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Study of Registration Practices of the
COLLEGE OF OCCUPATIONAL THERAPISTS OF ONTARIO, 2007

ISBN 978-1-4249-6466-6 [HTML English version]

  1. 1. INTRODUCTION
  2. 2. BACKGROUND OF THE REGULATORY BODY
    1. a. Legislation
    2. b. Protected Titles
    3. c. Definition of the Profession
    4. d. Labour Market/Economic Trends
    5. e. New Developments Within the Profession
    6. f. Staffing
  3. 3. REGISTRATION PRACTICES
    1. a. Registration Requirements and Application Process
    2. b. Documentation Required from Internationally Trained Individuals
    3. c. Credential Assessment (Third Party and/or Internal)
    4. d. Academic/Program Requirements
    5. e. Work Experience Requirements
    6. f. Examinations
    7. g. Language Requirements
    8. h. Fees
    9. i. Third Parties
    10. j. Typical Length of the Registration Process
    11. k. Accredited Programs
    12. l. Internal Review/Appeal Process
  4. 4. BRIDGING PROGRAMS
  5. 5. MUTUAL RECOGNITION AGREEMENTS
  6. 6. APPLICANTS’ INTERACTIONS WITH REGULATORY BODY
    1. a. Nature and Frequency of Communication
    2. b. Backlogs
    3. c. Complaints Regarding the Registration Process
  7. 7. CHANGES SINCE THE 2005 SURVEY
  8. 8. REGISTRATION INFORMATION AND STATISTICS
  9. 9. SOURCES

1. INTRODUCTION

The Office of the Fairness Commissioner (OFC) undertook a study of registration practices of Ontario's regulated professions during the fall and winter of 2007–2008. The purpose of the study was to understand each regulated profession's 2007 registration practices and to establish baseline data and information to enable the OFC to measure progress as it fulfills its mandate under the Fair Access to Regulated Professions Act, 2006.

This report reflects the registration practices of the College of Occupational Therapists of Ontario as of December 31, 2007. Information in this report was gathered from:

The College of Occupational Therapists of Ontario also provided registration information and statistics for 2005, 2006 and 2007 through a standard spreadsheet designed by the OFC.

An analysis and summary of the findings for all of the regulated professions is contained in the OFC's Ontario’s Regulated Professions: Report on the 2007 Study of Registration Practices.

2. BACKGROUND OF THE REGULATORY BODY

a. Legislation

The College of Occupational Therapists of Ontario (COTO) operates in accordance with the Regulated Health Professions Act, 1991 and the Occupational Therapy Act, 1991. The COTO’s registration regulation is the Ontario Reg. 130/00, Part VIII Registration.

b. Protected Titles

Persons calling themselves occupational therapists or holding themselves out to be occupational therapists must be registered with the COTO. Registration with the COTO qualifies an individual to use the title "occupational therapist," or OT, and the professional designation "OT Reg. (Ont.)."

c. Definition of the Profession

According to the Occupational Therapy Act, “The practice of occupational therapy is the 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.”

Occupational therapists (OTs) are health care professionals who help people learn or relearn how to manage the everyday activities that are important to them, including caring for themselves or others, caring for their homes, and participating in paid and unpaid work and leisure activities. The people occupational therapists work with may have difficulties due to accident, disability, disease, emotional or developmental problems, or changes related to the normal aging process.

d. Labour Market/Economic Trends

In January 2003, the Hospital Human Resource Policy and Research Unit of the Ontario Hospital Association (OHA) conducted a study to analyze workforce issues and trends that affect the supply of health care providers in Ontario. The study focused on six professions identified by the OHA as experiencing labour shortages; occupational therapists were among these six. There is also a shortage of occupational therapists in other Canadian provinces.

According to the career map of the occupational therapy profession in Ontario, which is published on the website of the Ontario Ministry of Citizenship and Immigration, “There is a continuing demand for occupational therapists because of an ageing population, increased attention to the needs of persons with disabilities and an increase in home care services. Areas of employment include health care, educational institutions, social agencies, private business and industry. Job growth may be found in the area of home-based care.”

