Annual Report 2024

The College acknowledges that we are in Mi’kma’ki, the ancestral and unceded territory of the Mi’kmaq People.

This territory is covered by the “Treaties of Peace and Friendship” which the Mi’kmaq and Wolastoqiyik People first signed with the British Crown in 1725. The treaties did not deal with surrender of lands and resources but recognized Mi’kmaq and Wolastoqiyik title and established the rules for what was to be an ongoing relationship between nations.

The College of Physicians and Surgeons of Nova Scotia serves the public by effectively regulating physicians, surgeons, physician assistants, and podiatrists in the province.

The College’s 2024 Annual Report provides an account to Nova Scotians regarding work of the College as set out in the Medical Act and other provincial statutes.

The focus of the College in 2024 was to move forward innovative solutions aimed at improving access to care for Nova Scotians. This report shares relevant statistics and key milestones achieved along with the audited financial statements.

Dr. Mary-Lynn Watson — Mary-Lynn Watson, MD, CCFP(EM), FCFP, FRCP(Edin) — *President*

As the regulator for the medical profession in Nova Scotia, the College has many challenges ahead. We have the ability, authority, and privilege to make substantive changes in the provision of healthcare, not only in our province but also on the national stage. In 2024, the strategic focus of the College has been on improving access to safe, competent care.

The College has been a leader in increasing physician mobility by spearheading the Atlantic Registry. This approach to regional licensure has provided a model to draw upon in the College’s efforts in advocating for the pan-Canadian licensure of physicians.

We have the ability, authority, and privilege to make substantive changes in the provision of healthcare, not only in our province but also on the national stage.

Addressing the lack of primary care providers continues to be a high priority for the College. A tremendous amount of work has been done to ensure a fair approach to assess and license physicians trained internationally. As well, the expansion of College accredited physician extender programs, such as for physician assistants and associate physicians, has been remarkable.

The Physician Assessment Centre of Excellence (PACE) was rapidly and efficiently developed and launched in 2024. Within a matter of months from its approval in principle, with the support of government and in partnership with the Medical Council of Canada, PACE was open and is running smoothly. PACE is unique, with a hybrid mission of assessing internationally trained physicians for licensure in Nova Scotia while also providing high quality primary care.

Through PACE, Nova Scotia will increase the number of safe and competent physicians practising in the province. PACE is serving our communities by ensuring increased access to physicians to deliver primary care so urgently needed in our communities.

The Regulated Health Professionals Act will bring changes to the composition of the College’s governing Council. These changes will further facilitate the participation of people who reflect our communities. The year ahead will involve a comprehensive governance review to align our structure with that required by the RHPA.

On a different note, I would like to extend my congratulations to our Registrar & CEO Dr. Gus Grant who was awarded the King Charles III Coronation Medal. This recognition was well deserved, recognizing the incredible contributions Dr. Grant has made to healthcare in the province.

The College is not only meeting but exceeding expectations to effectively address multiple issues in a proactive manner. It could not happen without the incredibly hard-working, knowledgeable and nimble staff. There are many changes on the horizon, and they are coming fast. I’m confident we will continue to meet these challenges head on by continuing to improve access to competent and safe care for Nova Scotians.

The College is dedicated to improving access to safe, competent medical care for Nova Scotians.

Access to care is a global issue. When it comes to primary care, Health Canada estimates our country is 13,000 family physicians short. While efforts are being made to expand medical faculties and residency programs, our short and intermediate-term needs can only be met through the successful recruitment, retention, and licensure of internationally trained physicians.

We continue to lead the country in opening the door wider for the assessment and licensure of internationally trained physicians.

We continue to lead the country in opening the door wider for the assessment and licensure of internationally trained physicians. The College opened the first of its kind Physician Assessment Centre of Excellence (PACE). PACE provides primary care in a collaborative care setting delivered by internationally trained physicians under assessment for licensure. These physicians are overseen by experienced family physicians trained in assessment. PACE is set to expand in 2025 delivering care to more patients.

