Composition of Council

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					                       BYLAWS OF
      THE COLLEGE OF PHYSICIANS AND SURGEONS
                   OF ALBERTA
                                                      PART B
                                             Table of Contents
                                         (Issued January 2, 2006)

1       Composition of Council ..................................................................... 1
2       Election of councilors ........................................................................ 1
3       Medical electoral districts .................................................................. 2
4       Representation ................................................................................... 2
5       Changes ............................................................................................. 3
6       President ............................................................................................ 3
7       Vice-President.................................................................................... 3
8       Duties of Council ............................................................................... 3
9       Annual organizational meeting of Council ........................................ 3
10      Regular meetings of Council ............................................................. 3
11      Special meetings of Council .............................................................. 4
12      Emergency meetings of Council ........................................................ 4
13      Annual general meeting of College ................................................... 4
14      Proceedings of Council ...................................................................... 4
15      Mail vote ............................................................................................ 4
16      Order of business ............................................................................... 4
17      Life members ..................................................................................... 5
18      Retired members ................................................................................ 5
19      Certificates of Merit ........................................................................... 5
20      Affiliation with Medical Faculty Council .......................................... 6
21      Affiliation with Medical Council of Canada ..................................... 6
22      Affiliation with Federation ................................................................ 6
23      Other affiliation ................................................................................. 6
24      Appointment of standing committees ................................................ 6
25      Executive Committee......................................................................... 7
26      Nominating Committee ..................................................................... 7
27      Finance and Audit Committee ........................................................... 8
28      Committee on Legislation.................................................................. 8
29      Duties ................................................................................................. 8
30      Other committees ............................................................................... 8
31      Costs .................................................................................................. 8
32      Fees .................................................................................................... 9

GENERAL ................................................................................................. 14
33 Storage of documents ........................................................................ 14
34 Money on deposit .............................................................................. 14
35 Bonding ............................................................................................. 15
           Table of Contents
           Part B (Continued)
           Issued January 2, 2006



36      Grants................................................................................................. 15
37      Passing By-laws ................................................................................. 15
38      Advertising ........................................................................................ 15
39      Records retention ............................................................................... 16

SPECIALIST CERTIFICATION ........................................................... 17
40 Specialist certificates ......................................................................... 17
41 Qualifications ..................................................................................... 18
42 Application ........................................................................................ 19
43 Issue of certificate .............................................................................. 19
44 Restricted Practice ............................................................................. 19
45 Special Interest................................................................................... 20

NON-HOSPITAL TREATMENT FACILITY AND NON-
HOSPITAL MEDICAL DIAGNOSTIC FACILITY ............................ 20
46 Regulation of non-hospital diagnostic and treatment facilities.......... 20
     Definition of medical practice ....................................................... 20
     Approved medical services ............................................................ 21
     Ownership and operation ............................................................... 28

MEDICAL FACILITY ASSESSMENT COMMITTEE....................... 29
47 Operation ........................................................................................... 29
     Committee constituted ................................................................... 29
     Purpose .......................................................................................... 29
     Membership ................................................................................... 30
     Committee objectives .................................................................... 30
     Medical Director ............................................................................ 31
     Responsibility of Medical Director ................................................ 31
     Cooperation by the Medical Director ............................................ 32
     Referral to Investigation Chair ...................................................... 32
     Committee responsibilities ............................................................ 32
     Referral of the matter to the Council ............................................. 33

CONFLICT OF INTEREST GUIDELINES.......................................... 34
48 Self-referral ........................................................................................ 34
49 Seeking or receiving benefits from a third party ............................... 34
50 Referral to a facility in which a registered practitioner holds an
   interest ............................................................................................... 34
51 Investment by a practitioner in a treatment and/or diagnostic
   facility ................................................................................................ 35
52 Sale by a registered practitioner of medical or health care products . 35
      Incentives Offered by Physicians................................................... 35

RESEARCH ETHICS REVIEW COMMITTEE .................................. 36
           Table of Contents
           Part B (Continued)
           Issued January 2, 2006


53      Operation ........................................................................................... 36

PRACTICE IN ASSOCIATION ............................................................. 40
54 Definitions ......................................................................................... 40
55 Conditions Governing Association .................................................... 41

LIMITED LIABILITY PARTNERSHIP ............................................... 41
56 Prohibition ......................................................................................... 41

NON-HOSPITAL MEDICAL IMAGING FACILITY ......................... 41
57 Approval of facility............................................................................ 41
58 Medical director and consultants ....................................................... 42
59 Procedures on request ........................................................................ 42
60 Employment of technical staff ........................................................... 42
61 Application for approval .................................................................... 42
62 Notification of changes ...................................................................... 42
63 Duties of director ............................................................................... 43
64 Requirements re: techniques .............................................................. 43
65 Facility records .................................................................................. 43
66 Contrast studies .................................................................................. 44
67 Image intensification ......................................................................... 44

DIAGNOSTIC MEDICAL LABORATORY ......................................... 44
68 Definitions ......................................................................................... 44
69 Ownership .......................................................................................... 46
70 Approval of laboratory director ......................................................... 47
71 Approval of procedures ..................................................................... 47
72 Employees.......................................................................................... 47
73 Quality assurance ............................................................................... 47
74 Duties of laboratory director .............................................................. 48
75 Approval to perform procedures ........................................................ 49
76 Classification of laboratories ............................................................. 51

DIAGNOSTIC ULTRASOUND .............................................................. 51
77 Definitions ......................................................................................... 51
78 Repealed ............................................................................................ 51
79 Approval of ultrasonologist ............................................................... 51
80 Eligibility as ultrasonographer ........................................................... 53
81 Operation requirements ..................................................................... 53
82 Term of approval ............................................................................... 54

COMPLEMENTARY HEALTH CARE THERAPY PROVIDED
BY MEDICAL PRACTITIONERS ........................................................ 55
83 Definition ........................................................................................... 55
           Table of Contents
           Part B (Continued)
           Issued January 2, 2006


84      Notification of Complementary Health Care Therapy(s) Practice..... 55
85      Practice Guideline for the Provision of Complementary Health
        Care Therapy ..................................................................................... 57

PHYSICIAN PERFORMANCE COMMITTEE ................................... 59
86 Operation ........................................................................................... 59

ADVISORY COMMITTEE FOR PRIVILEGES ................................. 63
87 Operation ........................................................................................... 63
     Committee Constituted .................................................................. 63
     Purpose .......................................................................................... 63
     Membership ................................................................................... 63
     Objectives ...................................................................................... 64
     Quorum .......................................................................................... 64
     Voting ............................................................................................ 64
     Meetings ........................................................................................ 64
     Investigation and Reporting ........................................................... 65
     Subcommittee ................................................................................ 65
     Fees ................................................................................................ 66

PROFESSIONAL CORPORATION ...................................................... 66
88 Registrar's records.............................................................................. 66
89 Articles of incorporation .................................................................... 66
90 Information to Registrar .................................................................... 67
91 Certificate .......................................................................................... 67
92 Renewal of permit.............................................................................. 67
93 Names ................................................................................................ 68
94 Reinstatement after suspension.......................................................... 68
95 Reissue after revocation ..................................................................... 68
96 Liability for payment of fees ............................................................. 69

PRACTICE OF MEDICINE BY TELECOMMUNICATION
ACROSS PROVINCIAL BOUNDARIES .............................................. 69
97 Operation ........................................................................................... 69
     Definitions ..................................................................................... 69
     Licensing........................................................................................ 69
     Conditions of Practice of Telemedicine ......................................... 70
     Exemptions .................................................................................... 70

TRIPLICATE PRESCRIPTION PROGRAM COMMITTEE ............ 71
98 Operation ........................................................................................... 71
99 Disclosure of Confidential Information ............................................. 72
100 Reporting of Blood Borne Infections................................................. 73
101 Repeal ................................................................................................ 73
                                 PART B
    BY-LAWS OF THE COLLEGE OF PHYSICIANS AND SURGEONS OF ALBERTA

1       Composition of Council
        The government of the College is vested in the Council, which shall consist of those
members who shall be elected or appointed as set out in the Medical Profession Act, Revised
Statutes of Alberta, 2000, Chapter M-11.
2      Election of councilors
       (1)     The Registrar of the College shall, at least 2 months before the date on which the
       election is to be held,

              (a)     make out an alphabetical list of the practitioners who are
                      (i)     in good standing, and
                      (ii)    entitled to vote at the election, showing the district in which each
                              conducts the practice of medicine as registered with the College, and

              (b)     mail to each registered practitioner
                      (i)     a copy of the list required by subsection (1)(a),
                      (ii)    the nomination paper in Form A in the Schedule, and
                      (iii)   a notice stating the date of election.

       (2)    Each nomination paper shall be signed by

              (a)     3 members of the College eligible to vote in the district, and

              (b)     the nominee indicating his acceptance of the nomination.

       (3)    The Registrar shall not accept any nomination that is not received by him at least 35
       calendar days before the date fixed for the election.

       (4)     If only one nomination is received for a vacancy, the nominee shall be declared
       elected by acclamation.

       (5)     If more than one nomination is received for a vacancy, the Registrar, no less than 28
       calendar days before the date fixed for the election, shall mail to each person eligible to vote
       in any district

              (a)     a copy of the instruction to voters in Form B in the Schedule, and

              (b)     a ballot in Form C in the Schedule listing the names of persons nominated for
                      the election in that district.

       (6)     Ballots shall be marked by an X and each registered practitioner shall have one vote
       for each vacancy in their district.

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                                           Replaces January 4, 2005 Issue                            1
    (7)     The candidate or candidates with the largest number of votes shall be declared
    elected by the Registrar and the members shall be notified of the results.

    (8)    Appointment of 3 councillors from the general public shall

           (a)     be made by the Council from names submitted to it, and

           (b)     be for 3-year terms.

    (9)     Prior to the election, the Council shall appoint 3 registered practitioners to act as
    presiding officers for the election.

    (10) The term of office for each elected councillor shall be a period of 3 years
    commencing on the first day of January of the year following his election.

    (11) There is no limitation as to the number of times a councillor may be elected or
    appointed.

3   Medical electoral districts
    (1)    The Province of Alberta shall be divided into two (2) medical electoral districts as
    follows:

           (a)     The Northern District, consisting of that portion of the Province lying north
                   of the northern boundary of the City of Red Deer;

           (b)     The Southern District, consisting of that portion of the Province lying south
                   of the northern boundary of the City of Red Deer, including the City of Red
                   Deer.

4   Representation


    (1)      As of July 1, 2005, each of the 8 members of Council currently elected, or to be
    elected or appointed, representing the former medical electoral districts of District 4, 5, 7
    and 8 shall be deemed to be members of Council elected for the Northern District and that
    each term of the respective member of Council will expire on the same date as when the
    member of Council was elected to represent the former medical electoral districts of District
    4, 5, 7 and 8, as the case may be.

    (2)     As of July 1, 2005, each of the 9 members of Council currently elected, or to be
    elected or appointed, representing the former medical electoral districts of District 1, 2, 3
    and 6 shall be deemed to be members elected for the Southern District and that each term of
    the respective member of Council will expire on the same date as when the member of
    Council was elected to represent the former medical electoral districts of District 1, 2, 3 and
    6, as the case may be.

    (3)    Of the 4 terms of office of members of Council for the Northern District that expire
    in 2005, there shall only be 2 terms of office of members of Council that will be filled by
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                                            Issued January 2, 2006
                                        Replaces January 4, 2005 Issue                              2
       election, with the total number of members of Council for the Northern District thereafter
       being six (6).

       (4)     Of the 3 terms of office of members of Council for the Southern District that expire
       in 2005, there shall only be 1 term of office of member of Council that will be filled by
       election, with the total number of members of Council for the Southern District thereafter
       being seven (7).

       (5)     Of the 2 terms of office of members of Council for the Northern District that expire
       in 2006, there shall only be 1 term of office of member of Council that will be filled by
       election, with the total number of members of Council for the Northern District thereafter
       being five (5).

       (6)     Of the 3 terms of office of members of Council for the Southern District that expire
       in 2006, there shall only be 2 terms of office of members of Council that will be filled by
       election, with the total number of members of Council for the Southern District thereafter
       being six (6).

       (7)     The total number of members of Council determined under Bylaws 4(1), (2), (3), (4),
       (5) or (6), does not include the members of Council appointed under Section 10(a) or (b) of
       the Act.

5      Changes
       (1)      The number of members constituting the Council shall be subject to change at any
       time by the Council by increasing or decreasing the number of representatives from any
       district.

       (2)    The boundaries and descriptions of the medical electoral districts shall be subject to
       change at any time by Council by amending these by-laws.

6      President
       The President shall preside in Council and be an ex officio member of all committees unless
excluded by the Medical Profession Act.
7      Vice-President
       The Vice-President, in the absence of the President, shall preside in Council.
8      Duties of Council
       The Council shall implement the provisions of the Medical Profession Act, Revised Statutes
of Alberta, 2000, Chapter M-11 to promote and encourage sound medical practice.
9       Annual organizational meeting of Council
        There shall be a regular annual organizational meeting of the Council held not later than 60
days after the annual election.
10     Regular meetings of Council
       (1)     In addition to its annual meeting, there shall be at least 3 regular meetings of the

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                                               Issued January 2, 2006
                                           Replaces January 4, 2005 Issue                             3
       Council during the calendar year.

       (2)     All councillors shall receive at least 15 days' notice of regular meetings.

11     Special meetings of Council
       (1)    Special meetings of the Council may be held from time to time at the call of the
       Registrar on the order of the President, or in his/her absence, the Vice-President.

       (2)     All councillors shall receive at least 7 days' notice of special meetings.

12      Emergency meetings of Council
        In the case of an emergency, the President, or in his/her absence, the Vice-President, may
order the Registrar to call an emergency meeting of the Council by providing a minimum of 24
hours' notice.
13     Annual general meeting of College
       (1)     There shall be an annual general meeting of the membership of the College to be
       held at a time and place as determined by Council.

       (2)     Thirty days' notice shall be given by the Registrar of the College to all members.

       (3)    The President or the Vice-President of the Council shall preside at the general
       meeting.

14     Proceedings of Council
       The proceedings of all meetings of the Council shall be conducted according to Robert's
Rules of Order.

15     Mail vote
       (1)    The President of the Council, or the executive committee, may refer any matter of
       importance to the whole membership of the Council by mail.

       (2)     The Registrar shall forward to each councillor a copy of the motion or resolution,
       with

               (a)    the name of the mover and seconder endorsed on it, and

               (b)    a line for recording the member's vote opposite a "yes" or "no".

               (c)    a line for the signature of the voting member of the Council.

       (3)    A resolution signed by not less than 75% of the members of the Council shall have
       the same force and effect as if passed at a regularly convened meeting of the Council.

16     Order of business
       The order of business at the annual organizational meeting of the Council shall be
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                                           Replaces January 4, 2005 Issue                            4
            (a)     roll call,

            (b)     minutes of the previous annual meeting,

            (c)     matters arising out of the minutes,

            (d)     reports of committees,

            (e)     retiring President's address,

            (f)     new business,

            (g)     election of officers,

            (h)     appointment of chairs and members of the standing committees,

            (i)     notice of motion, and

            (j)     correspondence.

17   Life members
     (1)    Life membership shall be granted to members who have been in good standing for
     40 years or may be granted to members who have been in good standing for a lesser term as
     approved by Council.

     (2)   Honorary life membership may be granted by resolution of Council to members who
     have made outstanding contributions to the College.

     (3)     The granting of life membership or honorary life membership does not entitle an
     individual to practise medicine or osteopathy when the individual is not also a registered
     practitioner.

18   Retired members
     (1)     A registered practitioner in good standing who wishes to take retirement from the
     practice of medicine and remain on the mailing list of the College for professional
     information purposes only may when requesting removal of his/her name from the Register
     apply for retired status.

     (2)    A former registered practitioner who has obtained retired status shall not practise
     medicine.

     (3)    The annual fee for the grant of retired status shall be $40.00.

19   Certificates of Merit
     (1)    Certificates of Merit may be awarded by resolution of Council to members of the
     College who have provided outstanding service to the profession and/or the community.

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                                             Issued January 2, 2006
                                         Replaces January 4, 2005 Issue                           5
20     Affiliation with Medical Faculty Council
       (1)   The Council shall be affiliated with medical faculties in Alberta by representation on
       the Medical Faculty Council as set out in the Universities Act.