Occupational therapists work in a variety of settings including hospitals, schools, long-term care facilities, mental health facilities, rehab clinics, community agencies, private homes, public or private health care offices, and vocational evaluation/training centres. Many occupational therapists have their own private practices.

e. New Developments Within the Profession

Until recently, hospitals often had a designated occupational therapy department, headed by an occupational therapist. Many hospitals have now moved to a multidisciplinary organizational model, and their occupational therapists are no longer managed by a member of the profession. Hospital-based OTs have more autonomy and must assume more responsibility for ensuring that any issues specific to occupational therapy are addressed by their multidisciplinary team. They also have increased responsibility to seek out support for problem solving within their practice area.

As a result of legislation governing automobile insurance in Ontario, more occupational therapists are in private practices where they work with insurance companies, providing assessments and treatment for claimants who have been involved in accidents. OTs in private practice have had to educate themselves about the ethical, legal and organizational implications of conducting a business.

The profession has moved its academic program to a master’s level degree (MSc), but as of December 31, 2007 the registration regulation has not been amended and COTO’s academic entry-to-practice requirement is still a bachelor of science degree in occupational therapy obtained in Ontario or an academic qualification deemed equivalent by the Registration Committee. This change to the academic requirements may present an obstacle in the future for internationally trained occupational therapists, as few possess a master’s degree.

The COTO is participating in the Health Human Resources Database Development Project with the Canadian Institute for Health Information, providing the OT data for Ontario. The COTO is collecting demographic data on its registrants to assist in developing a national occupational therapists database.

The Health System Improvements Act, 2007 (Bill 171) affects the COTO in a variety of ways, including:

f. Staffing

The COTO’s staff consists of 11 full-time and three part-time positions. Staff assigned to registration includes one employee, who is devoted full-time to the registration process and two employees who devote part of their time to the registration process.

3. REGISTRATION PRACTICES

a. Registration Requirements and Application Process

An applicant is a person who submits an application form to the COTO with the intention of obtaining a certificate and pays the application fee to the college.

i. Basic Requirements for Registration

To practise occupational therapy in Ontario, applicants must be registered members of the COTO. All applicants applying for registration must meet the following requirements:

Registration requirements are the same for Canadian graduates and international graduates. Demonstration of these requirements may be slightly different, however. For instance, COTO is able to verify academic credentials for Canadian programs, but an external agency is used to validate programs and documents for all internationally trained applicants.

ii. Steps in the Application Process

Step 1 – Provide Proof of English or French Fluency.
See Section 3.g below.

Step 2 – Send Application Documents to the College
Applicants can contact the COTO for the Registration Application Form or print it from the college’s website. Applicants must complete this form, attach the required documents, and pay the required fees.

Step 3 – Take the National Certification Examination.
See Section 3.f below.

Step 4 – Apply for a General Practising Certificate

iii. Classes of Registration

There are three classes of registration certificate:

b. Documentation Required from Internationally Trained Individuals

i. Standard documentation

Internationally trained individuals need to send the following information as part of the application:

Applicants who do not meet all of the above requirements can still start the application process by submitting their application form, application fee, academic documents, and any other documentation available at the time of submission.

The Registration Committee of the COTO will require an additional credential review if the program the applicant graduated from has not yet been approved by COTO. Applicants will need to provide the COTO with their transcript along with valid course descriptions, including the names, content and hours of the courses in their program. In these situations, the COTO will notify the applicant of specific requirements and fees.

If applicants meet the education and currency hour requirements, the college will inform them with a written statement of eligibility. Applicants will then be able to go on to apply to write the national examination administered by the CAOT.

ii. Options for Applicants with Unavailable/Destroyed Documents

Currently, the COTO does not have a documented policy to deal with applicants who do not have access to unavailable documents, as this situation has never occurred at the COTO. A possible option is to ask the applicant to swear an affidavit and, when possible, contact someone in Ontario who knows the applicant from his or her country of origin and who can verify that information contained in the affidavit is true. The COTO could also use WES to verify if an institution exists (if the institution is called into question), and it could ask the applicant to bring in textbooks (if the curriculum is called into question).

