists and SLPs.

Relevant Legislation

Governed by the Regulated Health Professions Act, 1991 and the Audiology and Speech-Language Pathology Act, 1991.

Scope of Practice Statement

Under section 3 of the Audiology and Speech-Language Pathology Act, 1991, the practice of audiology is defined as “assessment of auditory function and the treatment and prevention of auditory dysfunction to develop, maintain, rehabilitate or augment auditory and communicative functions."

Authorized Acts                                                                  

Under section 4, a member of CASLPO may prescribe a hearing aid for a person with hearing impairment, subject to the terms, conditions and limitations imposed on their certificate of registration.

Qualifications and Registration

Education: Under section 5 of O Reg 21/12 (General), an applicant must have obtained a degree in audiology or speech-language pathology from an accredited program or completed an education and training program that the Registration Committee deems to be substantially equivalent.

Registration Requirements: All applicants must pass the CAASPR examination to be licensed by CASLPO. There are four pathways for applying to CASLPO, which includes a Canadian accredited program, international and non-accredited Canadian programs, professionals from other regulated provinces, and cross provincial practice certificates. The registration requirements differ for each pathway.

Delegation and Collaboration

Audiologists and SLPs collaborate with physicians, nurses, and other rehabilitation professionals, particularly in rehabilitation units or during surgical recoveries. SLPs may overlap with physiotherapists and occupational therapists in rehabilitation ​settings, particularly in areas involving swallowing therapy.​

Legal and Regulatory Considerations

Overview of applicable legislation can be found on the College of Audiologists and Speech-Language Pathologists of Ontario webpage​


Dentistry

Definition

Dentists diagnose, prevent and treat conditions and diseases related to the teeth, gums and mouth. This includes restorative, cosmetic, surgical and preventative care related to oral health.

Regulatory Body

The Royal College of Dental Surgeons of Ontario (RCDSO) governs the professions of dentistry in Ontario. RCDSO sets education standards for dentists, provides guidelines and resources, and provide the complaints and investigation process for the public.

There is also a public registry for dentists.

Relevant Legislation

Governed by the Regulated Health Professions Act, 1991 and the Dentistry Act, 1991.

Scope of Practice Statement

Under section 3 of the Dentistry Act, 1991, the practice of dentistry is defined as “assessment of the physical condition of the oral-facial complex and the diagnosis, treatment and prevention of any disease, disorder or dysfunction of the oral-facial complex."

Authorized Acts                                                                  

While engaging in the practice of dentistry, dentists are authorized – subject to the terms, conditions, and limitations imposed on their certificate of registration – to perform various tasks. Dentists are authorized to communicate a diagnosis by identifying a disease or disorder of the oral-facial complex that is causing a person's symptoms. They may perform procedures on tissues of the oral-facial complex beneath the dermis, mucous membranes, or the surfaces of teeth, including scaling. Dentists are also permitted to harvest tissue for oral-facial surgery, set fractures or dislocations of bones or joints in the oral-facial complex, and administer substances by injection or inhalation. In addition, they may apply or order the application of prescribed forms of energy; prescribe, dispense, sell, or compound drugs in accordance with applicable regulations; and fit or dispense dental prostheses, orthodontic or periodontal appliances, and intraoral protective devices.

Qualifications and Registration

Education: Under O Reg 205/94 (General), an applicant must hold a degree in dentistry that demonstrates successful completion of a university-based dental program with a minimum duration of four years.

Registration Requirements: To be certified as a general dentist in Canada, graduates of accredited dental programs and accredited qualifying programs must pass the National Dental Examining Board (NDEB) Examination and the Objective Structured Clinical Examination (OSCE). There are different pathways for internationally educated dentists.

Delegation and Collaboration

Dentists work closely with dental hygienists, assistants, denturists, and laboratory technicians. They may also consult with physicians, particularly in cases involving surgery, systemic disease of the oral-facial complex, or when sedation or general anesthesia is used. Dentists may also delegate certain tasks to dental hygienists.

Legal and Regulatory Considerations

Overview of applicable legislation can be found on the Royal College of Dental Surgeons of Ontario's webpage​


Dietetics

Definition

Dietitians are health care professionals who apply the science of nutrition to promote health, manage diseases, and improve quality of life through diet. They work in hospitals to develop personalized nutrition plans for patients.

Regulatory Body

Founded December 31, 1993, the College of Dietitians of Ontario (CDO) was established to regulate the profession of dietitians in Ontario. The CDO enforces the standards for qualifications, registration, continuing competence, conduct and ethics of dietitians.

There is also a public registry for dietitians.

Relevant Legislation 

Governed by the Regulated Health Professions Act, 1991, and the Dietitians Act, 1991, and other health care regulations.

Scope of Practice Statement

Under section 3 of the Dietitians Act, the practice of dietetics is defined as “the assessment of nutrition and nutritional conditions and the treatment and prevention of nutrition related disorders by nutritional mean."

Authorized Acts

Under section 3.1, a CDO member may take blood samples by skin pricking for the purpose of monitoring capillary blood readings subject to the term, conditions and limitations imposed on their certificate of registration.

Qualifications and Training

Education: Under section 6 of O Reg 593/94 (General), an applicant must have completed a Canadian university program in food and nutrition accredited by an approved agency or an equivalent program outside Canada. Additionally, the applicant must have successfully completed an accredited internship, practicum, or graduate program, or demonstrated equivalent practical experience as determined by the Registration Committee.

Registration Requirements: All applicants must pass the Canadian Dietetic Registration Examination (CDRE) and be registered with the CDO. There are different ways to apply for CDO membership. Please see registration requirements based on application type.  

Delegation and Collaboration

Dietitians work closely with physicians, nurses, and pharmacists, particularly when managing patients on specialized diets (e.g., tube feeding or parenteral nutrition). There can be significant overlap with physicians, nurses, personal support workers and pharmacists in terms of managing patient nutrition, especially in intensive care units.

Legal and Regulatory Considerations

Overview of applicable legislation can be found on the College of Dieticians of Ontario webpage. 

