College Complaints in Canada: How Investigations, Remediation and Discipline Work

Health professions in Canada are regulated by the provinces and territories, not by Ottawa. In most cases a self-regulating college, or in Quebec an ordre, licenses you, sets your standards and deals with complaints, under a provincial statute. Your college's job is to protect the public, not to resolve a patient's grievance or award compensation; claims for compensation go through the civil courts or your protective association or insurer.

The other provinces and territories have their own statutes, in some cases one Act per profession, with the same broad stages: a complaint or report, an investigation, a screening decision, a possible hearing and an appeal. Check the process of the college that holds your licence; if you are licensed in more than one province, each college can act.

Many matters are resolved at the screening stage, and only the most serious go to a hearing.

1. A concern reaches the college. A patient, family member, colleague or employer complains, a mandatory report is made, or the college learns of something itself, such as a charge or a media report.
2. You are notified. The college sends you the complaint or a summary of the concern and invites a written response, usually by a stated date. Contact your adviser before you reply.
3. The college investigates. It may request your records, interview people, obtain an expert opinion or arrange a practice assessment. You must cooperate, and you will usually see the key material before a decision.
4. Interim action, rarely. If the college believes patients are at serious risk, it can seek interim terms, conditions or a suspension while the matter continues, with a chance for you to respond.
5. A screening decision. Outcomes range from no action, through advice or recommendations, a caution, a remediation requirement or an agreed undertaking, to referral to a hearing. Health concerns may go to a separate incapacity or fitness process.
6. Remediation, if required. You complete the education, mentoring, supervision or assessment set out, and report back to the college.
7. A hearing, for serious matters. A panel with professional and public members hears evidence and decides whether misconduct or incompetence is proven, then decides the penalty.
8. Review or appeal. Depending on the province and the decision, a complainant or registrant may ask a review board to look again at a screening decision, and either party may appeal a hearing decision to a court or tribunal.

Ontario's Regulated Health Professions Act, 1991 covers most regulated health professions, from physicians and nurses to dietitians and respiratory therapists, and their colleges all use the same Health Professions Procedural Code. Complaints and registrar's reports go to the college's Inquiries, Complaints and Reports Committee (ICRC), which works in panels with professional and public members.

After an investigation, and once you have had a chance to make written submissions, the ICRC can:

• take no action;
• give advice or recommendations;
• issue a caution, in writing or in person;
• require a specified continuing education or remediation program (SCERP), such as courses on documentation or ethics, mentoring or a reassessment;
• accept an undertaking from you, for example to complete education, practise under supervision or restrict your practice;
• refer allegations of professional misconduct or incompetence to the Discipline Committee (at CPSO, the Ontario Physicians and Surgeons Discipline Tribunal);
• refer a possible health concern for an incapacity inquiry, which can lead to the Fitness to Practise Committee.

Cautions, SCERPs and many undertakings are noted on the college's public register. For complaint decisions (not referrals to discipline or incapacity), either you or the complainant can ask the Health Professions Appeal and Review Board (HPARB) to review whether the investigation was adequate and the decision reasonable. Discipline decisions can be appealed to the Divisional Court. Ontario also has strict sexual-abuse provisions, including mandatory revocation for certain acts.

On 1 April 2026 the Health Professions and Occupations Act (HPOA) replaced BC's Health Professions Act. Regulated professionals are now called licensees, and a new provincial oversight office supervises the colleges.

• Colleges still take complaints and investigate. The former inquiry committee is now an investigation committee, which can resolve matters, sometimes by consent, once you have seen the investigation report.
• Summary protection orders can impose limits, conditions or a suspension where there are reasonable grounds to believe there is a significant risk of harm.
• Discipline is no longer decided by the college. A director of discipline, appointed by the Minister of Health, runs an independent discipline tribunal. Its panels include a licensee, a member of the public and a specialist in the relevant area, and colleges enforce their orders.
• Publication changes. CPSBC explains that disciplinary actions and summary protection orders appear on the public register, while complaints resolved without discipline, such as with advice, are not published.

Matters that started before 1 April 2026 may follow transition rules, so check with your college and adviser which process applies to yours.

Under Alberta's Health Professions Act, each college has a complaints director who decides what to do with a complaint. The director can dismiss it with written reasons, encourage resolution, conduct or appoint an investigation, and recommend interim suspension or conditions where there is a risk to the public. The Act also provides for alternative complaint resolution, where both sides agree.

If a complaint is dismissed, the complainant can ask a complaint review committee to consider whether the dismissal was reasonable. Serious matters go to a hearing tribunal. You or the complaints director can appeal the tribunal's decision to the college's council (at CPSA, an appeal panel of council members), and from there to the Court of Appeal of Alberta.

Quebec's Professional Code governs every professional ordre, including the Collège des médecins, the OIIQ, the Ordre des dentistes and the Ordre des pharmaciens. Anyone can ask an ordre's syndic to inquire into a professional's conduct. The syndic investigates and decides whether to file a complaint before the ordre's disciplinary council; a person who asked for the inquiry and disagrees with a decision not to file can ask the ordre's review committee for an opinion, and private complaints are also possible.