This situation is still under discussion by the Registration Committee and it is expected that a policy will be drafted in the future and posted on the COTO website.

c. Credential Assessment (Third Party and/or Internal)

All applicants who have obtained their occupational therapy degrees/diplomas outside of Canada must have their academic qualifications assessed by World Education Services (WES) or other member organizations of the Alliance of Credential Assessment Services of Canada.[3] The degree/program content is assessed by the college’s Registration Committee. Applicants should contact WES to obtain an application form for a document-by-document credential assessment.

d. Academic/Program Requirements

To be registered with the COTO, an applicant must have evidence of successful completion of a bachelor of science degree in occupational therapy obtained in Ontario, or an academic qualification considered equivalent by the Registration Committee.

e. Work Experience Requirements

The COTO requires that applicants demonstrate that they have the necessary current knowledge, skills, judgment and abilities to practise occupational therapy (the “currency hours” requirement). Applicants can do this one of three ways:

In order to obtain a General Practising Certificate or a Provisional Practising Certificate, applicants must have also successfully completed 1,000 hours of fieldwork or clinical practicum as part of their academic program.

If applicants do not meet the currency requirement for registration, they will be required to complete a re-entry program called the Currency Refresher Program. The COTO will notify the applicant of the number of hours required and explain the re-entry process. Applicants are required to secure a clinical setting to complete the volunteer hours under the supervision of a registered occupational therapist. An evaluation of the applicant’s performance during the review period is required. A Practice Supervisor Agreement Form and Learning Contract is completed by the applicant and approved by the COTO before the applicant starts the volunteer practice hours.

The Ontario Society of Occupational Therapists may be able to assist applicants in finding a re-entry program. Many facilities require group accident insurance, which is available through OSOT.

The Currency Refresher Program is different from the 1,000 hours of clinical fieldwork.

f. Examinations

All candidates who want to become registered as occupational therapists in Ontario must pass a COTO-approved exam that tests entry-level competency. Currently, the only COTO-approved exam is the CAOT Certification Examination, administered by the CAOT. This is a standardized, multiple-choice examination that poses a clinical scenario and asks questions coming out of that assessment/treatment. There is no practical component.

It takes four hours to complete the CAOT Certification Examination. It includes questions that test knowledge of specific areas of Canadian occupational therapy practice and theory. The examination is offered twice a year, in July and in November. The CAOT can provide applicants with all other relevant information regarding the exam.

Individuals who wish to write the CAOT examination must apply directly to the CAOT, which determines applicants’ eligibility to write the exam.

Once applicants are registered with the COTO, they have two chances to pass the CAOT exam and they must write the first available exam. Registrants who do not pass the exam on their second attempt have the option of reapplying to the COTO if there are extraordinary circumstances to be considered. The COTO may grant exemptions from writing the first available exam under extenuating circumstances, such as a death in the family.

Applicants who are not registered with the COTO can take the CAOT exam as many times as they want.

g. Language Requirements

Applicants whose first language is English or French, or who completed occupational therapy education in English or French, do not need to provide proof of fluency. Other applicants must get an acceptable score on a standardized English or French fluency test (both written and spoken) that is recognized in Canada and approved by the college. Applicants must have their results sent directly to the college.

Test Details Minimum Score

1a) Test of English as a Foreign Language (TOEFL)

Internet based test (iBT)

Speaking

26/30

Writing

22/30

Reading

22/30

Listening

22/30

Overall Score

92/120

1b) Part 1 Test of English as a Foreign Language (TOEFL)

Computer based test (CBT)
Paper based test (PBT)

230
580

1b) Part 2 Test of Spoken English (TSE)

Oral test (in conjunction with TOEFL, CBT and PBT)

50

2a) Michigan English Language Assessment Battery (MELAB)

Written component

85

2b) MELAB

Oral component

4–

3a) International English Language Testing System (IELTS)

Written component (overall band)

7.5

3b) IELTS

Oral test (minimum band)

7.5

4. TestCan

Test of French language fluency

5 on each section

h. Fees

The fees listed below do not include GST.