​Recent Regulatory Changes​

The RHPA was amended in October 2022 to reduce barriers to registration and require Colleges to establish an Emergency Class. To meet this requirement, the CDO amended its General Regulation made under the Dietetics Act, 1991, to add an emergency class certificate of registration (effective August 21, 2023).

The Ministry of Long-Term Care (MLTC) has proposed further amendments to Ontario Regulation 246/22 under the Fixing Long-Term Care Act, 2021. One of the amendments included the use of virtual care for nutritional assessments when onsite presence is not possible for registered dietitians in LTC homes. This amendment came into force on January 1, 2025.  ​


Medical Laboratory Technology

Definition

Medical laboratory technologists (MLTs) conduct laboratory tests on blood, tissue, and other samples to aid in the diagnosis and treatment of diseases. They are essential in hospital diagnostic labs.

Regulatory Body

The College of Medical Laboratory Technologists of Ontario (CMLTO) is the regulatory and governing body for MLTs who practice in Ontario. Additionally, the CMLTO sets the standards for entry to practice as an MLT and investigates MLT professional conduct complaints.

There is a public registry for MLTs.

Relevant Legislation

Governed by the Regulated Health Professions Act, 1991 and the Medical Laboratory Technology Act, 1991.

Scope of Practice Statement

Under section 3 of the Medical Laboratory Technology Act, the practice of medical laboratory technology is defined as “the performance of laboratory investigations on the human body or on specimens taken from the human body and the evaluation of the technical sufficiency of the investigations and their results."

Authorized Acts

A CMLTO member may take blood samples from veins or by skin pricking subject to the term, conditions and limitations imposed on their certificate of registration (s 4).

Qualifications and Training

Education: Under section 6 of O Reg 207/94 (General), an applicant must have either completed an approved medical laboratory technology program at a Canadian institution, obtained a relevant bachelor's degree from a Canadian university, or demonstrated equivalent education and experience through a comprehensive Prior Learning Assessment recognized by the Registration Committee.

Registration Requirements: All applicants must pass the national certification exam by the Canadian Society for Medical Laboratory Science (CSMLS) and be registered with CMLTO. The registration requirements for MLTs depend on whether the applicant was educated in Canada or internationally, or if the applicant was a registered MLT in another province. Please see registration requirements based on application type. 

Delegation and Collaboration

MLTs collaborate with pathologists, physicians and other health care providers who rely on laboratory results for diagnosis.

Legal and Regulatory Considerations

Overview of applicable legislation can be found on the College of Medical Laboratory Technologists of Ontario webpage.



Medical Radiation and Imaging Technology​

Definition

Medical radiation technologists (MRTs) use imaging technologies like X-rays, MRIs, CT scans, and ultrasounds to help diagnose and treat patients. They are vital in both diagnostic and therapeutic hospital settings.

Regulatory Body

The College of Medical Radiation and Imaging Technologists of Ontario (CMRITO) is the regulatory body responsible for MRTs in Ontario.

There is a public registry for MRTs.

Relevant Legislation

Governed by the Regulated Health Professions Act, 1991, the Medical Radiation and Imaging Technology Act, 2017, and other healthcare regulations.

Scope of Practice Statement​​​

Under section 3 of the Medical Radiation and Imaging Technology Act, the practice of medical radiation and imaging technology is defined as “the use of ionizing radiation, electromagnetism, soundwaves and other prescribed forms of energy for the purposes of diagnostic or therapeutic procedures, the evaluation of images and data relating to the procedures and the assessment of an individual before, during and after the procedures."

Authorized Acts

Under section 4, a CMRITO member may administer substances by injection or inhalation; perform tracheal suctioning of a tracheostomy; administer contrast media, or put an instrument, hand or finger beyond different points of the body; perform a procedure on tissue below the dermis; and apply a prescribed form of energy subject to the terms, conditions and limitations imposed on their certificate of registration.

Qualifications and Training

Education: Under section 4 of O Reg 31/24, an applicant must have completed an approved course of study in medical laboratory technology at a Canadian institution, obtained a relevant baccalaureate degree from a Canadian university, or demonstrated equivalent education and experience through a comprehensive Prior Learning Assessment recognized by the Registration Committee.

View more information about approved educational programs on the Regulator of Medical Radiation and Imaging Technologists in Ontario webpage​.

Registration Requirements: All applicants must pass the national certification exam by the Canadian Association of Medical Radiation Technologists (CAMRT) and register with CMRITO. There are four types of CMRITO applicants: Ontario graduates, Canadian labour mobility applicants, Canadian non-labour mobility applicants, and international graduates. The registration requirements differ for each pathway. View more information about the registration requirements.

Delegation and Collaboration

MRTs collaborate with radiologists, oncologists, and other specialists to inte​rpret imaging results and plan treatments.

Legal and Regulatory Considerations

Overview of applicable legislation can be found on the Regulator of Medical Radiation and Imaging Technologists in Ontario webpage​.


Medicine – Physicians​

Definition

Physicians diagnose, treat, and manage a wide range of health conditions. They are central to hospital care, offering direct patient care and coordinating teams.

Regulatory Body

The College of Physicians and Surgeons of Ontario (CPSO) is the regulatory body for the practice of medicine in Ontario.

There is a public registry for physicians.

Relevant Legislation

Governed by the Regulated Health Professions Act, 1991, Medicine Act, 1991, and Public Hospitals Act, 1990 (PHA).

Privileges and Appointments

The PHA governs the hospital-physician relationship. It requires the hospital's medical advisory committee (a committee of the hospital board) to consider and make recommendations regarding the appointment and privileges of physicians. As such, any physician seeking to provide services in a hospital must follow the processes outlined in the PHA. The PHA also sets out detailed rules around granting, renewal, termination and restriction of privileges (ss 35 – 37).

For more information on privileges and credentialing, please see the OHA Professional Staff Credentialing Toolkit.