       (2)    The representative shall be appointed at a regular meeting of the Council and shall
       hold appointment for a term of

               (a)    4 years, or

               (b)    until his successor is appointed

       subject to the Universities Act.

21     Affiliation with Medical Council of Canada
       (1)    The College shall be affiliated with the Medical Council of Canada by representation
       on the Medical Council as set out in the Canada Medical Act (Canada).

       (2)   Two representatives, one of whom shall be the Registrar, shall be appointed by
       Council and shall hold office for a term of 4 years or until their successors are appointed.

22     Affiliation with Federation
       (1)    The College shall be affiliated with the Federation of Provincial Medical Licensing
       Authorities of Canada.

       (2)     Two representatives shall be appointed by Council annually.

23      Other affiliation
        The Council may affiliate with other organizations which, in the considered opinion of the
Council, are interested in the development of a high standard of health services in the public
interest.
24     Appointment of standing committees
       (1)    Standing committees and their chairs shall be appointed at the annual organizational
       meeting of the Council.

       (2)      Appointments to standing committees shall be for a three-year term. There shall be
       an optional renewal of three additional years and a minimum period of one year off the
       committee prior to a further re-appointment. Provided further the Council by resolution
       may, in its sole discretion, either before or after the completion of the tenure of a member on
       a committee, extend the member‟s tenure on said committee for a period of 12 months.
       Such extension shall establish for the member a tenure of membership on the committee as
       if originally granted by the Council.

       (3)     A vacancy in a standing committee shall be filled at the next meeting of Council or
       by the executive committee. Should a member be unable to complete his term of
       appointment, a new member will be appointed to complete the unexpired term. Further
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                                               Issued January 2, 2006
                                           Replaces January 4, 2005 Issue                             6
     appointment at the end of this term shall be in accordance with subsection (2).

25   Executive Committee
     (1)    There shall be an executive committee of the Council which shall consist of the
     president, the vice-president and one other member of the Council to be appointed annually
     by the Council.

     (2)    The executive committee shall meet at the call of the Registrar and shall deal with

            (a)     all matters that are delegated to it by the Council,

            (b)     all matters that require attention between meetings of the Council, and

            (c)     the duties assigned to the executive committee by the Medical Profession Act
                    and the Bylaws of the College,

     and shall report its actions and recommendations to the Council on a regular basis.

     (3)    Two members of the executive committee constitute a quorum,

     (4)   The executive committee has no power to alter, repeal or suspend any by-law of the
     Council.

     (5)    The executive committee shall initiate and conduct a formal job performance
     appraisal of the Registrar and receive reports from the Registrar on the performance
     appraisal of the senior secretariat on an annual basis.

26   Nominating Committee
     (1)   The Nominating Committee shall be appointed annually by the Council at the
     Annual Organizational Meeting of the Council.

     (2)     The Nominating Committee shall consist of three members of the Council including
     a past president and a public member. If a past president is not a member of the Council that
     position shall be filled by a member who has previously sat on the Executive Committee of
     the Council.

     (3)    The Nominating Committee shall annually at the October meeting of the Council
     present a proposed list of nominees for election or appointment as the case may be to:

            (a)     Executive Committee;

            (b)     Standing Committees;

            (c)     Investigation Chair;

            (d)     Public Members of Council;


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                                            Issued January 2, 2006
                                        Replaces January 4, 2005 Issue                            7
                (e)    Members of Boards and Committees requiring College representation;

                (f)    Recipients of awards presented by the Council.

27      Finance and Audit Committee
        Council shall annually appoint a Finance and Audit Committee, whose terms of reference
will be reviewed and approved by Council at least every three years.
28    Committee on Legislation
      The Committee on Legislation shall consist of no fewer than three members, at least two of
whom shall be members of Council.
29     Duties
       (1)      The Committee on Legislation shall

                (a)    review the Medical Profession Act as directed by Council and keep informed
                       on all proposed amendments to the Medical Profession Act and bring them to
                       the attention of the Council,

                (b)    propose to the Council such legislation as may be in the best interests of the
                       College,

                (c)    on instructions from the Council bring such proposals to the attention of the
                       Provincial Legislature, and

                (d)    review and update the Bylaws of the College as directed by Council.

       (2)     The Committee shall also keep informed on all legislation which in any way affects
       the health services of the people of the Province of Alberta.

30     Other committees
       (1)    The Council shall appoint members to the following standing committees of the
       College:
                       Complaints Committee
                       Medical Facility Assessment Committee
                       Committee on Postgraduate Qualification
                       Research Ethics Review Committee
       (2)    The Council may appoint ad hoc committees as necessary to perform specific
       functions

       (3)     The Council may appoint, at the request of the Alberta Medical Association (C.M.A.
       - Alberta Division), representatives to the various committees of that organization.

31     Costs
       (1)    The investigating committee under section 61(2)(b) of the Act may recommend and
       the council under sections 62(1) or 66(2) may make an order against the registered
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                                           Replaces January 4, 2005 Issue                           8
     practitioner for the payment of any or all of the following costs as recommended by the
     investigating committee or determined by the council:

            (a)     the travel, accommodation and meal expenses of the members constituting
                    the investigating committee or council for the hearing, as well as to the per
                    diem allowances payable by the College to such members for such hearing;

            (b)     the cost of reporting services and expenses;

            (c)     witness fees and travel, accommodation and meal expenses;

            (d)     expert fees both for the preparation of written opinions and attending to give
                    evidence with travel, accommodation and meal expenses incurred by such
                    expert witness for the purpose of giving evidence;

            (e)     the fee and disbursements payable to the lawyer acting on behalf of the
                    College pursuant to section 54(1) or to a lawyer retained by the council and
                    the investigating committee pursuant to section 54(2);

            (f)     all expenses incurred by the College during the course of the pre-hearing
                    investigation which shall include but are not limited to travel,
                    accommodation and meal expenses, long distances telephone calls,
                    photocopying, delivery charges and fax communications;

            (g)     any other expenses incurred by the College incidental to the investigation and
                    hearing.

32   Fees
     (1)     Any person seeking a review of his or her medical education and post-graduate
     training for preliminary determination of eligibility for registration on the Alberta Medical
     Register or Special Register shall pay a fee of $214, and if that person is found to be eligible
     and goes on to apply for registration, this fee shall be credited towards the registration fee or
     fees otherwise payable under these bylaws.

     (2)     Where the Registrar determines that it is necessary to obtain confirmation of the
     authenticity or accuracy of any document or information submitted by a person applying for
     registration on the Alberta Medical Register or Special Register, the Registrar may:

            (a)     Direct an employee of the College to undertake the process of verification
                    and the person applying for registration shall pay a fee of $107 in addition to
                    any other registration fee or fees payable under these bylaws, or

            (b)     Direct the person applying for registration to submit the document or
                    information to a person determined by the Registrar to undertake the process
                    of verification and the person applying for registration shall:
                    (i)     cause the report arising from the process of verification to be
                            delivered to the Registrar, and
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                                         Replaces January 4, 2005 Issue                             9
               (ii)    Shall pay and provide to the Registrar proof of payment of the fee
                       charged for the process of verification in addition to payment of any
                       other registration fee or fees payable under these bylaws.

(3)    Any person applying for:

       (a)     registration on Part 6, Part 7 or Part 8 of the Special Register, shall pay a
               registration fee of $200, and if that person is subsequently registered on the
               Alberta Medical Register or Part 1 or Part 2 of the Special Register, this fee
               shall be credited towards the registration fee relating to that subsequent
               registration.

       (b)     registration on the Alberta Medical Register or the Special Register for the
               purpose of a locum tenens not to exceed 30 days in each calendar year, shall
               pay a registration fee of $200.

       (c)     registration on the Alberta Medical Register or the Special Register, and that
               person completed his or her most recent post-graduate medical training in
               Alberta, shall pay a registration fee of $400.

       (d)     registration on the Alberta Medical Register or the Special Register, and that
               person completed his or her most recent post-graduate medical training
               outside of Alberta, but within Canada, shall pay a registration fee of $500.

       (e)     registration on the Alberta Medical Register or the Special Register, and that
               person completed his or her most recent post-graduate medical training
               outside of Canada, shall pay a registration fee of $600.

       (f)     registration on the Alberta Medical Register or the Special Register and that
               person had previously been registered on the Alberta Medical Register or
               Parts 1, 2, 3, 4 or 5 of the Special Register, and his or her previous
               registration had lapsed within the prior two years, shall pay a fee of $100.

       (g)     registration on the Alberta Medical Register or the Special Register and that
               person had previously been registered on the Alberta Medical Register or
               Parts 1, 2, 3, 4 or 5 of the Special Register, and his or her registration had
               been lapsed for two years or more, shall pay a fee of $200.

(4)    The fees set forth in this Section of these bylaws are payable at the time an
application is received by the College, or for the purpose of Section 32 (2) of these bylaws,
when required by the Registrar.

(5)     Any person who fails to complete the registration process, or who withdraws his or
her application prior to the date of the person‟s registration interview at the College, will be
eligible for a refund of $200 or the full amount of his or her registration fee paid to the
College, which ever amount is less.

(6)    In addition to the fees required under Section 32 (3) of these bylaws, any person
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                                        Issued January 2, 2006
                                    Replaces January 4, 2005 Issue                           10
applying for registration with the College shall pay the applicable annual fee for the year in
which registration is effected.

(7)    A person who is registered with College and is taking a course of medical training in
Alberta, recognized by the Council, shall pay the annual registration fee in the following
manner:

       (a)     the sum of $100 on the date the name of the person is entered on the
               Educational Register, and

       (b)     the balance of the then current registration fee on the date on which the
               person ceases to participate in the course and commences the practice of
               medicine in Alberta.

(8)   Residents who are registered on the Educational Register shall pay an annual fee of
$100.

(9)     Medical students who are registered on the Educational Register shall pay an annual
fee of $50.

(10) Any person taking undergraduate electives who is registered on the Courtesy
Register shall pay an annual fee of $25.

(11) Any person qualified to be placed on the Alberta Medical Register or in the Special
Register with temporary registration for the purpose of performing a locum tenens not to
exceed 30 days in any calendar year shall pay a fee of $290.

(12) Each person registered on Part 7 or Part 8 of the Special Register shall pay an annual
fee of $580.

(13) Each person registered on the Alberta Medical Register or the Special Register shall
pay the annual relicensing fee of $1,160.

(14) A person applying for registration with the College under Section 32 (3) (c) or (d) of
these bylaws within six months of completion of said post-graduate medical training shall
pay an initial annual fee of not more than $580, and thereafter each subsequent annual fee
due and owing by that person shall be the annual fee specified in Section 32 (13) of these
bylaws.

(15) Each person who does not pay the annual relicensing fee, as required under section
32 (13) of these bylaws, in full by January 1 in each year shall then stand suspended
pursuant to section 29(3) of the Act and shall pay an additional fee of $560 for the re-
issuance of a suspended license.

(16) The following fees are payable to the College in respect of Professional
Corporations:

       (a)     initial registration and issuance of permit fee of $350 for each physician who
                               _____________________________________
                                        Issued January 2, 2006
                                    Replaces January 4, 2005 Issue                          11
              is a shareholder of the professional corporation;
       (b)    annual renewal of permit - a fee of $120 shall be paid for each physician who
              is a shareholder of the professional corporation;
       (c)    annual licensing fee - $1,160 for each physician who is a shareholder of the
              professional corporation;
       (d)    $560 fee for re-issuance of suspended licence - for each physician who is a
              shareholder of the professional corporation;
       (e)    $120 fee for re-issuance of an expired or suspended permit.

(17)   Applicants for specialist certification shall pay a fee of $50.

(18)   Each person registered on the Courtesy Register shall pay an annual fee of $100.

(19) The owner(s) of the practice of medicine conducted in the following facilities shall
pay or cause to be paid to the College the following fees and expenses:

       (a)    For a diagnostic imaging facility, the initial registration fee of $250, and
              (i)     For a facility with one imaging modality, the annual fee of $640;
              (ii)    For a facility with two or three imaging modalities, the annual fee of
                      $960;
              (iii)   For a facility with more than three imaging modalities, the annual fee
                      of $1,280;
              (iv)    For any facility which offers mobile imaging services, an additional
                      annual fee of $60 for each mobile service site.

       (b)    For a diagnostic medical laboratory, the initial registration fee of $250, plus
              (i)     In the case of a major laboratory, the annual fee of $1,910 plus the
                      additional Alberta Laboratory Quality Enhacement Program
                      (ALQEP) costs including the annual administration fee of $1,910 plus
                      the cost of individual programs;
              (ii)    In the case of an extended laboratory, the annual fee of $1,380 plus
                      the additional ALQEP costs including the annual administration fee of
                      $1,380 plus the cost of individual programs;
              (iii)   In the case of a basic laboratory, the annual fee of $480 plus if the
                      laboratory is participating in ALQEP, the additional ALQEP costs
                      including the annual administration fee of $380 plus the cost of
                      individual programs;
              (iv)    In the case of a specialized laboratory, the annual fee of $590.

       (c)    For a physician office laboratory as defined in Section 76 (1) to (5) of these
              bylaws, the annual fee of $220, plus applicable costs of the ALQEP.

                              _____________________________________
                                       Issued January 2, 2006
                                   Replaces January 4, 2005 Issue                             12
       (d)    For a pulmonary function laboratory, the initial registration fee of $250, plus
              (i)     For a Level II facility, the annual fee of $590;
              (ii)    For a Level III facility, the annual fee of $800;
              (iii)   For a Level IV facility, the annual fee of $1,010.

       (e)    For a clinical neurophysiologic diagnostic facility, the initial registration fee
              of $250, plus
              (i)     For a facility with one modality, the annual fee of $590;
              (ii)    For a facility with more than one modality, the annual fee of $800;
              (iii)   For any facility which offers mobile Electromyography (EMG)
                      services, an additional fee of $60 for each mobile site service.

       (f)    For a sleep medicine laboratory, the initial registration fee of $250, and the
              annual fee of $590.

       (g)    For a vestibular testing laboratory, the initial registration fee of $250, and the
              annual fee of $590.

       (h)    For a non-hospital surgical facility, the initial registration fee of $250, plus
              (i)     For a facility where a physician‟s only role is to administer
                      anesthesia, i.e., dental facilities, the annual fee of $800;
              (ii)    For a facility with less than 5 physicians and podiatrists with surgical
                      privileges, the annual fee of $1,910;
              (iii)   For a facility with 5 or more physicians and podiatrists with surgical
                      privileges, the annual fee of $7,210;
              (iv)    For a facility which has been approved for Extended Stay Procedures,
                      the annual fee of $10,600.

       (i)    For a hyperbaric oxygen therapy facility, the initial registration fee of $250
              and the annual fee of $590.

       (j)    For a cardiac exercise stress testing facility, the initial registration fee of $250
              and the annual fee of $590.

       (k)    For a hemodialysis facility, the initial registration fee of $250 and the annual
              fee of $590.

       (l)    The actual cost of any initial or subsequent inspection of the facility. Such
              cost to include all expenses incurred by the Committee including consultants‟
              fees for the conduct of such inspection(s).

(20) All fees and expenses established by the bylaws shall be paid on or before the date
set by the Council or the Committee and in default of such payment the registration, permit

                              _____________________________________
                                       Issued January 2, 2006
                                   Replaces January 4, 2005 Issue                             13
       or accreditation granted shall stand suspended effective 12:01 a.m. on the day following.

       (21) The registration, permit or accreditation suspended under section (20) shall be
       reinstated in good standing in respect of that suspension on payment to the College of such
       fee(s) or expense.

       (22) Fees for reviews conducted by the Research Ethics Review Committee are as
       follows:
               (a)     Full Review - $4,500
               (b)     Expedited Review - $900
               (c)     Reciprocal Review - $900
               (d)     Additional Qualified Investigator Review - $450
               (e)     Amendment Review - $900
               (f)     Annual Review - $200
               (g)     Extension Study Review or Sub-study Review
                       (i)    When done at the time of a full, expedited or reciprocal review,
                              additional fee of $900.
                       (ii)   When done as a separate application, the fee for a full, expedited or
                              reciprocal review, as appropriate, shall apply.
               (h)     Final Review
                       (i)    Within six months after an annual review, $200.
                       (ii)   Six months or longer after an annual review, $200.