The disciplinary council is an independent, quasi-judicial body chaired by a lawyer appointed by the government, sitting with two members of the profession. Hearings are generally public. Sanctions include a reprimand, fines, limits on or suspension of the right to practise, and temporary or permanent striking off the roll. Decisions can be appealed to the Tribunal des professions.

Ordres also run professional inspection, which can lead to refresher training or a limit on practice outside the disciplinary route.

Outside the four largest provinces the stages are similar, a complaint or report, an investigation, a screening decision and a possible hearing, but each college works under its own legislation and uses its own committee names. Read your college's complaints page and the letter itself for the exact terms.

• Saskatchewan regulates each profession under its own statute, for example The Medical Profession Act, 1981 for the College of Physicians and Surgeons of Saskatchewan. Other colleges include the College of Registered Nurses of Saskatchewan, the College of Licensed Practical Nurses of Saskatchewan, the College of Dental Surgeons of Saskatchewan and the Saskatchewan College of Pharmacy Professionals.
• Manitoba has moved several professions, including physicians (2019) and registered nurses (2018), under The Regulated Health Professions Act; others remain under profession-specific Acts. Colleges include the College of Physicians & Surgeons of Manitoba, the College of Registered Nurses of Manitoba and the College of Pharmacists of Manitoba.
• Nova Scotia passed a Regulated Health Professions Act in November 2023 and is migrating professions to it in phases, with dentistry and pharmacy in the first group and physicians and nursing in the last. Regulators include the College of Physicians & Surgeons of Nova Scotia, the Nova Scotia Nursing and Midwifery Regulator and the Nova Scotia Pharmacy Regulator.
• New Brunswick, Prince Edward Island and Newfoundland and Labrador each have a College of Physicians and Surgeons, along with bodies such as the Nurses Association of New Brunswick, the College of Registered Nurses and Midwives of Prince Edward Island and the College of Registered Nurses of Newfoundland and Labrador.
• Yukon, the Northwest Territories and Nunavut license many professions through territorial registrars or councils, such as the Yukon Medical Council, and nurses through the Yukon Registered Nurses Association or the Registered Nurses Association of the Northwest Territories and Nunavut.

Honesty with your college is itself a standard, and failing to report can become a separate concern. In Ontario, the Procedural Code requires registrants to report matters such as:

• being charged with or found guilty of an offence, including bail conditions or restrictions linked to a charge;
• findings of professional negligence or malpractice;
• membership of another regulatory body, and findings or proceedings against you by a regulator anywhere.

Ontario professionals must also report reasonable grounds to believe that another regulated health professional has sexually abused a patient, and employers and facility operators have their own reporting duties. Other provinces set comparable duties in statute, regulation or college standards, so check your own college's requirements and deadlines. The probity course covers mandatory declaration and self-reporting, including reporting criminal charges.

Get advice before you respond. The right source depends on your profession:

• Physicians: the Canadian Medical Protective Association. Its guidance for college complaints asks members to contact it early, before replying to the college, to leave records unaltered and not to contact the complainant about the matter.
• Nurses: the Canadian Nurses Protective Society or your union. What CNPS covers for regulatory complaints depends on your province and the coverage you hold, so check your eligibility.
• Other professions: your professional liability insurer, professional association or union, or a lawyer who practises regulatory health law.

Whatever your profession: keep copies of everything, meet every deadline or ask for more time in writing, never alter a record, and do not discuss the complaint with the complainant or on social media.

Screening committees aim to protect the public, and some colleges describe remediation as their main focus at that stage, weighing how serious the concern is, whether it has happened before and what the evidence shows. Within that, your own response matters most in three ways:

• Insight. Show that you understand what went wrong, why it mattered to the patient and what your part was, without minimizing or blaming others.
• Remediation with evidence. Targeted learning, supervision or mentoring, an audit of your own practice and written reflection show change that someone else can check.
• Candour and cooperation. A factual, respectful response on time, complete records and honesty with the patient from the start.

Our complaint, insight, reflection and remediation courses work as a set, with the preventing recurrence and rebuilding trust courses for later stages. See the remediation courses page to pair them with the topic of your concern.

Most professionals answering a complaint send one written response and, sometimes, later submissions. Evidence of remediation is usually most useful when it is organized, accurate and clearly linked to the concerns raised. A simple structure that works in any province:

Agree the content and timing with your adviser: the CMPA for physicians, the CNPS or your union for nurses, and your insurer or lawyer for other professions. If an undertaking, a SCERP or an order already sets out education, follow its terms first. Colleges decide what weight to give any learning, and no course, including ours, can promise a result.

Each profession page names the right colleges, maps courses to their standards and suggests a set by concern:

• Remediation courses for doctors
• Remediation courses for nurses and midwives
• Remediation courses for dentists
• Remediation courses for pharmacists
• Remediation courses for optometrists and opticians
• Remediation courses for chiropractors
• Remediation courses for osteopathic practitioners, a profession with no statutory regulator for manual practitioners