Scope of Practice Statement

Under section 3 of the Medicine Act, the practice of medicine is defined as “the assessment of the physical or mental condition of an individual and the diagnosis, treatment and prevention of any disease, disorder or dysfunction."

Authorized Acts

In the course of engaging in the practice of medicine, a physician is authorized, subject to the terms, conditions, and limitations imposed on their certificate of registration, to perform various tasks. These include communicating a diagnosis identifying a disease or disorder as the cause of a person's symptoms; performing procedures on tissue below the dermis or mucous membrane surfaces; setting or casting fractures or dislocations; moving spinal joints beyond their usual range of motion using a fast, low amplitude thrust; administering substances by injection or inhalation; and inserting instruments, hands, or fingers beyond certain anatomical points. Additionally, they can apply or order the application of prescribed forms of energy; prescribe, dispense, sell, or compound drugs; prescribe or dispense vision or eye-related devices; prescribe hearing aids; manage labor or conduct deliveries; perform allergy challenge testing; and treat serious disorders of thought, cognition, mood, emotional regulation, perception, or memory through psychotherapy techniques delivered in a therapeutic relationship.

Qualifications and Training

Education: The educational requirements vary depending on the type of certification, but all applicants seeking to practice as physicians must hold a medical degree.

Registration Requirements: For physicians, there are six registration types. View more information about the registration requirements on the CPSO webpage​

Physicians are licensed by the CPSO after passing Medical Council of Canada Qualifying Examination (MCCQE).

Delegation and Collaboration

Physicians can delegate tasks and work closely with health care teams.

Legal and Regulatory Considerations

Overview of applicable legislation can be found on the CPSO webpage​

Recent Regulatory Changes

N/A

Relevant Resources​


Medicine – Physician Assistants​

Definition

Physicians diagnose, treat, and manage a wide range of health conditions. They are central to hospital care, offering direct patient care and coordinating teams.​

As of April 1, 2025, physician assistants (PAs) will also be covered under the Medicine Act, 1991 and will be regulated under the authority of the College of Physicians and Surgeons of Ontario (CPSO).​

Regulatory Body

The College of Physicians and Surgeons of Ontario (CPSO) is the regulatory body for the practice of medicine in Ontario.

There is a public registry for physicians.

Relevant Legislation

Governed by the Regulated Health Professions Act, 1991, Medicine Act, 1991, and Public Hospitals Act, 1990 (PHA).

Scope of Practice Statement

Under section 3 of the Medicine Act, the practice of medicine is defined as “the assessment of the physical or mental condition of an individual and the diagnosis, treatment and prevention of any disease, disorder or dysfunction."

Authorized Acts

As of April 1, 2025, PAs will be authorized to perform certain authorized acts only if these acts have been delegated to them by a physician. However, PAs are not permitted to perform psychotherapy techniques for treating serious mental health disorders, even if delegated. Additionally, PAs cannot further delegate any acts that have been delegated to them. Before delegating an act, physicians must ensure they themselves are competent to perform the act and that the PA is also competent to perform it safely. PAs can assume that a physician is allowed to delegate an act unless they have reason to believe otherwise. Finally, PAs must ensure they have the necessary knowledge, skill, and judgment to perform any delegated act safely and competently before proceeding (O Reg 114/94 s 52).

For more information on delegation to PAs, please see the CPSO's guidance.

Qualifications and Training

Education: Under section 9.1, PAs must have completed an accredited physician assistant program, hold certification from an approved body such as the Canadian Certified Physician Assistant (CCPA) or Physician Assistant-Certified (PA-C), and meet Council-approved education and training requirements.

Registration Requirements: PAs must have graduated from an accredited PA education program and successfully completed a certifying examination in Canada or the U.S.

Delegation and Collaboration

Physician assistants are authorized to perform certain acts solely when a physician delegates these acts.

Legal and Regulatory Considerations

Overview of applicable legislation can be found on the CPSO webpage​

Recent Regulatory Changes

N/A

Relevant Resources


Midwifery​

Definition

Midwives provide comprehensive care to individuals during pregnancy, childbirth, and the postpartum period. They are skilled in managing low-risk pregnancies and are an integral part of hospital maternity care.

Regulatory Body

The College of Midwives of Ontario (CMO) is the regulatory body responsible for midwives in Ontario.

There is a public registry for midwives.

Relevant Legislation

Governed by the Regulated Health Professions Act, 1991, and the Midwifery Act, 1991.

Scope of Practice Statement

Under section 3 of the Midwifery Act, 1991, the practice of midwifery is defined as “assessment and monitoring of women during pregnancy, labour and the post-partum period and of their newborn babies, the provision of care during normal pregnancy, labour and post-partum period and the conducting of spontaneous normal vaginal deliveries."

Authorized Acts

Under section 4, Midwives are authorized to perform many acts in the context of labour, delivery and postpartum, subject to the terms, conditions and limitations imposed on their certificate of registration. These acts include communicating a diagnosis and disease, managing labour, inserting urinary catheters into women, performing episiotomies and amniotomies, administering substances, prescribing drugs, placing instruments beyond the labia majora, taking blood samples from newborns, intubating newborns, and administering substances by injection or inhalation when ordered by a physician.

Qualifications and Training

Education: Under section 8 of O Reg 168/11 (Registration), an applicant must have a baccalaureate degree in health sciences (midwifery) from an Ontario university, the Midwifery Pre-registration Program of the Michener Institute of Applied Health Sciences, or equivalent qualifications as determined by the Council or its designated body.

Registration Requirements: Applicants must register with the CMO and successfully complete the Canadian Midwifery Registration Examination (CMRE).

Other registration requirements for midwives depend on the applicant's background. These requirements vary based on whether the applicant is a graduate of an Ontario Midwifery Education Program (MEP), a former registrant of the CMO within the last five years, a midwife currently registered in another Canadian jurisdiction, a graduate of a Midwifery Education Program in another Canadian jurisdiction (but not currently registered), or an internationally educated midwife. Please see the registration requirements based on application type.