When licensing physicians, safeguards are necessary, but barriers are not. The College is committed to reducing all unnecessary administrative burdens while ensuring only appropriately qualified physicians are licensed. Once a completed application was received, in 2024 the College issued licensure within two days.

Physician mobility continues to be a priority. With the launch of the Atlantic Registry two years ago and our role in moving forward the National Registry of Physicians, we are leaning into the national efforts to facilitate physician mobility. This is long overdue.

As of April 1, 2024, the College commenced the regulation of podiatrists and physician assistants. It is hard to overstate the impact of physician extender programs on the delivery of excellent medical care in Nova Scotia. There are now 35 such programs, distributed across the province. In many instances, the presence of physician extenders, be they associate physicians or physician assistants, has enabled departments to remain open.

Against the backdrop of our strategic focus on access to care, I am pleased to report our operations are in good shape. The College once again successfully completed another clean audit, receiving an unmodified opinion from our auditors for the year 2024.

We have the advantage of working in Nova Scotia, with all organizational stakeholders united in the search for collaborative solutions. I readily call the Department of Health and Wellness, Nova Scotia Health and other stakeholders to discuss concerns and collaborate on a path forward. The shared commitment to improving access to care resonates in all hallways and around all boardrooms.

I want to acknowledge the dedication of physicians themselves. They navigate each day through our stressed healthcare system. Even within these trying times, physicians are stepping forward to fill needs. I would like to particularly thank those who have offered to become physician assessors, a role without which new pathways for licensing internationally trained physicians could not function.

My sincere appreciation to all physicians who continue to step up into leadership positions and to those who every day demonstrate the resilience and determination of the profession to participate in innovative ways to improve access to care for Nova Scotians.

Physicians Licensed: 2024 Snapshot

This data is as of December 31, 2024 and represents a physician headcount, not a total of full-time equivalent practising physicians.

4132

Total Licences

1580

Family Medicine

1954

Other Specialists

598

Postgraduate Trainees

331

Medical Students

The College licensed 573 more physicians including 260 more family physicians

19%

Increase in physicians licensed December 31, 2021 to December 31, 2024

More Licensing Statistics

Physicians Licensed: 5-Year Overview

Customize your view of licensing data by changing the chart type or click on the legend to show/hide each set of data.

Physicians Age Distribution

Customize your view of licensing data by changing the chart type or click on the legend to show/hide each set of data.

Improving Access to Care: Licensing More Physicians

The world is now competing for physicians. For Nova Scotia’s recruiting initiatives to keep pace, our province turns to the College for licensing policies that are safe and innovative. The College in many instances is leading the country in innovative collaboration, policies and partnerships that have resulted in new pathways for physician licensure.

While we are opening the door wider, we are not lowering the bar of competence. The College’s fundamental commitment is to public safety. Nova Scotians expect and are entitled to expect safe and competent medical care.

New Pathways to Licensure

Results of College’s new pathways to licensure January 1, 2023 to April 30, 2025

Royal College of Physicians and Surgeons of Canada Exam Eligibility

Accepted physicians from more international jurisdictions

64

new physicians

American Board of Medical Specialties Equivalent Certification

Provided a Full licence to American Board Certified specialists

49

new physicians

General Medical Council UK Comparable Licensure

Provided licensure to physicians licensed in UK

13

new physicians

Royal College of Physicians and Surgeons of Canada Pass-standing through Practice Eligibility Route

Accepted physicians from more jurisdictions

10

new physicians

Australian Health Practitioner Regulation Agency Comparable licensure

Provided licensure to physicians licensed by the Australian Health Practitioner Regulation Agency

3

new physicians

Medical Council of New Zealand Comparable licensure

Provided licensure to physicians licensed by the Medical Council of New Zealand

1

new physician

Royal College of Physicians and Surgeons of Canada Subspecialist Examination Affiliate Program

Licensed physicians who have completed post-graduate training and undertaking additional training now can be licensed to deliver care

2

new physicians

143

Total of New
Physicians Licensed

Practice Eligibility Route

In 2024, the College issued provisional licensure to 33 physicians in Royal College disciplines with significant experience in independent practice elsewhere in the world. Those who had not previously trained or practised in Canada or the USA participated in the Welcome Collaborative orientation program.