Initial application fee (non-refundable)

$200.00

Registration fee (pro-rated quarterly)

$657.55

Annual registration fee

$657.55

Credential review fee[4]

$150.00

Additional Fees

External credential assessment report (payable to organization completing the assessment)

$115.00 (varies)

CAOT Certification Examination fee (payable to CAOT)

$407.00

Applicants who are required to take the language proficiency test must pay that cost directly to the testing organization.

i. Third Parties

Name of Third Party Relationship to Regulatory Body

WES or other credential service

Credential assessment

Canadian Association of Occupational Therapists (CAOT)

Administers national certification exam

Language Testing Services (TOEFL, TSE, MELAB, IELTS)

Administer English language proficiency tests

TestCan

Administers French language proficiency test

j. Typical Length of the Registration Process

If all requirements are met, an application to the COTO can be processed in one week for Ontario graduates, Canadian graduates and international graduates.

If the application must be reviewed by the Registration Committee, the registration process can take one to two months after the Registration Committee has received all of the required documentation.

There is a one-year time limit to complete the application process; however, applicants can re-apply if they still wish to pursue registration.

Once an applicant is registered, he or she is immediately provided with a registration number. A new member package is mailed usually within 30 days of registration being finalized.

k. Accredited Programs

The following universities offer programs in occupational therapy in Canada that have been accredited by the CAOT and approved by the COTO:

Ontario
McMaster University, Hamilton
Queen’s University, Kingston
University of Ottawa
University of Toronto
University of Western Ontario, London

Alberta
University of Alberta, Edmonton

British Columbia
University of British Columbia, Vancouver

Manitoba
University of Manitoba, Winnipeg

Nova Scotia
Dalhousie University, Halifax

Quebec
McGill University, Montreal
Université de Montréal
Université Laval, Quebec City

For a full list of occupational therapy educational programs worldwide visit the World Federation of Occupational Therapists (WFOT) website

All educational programs must be approved by COTO to be accepted as meeting registration requirements.

l. Internal Review/Appeal Process

Applicants who do not meet the registration requirements can request a review by the Registration Committee of the COTO.

The Registration Committee is composed of two members of the Council who are members of the COTO, two members of the Council appointed to the Council by the Lieutenant Governor in Council, and one COTO registrant who is not a member of Council.

Decisions of the Registration Committee can be appealed to the Health Professions Appeal and Review Board (HPARB). As of December 31, 2007, the college has not received any appeals of registration decisions through HPARB.

The Health Professions Appeal and Review Board is an independent adjudicative agency established by the Regulated Health Professions Act, 1991. With regard to the COTO, on request HPARB will:

The information about appeals of registration decisions is not currently available on the COTO’s website; however, applicants are individually informed of this right in any written decisions made by the Registration Committee.

Applicants can access all the information concerning decisions made by the COTO with respect to their case.

Applicants should appeal credential-assessment decisions through the organization that conducted the credential assessment.

4. BRIDGING PROGRAMS

There is no formal bridging program for internationally trained occupational therapists.

5. MUTUAL RECOGNITION AGREEMENTS

Currently, the COTO has a mutual recognition agreement (MRA) with all provinces in Canada including Quebec. The territories of Canada do not have regulation of occupational therapists at the current time; however, occupational therapists from the territories are eligible to apply for registration with the COTO.

Occupational therapists must hold a current registration in another jurisdiction when applying under the MRA. The details of the MRA can be found on the COTO’s website and address education requirements, exam requirements, and regulatory requirements.

6. APPLICANTS’ INTERACTIONS WITH REGULATORY BODY

a. Nature and Frequency of Communication

Applicants who communicate via e-mail about the application requirements or process are responded to by e-mail.

Applicants who use telephone communication with the COTO will be responded to by telephone, and typically they will be referred to the website and/or sent an e-mail with pertinent information and documents related to registration. Potential applicants may send numerous questions back and forth as they go through the registration process.

Applicants who meet the education requirement but not all the other requirements will receive written documentation that they are eligible for registration once all outstanding requirements are met.

b. Backlogs

There is no backlog for applicants who meet all the registration requirements.

If all requirements are not met, the file remains pending until the applicant provides outstanding documents/requirements, or the Registration Committee reviews the application and makes a decision. Applicants have one year to complete their application.

c. Complaints Regarding the Registration Process

The majority of complaints to the COTO centre around how difficult it is to find a job and to find a supervising therapist if applicants require a re-entry program for the currency hours requirement. There are also many queries about how to prepare for the national certification exam.