Delegation and Collaboration

Midwives work closely with obstetricians, nurses, and family physicians, particularly when managing higher-risk pregnancies that require consultation or transfer of care.

Legal and Regulatory Considerations

Overview of applicable legislation can be found on the College of Midwives of Ontario webpage.​ 

Recent Regulatory Changes

N/A

Regulatory Amendments Under the Midwifery Act, 1991

On October 23, 2023, the CMO proposed several amendments to Ontario Regulation 884/93 (Designated Drugs) made under the Midwifery Act, 1991, to better reflect the current midwifery scope of practice and best practices for the profession. 

On May 3, 2024, O. Reg. 884/93 was revoked and replaced with Ontario Regulation 188/24 (Designated Drugs and Substances). The differences between the revoked regulation and new regulation include a revised list of the drugs and substances that midwives are authorized to prescribe and/or administer on their own authority, and authorizing midwives to administer certain drugs and substances in a hospital setting, so long as they have the knowledge, skill, and judgment to do so. The regulation sets out how midwives can demonstrate they have the necessary knowledge, skill and judgment. The new regulation also authorizes midwives to use or administer drugs or substances on the order of both physicians and nurse practitioners, whereas the revoked regulation only enabled midwives to act on the order of a physician.

Additionally, on April 10, 2024, the Ministry of Health proposed to amend Ontario Regulation 45/22 (General) under the Laboratory and Specimen Collection Centres Licensing Act, 1990 (LSCCLA) to expand midwives' scope of practice. Currently, midwives can order specific laboratory tests under Schedule 2 of the Regulation but are not authorized to perform point-of-care tests (POCTs) on collected specimens. The proposed amendments would expand the list of laboratory tests that midwives can requisition by adding 35 tests and would identify 8 POCTs that midwives can perform. The consultation phase closed in May 2024 and there is currently no anticipated proclamation date.

Relevant Resources


Nursing

Definition

Nurses, including registered nurses (RNs), registered practical nurses (RPNs), and nurse practitioners (NPs), provide direct patient care, including administering medications, monitoring health, and supporting recovery. NPs have advanced practice roles that allow them to diagnose, prescribe, and treat certain conditions independently.

Regulatory Body

The College of Nurses of Ontario (CNO) is the regulatory and governing body for nurses who practice in Ontario.

There is a public registry for nurses.

Relevant Legislation 

Governed by the Regulated Health Professions Act, 1991, the Nursing Act, 1991, and other health care regulations.

Scope of Practice Statement

Under section 3 of the Nursing Act, the practice of nursing is defined as “the promotion of health and the assessment of, the provision of care for and the treatment of health conditions by supportive, preventive, therapeutic, palliative and rehabilitative means in order to attain or maintain optimal function."

Authorized Acts

RPNs and RNs in Ontario are authorized to perform a range of controlled acts in the course of their practice, subject to the terms, conditions, and limitations imposed on their certificates of registration. They are permitted to:

  • Communicate a diagnosis to a patient or their representative; however, this is strictly limited to cases where the diagnosis is made for the purpose of prescribing a drug as authorized by regulation

  • Perform prescribed procedures below the dermis or a mucous membrane

  • Administer substances by injection or inhalation

  • Insert an instrument, hand, or finger beyond various anatomical points, including the external ear canal, the nasal passages beyond their normal narrowing, the larynx, the opening of the urethra, the labia majora, the anal verge, or into an artificial opening in the body

  • Prescribe drugs designated in the regulations, dispense drugs

  • Provide psychotherapy to individuals suffering from serious disorders affecting thought, cognition, mood, emotional regulation, perception, or memory when such conditions may significantly impair an individual's judgment, insight behavior, communication, or social functioning

NPs, who are registered nurses holding an extended certificate of registration, have a broader scope of practice that includes additional controlled acts beyond those authorized for RPNs and RNs. NPs are permitted to:

  • Communicate a diagnosis that identifies a disease or disorder as the cause of a patient's symptoms

  • Perform procedures below the dermis or a mucous membrane

  • Insert an instrument, hand, or finger beyond various anatomical landmarks, similar to RNs and RPNs.

  • Apply or order the application of a prescribed form of energy, such as defibrillation or ultrasound

  • Set or cast fractures and dislocations

  • Administer substances by injection or inhalation in accordance with the regulations, and, in some cases, administer such substances only when ordered by a physician or another authorized health care provider

  • Prescribe, dispense, sell, or compound drugs as permitted by the regulations

  • Provide psychotherapy for individuals experiencing serious mental health disorders that may significantly impact their cognitive or emotional well-being

Qualifications and Training

Education: Under O Reg 275/94 (Registration), applicants for registration as RPNs must have completed an approved diploma in practical nursing, while RNs must have a baccalaureate degree in nursing from an approved program or an equivalent qualification. NPs must be or have been registered as an RN, have completed an approved extended class nursing program, and passed an approved specialty examination. All applicants must meet examination, language proficiency, and practice requirements as determined by the Registration Committee.

Registration Requirements: All applicants must register with the CNO to become members. The registration requirements for nurses depend on the applicant's background and the type of registration they are seeking. Requirements vary based on whether the applicant is applying as an RN or RPN from Ontario, another Canadian jurisdiction, or outside Canada, applying as an NP, seeking registration in the Temporary Class, or applying for reinstatement of their membership with the CNO. Please see the registration requirements based on application type.

Delegation and Collaboration

Nurses collaborate with physicians, dietitians, and other health care providers to deliver comprehensive care.