To comply with the provisions of the Medical Act, these physicians required sponsorship and supervision. We are grateful to the practising physicians who conducted the supervision and the physician leaders who provided sponsorship.

The Practice Eligibility Route is helping our province. Of the 33 physicians issued provisional licensure under this pathway in 2024, 29 remain in practice here.

Identifying Faculty-Specific Eligibility for Licensure

The College is expanding its rigorous review of faculties and post-graduate training programs of excellence around the world in jurisdictions not generally recognized. We are the first College in Canada to pursue this opportunity.

After a comprehensive review of the training programs of the American University of Beirut and the Lebanese American University, last year the College participated in a physician recruitment visit. It is already paying significant dividends. Two family physicians have arrived in practice and are now on Restricted licences in the central zone. They have enjoyed terrific wrap around support (housing, places of worship, mentorship) from the local Lebanese community. Five more candidates, all graduates of the same programs, have initiated applications.

Doctors having a discussion in hospital hallway

The College is leading an initiative with Nova Scotia Health and a recruitment specialist from South Africa to identify suitable candidates for two pilot initiatives to be launched by late Spring of 2025. South African physicians with formal family medicine residency will be offered Defined licensure for a minimum of six months that starts with a period of high-level supervision. A long-term renewable licensure decision coming after supervision is complete. If successful, this pilot could lead to the designation of South African family medicine residency as equivalent to Canadian, joining the UK, Australia and New Zealand as jurisdictions already recognized as equivalent.

The second pilot includes South African physicians with a two-year internship and a minimum of two years current experience in emergency medicine. This group will have a similar pathway to practise in an emergency department setting. Starting on a Defined licence, a decision on long-term renewable licensure will follow a minimum of six months supervised practise that starts with a period of high-level supervision.

Physician Assessment Centre of Excellence (PACE)

Keri McAdoo, MD, CCFP – *CEO, Nova Scotia Physician Assessment Centre of Excellence*

The College launched the Physician Assessment Centre of Excellence (PACE) to help more internationally trained physicians become medically licensed in the province. PACE has a hybrid mission: it assesses internationally trained physicians for independent licensure while delivering excellent primary care in a busy clinic.

Candidate physicians work in the on-site medical clinic, providing patient care while being directly observed, overseen and evaluated by fully licensed physicians, trained and accredited in the science of physician assessment. In partnership with the Medical Council of Canada, PACE employs cutting edge tools and science to fairly and objectively assess the competencies necessary for independent licensure.

The assessments are competency-based, meaning that the time a candidate spends at PACE varies entirely on performance. Once enough data has been gathered, a recommendation regarding licensure will be made.

PACE is a partnership between the provincial government, the College of Physicians and Surgeons of Nova Scotia, and the Medical Council of Canada, and is a unique model in Canada.

The provincial government aims to support the expansion of PACE to include five physician-led teams, each with up to three international medical graduates, increasing the clinic’s capacity to about 6,400 patients.

Increasing Physician Extenders

At the onset of the pandemic, there were 13 physician extender programs in our province, all within the central zone. As of April 30, 2025, there are now 35 such programs, distributed across the province. In many instances, the presence of physician extenders, be they associate physicians or physician assistants, has enabled departments to remain open.

The College approves and helps develop the structure, supervision and scope of the programs, with periodic accreditation. We do this quickly and efficiently. These programs create another important efficiency, economies of scope. More patients are seen by appropriately trained and supervised professionals, allowing fully licensed physicians to focus on patients who truly need their expertise.

Physician Extender Programs

2021–2024

The College is enthusiastic about a new associate physician pilot launched in the northern zone. This pioneering project in Canada offers a pathway for associate physicians to become attending physicians through a competency-based assessment of their performance over time.