       (23)    Fees for reviews conducted by the Advisory Committee for Privileges are as follows:
               (a)     Initial Application - $480
               (b)     Locum Application - $240
               (c)     Non-procedural Consultant - $240
               (d)     Procedural Consultation - $480
               (e)     5 Year Privileges Review - $480

       (24)    Applicants for approval to provide complementary therapy(s) shall pay a fee of $100.

                                                 GENERAL

33     Storage of documents
       All deeds, mortgages, securities, documents or other papers not in current use in the
Registrar's office shall be kept by the Registrar in a safety deposit box with the chartered bank
designated by the Council as the bank of deposit or retained in safe keeping by authorized
investment institutions.
34     Money on deposit
       All monies of the Council shall be deposited in the chartered bank designated by the Council
and shall be withdrawn and paid out on cheques signed by persons duly authorized for that purpose
by resolution of the Council.
                                      _____________________________________
                                               Issued January 2, 2006
                                           Replaces January 4, 2005 Issue                           14
35     Bonding
       The Registrar and other members of the staff shall be bonded if so required by the Council.
36     Grants
       The Council may make such grants as it sees fit.
37     Passing By-laws
       (1)    A By-law may be passed under section 30 of the Medical Profession Act at any
       meeting of the Council provided

               (a)     a Notice of Motion
                       (i)     has been given at a previous meeting, or
                       (ii)    has been sent to all councillors at least 2 weeks prior to the meeting,

                       or

          o    (b)     a Notice of Motion is waived by unanimous vote of the Council.
  r
       (2)    A By-law may be given first reading at a session of a meeting and at a subsequent
       session given a second and third reading, whereupon it shall be declared as passed by the
       President or other presiding officer.

38      Advertising
        In this section “advertisement” means any communication made orally, in print or through
electronic media by or on behalf of a registered practitioner, to the public in general or to one or
more individuals, that has as its substantial purpose the promotion of the registered practitioner or a
clinic or group with which the registered practitioner is associated.
       (1)    Any statement by a registered practitioner made in the course of an interview with
       the media is deemed to be an advertisement.

       (2)     Any advertisement shall be in conformity with the relevant provisions of the Code of
       Ethics of the Canadian Medical Association as adopted annually by Council.

       (3)     An advertisement shall not:

               (a)     misrepresent fact;

               (b)     compare either directly, indirectly or by innuendo, the registered
                       practitioner‟s services or ability with that of any other registered practitioner,
                       facility, clinic or group or promise or offer more effective services or better
                       results than those available elsewhere;

               (c)     deprecate another registered practitioner, facility, clinic or group as to
                       service, ability, result or fees;

               (d)     create an unjustified or unreasonable expectation about the result the

                                       _____________________________________
                                                Issued January 2, 2006
                                            Replaces January 4, 2005 Issue                            15
                    registered practitioner can achieve;

            (e)     be made under any false or misleading guise or take physical, emotional or
                    financial advantage of any patient or use coercion, duress or harassment;

            (f)     be undignified, in bad taste or otherwise offensive so as to be incompatible
                    with the best interests of the public or tend to harm the standing or reputation
                    of the medical profession generally; or

            (g)     disclose the name or identifying features of a patient unless the patient‟s prior
                    consent has been obtained; but any inducement or benefit given to the patient
                    must be disclosed in the advertisement.

     (4)    A registered practitioner shall not use the term „surgeon‟ alone or in combination
     with other descriptors, unless he or she:

            (a)     Is recognized as a surgical specialist or equivalent by the Council, or

            (b)     Is entitled by a statutory body in Canada to use the term surgeon; or

            (c)     Uses the term in a manner that, in the opinion of the registrar, does not falsely
                    suggest to the public that the physician is a surgical specialist.

     (5)    A registered practitioner shall only use a term, title, or designation indicating or
     implying specialization in an area or branch of medicine if that practitioner is recognized by
     the Council as a specialist in that area or branch of medicine.

39   Records retention
     (1)    For the purpose of this bylaw, “records” shall mean the physical representation or
     record of any information, data or other thing that is capable of being represented or
     reproduced visually or by sound, or by both.

     (2)    The College shall retain for a period of at least ten (10) years:

            (a)     All records relating to a complaint dismissed by the Investigation Chair
                    pursuant to Section 46 or Section 49 of the Medical Profession Act;

            (b)     All records relating to a complaint dismissed after preliminary investigation
                    pursuant to Section 48 of the Act;

            (c)     All records relating to a complaint dismissed by Council pursuant to Section
                    50 of the Act;

            (d)     The transcript of proceedings, exhibits entered and the recommendations of
                    an Investigating Committee issued pursuant to Section 61 of the Act;

            (e)     The Order of Council issued pursuant to Section 65 or Section 66 of the Act;
                    and
                                   _____________________________________
                                            Issued January 2, 2006
                                        Replaces January 4, 2005 Issue                           16
            (f)     All records relating to any complaint that was resolved informally without
                    hearing before an Investigating Committee.

                                   SPECIALIST CERTIFICATION

40   Specialist certificates
     Certificates of qualification may be granted in the following specialties:
            (a)     in the case of medical specialties:
                    (i)     the following clinical specialties:
                            (A)    Anesthesia,
                            (B)    Cardiology,
                            (C)    Clinical Immunology and Allergy,
                            (D)    Clinical Pharmacology,
                            (E)    Community Medicine,
                            (F)    Critical Care Medicine,
                            (G)    Dermatology,
                            (H)    Diagnostic Radiology,
                            (I)    Emergency Medicine,
                            (J)    Endocrinology and Metabolism,
                            (K)    Gastroenterology,
                            (L)    Geriatric Medicine,
                            (M)    Hematology,
                            (N)    Infectious Diseases,
                            (O)    Internal Medicine,
                            (P)    Medical Genetics,
                            (Q)    Medical Oncology,
                            (R)    Neonatal-Perinatal Medicine,
                            (S)    Nephrology,
                            (T)    Neurology,
                            (U)    Nuclear Medicine,
                            (V)    Occupational Medicine,
                            (W)    Pediatrics,
                            (X)    Physical Medicine and Rehabilitation,
                            (Y)    Psychiatry,
                            (Z)    Radiation Oncology,
                            (AA)   Respiratory Medicine, and
                            (BB)   Rheumatology,
            (b)     and

                                    _____________________________________
                                             Issued January 2, 2006
                                         Replaces January 4, 2005 Issue                          17
                    (i)    the following laboratory medicine specialties:
                           (A)     Anatomical Pathology,
                           (B)     General Pathology,
                           (C)     Hematological Pathology,
                           (D)     Medical Biochemistry,
                           (E)     Medical Microbiology, and
                           (F)     Neuropathology,
            (c)     the following surgical specialties:
                           (A)     Cardiovascular and Thoracic Surgery,
                           (B)     General Surgery,
                           (C)     General Surgical Oncology,
                           (D)     Gynecologic Oncology,
                           (E)     Gynecologic Reproductive Endocrinology and Infertility,
                           (F)     Maternal-Fetal Medicine,
                           (G)     Neurosurgery,
                           (H)     Obstetrics and Gynecology,
                           (I)     Ophthalmology,
                           (J)     Orthopedic Surgery,
                           (K)     Otolaryngology,
                           (L)     Pediatric General Surgery,
                           (M)     Plastic Surgery,
                           (N)     Thoracic Surgery,
                           (O)     Urology, and
                           (P)     Vascular Surgery.
41   Qualifications
     (1)    The conditions precedent to the issuance of a certificate under section 43 are as
     follows:

            (a)     not less than four years postgraduate training acceptable to the Council for
                    the specialty of medicine in which the certificate is requested, and for that
                    purpose,
                    (i)    the training shall be acceptable to the Council if taken in a hospital or
                           institution recognized by the Council for the purpose of giving
                           instruction in the specialty in question, and
                    (ii)   the candidate may have acted as an intern or as an extern or clinical
                           assistant during the period of training as long as the whole time was
                           devoted to the specialty training,

            (b)     production of a certificate in that branch of medicine or surgery issued by the
                                   _____________________________________
                                            Issued January 2, 2006
                                        Replaces January 4, 2005 Issue                              18
                       Royal College of Physicians and Surgeons of Canada,

               (c)     candidates must be members in good standing and registered on the Alberta
                       Medical Register or Special Register of the College of Physicians and
                       Surgeons of Alberta, and

               (d)     candidates must satisfy the Council that they are fit to practise the specialty
                       of medicine for which the application is made.

       (2)     Subsection (1)(b) does not apply to a candidate who, prior to application for a
       certificate, is

               (a)     appointed to a full-time or geographic full-time position at a faculty of
                       medicine at a university in Alberta, or

               (b)     appointed to a full-time position in the public service in the Province of
                       Alberta and holds a certificate of postgraduate qualification in a branch of
                       medicine, which certificate is considered by the Council to be generally
                       equivalent to the certificate described in subsection (1)(b).

               (c)     appointed by a Regional Health Authority to occupy a full-time position in an
                       underserviced community in Alberta and holds a certificate of postgraduate
                       qualification in a branch of medicine, which certificate is considered by the
                       Council to be generally equivalent to the certificate described in subsection
                       (1)(b).

42      Application
        Applications shall be made on a form supplied by the College and accompanied by
documentary evidence in the form of diplomas, certificates and testimonials, or certified true copies
thereof, covering all aspects of postgraduate training and experience.
43      Issue of certificate
        Certificates are issued by the Registrar based on the Council's assessment of the applicant's
qualifications and fitness to practice as documented by the applicant in the application.
44     Restricted Practice
       (1)     Any registered practitioner restricting his practice:

               (a)     May only designate one area of practice restricted to Royal College
                       specialties and subspecialties or a completed training program for which a
                       certificate, satisfactory to the College, was issued;

               (b)     Shall limit his practice exclusively to that area;

               (c)     Shall, prior to any such designation and annually thereafter for so long as the
                       designation is used, undertake in writing to the Registrar that he will not
                       practise in areas or fields outside the one designated.

                                       _____________________________________
                                                Issued January 2, 2006
                                            Replaces January 4, 2005 Issue                            19
45   Special Interest
     (1)    Any practitioner may indicate an area of special interest if his training and practice
     experience is deemed satisfactory to the Council (eg. Sports Medicine, Contact Lenses).

     (2)    Shall, prior to any such designation being used, provide the Registrar with
     documentation regarding training, experience and interest, and submit a formal request for
     approval of the special interest.

     (3)    The practitioner shall inform the Registrar in writing if he wishes to cease using the
     approved designation.

       NON-HOSPITAL TREATMENT FACILITY AND NON-HOSPITAL MEDICAL
                       DIAGNOSTIC FACILITY

46   Regulation of non-hospital diagnostic and treatment facilities
                                    Definition of medical practice

     (1)     In this section, and pursuant to Section 103(1) of the Act "services performed by
     registered practitioners" constitute the practice of medicine and mean the professional
     business of medical diagnosis, advice and treatment conducted by a registered practitioner or
     a professional corporation.

     (1)(A) For the purpose of the Health Care Protection Act major surgical services are those
     that in the opinion of the Council may be performed only in a public hospital because there
     is a significant risk inherent in the procedure or by reason of the pre-operative condition of
     the patient either of which may require one or more of the following:
                    (i)     concurrent care within the facility by a physician other than the
                            operative team members;
                    (ii)    management of major complications such as hemorrhage, organ or
                            organ system failure or metabolic derangement;
                    (iii)   post-operative circulatory or respiratory support;
                    (iv)    continuous monitoring of vital signs beyond the period of recovery
                            from anesthetic.
     (1)(B) For the purpose of the Health Care Protection Act specific surgical services which
     may be performed only in a public hospital and which shall not be conducted in a non-
     hospital surgical facility also include:

                    (i)     procedures under general anesthetic on patients less than eighteen
                            months of age;
                    (ii)    procedures on the contents of the retroperitoneal space;
                    (iii)   procedures on the contents of the cranium;
                    (iv)    procedures on the contents of the thorax;
                                    _____________________________________
                                             Issued January 2, 2006
                                         Replaces January 4, 2005 Issue                          20
              (v)       any procedure lacking the approval of the Council for that facility.
(1)(C) For the purpose of the Health Care Protection Act minor surgical procedures are
those which may be performed in a physician‟s general office.

                                  Approved medical services

(2)   A diagnostic and treatment facility means a medical facility accredited by the
Council pursuant to Section 103 of the Act in which:

       (a)    the practice of medicine is supervised by a person accredited for that purpose
              by resolution of the Council;

       (b)    the Council has by resolution granted accreditation to provide specific
              medical services that do not require admission to a public hospital but may
              not be performed in a general medical office and include:
              (i)       diagnostic imaging services;
              (ii)      medical laboratory services;
              (iii)     pulmonary function diagnostic testing;
              (iv)      neurophysiologic diagnostic services;
              (v)       sleep medicine diagnostic services;
              (vi)      vestibular diagnostic testing;
              (vii)     the use of drugs which are intended or which may induce general
                        anaesthesia or sedation requiring the monitoring of vital signs,
                        including all uses of intravenously administered sedatives or
                        narcotics, except in emergency circumstances;
              (viii)    the use of drugs by injection which are intended or may induce a
                        major nerve block, or spinal, epidural, or intravenous regional block;
              (ix)      surgical and diagnostic procedures with risk of bleeding from major
                        vessels, gas embolism, perforation of internal organs and other life-
                        threatening complications or requiring sterile precautions to prevent
                        blood-borne, deep, closed cavity or implant-related infections;
              (x)       Hyperbaric oxygen therapy.
              (xi)      Cardiac exercise stress testing.
              (xii)     Hemodialysis.

(3)    The following surgical and endoscopic procedures are approved for performance by
a physician with privileges in an accredited non-hospital surgical facility:

       (i.)   DERMATOLOGY
              •      Liposuction to a maximum of five (5) litres total aspirate
              •      Mohs micrographic surgery
                                _____________________________________
                                         Issued January 2, 2006
                                     Replaces January 4, 2005 Issue                            21
(ii.)    GENERAL SURGERY
         •   Upper gastrointestinal endoscopy with or without biopsy
         •   Colonoscopy with or without biopsy or minor polypectomy
         •   Simple mastectomy
         •   Segmental resection of breast and sentinel node biopsy
         •   Resection of large or deep soft tissue lesions
         •   Deep lymph node biopsies – up to but not including full axillary
             dissection
         •   Inguinal hernia repair, including femoral
         •   Minor abdominal wall hernia repair, including umbilical hernia repair
         •   Varicose vein ligation and stripping
         •   Hemorrhoidectomy beyond simple single excision
         •   Trans-anal excision of rectal polyps
         •   Laparoscopic procedures
             - Diagnostic
             - Biopsies – peritoneal
         •   Endovenous laser sclerotherapy
(iii.)   GYNECOLOGY
         •   Perineoplasty not requiring extensive dissection
         •   Marsupialization of Bartholin cysts
         •   Cervical, vaginal and vulvar polypectomy and biopsy with risk of
             bleeding requiring surgical control
         •   Dilatation and curettage of uterus
         •   Trans-cervical global endometrial ablation procedures except those
             performed by resection or by electrocautery that does not have impedance
             regulation
         •   Cystoscopy
         •   Minimally invasive incontinence procedures: injectables, percutaneous
             slings
         •   Laparoscopy with minor surgical interventions:
             - Diagnostic
             - Tubal sterilization
             - Aspiration of cysts
             - Minor adhesiolysis
             - Diathermy for endometriosis (AFS Stages I and II)
             - Abortions – as per the general Non-hospital Surgical Facilities
                 Standards and Guidelines and the Supplementary Standards for the
                 Termination of Pregnancy
         •   Oocyte retrieval
         •   Tumescent anterior and posterior vaginal repair
(iv.)    OPHTHALMOLOGY
         •   Intra-ocular surgery requiring dissection of the tissues of the globe
             including procedures on:


                        _____________________________________
                                 Issued January 2, 2006
                             Replaces January 4, 2005 Issue                          22
           -   the cornea (including ring segment implants, keratotomies, LASIK
               and corneal transplant)
           - the lens and implants
           - the iris
           - the sclera
           - the vitreous
       •   Eyelid procedures requiring implants or dissection of the orbital septum
           or beyond.
       •   Lacrimal procedures requiring incision into the nasal passages.
       •   Orbital and socket procedures not associated with risk of intracranial or
           neurovascular complications, including:
           - orbital tumor excision
           - insertion of an implant
           - enucleation/evisceration with or without implant
           - socket reconstruction requiring implant, transplant or exposure of
               bone.
               [Note: Minor anterior orbital procedures are considered office
               procedures.]
       •   Strabismus procedures
       •   Rheopheresis for patients enrolled in a research study approved by a
           research ethics review body acceptable to the College.
(v.)   ORTHOPEDIC SURGERY
       •   ARTHROSCOPY
           - diagnostic
           - repair and reconstruction of ligaments
           - meniscectomy, meniscal repair and arthroplasty
           - excision meniscal cysts, loose bodies and foreign bodies

       •   AMPUTATION
           - finger through MCP or IP joints, hand
           - toe – through TP or IP joints foot
           - single ray amputation hand or foot

       •   ARTHRODESIS
           - hand and wrist
           - foot and ankle

       •   ARTHROPLASTIES
           - acromio-clavicular and sterno-clavicular joints
           - radial head arthroplasty
           - wrist and hand joints
           - foot

       •   OSTEOTOMIES
           - hand/wrist/foot

                      _____________________________________
                               Issued January 2, 2006
                           Replaces January 4, 2005 Issue                         23
•   REPAIR RECURRENT DISLOCATION/LIGAMENT
    RECONSTRUCTION
    - shoulder
    - elbow
    - wrist
    - hand
    - knee
    - ankle and foot

•   TENDONS OR MUSCLES – REPAIR/TRANSPLANT/TRANSFER
    - transfers repairs and transplants at or distal to elbow or knee
    - decompression/repair rotator cuff at shoulder

•   FASCIA/TENDON SHEATH
    - plantar fasciotomy/fasciectomy of hand or foot
    - release or excision Dupuytren‟s contracture
    - excision of minor hand tumors including ganglions
    - carpal tunnel release
    - excision tendon sheaths: wrist, forearm or hand

•   ARTHROTOMY/SYNOVECTOMY
    - shoulder
    - elbow
    - wrist and hand
    - knee
    - ankle and foot
    - excision Baker‟s cyst

•   EXCISION BURSAE & GANGLION

•   MUSCULO-SKELETAL TUMORS
    - biopsy of peripheral tumors
    - needle biopsy only of tumors of the spine
    - excision of minor tumors

•   DISLOCATIONS
    - open reduction acromio-clavicular joint
    - closed or open reduction of joints of upper extremity
    - closed reduction of dislocated total hip
    - closed or open reduction of patello-femoral joint
    - closed or open reduction of ankle, hindfoot, midfoot or forefoot

•   FRACTURES: UPPER EXTREMITIES
    - closed and open reduction clavicle, humerus, radius/ulna, wrist and
      hand
    - closed reduction of scapula

               _____________________________________
                        Issued January 2, 2006
                    Replaces January 4, 2005 Issue                       24
                 •    FRACTURES: LOWER EXTREMITIES
                      - closed and open reduction of patella, fibula, ankle and foot
                      - closed reduction of tibia

                 •    OTHER
                      - single level lumbar discectomy and/or decompression –
                        uncomplicated
                      - procedures listed under podiatric surgery
                      - removal of hardware including plates, pins, screws, nails and wires
                      - peripheral nerve surgery – repairs, decompression or grafts
                      - saucerization
                      - sequestrectomy

                 •    ON APPROVAL BY COUNCIL PURSUANT TO SECTION 46(4.1):
                      - Primary total hip arthroplasty – uncomplicated
                      - Primary total knee arthroplasty – uncomplicated
                      - Primary total shoulder arthroplasty – uncomplicated
                      - Lumbar posterior spinal fusion – not exceeding two disc-space levels
                      - Lumbar spinal laminectomy – not exceeding two disc-space levels
        (vi.)    OTOLARYNGOLOGY
                 •    Deep1 biopsy of the nasopharynx
                 •    Deep excision of intraoral papilloma
                 •    Major1 excision of lip, nasal, ear or neck lesions
                 •    Lip shave procedures
                 •    Major partial glossectomy limited to anterior 2/3 of tongue
                 •    Adenoidectomy
                 •    Rigid laryngoscopy
                 •    Rigid trans-oral nasopharyngoscopy
                 •    Complete esophagoscopy – flexible only
                 •    Complete bronchoscopy – flexible only
                 •    Caldwell Luc procedure
                 •    Intranasal antrostomy
                 •    Intranasal complete ethmoidectomy
                 •    Turbinate resection
                 •    Sphenoidotomy
                 •    Nasal septum reconstruction
                 •    Nasal septum submucous resection
                 •    Nasal polypectomy in conjunction with complete ethmoidectomy

1
  The terms “deep”, major”, and “complicated” refer to procedures that may require more resources than are
commonly available in a medical office. Surgeons should make decisions as to the appropriate location for
these surgical procedures in accordance with the resources necessary for unexpected complications and with
generally accepted standards of care in Alberta.


                                   _____________________________________
                                            Issued January 2, 2006
                                        Replaces January 4, 2005 Issue                                   25
                 •    Rhinoplasty
                 •    Complicated1 nasal fractures
                 •    Biopsies of the parotid beyond needle aspiration or sampling the tail of
                      the gland
                 •    Excision of submandibular gland
                 •    Excision of sublingual gland
                 •    Otoplasty
                 •    Complicated myringoplasty
                 •    Dissection of neck beyond the platysma muscle
                 •    Deep cervical node biopsy
                 •    Endoscopic soft-tissue surgery
        (vii.)   PLASTIC SURGERY
                 •    SKIN AND SUBCUTANEOUS TISSUE
                      - Excision of deep tumors outside a body cavity requiring exposure of
                        bone or isolation of vascular or nerve supply.
                      - Grafts, flaps, and tissue expansion where there is a minimal risk of
                        major bleeding or third space fluid loss that may require replacement
                        fluids.
                      - Liposuction to a maximum of 5 litres total aspirate.

                 •    HEAD AND NECK
                      - Grafts and flaps as above except where there is a significant risk of
                        airway compromise requiring post-operative or overnight monitoring.
                      - Eyelids (blepharoplasty, ptosis repair, tarsorrhaphy, canthopexy,
                        canthoplasty)
                      - Browlift, facelift (rhytidectomy), necklift
                      - Nose (SMR, rhinoplasty, turbinectomy, reduction of fractures)
                      - Ears (otoplasty)
                      - Genioplasty

                 •    BREAST
                      - Reduction mammoplasty
                      - Augmentation mammoplasty
                      - Mastopexy
                      - Mastectomy without chest wall, muscle or axillary node dissection
                      - Capsulotomy and capsulectomy
                      - Gynecomastia surgery
                      - Reconstruction of breast or nipple

                 •    ABDOMEN
                      - Repair of abdominal wall hernia

1
  The terms “deep”, major”, and “complicated” refer to procedures that may require more resources than are
commonly available in a medical office. Surgeons should make decisions as to the appropriate location for
these surgical procedures in accordance with the resources necessary for unexpected complications and with
generally accepted standards of care in Alberta.
                                   _____________________________________
                                            Issued January 2, 2006
                                        Replaces January 4, 2005 Issue                                   26
            -    Abdominoplasty not requiring overnight monitoring of blood or third
                space fluid loss.

        •   OTHERS
            - Tendon – repairs, transfers or grafts
            - Peripheral nerve – repairs, decompression or grafts
            - Muscle – flaps or repairs.
            - Fascia – flaps, decompression or excision
            - Bone – biopsies, fusions, removal of hardware, excision of exostoses,
              amputations of digits or rays, open and closed reduction of hand
              fractures
            - Joints – arthrotomy, arthroscopy, arthrodesis, and reductions of hands,
              wrists, feet and TMJ
            - Minor treatment of surgical complications such as hematoma or
              wound separation
(viii.) UROLOGY
        •   Inguinal canal surgery
        •   Open procedures on scrotal contents
        •   Penile procedures up to but not including implants
        •   Minor urethral reconstruction, urethal fistula repair and distal
            hypospadius repair
        •   Minimally invasive incontinence procedures, including injectables and
            percutaneous slings
        •   Cystoscopy and ureteroscopy with or without biopsy or minor
            manipulation of stones or obstruction
(ix.)   PODIATRY
        •   Amputation
            - single ray of the foot only
        •   Arthrodesis of joints of the foot and ankle
            - Lisfranc‟s joint procedures
        •   Arthroplasty of joints of the foot and ankle
            - foot procedures requiring significant exposure of the joint
            - ankle procedures which do not require tibial or fibular osteotomy for
                exposure
        •   Arthroscopy
            - ankle/subtalar joint/mid-tarsal joint
        •   Fractures and dislocations
            - uncomplicated closed fractures and dislocations of the foot
        •   Incision/excision/transfer/repair of tendons and ligaments
            - tendons and ligaments proximal to Lisfranc‟s joint but not of the rear-
                foot/leg via the interosseous route
        •   Neoplasms
            - benign neoplasms of the cuneiforms
            - benign neoplasms of soft tissues below deep fascia
        •   Neurolysis/neurectomy
                        _____________________________________
                                 Issued January 2, 2006
                             Replaces January 4, 2005 Issue                         27
                   -  deep nerves including and distal to the tarsal tunnel and proximal to
                      Lisfranc‟s joint
               •   Osteotomy of bones of the foot
                   - osteotomy of the calcaneus, mid-tarsus and cuneiforms
(4)    Permitted surgical procedures are those procedures which will safely allow the
discharge of a patient from medical care in the facility within 12 hours of completion of the
surgical procedure by a registered practitioner.
         (4.1) The Council may approve the provision of specified surgical procedures at
facilities which are approved for that purpose by the Council where patients undergoing
such procedures require medically supervised post-operative care exceeding twelve (12)
hours.
(5)    Council may make exceptions to the procedures above by specific resolution or by
approving accreditation standards for facilities which contain those exceptions.

(6)    Upon application by a Medical Director of a facility, the Registrar may provide
interim approval for the performance of any procedure not included in 46(3) until
consideration of the request by Council.

                                  Ownership and operation

(7)     No person may hold an ownership interest, directly or indirectly, in the practice of
medicine conducted in a facility described in Section 103(1) (hereinafter referred to as "the
facility") unless that person is a registered practitioner or a professional corporation.

(8)     When a person other than a registered practitioner or professional corporation is the
owner of the facility and provides or offers to provide medical diagnosis, advice and
treatment in the facility to the public by a registered practitioner or professional corporation,
the registered practitioner or professional corporation if approved by Council for the purpose
of this bylaw shall be the owner of the practice of medicine conducted in the facility.

(9)     The management and control of the practice of medicine in the facility including the
qualifications and supervision of all staff, registered practitioner and non-registered
practitioner, shall at all times be the responsibility of the practice of medicine.

(10) The availability and quality of care provided for patients and the safety and quality
of medical equipment utilized in the facility shall at all times be the responsibility of the
owner of the practice of medicine conducted in the facility.

(11) All medical records including charting of medical care to a patient, patient
appointment schedules, patient billing and payment records prepared for the medical care of
patients in the facility shall be:

       (a)     The property of the owner of the practice of medicine.

       (b)     The responsibility of the owner of the practice of medicine as to the
               protection of confidentiality, secure storage, and compliance with all

                               _____________________________________
                                        Issued January 2, 2006
                                    Replaces January 4, 2005 Issue                           28
                    applicable laws.

            (c)     The responsibility of the owner of the practice of medicine to provide to the
                    patient access for review and to provide a legible copy of the medical chart to
                    the patient, at a reasonable cost, on the request of the patient.

     (12) An owner of the practice of medicine conducted in the facility shall be responsible
     for the propriety and accuracy of all claims for payment of fees whether on a fee-for-service
     basis or by funding arrangements for medical services provided in the facility.

     (13) An owner of the practice of medicine conducted in the facility shall be responsible
     for the propriety and accuracy of advertising, promotion and other marketing activities for
     medical services provided in the facility.

     (14) For absolute clarity of medical responsibility, any agreement between an owner of
     the facility and a registered practitioner or professional corporation for the provision of
     medical diagnosis, advice or treatment in the facility shall expressly adopt the provisions of
     Section 46 in Part B of the bylaws as part of that agreement.

     (15) The owner of the practice of medicine conducted in such facility shall not enter into
     an agreement whereby the payment of rental consideration for the lease of office space,
     management services, or for equipment required for the practice of medicine is calculated or
     based on a percentage of the professional income derived from the practice of medicine.

     (16) The owner of the practice of medicine conducted in such facility shall pay or cause
     to be paid to the College those fees and expenses set by the bylaws which shall include:

            (a)     initial registration fee

            (b)     an annual renewal of registration fee;

            (c)     the actual cost of any initial or subsequent inspection of the facility. Such
                    cost to include all expenses incurred by the Committee including consultant's
                    fees for the conduct of such inspection.

                      MEDICAL FACILITY ASSESSMENT COMMITTEE

47   Operation
                                         Committee constituted

     (1)     Pursuant to section 103(2) of the Medical Profession Act, the Council does hereby
     constitute a Standing Committee to be known as the Medical Facility Assessment
     Committee.

                                                 Purpose

     (2)    The purpose of the Committee is to advise the Council on the appropriate standards
                                    _____________________________________
                                             Issued January 2, 2006
                                         Replaces January 4, 2005 Issue                         29
for the operation of accredited facilities, to coordinate accreditation of facilities by the
Council, and to ensure the uniform implementation of Council resolutions pertaining to
those facilities.

(3)     The Committee may, on behalf of Council, investigate and inspect the ownership and
operation of diagnostic and treatment facilities and financial arrangements pertaining
thereto.

(4)    The Committee shall establish, develop and administer an ongoing program of
review and assessment of such facilities for the purpose of advising the Council as to the
ownership and operation of said facility.

                                         Membership

(5)     The Committee shall be composed of not more than nine (9) members all of whom
shall be appointed by the Council.
       The Committee members and the Chair of the Committee shall be appointed in
accordance with section 24(1) to (3) of the Bylaws.
(6)    Subject to the direction of Council and this bylaw, the Committee shall conduct its
business in such manner and may adopt and vary such programs and forms as it sees fit.

(7)    The Committee shall report to the Council on its activities and programs of
assessment at such times and in such manner as the Council may from time to time direct.

(8)    The Committee may, from time to time, appoint one or more of its members or
consultants as assessors or as a sub-committee with particular expertise in the services
provided in a facility and delegate to such persons so appointed the authority to conduct an
assessment of a diagnostic and treatment facility and report thereon to the Committee.

(9)    There shall be paid to members of the Committee and consultants retained by them
such fees for attendance and such reasonable traveling expenses as may be fixed by Council.

                                    Committee objectives

(10)   The objectives of the Committee shall be:

       (a)     to develop and direct regular reviews of the ownership and operation of
               diagnostic and treatment facilities and the financial arrangements pertaining
               thereto;

       (b)     to ensure that the operation of each such facility is in accordance with
               standards established by the Council;

       (c)     to confirm that the practice of medicine conducted in a facility and the
               financial arrangements pertaining thereto are in accordance with Part B of the
               Bylaws of the College of Physicians and Surgeons of the Province of Alberta
               and other published policies passed by resolution of the Council;
                               _____________________________________
                                        Issued January 2, 2006
                                    Replaces January 4, 2005 Issue                             30
       (d)    to assess the educational background, qualifications and ongoing experience
              of both physicians and non-medical personnel assisting those physicians in
              the provision of medical services in the facility;

       (e)    to assess the adequacy of the design of the facilities and the equipment
              utilized therein along with the standards of operation of the facility in
              providing medical services to the public;

       (f)    to assess the business and professional relationships between physicians
              conducting the practice of medicine and the owners of the facility.

                                     Medical Director

(11) A facility described in section 103(1) shall have a designated medical director who is
a medical practitioner registered and in good standing under the Medical Profession Act
with qualifications set out in facility standards approved by resolution of the Council.