Legal and Regulatory Considerations

Overview of applicable legislation can be found on the College of Nurses of Ontario webpage​

Recent Regulatory Changes

The CNO is proposing amendments to Ontario Regulation 275/94 (General) under the Nursing Act, 1991. The proposed amendments relate to the education requirements for RNs and RPNs, including:

  • RN applicants who have completed a baccalaureate RN program, or RPN applicants who have completed a diploma RPN program, will be considered to have met the education requirement - without further assessment - if their program is recognized or approved in the jurisdiction where it was completed as qualifying them to practice as an RN or RPN, respectively

  • Revising the standard for the knowledge, skill and judgment of RN applicants who have not completed a baccalaureate RN program or RPN applicants who have not completed a diploma RPN program to “substantially equivalent" rather than “at least equivalent" to applicants who have completed such programs

  • Adding a requirement for applicants to complete a course to support their integration into the health care system in Canada (unless they quality for a prescribed exemption)

These proposed amendments are intended to create evidence-informed efficiencies for internationally educated nurse (IEN) applicants to meet the education requirement while also supporting IEN applicants' transition to safe practice in Ontario. Read the CNO's proposal. The anticipated proclamation date is April 1, 2025.

Government Proposes Revising Immigration Program Requirements for Nurses

On June 12, 2024, the provincial government proposed revising the requirements for nurses applying to the Ontario Immigrant Nominee Program (ONIP), which are set out in Ontario Regulation 280/24 (General) under the Ontario Immigration Act, 2015. The OINP is Ontario's economic immigration program that nominates individuals who meet certain requirements to the federal government for permanent residence. The Express Entry Human Capital Priorities (HCP) and Express Entry French-Speaking Skilled Worker (FSSW) streams under the OINP have specific education requirements.

Effective July 1, 2024, in an effort to support Ontario's health human resources capacity, nurses applying for the HCP or FSSW streams are no longer required to demonstrate they meet the education requirements if they can establish that they are registered with the CNO in the General, Extended or Temporary class. 

Provincial Government Initiates Nursing Scope of Practice Consultation 

On September 10, 2024, the Min​istry of Health (MOH), along with the Ministry of Public and Business Service Delivery (MPBSD) launched another consultation as part of the MOH's Your Health: A Plan for Connected and Convenient Care initiative. The consultation focuses on whether expanding the scopes of practice for NPs and RNs would help improve the timeliness of health care delivery.​

Specifically, the MOH is seeking feedback on whether NPs should be authorized to order and apply electricity in certain situations - such as using defibrillation to treat heart conditions - and whether they should be permitted to complete and sign mandatory blood testing forms. In addition, both the MOH and the Ministry of Public and Business Service Delivery (MPBSD) are consulting on proposed amendments to Regulation 1094 (General) under the Vital Statistics Act to remove restrictions on when NPs can certify death and to authorize RNs to complete and sign a Medical Certificate of Death, provided certain criteria are met. There is currently no anticipated proclamation date. ​


Occupational Therapy​

Definition

Occupational therapists (OTs) help individuals regain or improve their ability to perform daily activities following illness, injury, or disability.

Regulatory Body

The College of Occupational Therapists of Ontario (COTO) is the regulatory and governing body for occupational therapists who practice in Ontario.

There is a public registry for OTs.

Relevant Legislation

Governed by the Regulated Health Professions Act, 1991 and the Occupational Therapy Act, 1991.

Scope of Practice Statement

Under section 3 of the Occupational Therapy Act, 1991, the practice of occupational therapy is defined as “assessment of function and adaptive behaviour and the treatment and prevention of disorders which affect function or adaptive behaviour to develop, maintain, rehabilitate or augment function or adaptive behaviour in the areas of self-care, productivity and leisure."

Authorized Acts

Under section 3.1, a member of COTO may treat, by means of psychotherapy technique delivered through a therapeutic relationship, an individual's serious disorder of thought, cognition, mood, emotional regulation, percep​tion or memory that may seriously impair the individual's judgement, insight, behaviour, communication or social functioning subject to the term, conditions and limitations imposed on their certificate of registration.

Qualifications and Training​

Education: Under section 36 of O Reg 122/01 (Registration), an applicant for a general practicing certificate must have a Bachelor of Science or Master of Science in Occupational Therapy from Ontario, an equivalent academic qualification approved by the Registration Committee, or a recognized diploma granted before 1973.

Registration Requirements: All applicants must pass the national certification exam and be registered with COTO. The registration requirements for OTs depend on the applicant's background and registration type. General registration is available to applicants who meet all requirements, including those educated in Canada or abroad and those registered in another province. Applicants may also be Canadian-educated, internationally educated, or already registered in another province. Former registrants of COTO must reapply and meet all currency, suitability to practice, and insurance requirements. Provisional registration may be granted to applicants awaiting the National Occupational Therapy Certification Examination (NOTCE), while temporary registration allows occupational therapists from other provinces or countries to practice in Ontario for a limited period. For more details, see the registration requirements based on application type.

Delegation and Collaboration

OTs work closely with physiotherapists, speech therapists, and physicians in rehabilitation settings.

Legal and Regulatory Considerations

Overview of applicable legislation can be found on the College of Occupational Therapists of Ontario webpage​​


Personal Support Work​

Definition

Personal Support Workers (PSWs) provide care to individuals requiring assistance with activities of daily living (ADLs), such as feeding, bathing, and mobility. They often work in homes, long-term care facilities, and community settings.  

Oversight Authority

As of December 2024, the Health and Supportive Care Providers Oversight Authority (HSCPOA) is responsible for registering and overseeing PSWs in Ontario.   

There is a public registry for PSWs.

Relevant Legislation

Governed by the Health and Supportive Care Providers Oversight Authority Act, 2021.

Scope of Practice Statement

The PSW framework does not define a specific scope of practice for PSWs. Instead, each hospital may choose to determine the scope of practice for PSWs working within their organization, subject to the controlled acts provisions in the Regulated Health Professions Act, 1991.

Authorized Acts

N/A

Qualifications and Training

Education: Under section 5(2) of O. Reg. 217/24 (Registration), an applicant must have completed a program that meets the standards set by the Ministry of Colleges and Universities for preparing individuals to provide personal support services. The program must have been delivered by an Ontario post-secondary institution or district school board that issued the applicant a personal support worker certificate. Applicants who do not meet this requirement must explore alternative pathways to registration.

Registration Requirements: PSWs can apply for registration with HSCPOA through four different pathways based on their qualifications and experience. For more information about the registration pathways and the documentation requirements for each pathway, please visit the HSCPOA website.

