CPSO Physician Complaints in Ontario: What Physicians Should Know
The College of Physicians and Surgeons of Ontario (CPSO) regulates more than 47,000 physicians and surgeons in Ontario under the Medicine Act, 1991 and the Regulated Health Professions Act, 1991 (RHPA). Most complaints are handled by the Inquiries, Complaints and Reports Committee (ICRC). Serious matters can be referred to the independent Discipline Tribunal of the CPSO, and most ICRC decisions can be appealed to the Health Professions Appeal and Review Board (HPARB).
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Governing statute
Medicine Act, 1991 and the Regulated Health Professions Act, 1991 (RHPA)
First-stage decision-maker
Inquiries, Complaints and Reports Committee (ICRC)
Registrant response window
At least 30 days (statutory minimum under the RHPA)
Mailing address
80 College Street Toronto, ON M5G 2E2
1-800-268-7096
Understanding the CPSO complaints process
Ontario's medical regulator runs the largest physician-complaints workflow in Canada. Because the RHPA is the shared procedural backbone for more than two dozen Ontario health professions, much of what applies to physicians at the CPSO will look familiar to anyone who has navigated a complaint at the CNO, College of Pharmacists, or RCDSO.
When a complaint reaches the CPSO, intake staff log it, assign a file number, and forward a complete copy of the materials to the physician. The statutory floor for your written response is 30 days, but extensions are routinely granted on written request. The ICRC reviews the file on the written record (there is no oral hearing at the ICRC stage), so the quality and clarity of your written response, supporting documents, and any expert opinion you submit is the most important factor at this level.
Most ICRC outcomes (no action, advice, a caution in person, a SCERP, or an undertaking) can be appealed by either side to the Health Professions Appeal and Review Board (HPARB), which is an independent tribunal that can confirm, vary, or send the matter back. The Discipline Tribunal of the CPSO sits separately from the College's internal committees and conducts formal hearings on serious matters; its decisions are published on the CPSO public register.
Mandatory reporting drives a meaningful share of CPSO intake. Ontario employers, hospital CEOs, and other regulated health professionals all have statutory obligations to report certain conduct, terminations, resignations, or findings. If you are the subject of an employer or hospital report, expect CPSO to contact you even when no patient has filed a complaint. Engage CMPA the day you receive the notice.
What's distinctive about the CPSO complaints process
- RHPA gives you a minimum of 30 days to provide a written response, and CPSO typically grants extensions on written request.
- CPSO offers Alternative Dispute Resolution (ADR) for appropriate communication-style complaints, with restrictions (no ADR for sexual abuse or moderate-or-higher public risk matters).
- Most ICRC decisions can be reviewed by HPARB, which is a meaningful external check unique to Ontario and a small handful of other provinces.
- Ontario operates a strict zero-tolerance sexual abuse regime under the RHPA, including mandatory licence revocation for prescribed acts.
What triggers complaints against physicians in Ontario
Administrative concerns
- •Practising on an expired or lapsed certificate of registration
- •Failing to meet continuing professional development (CPD) or revalidation requirements
- •Not reporting a change of practice location, employer, or hospital privileges in time
- •Failing to disclose a charge, finding, or condition on annual renewal
- •Inadequate or missing chart documentation discovered on audit
Conduct or practice concerns
- •Prescribing concerns (opioids, benzodiazepines, controlled drugs, off-label use)
- •Standard-of-care concerns raised by a patient, family, or another physician
- •Professional boundary or sexual abuse allegations (zero-tolerance regime in most provinces)
- •Communication concerns: tone, lack of informed consent, or perceived dismissiveness
- •Billing or OHIP/MSP/AHCIP irregularities flagged by the provincial insurer
- •Confidentiality or privacy breaches under PHIPA / PIPA / HIA
- •Concerns about fitness to practise (health, cognition, substance use)
How a CPSO complaint typically moves
- 1
Complaint received and acknowledged
The College receives the written complaint, assigns a file number, and sends a written acknowledgement to the complainant and the physician.
- 2
Notice to the physician
You are sent the complaint and supporting materials, and invited to provide a written response. The College's investigations or professional conduct staff is typically your point of contact.
- 3
Investigation
An investigator gathers records (chart, billing, hospital file, expert opinions), interviews witnesses, and asks you targeted questions. You have a duty to cooperate but you are entitled to counsel and to decline to admit fault.
- 4
Written response from the physician
You submit a written response addressing each allegation, ideally with supporting documentation and, where appropriate, a peer-reviewed clinical rationale. This is usually the single most important document on the file.
- 5
Review by the ICRC
The ICRC reviews the investigation file and your response on the record. It can take no action, issue advice or a caution, accept an undertaking, require remediation (SCERP), or refer the matter forward.
- 6
Possible referral to the Discipline Tribunal of the CPSO
Serious matters or unresolved factual disputes may be referred to the Discipline Tribunal of the CPSO for a formal hearing on the merits.
Possible outcomes
No further action or dismissal
The committee determines the complaint is unfounded, outside its jurisdiction, or does not warrant further action. The file is closed and (in most provinces) does not appear on the public register.
Advice, caution, or reminder
A non-disciplinary measure intended to support reflection on practice. Usually recorded on your College file; often not posted publicly.
Specified Continuing Education and Remediation Program (SCERP) or undertaking
A structured remedial plan, typically including coursework, a chart-stimulated recall, or a period of practice monitoring. Some appear on the public register.
Referral to discipline or formal hearing
A formal hearing-style proceeding before a panel that can issue findings of professional misconduct or incompetence and impose conditions, suspension, or licence revocation.
Suspension or revocation of certificate of registration
Reserved for the most serious findings, including sexual abuse, criminal-grade conduct, or repeated failures of practice. Always published on the College's public register.
Practical tips for physicians in Ontario
- Use your full statutory response window. CPSO will usually grant a reasonable extension if requested in writing before the deadline.
- Notify CMPA (Canadian Medical Protective Association) the day you receive the notice. CMPA assistance includes legal representation throughout.
- Request the complete investigation package (the complainant's submission, any records the investigator has gathered, expert opinions if any) before drafting your response.
- Do not alter charting after the fact. If you discover an error, follow your facility's late-entry policy and disclose it in your response.
- Consider whether Alternative Dispute Resolution (ADR) is appropriate, especially for communication-only complaints.
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Northwest Territories
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