                           Responsibility of Medical Director

(12)   A medical director shall:

       (a)    renew yearly the registration of the facility by completing the appropriate
              forms as required by the Committee;

       (b)    provide evidence of a satisfactory initial inspection and any subsequent
              inspection(s) as required by the Committee;

       (c)    institute and maintain an adequate quality assurance program;

       (d)    provide continuous adequate and effective direction and supervision of
              personnel and the medical service performed;

       (e)    ensure that the procedures employed in the facility are selected and
              performed in accordance with current accepted medical practice;

       (f)    ensure that the practice of medicine is conducted in accordance with all
              applicable provisions of Part B of the Bylaws;

       (g)    ensure that there is remitted to the College within the time required all fees
              established by the Act or by the Bylaws for any registration, initial or annual,
              and inspections of the facility;

       (h)    notify the Registrar forthwith of any proposed change in:
              (i)     the ownership of the facility;
              (ii)    the ownership of the practice of medicine conducted therein; or
              (iii)   the designated medical director.

                             _____________________________________
                                      Issued January 2, 2006
                                  Replaces January 4, 2005 Issue                            31
                          Cooperation by the Medical Director

(13) The medical director of a diagnostic and treatment facility which is the subject of an
assessment by the Committee shall co-operate fully with the Committee and its assessors.
Such co-operation shall include:

       (a)    permitting assessors to enter the facility and inspect the premises and all
              diagnostic equipment located therein;

       (b)    permitting the assessors to inspect all records pertaining to the provision of
              medical services and providing copies of the same if so requested;

       (c)    providing to the assessors information requested by them in respect of the
              provision of medical services in the facility;

       (d)    providing the information described in clause (c) in the form requested by the
              assessors;

       (e)    to provide on request samples or copies of any material, specimen,
              radiological image or product originating from the medical service provided
              by the facility;

       (f)    answering questions posed by the assessors as to procedures or standards of
              performance and if requested providing copies of records relating to
              procedures followed and standards of performance applied in the facility;

       (g)    providing to the assessors copies of all documents and information relating to
              business arrangements involving the practice of medicine conducted in the
              facility. The production of documents and information shall include lease
              arrangements, management agreements, records of advertising and
              agreements for the provision of medical services.

                             Referral to Investigation Chair

(14) The Committee shall refer a matter to the Investigation Chair when it is of the
opinion that the conduct of a registered practitioner:

       (a)    should be subject to review pursuant to section 46(2) of the Act; or

       (b)    has failed to comply with a requirement of the bylaws under the Act.

                                Committee responsibilities

(15)   The Committee shall be responsible for:

       (a)    the administration of this program by which periodic assessments of
              diagnostic and treatment facilities shall be conducted;

       (b)    the administration of processes for facility-based audits which may include:
                             _____________________________________
                                      Issued January 2, 2006
                                  Replaces January 4, 2005 Issue                            32
               (i)     a review of the facilities medical records;
               (ii)    personal interviews with medical practitioners and support staff;
               (iii)   reviews of quality control;
               (iv)    inspection of the facility‟s premises and diagnostic equipment;
               (v)     obtaining copies of documents or samples of any material, specimen,
                       radiologic image or substance originating from the medical service
                       provided by the facility;
               (vi)    a review of all contractual and financial arrangements pertaining to
                       the provision of medical services in the facility.

(16) The Committee shall on the conclusion of an assessment conducted on a diagnostic
and treatment facility prepare a report which:

       (a)     confirms that the facility meets the requirements set by the Council as to
               procedures, standards, ownership and financial arrangements as relating to
               the practice of medicine;

       (b)     describes in detail any material deviation(s) from requirements approved by
               the Council for diagnostic and treatment facilities;

       (c)     prescribes a period of time for correction of deviations.

(17) If the Committee reports/requires action as provided in section 16(b) and (c) the
Committee shall forthwith:

       (a)     provide a copy of the report to the medical director of the facility requiring
               the deviation(s) to be corrected within a prescribed period of time;

       (b)     at the end of the prescribed period, review the corrections made or carry out a
               re-assessment of the facility to verify that said deviation(s) has been
               corrected.

(18) Should the Committee establish that a facility has failed to correct the deviation(s)
described in a report as provided in section 16(b) and (c), the Committee shall forthwith
forward to the Registrar a complete record of the assessment conducted, a copy of its report
to the medical director and the result of any review or re-assessment.

                           Referral of the matter to the Council

(19) The Registrar shall provide a copy of the record to all parties in accordance with
sections 64(a) and (b) of the Act.

(20) The Council shall consider the record and shall hear representations advanced by the
medical director of the facility or its counsel and shall further hear representations of
counsel representing the Committee.

                              _____________________________________
                                       Issued January 2, 2006
                                   Replaces January 4, 2005 Issue                           33
     (21)   The Council may:

            (a)      grant adjournments of the proceedings to, or reserve the determination of the
                     matters before, a future meeting of the Council;

            (b)      on granting special leave therefor, receive further evidence in the same
                     manner and subject to the same rules and with the same powers as are
                     provided for in this Act with respect to hearings before an Investigating
                     Committee;

            (c)      make any other findings that in its opinion ought to have been made;

            (d)      quash or confirm the findings of the Committee;

            (e)      vary the finding of the Committee as it deems necessary;

            (f)      order the matter to be referred back to the Committee for further assessment
                     and report.

     (22) The Council shall at or within a reasonable time after the conclusion of all
     proceedings before it, issue its decision.

     (23)   The decision of the Council shall be final and binding.

                             CONFLICT OF INTEREST GUIDELINES

48   Self-referral
     (1)     In accordance with the decision of the Supreme Court of Canada in the case of
     McInerney v. Macdonald, a practitioner-patient relationship is a fiduciary relationship
     requiring a high duty of care by the practitioner to his patient. Self-referral by a registered
     practitioner may occur only where there is a demonstrable objective medical benefit for the
     proposed intervention to the patient.

49   Seeking or receiving benefits from a third party
     (1)     A registered practitioner shall not seek or accept any payment or benefit, directly or
     indirectly, for any service rendered to a patient by any other practitioner or person other than
     for services provided by a partner, associate, employee or locum of such registered
     practitioner. A benefit shall include but is not limited to any financial advantage, good or
     service sought or received by the registered practitioner.

50   Referral to a facility in which a registered practitioner holds an interest
            (a)      A registered practitioner who holds an investment in a treatment and/or
                     diagnostic facility operated separate and apart from the practitioner's office
                     practice shall not refer patients to such facility unless the registered
                     practitioner directly provides care or services approved by the Council in
                     such facility.
                                    _____________________________________
                                             Issued January 2, 2006
                                         Replaces January 4, 2005 Issue                           34
             (b)     The Council may, in its sole discretion and upon special application, make an
                     exception to subsection (a) based on a demonstrated need in the community
                     for the said facility in which a registered practitioner has or will have an
                     investment.

51   Investment by a practitioner in a treatment and/or diagnostic facility
     (1)    An investment in a treatment and/or diagnostic facility operated separate and apart
     from an office practice by a registered practitioner whether or not the registered practitioner
     provides direct care or services at such facility shall meet the following conditions:

             (a)     the terms on which an investment is offered to a registered practitioner must
                     not be related to the past or expected volume of referrals of patients or other
                     business from the registered practitioner to such facility;

             (b)     there shall be no requirement that a registered practitioner make referrals to
                     the facility or otherwise generate professional business as a condition for
                     investment or remaining as an investor; and

             (c)     the return on the practitioner's investment must be directly attributable to the
                     practitioner's equity or interest in the facility rather than to the volume of
                     referrals made by that practitioner.

52   Sale by a registered practitioner of medical or health care products
     (1)     A registered practitioner shall not sell to the practitioner's patients medical or health
     care products at a price in excess of the market price paid by the medical practitioner plus a
     reasonable handling cost.

     (2)     For the purpose of this section, health care products include any product, device or
     appliance offered for the diagnosis, cure, alleviation or prevention of disease, disorders or
     injuries in human beings.

                                    Incentives Offered by Physicians

     (3)    A registered practitioner shall not offer or cause any inducement to be received by
     any person, including a patient of the registered practitioner, in return for the referral of
     another person to the registered practitioner for the provision of any service or product,
     whether or not it is medically necessary.

     (4)     A registered practitioner shall not offer or cause any inducement to be received,
     directly or indirectly, by a patient of the registered practitioner, in return for the provision of
     any service or product to that patient, whether or not it is medically necessary.

     (5)     Notwithstanding Sections 52 (3)and (4), a registered practitioner may offer a reduced
     fee or charge to a patient for any medical service or product provided to that patient and not
     covered in full by the Alberta Health Care Insurance Plan.


                                     _____________________________________
                                              Issued January 2, 2006
                                          Replaces January 4, 2005 Issue                             35
                           RESEARCH ETHICS REVIEW COMMITTEE

53     Operation
       (1)    There shall be a Standing Committee appointed by the Council known as the
       Research Ethics Review Committee.

       (2)     The purpose of this Committee is to establish, develop and administer an ongoing
       program to provide access for ethics reviews of research projects involving human
       participants conducted by registered practitioners who are ineligible for such review by the
       Health Research Ethics Advisory Board of the Capital Health Authority, University of
       Alberta and Caritas Health Group; the Conjoint Health Research Ethics Board of the Faculty
       of Medicine, University of Calgary; or the Alberta Cancer Board.

       (3)    A registered medical practitioner shall, before engaging in a research project
       involving human subjects, obtain the written approval either of a Research Ethics Board
       conducted under the jurisdiction of the Health Research Ethics Advisory Board, Conjoint
       Health Research Ethics Board or the Alberta Cancer Board; or of the Research Ethics
       Review Committee of the College of Physicians and Surgeons of the Province of Alberta.

       (4)    The Committee shall act to:

              (a)    advance the dignity of human research subjects;

              (b)    determine the scientific validity of research proposals;

              (c)    facilitate ethical research;

              (d)    review the qualifications and relevant competencies of researchers;

              (e)    encourage both education and improvement in research quality;

              (f)    through its members bring social and scientific breadth to ethics review of
                     research proposals advanced to it.

       (5)     Subject to this bylaw, the Committee shall develop a process of ethics review
       consistent with that taken by the National Tri-Council in the Code of Ethical Conduct for
       Research with Humans.

       (6)    The Committee may collaborate with the Research Ethics Boards of the Health
       Research Ethics Advisory Board, the Conjoint Health Research Ethics Board, and the
       Alberta Cancer Board in order to develop and/or provide a uniform standard of ethics review
       including an audit process of reviews, completed or continuing, performed by the
       Committee and the said Boards.
       (6)(1) Notwithstanding Section 17 of the Act, the Committee may disclose information
concerning the individuals involved in the research being reviewed by the Committee for the
purposes set out in Section 53(6) of these bylaws.
       (7)
                                     _____________________________________
                                              Issued January 2, 2006
                                          Replaces January 4, 2005 Issue                           36
      (a)   The Committee shall be composed of not less than six members and a Chair,
            not all of whom are of the same gender.

      (b)   The Chair of the Committee must have demonstrated previous experience as
            a member of an Academic Research Ethics Board in Canada.

      (c)   The Committee shall have:
            (i)     at least one member who is knowledgeable in the field of ethics;
            (ii)    at least one member who is knowledgeable in the discipline of law;
            (iii)   at least one member recruited from the community at large;
            (iv)    at least one member appointed from nominees submitted by each of
                    the Health Research Ethics Advisory Board, Conjoint Health
                    Research Ethics Board and Alberta Cancer Board.

      (d)   The Committee members and Chair of the Committee shall be appointed in
            accordance with section 24(1) to (3) of the Bylaws.

      (e)   The Committee may add additional non-voting members and retain
            consultants and advisers or appoint subcommittees as is necessary to assist it
            in conducting ethics reviews.

      (f)   The Committee may from time to time appoint one or more of its members or
            other persons as reviewers of any applications and to provide reports for the
            advice of the Committee.

      (g)   Subject always to the direction of the Council and this bylaw, the Committee
            may conduct ethics reviews in such a manner and may adopt, use and vary
            such programs and forms as it sees fit.

(8)

      (a)   The Committee shall meet as frequently as necessary to prevent delays in the
            review process but not less than nine times annually. The dates of meetings
            of the Committee shall be publicly advertised.

      (b)   One-half of the voting membership of the Committee shall constitute a
            quorum.

      (c)   The Committee shall cause to be prepared detailed minutes of all meetings
            which shall clearly document decisions taken by the Committee and the
            reasons for each decision.

      (d)   The decision-making process shall be guided by the principles set out by the
            National Tri-Council in the Code of Ethical Conduct for Research with
            Humans and shall, where possible, be based on a consensus of Committee
            members. If consensus cannot be achieved a majority vote will establish the
                           _____________________________________
                                    Issued January 2, 2006
                                Replaces January 4, 2005 Issue                         37
              Committee decision on any application.

       (e)    The Committee may approve, refuse to approve or require modification of
              any research proposal submitted to it.

       (f)    There shall be paid to the members of the Committee, both voting and non-
              voting, consultants and advisers retained by them, such fees for attendance
              and such reasonable traveling expenses as may be fixed by the Council from
              time to time.

       (g)    All expenses incurred by the Council for the operation of the Committee shall
              be recovered through a review levy to be paid by each applicant or the
              sponsor of each applicant for approval of a research protocol.

(9)    The Committee may request an applicant to appear in person before it to speak to the
application.

(10)

       (a)    Where an application has been refused or a request has been made by the
              Committee for modification of the research protocol, the applicant may
              appeal the Committee decision to the Council within thirty days of the date of
              service of such decision on the applicant.

       (b)    The appeal shall be commenced by serving a Notice of Appeal on the
              Registrar.

       (c)    The appeal shall be founded on all materials contained in the application to
              the Committee and the decision of the Committee.

       (d)    The Council shall consider the Notice of Appeal and all material in support
              and may either:
              (i)     hear the appeal on a date set by the Council. The Council shall
                      consider all materials contained in the application to the Committee
                      and the decision of the Committee and shall hear any representations
                      by the applicant or his counsel and representations by counsel
                      representing the Committee.
                      or
              (ii)    refer all materials received to an Academic Research Ethics Board for
                      its opinion and advice to the Council. A copy of the opinion and
                      advice to the Council as provided by an Academic Research Ethics
                      Board shall upon receipt be provided to the applicant or counsel for
                      the applicant.

       (e)    Where the Council has received the opinion and advice of an Academic
              Research Ethics Board, the Council may hear representations made on behalf

                             _____________________________________
                                      Issued January 2, 2006
                                  Replaces January 4, 2005 Issue                         38
             of the applicant or the Committee as to that report.

       (f)   The Council on hearing the appeal, or after considering the opinion and
             advice of the Academic Research Ethics Board, may:
             (i)     make any other findings that in its opinion ought to have been made;
             (ii)    quash or confirm the decision of the Committee;
             (iii)   refer the matter back to the Committee for its further review and
                     decision.

       (g)   The decision of the Council shall be final and binding.

(11)

       (a)   All research protocols approved by the Committee and continuing for a
             period in excess of one year shall be reviewed by the Committee on an
             annual basis.

       (b)   Such review shall include any changes which may have occurred in respect
             of ethical or scientific validity, in the design of the research study and the
             progress achieved in the study.

       (c)   In addition, the Committee in its sole discretion may require of the applicant
             any additional monitoring procedures including, but not restricted to:
             (i)     continuing consent monitoring;
             (ii)    monitoring of adherence to protocol.

       (d)   The principal researcher shall conduct the following self-monitoring:
             (i)     provide written notice to the Committee of all changes to an approved
                     protocol before such changes are implemented;
             (ii)    in the case of extended studies, provide annual reports to the
                     Committee describing the progress of the research study.
             (iii)   provide to the Committee an end of project report detailing the
                     research conducted and the results obtained;

       (e)
             (i)     If as a result of monitoring conducted on a research study, the
                     Committee is satisfied that the study for whatever reason lacks ethical
                     and/or scientific validity the Committee may provide written notice of
                     rescission of approval to the principal researcher and so advise the
                     Council;
             (ii)    If as a result of monitoring conducted on a research study, the
                     Committee is satisfied that the research protocol as originally
                     approved is no longer being followed, the Committee may provide
                            _____________________________________
                                     Issued January 2, 2006
                                 Replaces January 4, 2005 Issue                           39
                              written notice of rescission of approval to the principal researcher and
                              refer the matter for investigation by the Investigation Chair;
                    (iii)     Where the Committee has provided notice of rescission of approval,
                              on the basis that the study for whatever reason lacks ethical and/or
                              scientific validity, all further research shall cease until the principal
                              researcher can satisfy the Committee that any defect or deficiency in
                              the research study can be rectified so as to allow the research to
                              continue with scientific validity.