The ongoing pilot project involves associate physicians working in a hospitalist setting with oversight of fully licensed physicians. Over 18 months, the associate physicians will be assessed for promotion to a Restricted license, which will entitle them to act as the Most Responsible Physician.

At present, three associate physicians are now seeing patients and progressing successfully through the pilot—one at the Aberdeen Rural Hospital and two at the Colchester East Hants Health Center. Hospitalist care is an area of need, particularly outside the central zone.

This pilot will introduce up to eight new hospitalists into the healthcare system over the next few years. With success, this approach may well be scaled up.

Atlantic Registry

The Atlantic Registry (AR) launched on May 1, 2023. The first of its kind in Canada, the AR enables ease of mobility for physicians licensed in New Brunswick, Newfoundland and Labrador, Nova Scotia, and Prince Edward Island. The Registry streamlines administrative processes and lowers licensing costs for physicians to practise across the region.

As of January 1, 2025, there were 377 physicians on the Atlantic Registry, including 213 physicians from NB, NL, and PEI who hold Full licences in NS by way of the Atlantic Registry, 98 of whom are family physicians.

Health Canada supported the first evaluation of the impact, efficiency, and sustainability of the AR. The complete evaluation can be downloaded here.

Welcoming New Physicians

The Welcome Collaborative supports physicians trained outside of Canada and the USA that are new to licensure and practice in Nova Scotia. It is an orientation to help physicians successfully integrate into our healthcare system.

Funded by the provincial government, it is the first of its kind in Canada. Since the program was piloted in 2022, 165 physicians trained outside of Canada or the USA have participated in the Welcome Collaborative program.

In 2024, the program welcomed 73 physicians, exceeding the program’s budgeted estimate of 45. Of the 73 physicians, 36 were family medicine specialists, 34 practised in other specialties, including internal medicine, anesthesiology and psychiatry, with three entering as associate physicians.

The curriculum of the program is dynamic, informed by feedback from the physician participants and overseen by an Advisory Council made up of internationally trained physicians with representation from Immigrant Services Association of Nova Scotia. The goal is to set physicians up for success in practice by strengthening their knowledge of how to navigate the many facets of our unique healthcare system.

For 2025, the Welcome Collaborative orientation session is expanding to four days for family physicians. The decision to extend the orientation was driven by participant feedback identifying the need to offer more in-depth training and support for family physicians. Feedback from previous participants highlighted the importance of dedicating more time to critical topics, allowing for more robust discussion, and opportunities to connect with new peers in the same circumstances.

Welcome Collaborative Participants

by Health Zone and Specialty

October 2022 – March 2025

FP = Family Physicians, OS = Other Specialists
No practice = 6, Associate Physician = 1

Outreach to Expand Licensure, Recruit & Retain Physicians

The College is regularly invited to participate in national and provincial efforts to develop solutions to issues within healthcare.

Dr. Grant and Dr. McAdoo participated in a physician recruitment initiative to Australia as part of a provincial effort to recruit family physicians.
Dr. Grant is a member of the Board of the Federation of Medical Regulatory Authorities of Canada (FMRAC).
Dr. Grant is the Chair of FMRAC’s Committee on Medical Licensure in Canada, which works toward shared licensing standards across the country.
Dr. Grant is a member of the Board of Directors of the Canadian Resident Matching Service (CaRMS).
Dr. Grant is on the Data Governance Committee of the National Registry of Physicians, an initiative housed in the Medical Council of Canada.

The College recognizes the importance of the well-being of its registrants. The Health and Practice Support Program provides confidential support for registrants facing mental health concerns, substance abuse, or other issues impacting their professional performance. The program ensures registrants are fit to practise and can offer patients safe, high-quality care.

The College learns about a registrant’s health condition during registration, practice permit renewal, self-reporting, or reports from colleagues. Each situation is approached respectfully, sensitively, and confidentially.