Delegation and Collaboration

PSWs work closely with nursing staff, occupational therapists and other health professionals particularly in long-term care settings.

Legal and Regulatory Considerations

Overview of applicable legislation can be found on the Health and Supportive Ca​re Providers Oversight Authority webpage.​​ 

Relevant Resources

Pharmacy​​

Definition

Pharmacists and pharmacy technicians in hospitals manage medications, review prescriptions, and advise health care teams on drug therapies. They play a critical role in ensuring medication safety and effectiveness.

Regulatory Body

The Ontario College of Pharmacists (OCP) is the regulatory and governing body for pharmacists who practice in Ontario.

Relevant Legislation

Governed by the Regulated Health Professions Act, 1991 and the Pharmacy Act, 1991.

Scope of Practice Statement

Under section 3 of the Pharmacy Act, 1991, the practice of pharmacy includes the custody, compounding, dispensing and prescribing of drugs, the provision of health care aids and devices and the provision of information and education related to the aforementioned. Additionally, the practice includes the promotion of health, prevention and treatment of disease, disorders and dysfunctions through monitoring and management of medication therapy and the assessment of conditions for the purposes of providing medication therapies.

Authorized Acts

Under section 4 of the Pharmacy Act, 1991, an OCP member may dispense and prescribe drugs, supervise the part of the pharmacy where drugs are kept, administer substances specified in the regulations by injection or inhalation, prescribe drugs listed in the regulations as well as those not in accordance with them, and perform procedures on tissue beneath the dermis, subject to the terms, conditions, and limitations set forth in their certificate of registration their certificate of registration.

Additionally, these acts must be performed in accordance with the regulations under the Pharmacy Act, 1991, which pharmacists, interns, pharmacy technicians, and intern technicians are authorized to do, specifies the substances and drugs that may be administered or prescribed, and sets out procedural safeguards, including informed consent, patient record-keeping, and collaboration requirements where applicable (see Part XIV – O Reg 256/24).

Qualifications and Training

Education: Under O. Reg. 202/94 (Registration), applicants for registration as pharmacists must hold a baccalaureate degree in pharmacy from a Canadian program accredited by the Canadian Council for Accreditation of Pharmacy Programs, or possess an equivalent qualification approved by the Council. Pharmacy technicians must have a certificate, diploma, or university degree in pharmacy from an accredited program, or an equivalent qualification approved by the Council. Applicants whose education does not meet these requirements must undergo an evaluation and complete either a bridging program or the qualifying examination of the Pharmacy Examining Board of Canada (PEBC).

Registration Requirements: All registrants must successfully complete OCP national and provincial examinations. The registration requirements for pharmacists in Ontario depend on the applicant's education and licensing background. While all applicants must meet the same requirements and qualifications, there are different pathways to registration.

Applicants must first complete the education requirement before beginning the registration process. Pathways include graduating from a CCAPP-accredited pharmacy program in Ontario or another province, an ACPE-accredited pharmacy program, or an international pharmacy program. International graduates who have passed the PEBC Qualifying Exam on the first attempt may have additional considerations. Additionally, pharmacists already licensed in Canada outside Ontario can apply through a separate process. For more details, see the registration requirements based on application type.

Delegation and Collaboration

Pharmacists work closely with physicians, nurses, and dietitians to optimize patient medication plans.

Legal and Regulatory Considerations

Overview of applicable legislation can be found on the Ontario College of Pharmacists webpage. ​

Recent Regulatory Changes

Pharmacy Scope of Practice Consultation

In February 2023, the Ministry of Health (MOH) released Your Health: A Plan for Connected and Convenient Care (the Plan), which includes exploring the expansion of pharmacists' scope of practice. Since the release of the Plan, the scope of practice of community pharmacists has been expanded to allow them to administer more vaccines and to prescribe for 19 minor ailments. On September 5, 2024, the MOH initiated a consultation on further expanding pharmacists' scope of practice and is seeking feedback on adding new minor ailments that pharmacists can prescribe for, allowing pharmacists to order certain laboratory tests and perform more point-of-care tests (POCTs) for minor ailments, and allowing pharmacists to communicate a diagnosis for specific minor ailments.

To date, hospital pharmacists have not been able to participate in the expanded scope of practice due to provisions in Regulation 965 (Hospital Management) under the Public Hospitals Act (PHA). As part of its consultation, the MOH explored if there are other barriers, outside of the PHA, that prevent pharmacists from working to the full scope of their practice in a hospital setting.

The MOH also sought feedback on enabling pharmacy technicians to administer additional vaccines and offering a publicly funded adult vaccine bundle. The final area that was consulted on is current issues and opportunities to improve the MOH's MedsCheck program. This consultation is closed in October 2024.

Proposed Regulatory Amendments under the Pharmacy Act, 1991

In December 2023, the MOH proposed regulatory amendments to Ontario Regulation 202/94 (General) under the Pharmacy Act, 1991, which would, among other things, create a two-part register for pharmacy technicians, revise the quality assurance program for pharmacists and pharmacy technicians, and shift from a minimum practice hour requirement to a self-declaration of competency in conjunction with practice assessments. However, rather than amending O. Reg 202/94, this regulation was revoked on October 1, 2024, and replaced with a new regulation, Ontario Regulation 256/24 (General), which incorporates what was outlined in the government's proposal.

Relevant Resources


Physiotherapy​

Definition

Physiotherapists help individuals restore movement and function following injury, illness, or disability. They use physical therapy techniques to manage pain, improve mobility, and prevent further injury.

Regulatory Body

The College of Physiotherapists of Ontario (CPO) is the regulatory and governing body for physiotherapists who practice in Ontario.

Relevant Legislation

Governed by the Regulated Health Professions Act, 1991 and the Physiotherapy Act, 1991.