            (f)     A researcher who is subject to a notice of rescission of approval by the
                    Committee may appeal that decision in accordance with the provisions of
                    subsection 10 of this bylaw.

            (g)     Where written notice of rescission of approval has been issued to the
                    principal investigator, the Committee may require written evidence that the
                    principal investigator has advised any and all of that project‟s sponsors, of the
                    Committee‟s action.

     (12) Applicants to the Research Ethics Review Committee shall pay the fees outlined in
     section 32(22) of these bylaws.

                                     PRACTICE IN ASSOCIATION

54   Definitions
     (1)    In this section

            (a)     a “registered practitioner” refers to a practitioner registered and in good
                    standing under the Medical Profession Act,

            (b)     a “health professional” refers to a practitioner registered and in good standing
                    with any other health profession regulatory authority established by statute in
                    the Province of Alberta and who practises within a scope of practice defined
                    by such statute,

            (c)     “practice in association” means a professional relationship between a
                    registered practitioner and a health professional who is not an employee of
                    the registered practitioner in which any of the following apply:
                    (i)       joint advertising,
                    (ii)      joint office phone number,
                    (iii)     joint billing for professional services,
                    (iv)      joint office reception area,

            (d)     “practice in association” does not refer to the release of copies of medical
                    records to any person at the request and with the consent of the patient or

                                      _____________________________________
                                               Issued January 2, 2006
                                           Replaces January 4, 2005 Issue                            40
                    appropriately authorized agent for the patient. Neither does it refer to
                    consultation between a “registered practitioner” and an independent “health
                    professional”.

55   Conditions Governing Association
     (1)     The registered practitioner shall, before entering into and while engaged in such an
     association, be certain that the qualifications, professional standing, and scope of practice of
     the health professional are acceptable to the health professional‟s own regulating authority.

     (2)     The registered practitioner shall ensure that a clear identification is made for the
     benefit of the public as to the qualifications or professional designation of each health
     professional where practising in the same office or clinic with the registered practitioner.

     (3)    Any referral by the registered practitioner to an associated health professional and
     any resulting opinion or provision of health care shall be in written form and must be
     maintained on the patient‟s medical record by the registered practitioner.

     (4)    A referral by the registered practitioner to an associated health professional shall
     occur only when there is a demonstrable objective health benefit to the patient arising from
     such referral.

     (5)     A registered practitioner shall not enter into a legal partnership arrangement with a
     health professional but may enter into a contractural arrangement for cost-sharing of office
     or clinic expenses.

     (6)    A registered practitioner shall not enter into a practice in association with any person
     who is not a health professional as defined in subsection (1)(b).

     (7)    A registered practitioner may delegate to an employee only those health care services
     which the registered practitioner is qualified to provide unless that employee also is a health
     professional as described herein.

     (8)     A referral to a non-regulated health care provider is acceptable when the physician is
     satisfied that those services can reasonably be expected to benefit the patient, and not to
     cause harm.

                              LIMITED LIABILITY PARTNERSHIP

56   Prohibition
     (1)    Registered practitioners or professional corporations are not permitted to enter into
     an Alberta Limited Liability Partnership for the practice of medicine or osteopathy.

                       NON-HOSPITAL MEDICAL IMAGING FACILITY

57   Approval of facility

                                    _____________________________________
                                             Issued January 2, 2006
                                         Replaces January 4, 2005 Issue                             41
     (1)    A non-hospital medical imaging facility that is used for diagnostic purposes must be
     approved by the College and must meet the requirements of section 46.

     (2)     Subsection (1) does not apply to a facility that is operated by the federal government
     or a provincial or municipal government.

58   Medical director and consultants
     (1)    The facility shall have a Medical Director who is a physician registered in Alberta
     who is responsible for supervision of the day-to-day care of patients in the imaging facility.

     (2)    The facility shall have a Medical Director or a Medical Consultant who is
     responsible for supervision of imaging services in the facility who is a radiologist or other
     physician registered in Alberta and approved by the College for the imaging services
     provided.

     (3)     The physician responsible for imaging services shall visit the facility at an interval
     prescribed by accreditation standards of the College which shall be no less than once a year
     and shall make an annual written report to the owner(s) of the facility.

     (4)    All films/images produced by the facility shall be interpreted and reported on by an
     approved imaging specialist.

59   Procedures on request
     (1)     A facility may perform procedures only at the request of a physician, dentist,
     chiropractor, podiatrist, registered midwife, or registered nurse approved to provide
     extended health services, and all reports shall be made available to the requisitioning
     practitioner.

60   Employment of technical staff
     (1)    Radiological examinations shall be performed by a physician approved by the
     College or a registered imaging technologist or technician.

61   Application for approval
     (1)    The director of a facility shall make an application for approval of the facility by
     providing such information as required by the Registrar.

     (2)   Approval of the facility may be granted by the Council on the recommendation of
     the Medical Facility Assessment Committee.

62   Notification of changes
     (1)     Where there is a change in the ownership of the facility, the ownership of the
     practice of medicine, or the medical director, the College shall be notified.

     (2)    Any extension or modification of equipment requires prior written notification to the
     College to obtain approval for such extension or modification.
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                                             Issued January 2, 2006
                                         Replaces January 4, 2005 Issue                            42
63   Duties of director
     The director of each facility shall
            (a)     apply yearly for approval of the facility by completing the appropriate form
                    as required by the Registrar,

            (b)     from time to time as required make available films/images, records and
                    reports together with details of the qualifications of the staff of the facility to
                    the Council or the Medical Facility Assessment Committee appointed by the
                    Council,

            (c)     remit the initial registration fee and subsequent annual fee, as determined by
                    Council,

            (d)     provide evidence of a satisfactory initial inspection and subsequent
                    inspections by an approved health physicist or radiation health officer,

            (e)     maintain the standards set by Provincial and Federal authorities,

            (f)     ensure that all personnel participate in a radiation exposure monitoring
                    service and maintain a record of results,

            (g)     institute and maintain an adequate quality assurance program,

            (h)     ensure that each facility has a procedure manual approved by the Medical
                    Facility Assessment Committee outlining all aspects of imaging practice.

64   Requirements re: techniques
     The techniques used must include the following:
            (a)     all films/images must be identified using photo identification. They must
                    include the patient's name, age or date of birth, date of examination, and the
                    name of the facility;

            (b)     each examination must have the optimal number of views considered
                    necessary for an adequate radiological assessment as described in the
                    procedure manual referred to in section 63(h);

            (c)     there shall be a procedure in place to determine whether or not a patient may
                    be pregnant for all procedures involving any radiation to the abdomen or
                    pelvis on women of childbearing age, and that this be demonstrated;

            (d)     all films/images must show evidence of collimation;

            (e)     evidence of gonadal shielding must be present where applicable;

            (f)     child immobilizers shall be used, where indicated.

65   Facility records
                                    _____________________________________
                                             Issued January 2, 2006
                                         Replaces January 4, 2005 Issue                             43
       (1)    The facility shall maintain a record indicating the daily requests for examinations,
       which have been numbered, filed and reported.

       (2)     Films/images and interpretive reports shall be retained for the following time
       intervals:

               (a)    Records of diagnostic imaging services provided to a patient including test
                      results, archived digital images and interpretation reports shall, subject to
                      subsection (b), be securely stored for a period of at least ten years.

               (b)    Where the patient was a minor at the time the diagnostic imaging services
                      was provided, the record shall be securely stored for a minimum period
                      ending:
                      (i)     ten years

                              or
                      (ii)    two years after the patient‟s eighteenth birthday, whichever date is
                              later.

               (c)    Diagnostic images stored on film shall be securely stored for a minimum of 5
                      years or in the case of minors, 2 years after the patient‟s eighteenth birthday,
                      whichever date is later;

               (d)    Mammography films shall be securely stored for a minimum of five years
                      and should be securely stored for a minimum of ten years when there is no
                      intervening study.

66     Contrast studies
               (a)    The use of contrast shall adhere to a policy approved by the
                      radiologist/imaging specialist responsible for imaging in the facility.

               (b)    Ionic or high osmolality agents shall not be used for intravenous contrast
                      studies.

67     Image intensification
       All fluoroscopic installations require image intensification. Image intensifiers shall only be
operated under the supervision of a physician in accordance with policy approved by the radiologist
responsible for imaging in the facilities.

                              DIAGNOSTIC MEDICAL LABORATORY

68     Definitions
       In this section and in sections 69 to 76,
               (a)    "approved method" means one that is accepted in the literature as reliable and
                      trustworthy and is accepted as such by those in actual practice as having
                      clinical use and value for physicians and patients, but does not include a
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                                               Issued January 2, 2006
                                           Replaces January 4, 2005 Issue                            44
      procedure which is considered by the Council to be within the realm of
      experimentation or research;

(b)   "bench or procedure manual" means a written systematized documentation of
      all procedures performed in a laboratory, describing and giving the title or
      name of procedure, principle of the method, collection of specimens,
      procedure step by step in detail, calculations, form of report, normal values,
      control procedures, notes and precautions, calibration procedure and
      references in order to
      (i)     enable workers to perform the procedures accurately and repetitively
              in the same manner,
      (ii)    ensure continuity of methods and procedures without the introduction
              of modifications,
      (iii)   describe the methodology for others, and
      (iv)    assist others in the interpretation of results;

(c)   "laboratory assistant" means a member of the staff of a diagnostic medical
      laboratory who may have had no formal training or qualifications necessarily
      related to the field but who, by virtue of experience and on-the-job training, is
      capable of performing, under supervision of a technologist, certain routine
      test procedures of a simpler and often repetitive nature and other duties such
      as venipuncture, specimen control and clerical duties;

(d)   "certified combined laboratory and x-ray technician" means a person who,
      having received training, has a diploma from a Canadian school of Combined
      Laboratory and X-Ray Technicians enabling him/her to do certain laboratory
      procedures in clinical medical laboratories as determined by provincial
      regulations and Council to be within their competence and experience;

(e)   "medical laboratory technologist (MLT and RMLT)" means a registered
      practitioner according to the Medical Laboratory Technologists Regulation of
      the Health Disciplines Act.

(f)   "laboratory scientist" means a person with a degree of Master of Science or
      higher from a university acceptable to the Council, who, having obtained
      further training and experience in a university department of laboratory
      medicine, has demonstrable expertise in one or more areas of diagnostic
      laboratory procedures;

(g)   "medical practitioner" means a person who has obtained a medical degree
      from a university acceptable to the Council and who is registered with the
      College of Physicians and Surgeons of Alberta to practise medicine;

(h)   "certified laboratory physician" means a medical practitioner who has
      obtained certification from the Royal College as a specialist in Laboratory
      Medicine in any of the following disciplines:
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                               Issued January 2, 2006
                           Replaces January 4, 2005 Issue                           45
                     (i)       General Pathology,
                     (ii)      Anatomical Pathology,
                     (iii)     Hematological Pathology,
                     (iv)      Medical Biochemistry,
                     (v)       Medical Microbiology, and
                     (vi)      Neuropathology,
                     and is registered with the College of Physicians and Surgeons of Alberta as a
                     specialist in the respective disciplines;
              (i)    "consultant to a laboratory" means a certified laboratory physician who
                     assists and advises a director of a laboratory;

              (j)    "laboratory director" is a medical practitioner or a certified laboratory
                     physician approved by the Council of the College to direct a laboratory.

              (k)    Notwithstanding the above,
                     (i)       A medical practitioner may be approved as a director of a laboratory
                               for a limited number of procedures and is subject to the guidelines for
                               a laboratory without a certified laboratory physician.
                     (ii)      A certified laboratory physician may be approved as a director of a
                               laboratory for all the procedures in the discipline in which he is
                               recognized as a specialist. He may be approved for other procedures
                               only if he retains a laboratory physician certified in these other
                               disciplines as a consultant.

              (l)    "diagnostic medical laboratory" or "laboratory" means a facility under the
                     direction of an approved laboratory director as defined in section 68(j),
                     (i)       wherein the practice of laboratory medicine is conducted to provide
                               information for the diagnosis, prevention, treatment and assessment of
                               a medical condition, and
                     (ii)      which has been specifically designed, equipped and staffed
                                (A)    for the purpose of performing laboratory examinations, assays
                            and detailed examinations of specimens and materials from the human
                            body, and
                                (B)    to perform investigative procedures, including all or any of the
                            methods and procedures used in the fields of microbiology, histology,
                            cytology, hematology, serology, chemistry, nuclear medicine, transfusion
                            medicine and genetics.
69    Ownership
      The ownership of the practice of medicine in a non-hospital diagnostic medical laboratory
must meet the requirements of section 46.

                                       _____________________________________
                                                Issued January 2, 2006
                                            Replaces January 4, 2005 Issue                         46
70   Approval of laboratory director
     (1)     All laboratories shall have a laboratory director who has final responsibility of the
     day to day operation of the laboratory, the quality of the work performed and all other
     aspects of the laboratory, including the safety of patients upon whom diagnostic laboratory
     procedures are performed under its direction and who shall be a registered medical
     practitioner who is acceptable to the Council of the College.

     (2)    The laboratory director named shall have appropriate knowledge of the procedures
     performed under his direction in the laboratory.

71   Approval of procedures
     (1)     Full approval may be given to perform all methods and procedures which pertain to
     the practice of laboratory medicine or any section of it if the laboratory is under the direction
     of a medical practitioner who is registered in the Province of Alberta to practise medicine
     and is certified as a specialist in the Province of Alberta in one or more branches of
     laboratory medicine as defined in section 68(h).

     (2)    Except in the case where full approval has been given, approval may be given to
     perform specific diagnostic laboratory procedures which shall be listed.

72   Employees
     (1)   In addition to the director, the following persons may be employed at a diagnostic
     medical laboratory:

            (a)     consultants to the laboratory, who are certified laboratory physicians and who
                    may be full-time, part-time or occasional consultants;

            (b)     associate medical laboratory physicians;

            (c)     medical laboratory scientists;

            (d)     medical laboratory technologists;

            (e)     certified combined laboratory and x-ray technicians;

            (f)     laboratory assistants;

            (g)     other persons who are acceptable to the Council.

     (2)     The Council shall determine an individual's acceptability for employment as
     technical personnel in those instances where the individual does not have formal
     qualifications but has relevant experience and training.

73   Quality assurance
     (1)    The quality of work performed in a laboratory must be acceptable to the Council and,
     without restricting the generality of the foregoing,
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                                             Issued January 2, 2006
                                         Replaces January 4, 2005 Issue                           47
            (a)    all procedures must be carried out according to the approved method,

            (b)    methods must be fully documented in a bench or procedural manual
                   according to the standards accepted by the Council as good practice,

            (c)    the work must be performed by personnel who meet the requirements of
                   section 68, are competent and are supervised adequately at the professional
                   and technical levels of management,

            (d)    quality control programs which are acceptable to the Council must be used
                   and understood by those who are responsible for the results which are
                   reported,

            (e)    equipment must be appropriate, safe and well maintained for the procedures
                   being done,

            (f)    a safety program appropriate to the hazards present is required,

            (g)    a procedural manual must be prepared, reviewed and updated annually, and

            (h)    there must be proper documentation with regard to quality control, safety and
                   specimen identification, and

            (i)    participate in the College's Alberta Laboratory Quality Enhacement Program
                   established by the Council for the procedures which are covered by the
                   Program.

74   Duties of laboratory director
     A laboratory director shall
            (a)    obtain from the Council, approval for all diagnostic procedures to be carried
                   out in a new facility prior to commencement of those procedures;

            (b)    renew yearly the registration of the facility and all diagnostic laboratory
                   procedures to be performed in the laboratory facility;

            (c)    pay or cause to be paid the fees outlined in section 32(19) of these bylaws.