When the College learns of a registrant’s health condition:

It contacts the registrant confidentially to discuss next steps without requesting personal or health information.
If necessary, the registrant may need to arrange for an independent medical examination to develop a beneficial return-to-work plan.
A determination is made regarding any necessary modifications, limitations, restrictions, or monitoring of the health condition.
The registrant may be asked to enroll in a third-party monitoring service, after which the matter can be closed.

Registrants can contact the Health and Practice Advisor to discuss health concerns during annual renewals. This approach has been well-received and reduces anxiety about form submissions.

In 2024, the College met with Doctors Nova Scotia to learn about its Physician Navigator Program and the new Physician Wellness Navigator role, a social worker providing confidential, non-judgmental support to physicians.

Registrant support is a key component of the Health and Practice Program. Having regular communication with registrants in addition to removing stigmas and providing access to wellness support is what makes our program a continued success. This benefits both the registrant and the public.”
Health and Practice Advisor

The Council governs the affairs of the College in the public interest and in accordance with the Medical Act. It is responsible for setting strategic direction, developing policies, setting licensing fees and providing oversight of the College’s performance.

The Council is composed of physician members elected by registrants and public members appointed by the College through a nominations process. Nova Scotia’s medical school holds a Council seat, and medical learners are represented as observers.

Council members also participate on many College committees. With an informed understanding of the social context and of the healthcare system, the Council and committees target a well-balanced and equitable approach to regulating medicine in the public interest.

It is time-intensive, thought provoking, and important work that directs the College and serves the public. The College wishes to thank all Council and committee members.

Members of Council 2024–2025

BACK ROW (left to right)
Dr. Michael Clory, Ms. Sherry McNeil-Mulak, Mr. Carlos Lazcano, Dr. D.A. (Gus) Grant (Registrar & CEO), Mr. Barrie Dunn, Dr. Andria MacAulay (Past President), Dr. Martin Gardner (Dalhousie University Faculty of Medicine Appointee), Dr. Umesh Prabhu

FRONT ROW (left to right)
Dr. Mutiat Sulyman, Dr. Kathleen MacMillan (Maritime Resident Doctors Appointee), Dr. Mary-Lynn Watson (President), Dr. Alyson Holland, Ms. Rachel Tooth (Dalhousie Medical Students' Society Representative)

ABSENT
Dr. Minoli Amit, Dr. Melissa Broaders, Ms. Damilola Iduye

Formal complaints have increased against physicians, with annual volumes jumping by 32% from 2018 to 2023.

This surge of complaints had many negative consequences. It drove regulatory costs. It extended timelines for resolution, overwhelming the College’s resources. It added stress to an already stressed system. More importantly, it added stress to the physicians and the patients involved in each complaint.

The College has responded with substantial investments to change its complaint investigation process to effectively resolve complaints earlier and to limit the filing of unnecessary complaints.

2024 Complaint Statistics

265

Complaints received (down 23% from last year)

292

Complaints closed by disposition (down 9% from last year)

The College hired three licensed physicians as investigators, who work closely with a public support advisor, a trained social worker. Together, along with investigation leads, they have sensitized the process, making sure the physicians and the complainants have personal contact throughout. This team oversees a preliminary investigation of most complaints, taking statements, reviewing medical charts, and, when indicated, gathering independent expert opinion. Increasingly, this process can bring satisfaction or closure to the complainant, through voluntary withdrawal of the complaint or informal resolution.

Prior to these changes in our process, less than half of all complaints were resolved at the preliminary stage. In 2024, 68% of complaints were resolved without referral to an Investigation Committee, a number that increases to 82% once informal resolutions and withdrawals are considered.

Closed by Registrar

Total: 238

Closed by Investigation Committee

Total: 54

The College now has a Health and Practice Advisor to help physicians navigate difficult challenges, such as when they are closing or reducing the size of their practice. With the help of this new office, physicians have been able to resolve patient-physician sources of friction without need for a formal complaint.

The College also introduced an explanatory video on its website, outlining the complaint process and identifying what matters the regulator can investigate and what matters are beyond its jurisdiction.

