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CPSO Policy on Professional Responsibilities in Postgraduate Education 2003

The purpose of this policy is to clarify the roles and responsibilities of most responsible physicians, supervisors and trainees engaged in postgraduate medical education programs, thereby ensuring the safety and proper care of patients in situations where postgraduate clinical trainees are being educated.

This policy focuses on professional responsibilities in the following aspects of medical education:

  • Supervision and Training

  • Professional Relationships

  • Reporting Responsibilities

  • Respecting Patient Rights and Consent to Treatment

Supervision and Training

One physician must always be designated the most responsible physician for the patient’s care. In a teaching environment, the most responsible physician may or may not also be the supervisor of the trainee.

The supervisor and/or most responsible physician must provide appropriate supervision to the trainee:

  • allowing trainees the responsibility appropriate to their level of training, and commensurate with their ability;

  • ensuring ongoing evaluation to determine the trainee’s clinical competence and educational requirements;

  • meeting regularly with the trainee to discuss the trainee’s assessment, management, and documentation of patient care; and

  • ensuring that all relevant clinical information is made available for the best care of the patient.

Trainees must actively participate in the provision of health care in order to receive the training they require for future independent practice. They must:

  • be willing and able to see patients and to report information to the supervisor and/or most responsible physician according to any guidelines laid down by the postgraduate program and clinical placement setting;

  • document his/her findings and management plans and discuss these with the supervisor and/or most responsible physician.

Professional Relationships

The most responsible physician, supervisor and trainee should:

  • maintain an ethical approach to the care of patients;

  • maintain a professional supervisor-trainee relationship at all times, which includes: not exploiting the power differential that is inherent in the supervisor-trainee relationship, not becoming involved in situations involving conflicts of interest, and not intimidating or harassing one another emotionally, physically or sexually.

  • maintain an appropriate relationship with all other colleagues, which includes not intimidating or harassing them emotionally, physically or sexually

In addition, the most responsible physician/supervisor is responsible for providing a model of appropriate and compassionate care.

Reporting Responsibilities

Legal Reporting:

...sexual abuse

Ethical Reporting:

...if another physician exhibits behaviour that would suggest incompetence or incapacity that compromises his/her ability to care for patients. This applies to the most responsible physician, supervisor or trainee.

Respecting Patient Rights and Consent to Treatment

Patients have the right to be fully informed about, and to refuse to participate in, medical education; however, alternative care arrangements may be required if a patient refuses treatment in a clinical teaching setting. The most responsible physician/supervisor and trainee are jointly responsible for trying to ensure that patients are aware of their rights in this context, and that such rights are respected.


Patients must consent to treatment. It is understood that patients entering teaching facilities will be notified of the educational nature of the patient care to be provided and will give informed consent.

Examination and Clinical Demonstration Solely for Educational Purposes:

When a patient’s participation is purely for educational reasons, the patient must be notified and must provide consent. The most responsible physician and/or supervisor should ensure that the proposed examination or clinical demonstration is not detrimental to the patient, either physically or psychologically.[2]

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2. Content for this section was provided by Dr. Janet Dollin, Office of Gender and Equity Issues, Faculty of Medicine, University of Ottawa

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