            (d)    ensure that each annual renewal shall describe and document all changes in
                   staff, equipment, space and location for the purpose of the annual renewal of
                   approval and accreditation;

            (e)    make application for accreditation of the medical diagnostic laboratory by the
                   Council immediately on any change in ownership or directorship of the
                   practice relating to the medical laboratory;

            (f)    in the case of a medical laboratory which does not have full approval, make
                   application for approval of any additional procedures with documented
                   reasons for the request and shall notify the College of Physicians and
                                  _____________________________________
                                           Issued January 2, 2006
                                       Replaces January 4, 2005 Issue                             48
                    Surgeons of Alberta of any deletion of procedures previously performed;

            (g)     have the following responsibilities for the day-to-day operation and direction
                    of the facility;
                    (i)      ensure that reliable work is being produced in the facility under the
                             director's supervision;
                    (ii)     provide continuous, adequate and effective direction and supervision
                             of personnel and the work performed;
                    (iii)    ensure that methods employed in the facility are selected and
                             performed in accordance with the current accepted practice of
                             laboratory medicine;
                    (iv)     establish and maintain effective and appropriate safety procedures in
                             the laboratory in regard to fire, contamination, cleanliness and
                             accident prevention;
                    (v)      establish and maintain an effective program of quality control for all
                             tests performed;
                    (vi)     prepare and maintain a current bench or procedural manual of all
                             procedures performed in the laboratory;
                    (vii)    establish and maintain a system of clear and concise records
                             satisfactory to the Council;
                    (viii)   engage and employ an adequate number of sufficiently trained,
                             qualified and competent professional and technical personnel
                             appropriate for the workload, range and complexity of the procedures
                             performed in the laboratory;
                    (ix)     notify the Council in writing of significant changes in personnel in the
                             laboratory;
                    (x)      obtain and use the services of a consultant when necessary;
                    (xi)     perform laboratory examinations and diagnostic procedures only at
                             the request of a licensed physician, dentist, podiatrist, veterinarian,
                             registered midwife, or registered nurse approved to provide extended
                             health services, and report directly to that person;

            (h)     make available for inspection the facility‟s records, bench or procedural
                    manuals and equipment, as well as personnel for the purpose of interviews,
                    and any other data and information that may be required for the assessment of
                    the operation of the facility and the quality of work produced in it.

75   Approval to perform procedures
     (1)    Notwithstanding section 71, approval to perform procedures in the basic list of
     procedures listed in subsection (4) is given to any medical practitioner registered in the
     Province of Alberta for patients in his/her own medical practice.

                                    _____________________________________
                                             Issued January 2, 2006
                                         Replaces January 4, 2005 Issue                           49
(2)      A medical practitioner who performs the procedures listed in subsection (4) acts as a
laboratory director and must comply with the duties listed in section 74 except subsections:
(a), (b), (c), (d), (e), (f), (g)(ix) and (g)(xi).

(3)      Notwithstanding subsection (2), a medical practitioner who performs hemoglobin
determination (non-automated) acts as a laboratory director and must comply with the duties
listed in section 74 in relation to hemoglobin determination only.

(4)    The following are the basic list of procedures for the purposes of this section:

       (a)     Hemoglobin (excluding automated methods);

       (b)     Glucose - stick test or meter;

       (c)     Basic routine examination of urine, including simple chemistry and
               examination of centrifuged sediment;

       (d)     Occult blood;

       (e)     Microscopic examination of smears, hair and nails for bacteria, ectoparasites,
               fungi or worms;

       (f)     Wet mount and/or hanging drop for Trichomonas;

       (g)     Sperm - presence or absence only; and

       (h)     Urine Beta HCG.

(5)    In exceptional circumstances, where there is no reasonable accessibility to laboratory
services supervised by a certified laboratory physician, approval may be given to a medical
laboratory facility with a non-certified laboratory physician to perform certain tests not
included in the basic list in subsection (4) above. In these instances, the following
conditions shall be met:

       (a)     that a director who fulfills section 70(1) and (2) be designated;

       (b)     that specific tests be approved;

       (c)     that qualified personnel be employed to perform these tests;

       (d)     that a consultant laboratory physician certified in the tests approved be
               retained and that the consultant shall visit at least three times per year and
               more frequently if automation and/or microbiology is performed;

       (e)     that a procedure manual and quality control protocol be approved by the
               Council through the Medical Facility Assessment Committee;

       (f)     that proficiency testing be performed; and

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                                        Issued January 2, 2006
                                    Replaces January 4, 2005 Issue                              50
               (g)         that an accreditation inspection be conducted at four year intervals."

76     Classification of laboratories
       The Council shall, after acceptance of a facility and its medical and technical personnel,
accredit the facility under one of the following categories:

                     (1)         major laboratory;

                     (2)         extended laboratory;

                     (3)         basic laboratory;

                     (4)         specialized laboratory;

                     (5)         physician office laboratory.

                                          DIAGNOSTIC ULTRASOUND

77     Definitions
       In these By-laws, the following definitions apply:
               (a)         "diagnostic ultrasound facility" means a facility using ultrasound in medical
                           diagnosis;

               (b)         "diagnostic ultrasound" includes A-mode, B-mode, M-mode, doppler or any
                           combination;

               (c)         "ultrasonographer" means a technologist trained in the performance of
                           diagnostic ultrasound;

               (d)         "ultrasonography" means a method of investigation using ultrasound to
                           produce a graphic or cross-sectional images of the body part being examined;

               (e)         "ultrasonologist" means a physician trained in performing and interpreting
                           ultrasonography and who has been approved by the College of Physicians
                           and Surgeons of Alberta;

               (f)         "ultrasound" means an acoustic radiation at frequencies above the range of
                           human hearing used for medical diagnosis.

78     Repealed
79      Approval of ultrasonologist
        A physician who has experience in specific areas of training as assessed by the Medical
Facility Assessment Committee may be approved as an ultrasonologist.
               (a)         The minimum standards for approval as an ultrasonologist are:
                           (i)     Specialist certification under the Medical Profession Act in any field,
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                                                    Issued January 2, 2006
                                                Replaces January 4, 2005 Issue                          51
             and
      (ii)   Six months' full-time training at a tertiary care teaching ultrasound
             centre as recognized and approved by the Royal College of Physicians
             and Surgeons of Canada for specialist training.

(b)   Specialists are limited to practise ultrasound only in their recognized field of
      expertise and certification.

(c)   Diagnostic radiologists after six months of ultrasound training and having
      completed a minimum of 1,000 studies are eligible for approval in all areas of
      ultrasound except echocardiography. Radiologists seeking approval in
      echocardiography must have undertaken an additional three months' full-time
      training in a dedicated tertiary echocardiography laboratory and have
      completed a minimum of 300 studies, of which at least 80 shall be by
      transesophageal, if approval in TEE is also requested.

(d)   Obstetricians and gynecologists require a minimum of six months' training in
      all areas of obstetrical and gynecological ultrasound and have completed a
      minimum of 500 studies.

(e)   A cardiologist may be approved in echocardiography if he/she has undergone
      six months' full-time training in a tertiary care centre and has completed a
      minimum of 300 studies, of which at least 80 shall be by transesophageal, if
      approval in TEE is also requested.

(f)   An anesthesiologist may be approved in transesophageal echocardiography if
      he/she has successfully completed six months‟ of full-time training in an
      approved centre during which the anesthesiologist performed at least 300
      echocardiography studies, of which at least 80 shall be by transesophageal, if
      approval in TEE is also requested.

(g)   A urologist may be approved in ultrasound imaging of the prostate gland if
      he/she has undergone one month‟s full-time training in a tertiary care centre
      and has completed a minimum of 80 studies.

(h)   An ultrasonologist must maintain an active practice in ultrasound in order to
      maintain these skills. "Active practice" refers to the performance by the
      physician of a minimum of 100 ultrasound examinations per year.

(i)   A physician who has previously satisfactorily completed the training
      requirements for approval in echocardiography but has not:
      (i)    actively practised echocardiography for the previous two years, will
             be required to undertake an additional one month's full-time training
             before receiving approval;
      (ii)   actively practised echocardiography for the last five years, will be
             required to undertake an additional three months' full-time training.
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                              Issued January 2, 2006
                          Replaces January 4, 2005 Issue                           52
            (j)     Notwithstanding (a) above,
                    (i)    certified specialists in ophthalmology may perform simple ophthalmic
                           biometry without approval. Ophthalmologists seeking approval for
                           all other ophthalmic ultrasound require a minimum of three months'
                           full-time training.

80   Eligibility as ultrasonographer
     The minimum requirements for a person to be employed as an ultrasonographer are:
            (a)     Certification by the Canadian Association of Registered Diagnostic
                    Ultrasound Professionals (CARDUP) or by the American Registry of
                    Diagnostic Medical Sonographers (ARDMS) specialty examinations;

            (b)     Maintenance of membership status in CARDUP or ARDMS and achievement
                    of at least 30 hours of approved continuing education in every three-year
                    period;

            (c)     Notwithstanding the above, the Council may approve individuals as
                    ultrasonographers who do not meet the above criteria but whose training and
                    experience are considered acceptable.

81   Operation requirements
     The following operational requirements apply to diagnostic ultrasound facilities:
            (a)     All diagnostic ultrasound equipment must meet Canadian electrical safety
                    standards and
                    (i)    the power output must be known and must not exceed international
                           standards of safety. Wherever possible, indices of power output
                           (Mechanical Index and Thermal Index) should be displayed in real
                           time so that the principle of ALARA (As Low As Reasonably
                           Achievable) can be applied.
                    (ii)   all transducers shall be appropriate to intended application and shall
                           be characterized as to their function, operating design (electronic or
                           mechanical), central frequency, image display, doppler capability
                           (cw.pulsed.colour).

            (b)     A procedure manual detailing routine examination techniques must be kept
                    on site and reviewed regularly. Basic examinations for general, obstetrical,
                    gynecological, small parts and doppler vascular work shall be consistent with
                    national or international guidelines approved by the College.

            (c)     All sites shall have a quality control program for equipment consistent with
                    national or international guidelines approved by the College.

            (d)     Calibration and quality control records shall be kept.

            (e)     Recording devices should be specified as to type and manufacturer.
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                                            Issued January 2, 2006
                                        Replaces January 4, 2005 Issue                          53
               (f)    Films/images and interpretive reports shall be retained for the following time
                      intervals:
                      (i)     Films/images shall be retained for a minimum of five years. In the
                              case of minors, they shall be retained for a minimum of five years or
                              until two years after the patient reaches the age of majority,
                              whichever is the longer.
                      (ii)    X-ray films/images of studies on patients for whom a guardian is
                              appointed with authority to give consent for procedures shall be
                              retained for a minimum of ten years.
                      (iii)   All interpretive reports must be kept for a minimum of ten years.

               (g)
                      (i)     Records of diagnostic ultrasound services provided to a patient
                              including test results, archived digital images and interpretation
                              reports shall, subject to subsection (ii), be securely stored for a period
                              of at least ten years.
                      (ii)    Where the patient was a minor at the time the diagnostic ultrasound
                              service was provided, the record shall be securely stored for a
                              minimum period ending:
                              (A)     ten years
                                      or
                               (B)      two years after the patient‟s eighteenth birthday, whichever
                           date is later.
                      (iii)    Ultrasound images stored on film shall be securely stored for a
                               minimum of 5 years or in the case of minors, 2 years after the
                               patient‟s eighteenth birthday, whichever date is later.

               (h)    Approvals in section 79 (g) are subject to adequate arrangements for the
                      prompt interpretation of studies by an ultrasonologist and a process for
                      immediate referral of complex cases.

               (i)    Interpretation of studies by ultrasonographers or others who are not
                      ultrasonologists is not acceptable.

               (j)    All examinations should be done only at the request of a registered
                      practitioner or a podiatrist and the request should be documented by an
                      appropriate requisition which specifies all relevant clinical information.

               (k)    All facilities must have a director who shall be an approved ultrasonologist
                      and is responsible for the proper operation of the facility.

82     Term of approval
       Approval granted by the College in respect of a facility and its technical personnel is subject
to payment of all fees required in these bylaws and to compliance with accreditation standards
                                      _____________________________________
                                               Issued January 2, 2006
                                           Replaces January 4, 2005 Issue                              54
approved by the College.

             COMPLEMENTARY HEALTH CARE THERAPY PROVIDED BY MEDICAL
                              PRACTITIONERS

83      Definition
        Complementary health care therapy is defined for the purpose of this bylaw as any form of
treatment provided by a medical practitioner which has not been proven by orthodox scientific
methodology and/or accepted by statutory medical or health care authorities as effective for the
prevention, treatment, or cure of any human disease, ailment, physical or mental condition,
deformity, defect or injury. Without limiting the generality of the foregoing, complementary health
care therapy(s) may include:
               (a)    Diet/Nutrition/Lifestyle Changes

               (b)    Mind/Body Control

               (c)    Traditional and Ethnomedicine

               (d)    Structural and Energetic Therapies

               (e)    Pharmacological and Biological Treatments

               (f)    Bioelectromagnetic Applications
where in each case therapy or its application to any patient would meet the definition herein.
84     Notification of Complementary Health Care Therapy(s) Practice
       (1)     A registered practitioner shall not provide subject to subsection (2) complementary
       health care therapy(s) to some or all of his or her patients until the Registrar is advised in
       writing of his or her intention to provide such therapy(s) and such therapy(s) is approved as
       provided hereafter.

       (2)    The provision of medical information in support of an application by a patient for
       authorization to possess dried marihuana pursuant to the Marihuana Medical Access
       Regulations does not constitute complementary health care therapy.

       (3)     Such notice shall provide the specific identification of such therapy(s).

       (4)    In support of such notice a registered practitioner shall provide to the satisfaction of
       the Registrar:

               (a)    documentation of postgraduate education, certification and continuing
                      education acceptable to the Registrar;

               (b)    documentation of the standards of practice of the complementary therapy
                      accepted by educational centres where the therapy is taught.

       (5)     If appropriate documentation required in the immediate preceding paragraph is not
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                                               Issued January 2, 2006
                                           Replaces January 4, 2005 Issue                           55
available the medical practitioner shall submit to the satisfaction of the Registrar such
evidence as is available for the theoretical and scientific rationale for diagnosis and use of
the complementary therapy(s) and further submit evidence satisfactory to the Registrar of
the following:

       (a)     official regulatory recognition of the complementary therapy in Canada or
               other countries or by the World Health Organization;

       (b)     positive clinical outcomes including a comparison with orthodox methods of
               treatment;

       (c)     safety and standards of practice with regard to the same;

       (d)     in the case of a therapeutic pharmacological agent that Health Canada has
               provided a written opinion that such agent is appropriate for use in humans.

(6)     The Registrar upon receipt of the notice with attached material in support shall
consider the same and take a decision as to whether or not the specified complementary
health care therapy(s) is appropriate as a service to be provided by the registered practitioner
which consideration shall include the protection of the public of the Province of Alberta.

(7)    Should the Registrar in his sole discretion find that the information provided in
support of the notice by the registered practitioner is not sufficient to allow a decision to be
taken on the matter then the Registrar may refer the application to the practitioner for
provision of further information and reconsideration by the Registrar.

(8)     If the Registrar after consideration of the information received is satisfied that the
specified therapy(s) is an appropriate procedure to be conducted by the registered
practitioner, the Registrar shall require the registered practitioner prior to conducting such
therapy(s) to agree to follow a practice guideline, such agreement evidenced by the signature
of the registered practitioner on the form of practice guideline attached to this bylaw.

(9)     A registered practitioner who has received the approval of the Registrar and has
undertaken to follow the practice guideline, as described herein, may provide such
therapy(s) to his or her patients and hold out to the public that he or she is authorized to offer
specified complementary health care therapy(s) by the use of those words.

(10) If the Registrar is not satisfied that approval should be granted he shall refer the
application to the Council.

(11) If the Council is satisfied that approval should be granted it shall direct the Registrar
to grant approval to the registered practitioner to conduct the specified therapy(s).

(12) If the Council is not satisfied that approval should be granted it shall direct the
Registrar not to approve the registered practitioner for the specified therapies and shall give
the registered practitioner written notice thereof giving the reasons therefor.

(13)   A registered practitioner who by Order of the Council has been denied approval to
                               _____________________________________
                                        Issued January 2, 2006
                                    Replaces January 4, 2005 Issue                            56
     conduct complementary health care therapy(s) may apply pursuant to section 28 of the Act
     for a review of the Council's decision by a Review Panel. Such review shall be governed by
     section 28 (1) to (10) inclusive.