Any questions or concerns are handled as quickly as possible either through e-mail or telephone; if necessary, a meeting may be arranged. The goal is to resolve any issues as soon as possible. If the applicant requires clarification or more information they are provided with this as soon as possible.

7. CHANGES SINCE THE 2005 SURVEY

The Ministry of Citizenship and Immigration conducted a survey in 2005 to collect information about occupational regulatory bodies in Ontario.

The COTO career map was last updated in December 2006.

In addition, the COTO has been involved with universities and associations to advocate for re-entry placements for internationally trained applicants. The COTO has also advocated for the inclusion of re-entry candidates on the liability insurance for the supervising therapists, eliminating one more roadblock to re-entry placements, and it has implemented an outline of expectations of re-entry candidates for their placement experiences to improve the development of their learning contracts.

The COTO will act in an advisory capacity with McMaster University’s OT/PT departments in a project funded by the province to develop a structured examination assistance program suitable for internationally trained applicants.

The CAOT has revised the format of its national certification exam: changing it to plain language, reducing the length of the exam and allowing special accommodations such as additional time to write the exam.

8. REGISTRATION INFORMATION AND STATISTICS

Definitions used in these tables:

Alternative class of licence: a class of licence that enables its holder to practise with limitations; additional registration requirements must be met in order to be fully licensed. Alternative classes of licence granted by the College of Occupational Therapists of Ontario are specified under the tables below.

Applicant: an individual who has applied to start the process for entry to the profession.

Applicant actively pursuing licensing: an applicant who had some contact with the College of Occupational Therapists of Ontario within the year specified.

Inactive applicant: an applicant who had no contact with the College of Occupational Therapists of Ontario within the year specified.

Member: an individual who is currently able to use the protected title or professional designation of “occupational therapist.”

Languages in which application information materials are available
Language 2005 2006 2007
English

Yes

Yes

Yes

French

Yes

Yes

Yes

Other(s)

 

 

 

Countries where internationally educated applicants were initially trained in occupational therapy
Applications received 2005 2006 2007
Largest number

United States

United States

United States

Second-largest number

Philippines

India

Philippines

Third-largest number

India

Philippines

United Kingdom

Fourth-largest number

United Kingdom

Brazil

Pakistan

Fifth-largest number

South Africa

United Kingdom

Germany

Staff employed by the College of Occupational Therapists of Ontario
Number of staff 2005 2006 2007
Involved in registration process

1

1.5 FTE

1.7 FTE

Involved in appeals process

N/A

N/A

N/A

Jurisdiction where members were initially trained in occupational therapy (before they were granted use of the protected title or professional designation in Ontario)
Members Ontario Other Canadian Provinces USA Other International TOTAL
Total members

3,468

442

115

328

4,353

Non-practising members

N/A

N/A

N/A

N/A

N/A

Applicants processed by the College of Occupational Therapists of Ontario in 2005

 

Jurisdiction where members were initially trained in occupational therapy (before they were granted use of the protected title or professional designation in Ontario)
In 2005 (Jan. 1 to Dec. 31) Ontario Other Canadian Provinces USA Other International TOTAL
New applications received

N/A

N/A

N/A

N/A

N/A

Applicants actively pursuing licensing

N/A

N/A

N/A

N/A

N/A

Inactive applicants

N/A

N/A

N/A

N/A

N/A

Applicants who met all requirements and were authorized to become members but did not become members

N/A

N/A

N/A

N/A

N/A

Applicants who became members

294

35

14

31

374

Applicants who were authorized to receive an alternative class of licence1 but were not issued a licence

N/A

N/A

N/A

N/A

N/A

Applicants who were issued an alternative class of licence1

N/A

N/A

N/A

N/A

N/A

1 Provisional Practising Certificate of Registration: Issued when an applicant meets all the requirements except for having completed the exam requirement. Registrant must sit the first National Certification Exam from date of registration. Exam held twice per year. Registrant has two chances to pass before certificate expires.

Temporary Certificate of Registration: For occupational therapists licensed in another jurisdiction who need short-term (maximum four months) registration in Ontario; e.g., attend a clinical workshop. The visiting OT must obtain a temporary certificate which requires supervision by a registrant of the COTO who holds a general practising certificate.