Scope of Practice Statement

Under section 3 of the Physiotherapy Act, 1991, the practice of physiotherapy is defined as “the assessment of neuromuscular, musculoskeletal and cardio respiratory systems, the diagnosis of diseases or disorders associated with physical dysfunction, injury or pain and the treatment, rehabilitation and prevention or relief of physical dysfunction, injury or pain to develop, maintain, rehabilitate or augment function and promote mobility."

Authorized Acts

Under section 4 of the Physiotherapy Act, 1991, physiotherapists are authorized to perform several controlled acts in the course of their practice, subject to the terms, conditions, and limitations imposed on their certificate of registration. These acts include communicating a diagnosis identifying a disease, physical disorder, or dysfunction as the cause of a person's symptoms; moving the joints of the spine beyond a person's usual physiological range of motion using a fast, low-amplitude thrust; performing tracheal suctioning; and treating wounds below the dermis through cleansing, soaking, irrigating, probing, debriding, packing, and dressing. Physiotherapists are also authorized to assess or rehabilitate pelvic musculature related to incontinence or pain disorders by inserting an instrument, hand, or finger beyond the labia majora or anal verge, order the application of a prescribed form of energy, and administer substances by inhalation.

Qualifications and Training

Education: Regardless of the type of certification, under O Reg 532/98, a member requires a degree in physiotherapy.

Registration Requirements: The registration requirements for physiotherapists in Ontario depend on their educational background. Canadian-educated applicants can apply for Provisional Practice after graduating from a Canadian physiotherapy program, passing the written exam, and registering for the Ontario Clinical Exam. Once both exams are completed, they can apply for Independent Practice to become fully licensed. Internationally educated applicants must have their education credentialed and complete a language assessment through the Canadian Alliance of Physiotherapy Regulators (CAPR) before registering with the CPO. For more details, see the registration requirements.

Delegation and Collaboration

Physiotherapists work closely with physicians, occupational therapists, and other health care professionals to develop treatment plans for patients in hospitals and rehabilitation centers.

Legal and Regulatory Considerations

Overview of applicable legislation can be found on the College of Physiotherapists of Ontario webpage.​ 


Psychology and Applied Behaviour Analysis​

Definition

​Psychologists assess, diagnose, and treat mental health conditions and cognitive disorders. They use psychological interventions to support individuals experiencing emotional and behavioral challenges.

Regulatory Body

The College of Psychologists and Behaviour Analysts of Ontario (CPBAO) is the regulatory and governing body for psychologists who practice in Ontario.

Relevant Legislation

Governed by the Regulated Health Professions Act, 1991 and the Psychology and Applied Behaviour Analysis Act, 2021.

Scope of Practice Statement

Under section 3 of the Psychology and Applied Behaviour Analysis Act, 2021, the practice of psychology is defined as “the assessment of behavioural and mental conditions, the diagnosis of neuropsychological disorders and dysfunctions and psychotic, neurotic and personality disorders and dysfunctions, the prevention and treatment of behavioural and mental disorders and dysfunctions and the maintenance and enhancement of physical, intellectual, emotional, social and interpersonal functioning." Meanwhile, the practice of applied behaviour analysis is defined as “the assessment of covert and overt behaviour and its functions through direct observation and measurement, and the design, implementation, delivery and evaluation of interventions derived from the principles of behaviour in order to produce meaningful improvements."

Authorized Acts

Under section 4 of the Psychology and Applied Behaviour Analysis Act, 2021, a CPBAO member is authorized to perform specific controlled acts in the course of their practice, subject to the terms, conditions, and limitations imposed on their certificate of registration. These acts include communicating a diagnosis that identifies a neuropsychological disorder or a psychologically based psychotic, neurotic, or personality disorder as the cause of a person's symptoms. Additionally, psychologists are authorized to treat individuals with serious disorders of thought, cognition, mood, emotional regulation, perception, or memory that may significantly impair judgment, insight, behavior, communication, or social functioning through psychotherapy techniques delivered within a therapeutic relationship.

Qualifications and Training

Education: Under section 6(1) of O Reg 67/15 (Registration), an applicant must have completed a psychotherapy program approved by the Registration Committee, received a master's degree in the same program or completed a program substantially equivalent to the ones mentioned above, or have other education and training that, when combined, meet the Committee's standards for substantial equivalence.

Registration Requirements: The registration requirements for psychology and behavioural analysis in Ontario depend on the applicant's background and application stream. Applicants may apply for Supervised Practice as a Psychologist or Psychological Associate, including those educated outside Canada/U.S. Those already licensed in another Canadian jurisdiction can apply for Autonomous Practice under Canadian Labour Mobility, while applicants currently licensed in the U.S. have a separate process. For more details, see the registration requirements.

Delegation and Collaboration

Psychologists collaborate with psychiatrists, social workers, and health care teams in hospitals and mental health clinics.

Legal and Regulatory Considerations

Overview of applicable legislation can be found on the College of Psychologists and Behaviour Analysts of Ontario webpage. ​


Psychotherapy​

Definition

Psychotherapists provide therapeutic interventions to help patients manage mental health conditions and emotional challenges.

Regulatory Body

The College of Registered Psychotherapis​ts of Ontario (CRPO) is the regulatory and governing body for psychotherapists who practice in Ontario.

Relevant Legislation

Governed by the Regulated Health Professions Act, 1991 and the Psychotherapy Act, 2007.

Scope of Practice Statement

Under section 3 of the Psychotherapy Act, 2007, the practice of psychotherapy is defined as “the assessment and treatment of cognitive, emotional or behavioural disturbances by psychotherapeutic means, delivered through a therapeutic relationship based primarily on verbal or non-verbal communication."

Authorized Acts

Under section 4 of the Psychotherapy Act, 2007, a CRPO member may treat, by means of psychotherapy technique delivered through a therapeutic relationship, an individual's serious disorder of thought, cognition, mood, emotional regulation, perception or memory that may seriously impair the individual's judgement, insight, behaviour, communication or social functioning, subject to the terms, conditions and limitations imposed on their certificate of registration.