Prior to these changes, less than half of all complaints were resolved at the preliminary stage. There has been significant progress. In 2024, 68% of complaints were resolved without referral to an Investigation Committee, a number that increases to 82% once informal resolutions and withdrawals are considered. In 2024, the College received 23% fewer complaints than the previous year, reversing a longstanding trend of complaint volumes.

These changes have brought operational changes. We have increased staff at the front end of investigations, allowing us to reduce the number of Investigation Committees from seven to three. A consequence of these changes is that the matters that get before an Investigation Committee are increasingly complex and serious. We are grateful to the physicians and members of the public that do this important work on behalf of the public and the profession.

We value the importance of complaints as a mechanism of public safety and professional accountability but recognize the emotional burden they author for the patients and physicians involved. We wish to express our gratitude to all the public for coming forward with their complaints.

Categories of Complaints upon Disposition

Complaints Received: 5-Year Overview

Vision

Our vision is to be a respected leader that protects the public while supporting the medical profession.

Mission

Our mission is to serve the public by effectively regulating the medical profession.

Commitment

We will be thorough, clear, decisive and fair.

Values

Our work will reflect the value we place in:

Professionalism;
Excellence in medical care;
Consultation and collaboration; and
Anti-racism and anti-oppression.

Strategic Focus – Access to Care

The College will improve access to equitable, competent care by:

Expanding the recognition of acceptable international training and practice, to license more physicians.
Growing physician extender programs, to increase the number of Associate Physicians and Physician Assistants.
Facilitating multi-jurisdictional licensing agreements, such as the Atlantic Registry, to promote mobility of physicians and postgraduate trainees.
Supporting physicians trained outside of Canada through the Welcome Collaborative orientation program, to advance long term success and retention.

2024 Strategic Plan Outcomes

1

Expanding the recognition of acceptable international training and practice, to license more physicians

The College is expanding its rigorous review of faculties and post-graduate training programs of excellence around the world in jurisdictions not generally recognized. We are the first College in Canada to pursue this opportunity.
After a comprehensive review of the training programs of the American University of Beirut and the Lebanese American University, last year the College participated in a physician recruitment visit. It is already paying significant dividends. Two family physicians are in practice on Restricted licences in the central zone.
The College is leading an initiative with Nova Scotia Health and a recruitment specialist from South Africa to identify suitable candidates for two pilot initiatives to be launched by late Spring of 2025.
This pilot could lead to the designation of South African family medicine residency as equivalent to Canadian, joining the UK, Australia and New Zealand as jurisdictions already recognized as equivalent.
The second pilot includes South African physicians with a two-year internship and a minimum of two years current experience in emergency medicine will have a pathway to practise in an emergency department setting.

2

Growing physician extender programs, to increase the number of Associate Physicians and Physician Assistants

As of April 30, 2025, there are 35 such programs, distributed across the province. In many instances, the presence of physician extenders, be they associate physicians or physician assistants, has enabled departments to remain open.
An associate physician pilot launched in the northern zone. This pioneering project in Canada offers a pathway for associate physicians to become attending physicians through a competency-based assessment of their performance over time. This pilot will introduce up to eight new hospitalists into the healthcare system over the next few years. With success, this approach may well be scaled up.

3

Facilitating multi-jurisdictional licensing agreements, such as the Atlantic Registry, to promote mobility of physicians and postgraduate trainees

As of January 1, 2025, there were 377 physicians on the Atlantic Registry, including 213 physicians from NB, NL, and PEI who hold Full licences in NS by way of the Atlantic Registry, 98 of whom are family physicians.

4

Supporting physicians trained outside of Canada or the USA through the Welcome Collaborative orientation program, to advance long term success and retention

The Welcome Collaborative is an orientation program which aims to support internationally trained physicians to successfully integrate into medical practice in Nova Scotia.
Over the last two years, 165 physicians trained outside of Canada or the USA have attended the orientation program, including 73 physicians in 2024, exceeding the program’s original estimate of 45 for that year. In response to participant feedback the Welcome Collaborative orientation session expanded to four days by adding a day for family physician participants.