Applicants processed by the College of Occupational Therapists of Ontario in 2006

 

Jurisdiction where members were initially trained in occupational therapy (before they were granted use of the protected title or professional designation in Ontario)
In 2006 (Jan. 1 to Dec. 31) Ontario Other Canadian Provinces USA Other International TOTAL
New applications received

294

29

12

21

356

Applicants actively pursuing licensing

N/A

N/A

N/A

N/A

N/A

Inactive applicants

N/A

N/A

N/A

N/A

N/A

Applicants who met all requirements and were authorized to become members but did not become members

N/A

N/A

N/A

N/A

N/A

Applicants who became members

297

27

9

23

356

Applicants who were authorized to receive an alternative class of licence1 but were not issued a licence

N/A

N/A

N/A

N/A

N/A

Applicants who were issued an alternative class of licence1

N/A

N/A

N/A

N/A

N/A

1 Provisional Practising Certificate of Registration: Issued when an applicant meets all the requirements except for having completed the exam requirement. Registrant must sit the first National Certification Exam from date of registration. Exam held twice per year. Registrant has two chances to pass before certificate expires.

Temporary Certificate of Registration: For occupational therapists licensed in another jurisdiction who need short-term (maximum four months) registration in Ontario; e.g., attend a clinical workshop. The visiting OT must obtain a temporary certificate which requires supervision by a registrant of the COTO who holds a general practising certificate.

Applicants processed by the College of Occupational Therapists of Ontario in 2007

 

Jurisdiction where members were initially trained in occupational therapy (before they were granted use of the protected title or professional designation in Ontario)
In 2007 (Jan. 1 to Dec. 31) Ontario Other Canadian Provinces USA Other International TOTAL
New applications received

302

27

17

23

369

Applicants actively pursuing licensing

0

0

0

10

10

Inactive applicants

N/A

N/A

N/A

N/A

N/A

Applicants who met all requirements and were authorized to become members but did not become members

N/A

N/A

N/A

N/A

N/A

Applicants who became members

296

30

15

22

363

Applicants who were authorized to receive an alternative class of licence1 but were not issued a licence

N/A

N/A

N/A

N/A

N/A

Applicants who were issued an alternative class of licence1

4

1

4

4

13

1 Provisional Practising Certificate of Registration: Issued when an applicant meets all the requirements except for having completed the exam requirement. Registrant must sit the first National Certification Exam from date of registration. Exam held twice per year. Registrant has two chances to pass before certificate expires.

Temporary Certificate of Registration: For occupational therapists licensed in another jurisdiction who need short-term (maximum four months) registration in Ontario; e.g., attend a clinical workshop. The visiting OT must obtain a temporary certificate which requires supervision by a registrant of the COTO who holds a general practising certificate.

9. SOURCES

Canadian Association of Occupational Therapists (CAOT) website: http://www.caot.ca/default_new.asp. Last accessed: March 31, 2008.

College of Occupational Therapists of Ontario website: http://www.coto.org/default.asp. Last accessed: March 31, 2008.

College of Occupational Therapists of Ontario and Ministry of Citizenship and Immigration. “Access to the Occupational Therapy Profession in Ontario.” Ministry of Citizenship and Immigration website: http://www.citizenship.gov.on.ca. Last accessed: March 31, 2008.

Ontario Society of Occupational Therapists website: http://www.osot.on.ca/eng/aboutosot/aboutosot.asp. Last accessed: April 7, 2008

World Federation of Occupational Therapists website: http://www.wfot.org/default.asp. Last accessed: April 1, 2008.

Representatives of the College of Occupational Therapists of Ontario met with staff of the Office of the Fairness Commissioner on November 28, 2007, to provide further information for this study.



[1] The Canadian Association of Occupational Therapists provides services, products, events and networking opportunities to assist occupational therapists in their professional practice.

[2] The Ontario Society of Occupational Therapists is the voluntary provincial professional association of Ontario's occupational therapists. With focus in the areas of member services, policy and practice, professional promotion, education and regional affairs, the society serves and represents the interests of members and promotes the profession of occupational therapy in the province of Ontario.

[3] Some individuals who obtained a diploma may be grandfathered after the credential assessment is completed.

[4] This fee is only for those who go to the Registration Committee because the program they obtained their academic qualification from has not yet been approved by the COTO.