Qualifications and Training

Education: Under section 6(1) of O Reg 67/15 (Registration), an applicant must have completed a psychotherapy program approved by the Registration Committee, received a master's degree in the same program or completed a program substantially equivalent to the ones mentioned above, or have other education and training that, when combined, meet the Committee's standards for substantial equivalence.

Registration Requirements: The registration requirements for psychotherapy in Ontario depend on the applicant's background and application type. Applicants have five types of applications they can choose from, which includes CRPO recognized/accepted program, non-recognized program, labour mobility, Indigenous registration pathway and temporary. For more details, see the registration requirements.

Delegation and Collaboration

Psychotherapists work alongside psychologists, psychiatrists, and social workers to provide mental health care services in clinical and community settings.

Legal and Regulatory Considerations

Overview of applicable legislation can be found on the College of Registered Psychotherapists of Ontario webpage​

Recent Regulatory Changes

In October 2024, several colleges proposed regulations related to protecting patients against sexual abuse by members of the profession. One of these proposals included a proposed regulation from CRPO, which would extend the definition of “sexual abuse" to include conduct toward any individual who was a member's client within the past five years.​


Respiratory Therapy

Definition

Respiratory therapists (RTs) provide care for patients with breathing disorders, including managing ventilators and administering oxygen therapy.

Regulatory Body

The College of Respiratory Therapists of Ontario (CRTO) is responsible for governing the practice of respiratory therapy and RTs in Ontario.

Relevant Legislation

Governed by the Regulated Health Professions Act, 1991 and the Respiratory Therapy Act, 1991.

Scope of Practice Statement

Under section 3 of the Respiratory Therapy Act, the practice of respiratory therapy is defined as “providing of oxygen therapy, cardio-respiratory equipment monitoring and the assessment and treatment of cardio-respiratory and associated disorders to maintain or restore ventilation."

Authorized Acts

Under section 4 of the Respiratory Therapy Act, RTs are authorized to perform several key medical procedures, subject to the terms, conditions and limitations imposed on their certificate of registration. These include performing prescribed procedures below the dermis, intubating and suctioning beyond the normal narrowing points in the nasal passages or beyond the larynx, and administering substances by injection or inhalation. Additionally, they can administer prescribed substances specifically by inhalation.

Qualifications and Training

Education: Under section 6 of Ontario Regulation 596/94 (General), an applicant must have completed a Canadian approved respiratory therapy program or have completed an acceptable program with additional education or supervised practice and demonstrate equivalent knowledge, skills, and judgment through an acceptable assessment process.

Registration Requirements:  All applicants must register with the CRTO and pass the national certification exam by the Canadian Board for Respiratory Care (CBRC). There are different application types including graduates of Canadian RT programs, RTs working elsewhere in Canada, and internationally educated RTs or other health care professionals.  View information about these different pathways.

Delegation and Collaboration

RTs collaborate with physicians, nurses, and other health care professionals in hospitals, long-term care facilities, and home health care settings. They often work under physician orders but also exercise professional judgment in emergency and critical care situations.

Legal and Regulatory Considerations

Overview of Applicable Legislation can be found ​on the College of Respiratory Therapists of Ontario webpage​​​.

Recent Regulatory Changes

On January 1, 2025, Ontario Regulation 596/94 (General) under the Respiratory Therapy Act, 1991 was amended to revise the registration requirements for RTs. The period for applicants to meet all registration requirements was extended from two to three years, aligning with the practices of other health regulators. However, an applicant is not subject to the three-year time limit if they have practiced respiratory therapy for at least 1,125 hours within the three years immediately preceding the date of the application for registration. The registration process for applicants who fail the required examinations multiple times was also updated.

Additionally, the amendments introduce new conditions for general certificate holders, requiring them to meet specific practice hours, refresher course requirements, or otherwise demonstrate they can meet the current standards of practice every three years in order to continue engaging in direct patient care or supervising others. Those who do not meet these requirements must practice under supervision until deemed qualified.​


Social Work and Social Services ​

Definition

Social workers and social service workers assist individuals, families, and communities to enhance their well-being. They provide services such as counseling, advocacy, and connecting clients with resources.

Regulatory Body

The Ontario College of Social Workers and Social ​Service Workers (OCSWSSW) is responsible for governing social workers and social service workers in Ontario.

Relevant Legislation

Governed by the Social Work and Social Service Work Act, 1998.

Scope of Practice Statement

The OCSWSSW defines the scope of practice for social workers and social service workers in its Code of Ethics

Social work is the “the assessment, diagnosis, treatment and evaluation of individual, interpersonal and societal problems using social work knowledge, skills, interventions and strategies, to assist individuals, couples, families, groups, organizations and communities to enhance psychosocial and social functioning and/or reduce systemic barriers and promote equity, inclusion and belonging."

Social services work is “the assessment, treatment, and evaluation of individual, interpersonal and societal problems using social service work knowledge, skills, interventions and strategies, to assist individuals, couples, families, groups, organizations and communities to enhance social functioning and/or to reduce systemic barriers and promote equity, inclusion and belonging."

Authorized Acts

While social workers and social service workers do not have authorized acts under the Regulated Health Professions Act, 1991, they perform various professional activities within their scope of practice, adhering to the standards set by the OCSWSSW.

Qualifications and Training

Education: Under section 7 of Ontario Regulation 838/00 (Registration), a social work a​pplicant must have obtained a degree in social work from a program accredited by the Canadian Association for Social Work Education or approved by the OCSWSSW. Under section 8 of the same regulation, a social services work applicant must have obtained a diploma in social service work from a program approved by the OCSWSSW.

Registration Requirements: The registration process varies depending on type of application. For more information regarding the application process for social work and social service work applicants, visit the social work registration page or the social service work registration page​. ​

Delegation and Collaboration

Social workers and social service workers often work as part of interprofessional health care teams, particularly in hospitals, community mental health agencies, and long-term care.

Legal and Regulatory Considerations

Overview of applicable legislation can be found on the Ontario College of Socia​l Workers and Social Service Workers webpage​

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