The development of professional standards is led by the Professional Standards Committee, composed of practising physicians and public members. This work is strengthened by consultations undertaken to inform these documents.

This work requires consultation among stakeholders within healthcare. We recognize the profession, the public, government, health authorities and educational bodies, as valued partners in this work.

Professional Standards serve multiple purposes. They provide direction to registrants, setting out in clear terms the professional expectations of the College. They serve as a lens to examine registrant conduct or performance. Finally, they provide the public with a clear understanding of what they are entitled to expect from their caregivers.

The following standards were reviewed and revised:

Professional Standards and Guidelines Regarding Virtual Care

The provincial government, under the Regulated Health Professions Act, directed the Nova Scotia Health Professions Network (The Network) to develop the Requirements for Sexual Abuse and Sexual Misconduct Standards to set minimum requirements for sexual misconduct standards for each professional health regulator. To align with this document, the College reviewed and revised the following:

The Professional Standards Committee also developed the following new standards:

Adherence to the College’s standards and guidelines is the first lens through which a registrant’s conduct is viewed by the College. As such, registrants are expected to stay current with these documents which are available on our website. Physicians are also expected to adhere to the CMA’s Code of Ethics and Professionalism and the recommendations of Choosing Wisely Canada, both of which have been endorsed by the College.

Dr. Alyson Holland — Alyson Holland, MPhil, MD, FRCPC – *Chair, Professional Standards Committee*

Health care has to evolve to address challenges including systemic inequities and lack of access to primary care. The Professional Standards Committee strives to be responsive in developing clear, evidence-informed standards that protect public safety and support physicians in delivering equitable, high-quality care."
Dr. Alyson Holland

In 2024, the College maintained its commitment to prioritizing Access to Care. The primary focus for 2024 included the development of new licensure pathways, encompassing revisions to the Royal College Practice Eligibility Route (PER) and the hospitalist pilot for Associate Physicians. Additionally, as of April 1, 2024, the College commenced the regulation of podiatrists and physician assistants.

We have successfully completed another clean audit, receiving an unmodified opinion from our auditors for the year 2024. The financial statements approved by the Council indicate a surplus of $717,749. This surplus is composed of an unrestricted fund surplus of $269,562 (2023 — $70,623 deficit) and internally restricted funds amounting to $448,187 (2023 — $423,617). For 2024, the internally restricted funds have been redefined to encompass both combined investment income and an increase in the fair market value of our investments, resulting in a reserve fund surplus of $627,287. Additionally, the investment in capital assets includes the amortization expense of $179,100 for 2024. Despite budgeting for an operational surplus of $212,620, the actual results for 2024 revealed a surplus of $269,562. The primary contributing factors to this outcome were an increase in the number of licenses issued, the temporary suspension of peer reviews, counterbalanced by hearing costs totaling approximately $435,000.

In Q4 2024, the College provided consulting and accounting services to the Department of Health and Wellness (DHW) for the Physician Assessment Centre of Excellence (PACE). DHW sent $2.5 million to cover PACE costs, with $2.38 million remaining on the Statement of Financial Position to be used in Q1 2025.

Update on Investments

We continue to ensure that our investments are managed in a manner that supports the short-term and long-term sustainability of our operations. The preservation and safety of principal remain the paramount considerations in our investment decisions. Regarding our reserve fund, the College has increased its target to 75% of our annual budget, up from the previous target of 60%. It is acknowledged that achieving this 75% target will take several years. Currently, the reserve fund stands at 66.6% of the 2025 annual budget. It is understood that investments will fluctuate, and declines in fair market value are anticipated.

One of our objectives, included in the College’s Statement of Investment Policy and Goals policy, is to ensure investments are in accordance with socially responsible investing as follows: To invest funds in a responsible manner with a specific focus on Socially Responsible Investing (SRI), with direct investments in the following areas excluded: gambling, tobacco, alcohol, cannabis, and weapons.

View Financial Statements

Dr. Samuel Allan Muir — Dr. Samuel Muir
*A painting of Dr. Muir donated to the Colchester County Historeum by one of his descendants.*

Dr. Samuel Muir was born in Glasgow, Scotland, on 1 January 1813, the son of John Muir. Following training as an apprentice, he received his medical and surgical training in Edinburgh and Glasgow and qualified as a Licentiate of the Royal College of Surgeons of Edinburgh in 1835 and as a Licentiate of the Royal College of Physicians and Surgeons of Glasgow in 1839. Shortly after he was awarded his diplomas they were stolen and he traced the thief to River John, Nova Scotia. When he came to River John and confronted the imposter, he retrieved his diplomas and decided to remain in the province.

Remarkably, Dr. Muir was the preceptor for over 21 young men from Nova Scotia and elsewhere who chose to serve their apprenticeship with him. He took his first apprentice in 1846 and his last in 1870.

Dr. Muir opened a practice at West River, Pictou County, in July 1842 with an office at the Ten-Mile House. He was appointed to form a Board of Health in Colchester County in 1848 and to be coroner for the County in 1850.

Remarkably, Dr. Muir was the preceptor for over 21 young men from Nova Scotia and elsewhere who chose to serve their apprenticeship with him. He took his first apprentice in 1846 and his last in 1870.

Almost all his apprentices went on to Harvard Medical School to complete their medical training except for Thomas Roddick who, after beginning an apprenticeship with Muir in 1864, went to McGill where he graduated with his MD in 1868.

Dr. Roderick became the leading surgical and political figure in Canadian medicine of his generation. He became the Surgeon-in-Chief of the Royal Victoria Hospital in Montreal in 1893 and Chief and Professor of Surgery at McGill in 1894. Roddick served as Dean of Medicine at McGill from 1901 to 1908 and, in 1914, was knighted by King George V. His major political accomplishment was to convince Prime Minister Laurier to pass the Canadian Medical Act in 1908 which led to the establishment of the Dominion Medical Board. This allowed physicians to practise in any province by breaking down the protectionist, provincial barriers that had existed for many years.

Dr. Muir, who died in 1876, would have been very proud of his apprentice.

Improving Access to Care

The College of Physicians and Surgeons of Nova Scotia serves the public by effectively regulating physicians, surgeons, physician assistants, and podiatrists in the province.

President's Message

Registrar's Message

Licensing & Welcoming Physicians

Physicians Licensed: 2024 Snapshot

Physicians Licensed: 5-Year Overview

Physicians Age Distribution

Improving Access to Care: Licensing More Physicians

New Pathways to Licensure

Results of College’s new pathways to licensure January 1, 2023 to April 30, 2025

Royal College of Physicians and Surgeons of Canada Exam Eligibility

American Board of Medical Specialties Equivalent Certification

General Medical Council UK Comparable Licensure

Royal College of Physicians and Surgeons of Canada Pass-standing through Practice Eligibility Route

Australian Health Practitioner Regulation Agency Comparable licensure

Medical Council of New Zealand Comparable licensure

Royal College of Physicians and Surgeons of Canada Subspecialist Examination Affiliate Program

Practice Eligibility Route

Identifying Faculty-Specific Eligibility for Licensure

Physician Assessment Centre of Excellence (PACE)

Increasing Physician Extenders

Physician Extender Programs

Atlantic Registry

Welcoming New Physicians

Welcome Collaborative Participants

by Health Zone and Specialty

Outreach to Expand Licensure, Recruit & Retain Physicians

Health and Practice Support Program

Council 2024–2025

Members of Council 2024–2025

Investigating Complaints

2024 Complaint Statistics

Closed by Registrar

Total: 238

Closed by Investigation Committee

Total: 54

Categories of Complaints upon Disposition

Complaints Received: 5-Year Overview

Strategic Plan 2024–2025

Access to Care

Vision

Mission

Commitment

Values

Strategic Focus – Access to Care

2024 Strategic Plan Outcomes

Developing Professional Standards

Operations

Update on Investments

Medical History Vignette