     (14)

            (a)     The Registrar may from time to time in his sole discretion direct that the
                    practice of a registered practitioner practicing in whole or in part
                    complementary health care therapy(s) be subject to peer review at the
                    expense of the registered practitioner by a committee appointed for that
                    purpose by the Council to assess the continued ethical and competent
                    provision of such therapy(s) and medical services by the registered
                    practitioner.

            (b)     If the peer review committee reports to the Registrar that the registered
                    practitioner has failed to provide therapy in an ethical and/or competent
                    manner, the Registrar shall consider the report and may refer the same to the
                    Investigation Chair for his or her decision pursuant to section 46(2) of the
                    Act.

     (15)

            (a)     Registered practitioners conducting clinical research into the use of
                    complementary therapy(s) must have approval for the said research from an
                    ethics review board as approved by the Council.

            (b)     Under exceptional circumstances the Registrar may permit a registered
                    practitioner who does not hold approval to administer complementary health
                    care therapy(s) to provide the same to a patient who suffers from an
                    imminently fatal, incurable disease so as long as the practice guideline
                    attached hereto is accepted and followed by the registered practitioner.

     (16)

            (a)     Each applicant for approval to provide complementary health care therapy(s)
                    shall pay at the time of application an application fee as outlined in Section
                    32 (24).

85   Practice Guideline for the Provision of Complementary Health Care Therapy
     (1)     Communication relating to the use of complementary health care therapy(s) may be
     initiated by the registered practitioner or the patient.

     (2)     Prior to offering advice about complementary health care therapy(s) the registered
     practitioner shall document the following:

            (a)     Is the conventional evaluation complete?


                                   _____________________________________
                                            Issued January 2, 2006
                                        Replaces January 4, 2005 Issue                           57
       (b)     What is the diagnosis?

       (c)     What are the conventional medical treatment options? Have these options
               been reviewed with the patient, with referral input if necessary?

       (d)     Have the conventional medical options been tried? To what effect? Have
               such options been refused by the patient?

       (e)     How will the complementary health care therapy interfere with conventional
               treatment?

(3)     The registered practitioner shall undertake a functional assessment of the patient
prior to introducing the complementary health care therapy(s) paradigm. Each step in the
strategy shall be documented and include:

       (a)     The chief symptom or complaint.

       (b)     A symptom diary in which are recorded all symptoms reported by the patient.

       (c)     Discussions with the patient which include:
               (i)      the patient's preferences, expectations, and experiences with the
                        available options for conventional medical therapy(s) and
                        complementary health care therapy(s) for this medical condition;
               (ii)     the medical practitioner's assessment of the disease and
                        recommendations as to conventional and/or complementary
                        therapy(s);
               (iii)    the evidence for efficacy of the therapy(s);
               (iv)     the safety and potential toxicity or adverse effects of the therapy(s);
               (v)      the limitations of existing information including that complementary
                        therapy(s) is largely unproven, and the difference between anecdotal
                        and scientific evidence;
               (vi)     that delay in using conventional therapy(s) could permit the disease to
                        progress;
               (vii)    the medical practitioner's professional experience with the use of the
                        therapy(s);
               (viii)   the number of treatments and time frame suggested for the therapy(s);
               (ix)     the costs involved and the possibility, if any, for reimbursement to the
                        patient.

       (d)     A communication plan with the patient's providers of conventional medical
               care.

       (e)     Identify any recommendations for treatment that are in conflict with
               conventional medical treatment.
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                                        Issued January 2, 2006
                                    Replaces January 4, 2005 Issue                            58
            (f)     Indicate the likely effect of the recommended therapy(s) on the patient's
                    functioning in the family, and the social and workplace environments.

     (4)

            (a)     Prior to the provision of complementary health care therapy(s) the medical
                    practitioner shall document a reflection period of 72 hours prior to the
                    initiation of such therapy(s). If the patient refuses such reflection period, the
                    medical practitioner shall document the written request of the patient for the
                    immediate initiation of the therapy(s) without a period of reflection.

            (b)     If a reflection period has taken place, the medical practitioner shall, prior to
                    providing treatment review and document any questions the patient may
                    have, review issues of safety and toxicity, and review choices, risk and
                    preferences which are relevant to the health care of the patient.

     (5)    Prior to the provision of treatment, the medical practitioner shall obtain the written
     consent of the patient for the initiation of complementary health care therapy(s) that contains
     evidence of the understanding of the above-noted by the patient.

     (6)     The medical practitioner shall, upon initiation and throughout the provision of the
     complementary medical health therapy(s), document in sufficient detail to allow subsequent
     peer review the following:

            (a)     All discussions with the patient as outlined in section 3.

            (b)     All relevant physical findings and results of diagnostic investigations.

            (c)     The contents of a symptom diary.

            (d)     All correspondence with providers of conventional care and complementary
                    health care therapy(s).

            (e)     All subjective and objective results of the complementary health care
                    therapy(s).

            (f)     Discussion with the patient as to continuation or discontinuation of the
                    therapy(s).

            (g)     Review of the need for conventional medical treatment if the patient's health
                    status changes.

                          PHYSICIAN PERFORMANCE COMMITTEE

86   Operation
     (1)    The Committee shall be composed of nine members all of whom shall be appointed
     by the Council of the College of Physicians and Surgeons of the Province of Alberta.
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                                             Issued January 2, 2006
                                         Replaces January 4, 2005 Issue                            59
(2)   The Committee members shall be appointed by the Council for a three year term
which may be renewed for a second term.

(3)    Membership of the Committee shall include no fewer than three non-specialists and
no fewer than three certified specialists. The Council may fill a vacancy in the Committee
by appointing such person or persons of similar medical training as the Council deems
appropriate.

(4)      Subject always to the direction of the Council and this bylaw, the Committee shall
conduct its business in such manner and may adopt, use and vary such programs and forms
as it sees fit.

(5)     There shall be paid to members of the Committee, members of a sub-committee or
appointees retained by the Committee such fees for attendance and such reasonable
travelling expenses as may be fixed by the Council by resolution passed annually.

(6)    The objectives of the Committee shall be:

       (a)    To develop and direct regular reviews of the professional performance of all
              Alberta physicians;

       (b)    To facilitate and promote appropriate medical education opportunities to
              practising physicians;

       (c)    To identify trends on the performance of physicians, and

       (d)    To identify personal and system factors affecting physicians‟ performance;

       (e)    To direct registered practitioners to undertake individual assessments and
              remediation of competence and performance as required.

(7)      Every member of the College whose practice is the subject of an assessment as part
of this assessment program shall co-operate fully with the Committee and its assessors. The
co-operation required of a member includes:

       (a)    Permitting the Committee or assessors appointed by the Committee to enter
              and inspect the premises where a member engages in the practice of
              medicine;

       (b)    Permitting the Committee or assessors appointed by the Committee to inspect
              the member‟s records of the care of patients;

       (c)    Providing to the Committee or its assessors information requested by the
              Committee or the assessors in respect of the practice of medicine conducted
              by a physician;

       (d)    Providing the information mentioned in clause (c) in the form requested by
              the Committee or its assessors; and

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                                       Issued January 2, 2006
                                   Replaces January 4, 2005 Issue                          60
      (e)    Answering questions posed by the Committee or its assessors when requested
             to do so on issues of medical competence and performance.

(8)   The Committee shall be responsible for:

      (a)    Administration of this program, by which all physicians‟ practices will be
             reviewed once every five years by surveys and other means as adopted by the
             Committee;

      (b)    The development and administration of processes for practice-based audits of
             physician performance, which may include:
             (i)     Review of their medical records;
             (ii)    Personal interviews
             (iii)   Discussion of case management
             (iv)    Review of recent continuing medical education
             (v)     Inspection of physical office premises; and/or
             (vi)    Interview of office staff members.

      (c)    The development and administration of processes for individualized
             assessments of professional competence by examination, which may address:
             (i)     Medical knowledge and skills;
             (ii)    Communication skills
             (iii)   Mental & physical health; and/or
             (iv)    Professional role including ethics, office management and
                     professional relations.

      (d)    The development and administration of processes for further action by a
             physician which may include:
             (i)     Completing a course of self-directed study;
             (ii)    Satisfactorily completing a course of study in a specified educational
                     program(s);
             (iii)   Satisfactorily completing a course of training in a specified hospital or
                     office setting.

(9)   The Committee shall be authorized to:

      (a)    Review information about the competence and performance of individual
             physicians and prepare a report describing the review conducted, the findings
             of the Committee and its directive;

      (b)    Direct said physicians in accordance with section 35(2) and section 36(3) of
             the Act;
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                                     Issued January 2, 2006
                                 Replaces January 4, 2005 Issue                           61
       (c)     Refer a physician‟s name to the Investigation Chair in the circumstances
               described in section 36(5) of the Act.

(10) The Committee shall report to the Council on its activities and programs of
assessment at such times and in such manner as the Act or the Council may from time to
time direct.

(11) The Committee will select the members of the College to be assessed and in doing so
will endeavor to have due regard for the distribution of medical practitioners in the Province
and the differences in practice and specialties to the end that the benefits of the service
performed by the Committee may be fairly extended to the public and members of the
College throughout the Province.

(12)   When the Performance Committee directs that a registered practitioner

       (a)     undergo individualized assessments of professional competence, as described
               in section 8(c) of these bylaws, or

       (b)     undertake further action, as outlined in section 8(d)(ii) or (iii) of these
               bylaws,

the Committee may require that registered practitioner to pay within a specified period of
time with or without conditions all or any of the costs attributable to each process, which
shall include:
               (i)     The fees paid for attendance and reasonable travelling expenses of the
                       Committee or a sub-committee;
               (ii)    Fees and travelling expenses paid to any persons appointed by the
                       Committee to make enquiry and report to the Committee;
               (iii)   The cost of any assessments conducted on the physician on the
                       direction of the Committee;
               (iv)    The cost of any retraining directed by the Committee;
               (v)     Legal representation of the Committee;
               (vi)    All other out-of-pocket expenses incurred, which shall include
                       reporting services, photocopying, long distance telephone calls, fax
                       and delivery services.

(13) A physician who is subject to a directive of the Committee may appeal within thirty
(30) days of the date of service of the directive on the physician or his counsel. The Appeal
Committee shall consist of a panel of three members of Council appointed for that purpose.

(14) The Appeal Committee when sitting from time to time may appoint from its
members a Chair.

(15) The Appeal Committee shall be paid the same fees and reasonable travelling
expenses as established annually by resolution of the Council for members of the Council.
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                                        Issued January 2, 2006
                                    Replaces January 4, 2005 Issue                            62
     (16) The appeal shall be founded on a copy of the report of the Committee and its
     directive to the physician.

     (17) The procedure in an appeal shall, with any necessary modifications, be conducted in
     accordance with section 65(1 to 4) of the Act.

     (18) The Appeal Committee on hearing the appeal may make a finding and issue an Order
     in accordance with section 38(6) of the Act.

     (19) The Appeal Committee may order the payment of all or any portion of the costs of
     the appeal process and hearing payable by the registered practitioner to the College within a
     period of time set by the Committee. Such costs shall include:
                    (i)      Fees and travelling expenses paid to Committee members;
                    (ii)     Legal representation of the Committee;
                    (iii)    Cost of court reporting services;
                    (iv)     All out-of-pocket expenses, which shall include photocopying, long
                             distance calls, fax and delivery services.

     (20) A registered practitioner who defaults in paying the costs ordered by the
     Performance Committee or the Appeal Committee within the time set by such Order or
     directive shall be suspended from the practice of medicine in the Province of Alberta until
     such costs are paid in full to the College.

                            ADVISORY COMMITTEE FOR PRIVILEGES

87   Operation
                                        Committee Constituted

     (1)     Pursuant to section 30 of the Medical Profession Act, the Council does hereby
     constitute an Advisory Committee for Privileges in approved hospitals, as designated
     pursuant to the Hospitals Act, to be known as the Advisory Committee for Privileges.

                                                 Purpose

     (2)     The purpose of the Committee is to advise on the appropriate standards of
     experience, training and qualifications for services to be provided by any registered
     practitioner in an approved hospital.

                                              Membership

     (3)     The Committee shall be composed of not more than nine (9) members all of whom
     shall be appointed by the Council. The Committee members shall include:

            (a)     two (2) rural general practitioners of whom at least one (1) must do either
                    surgery or anaesthesia;
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                                             Issued January 2, 2006
                                         Replaces January 4, 2005 Issue                           63
       (b)     two (2) certified specialists;

       (c)     a physician administrator from a Regional Health Authority, excluding the
               Capital Health Authority and the Calgary Health Authority;

       (d)     a representative of Post-graduate Medical Education from either the
               University of Alberta or the University of Calgary; and

       (e)     a member of Council.

(4)  The Chair of the Committee shall be selected annually by the members of the
Committee at the Committee‟s first meeting of the calendar year.

(5)     The Committee members shall be appointed in accordance with section 24(2) and
section 24(3) of the Bylaws.

                                           Objectives

(6)    The objectives of the Committee shall be:

       (a)     to respond to any request from a Regional Health Authority, or a Board of an
               approved hospital for advice on the assessment of a registered practitioner‟s
               training, experience and qualifications for the provision of services in an
               approved hospital for which privileges have been sought by the registered
               practitioner;

       (b)     to advise Council on the minimum level of training, experience and
               qualifications for services provided by registered practitioners in an approved
               hospital;

       (c)     to develop and maintain expertise in quality assurance and clinical audits.


(7)    The Committee has no authority to grant or reject a registered practitioner‟s
application for privileges at an approved hospital.

                                            Quorum

(8)  Quorum of the Committee shall consist of fifty percent (50%) of the Committee
membership.

                                                Voting

(9)    A motion may be passed by simple majority of the members of the Committee
present at the meeting.

(10)    In the event of a tie vote, the Chair shall have a second and deciding vote.

                                            Meetings
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                                        Issued January 2, 2006
                                    Replaces January 4, 2005 Issue                           64
(11)   The Committee shall meet on a quarterly basis or at the call of the Chair.

                                Investigation and Reporting

(12) When the Committee receives a request for advice, the Committee shall obtain the
information and records it requires to assess the request for advice and to provide the advice
within a reasonable period of time.

(13) The Committee shall not provide advice unless it has been provided with all of the
information and records it requires to fully assess the issues relating to the request for
advice.

(14) The Committee shall provide its written advice to the requesting party and to the
physician who is seeking privileges in the approved hospital within a reasonable period of
time.

(15) Following each meeting, the Committee shall report to the Council at the next
meeting of Council.

(16) The Council may, at any time, require the Committee to report to Council on any
matter, policy or function of the Committee.

(17) The Committee may report any matter, conduct or thing to the Investigation Chair
that comes to the attention of the Committee in consideration of and response to a request
for advice.

(18) The advice shall relate only to the Committee‟s assessment of the registered
practitioner‟s training, experience and qualifications as it relates to the provision of the
services in an approved hospital for which privileges have been sought by the registered
practitioner.

(19) In developing and providing its advice, the Committee may consider factors relevant
to the request for advice including, but not limited to:

       (a)     the policies of Council,

       (b)     the training, experience and qualifications of the registered practitioner,

       (c)     the extent of local resources in the approved hospital, and

       (d)     the community‟s need for a particular service.

(20) The geographical location of a community shall not be considered a factor affecting
the standard by which the registered practitioner and the proposed services shall be assessed.

                                          Subcommittee

(21) The Committee may appoint an ad hoc subcommittee to investigate and provide
information to the Committee on a particular issue relating to a request for advice. The
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                                        Issued January 2, 2006
                                    Replaces January 4, 2005 Issue                             65
     membership, terms of reference and the term of the subcommittee shall be established by the
     Committee.

                                                  Fees

     (22) The Advisory Committee for Privileges shall charge the fees outlined in section
     32(23) of these bylaws.

                                 PROFESSIONAL CORPORATION

88   Registrar's records
     (1)    The Registrar shall keep and maintain a register of professional corporations
     containing the following information:

            (a)     the name and registered office of the professional corporation, its address and
                    the number on the register assigned to it,

            (b)     the date of issue of the permit to the professional corporation,

            (c)     the date of renewal of the permit of the professional corporation, and

            (d)     any other particulars that may be directed by the Council or the Executive
                    Committee.

     (2)    The Registrar shall prepare any other records with respect to the professional
     corporation that the Council or the Executive Committee may direct.

89   Articles of incorporation
     (1)     A registered practitioner or registered practitioners proposing to incorporate a
     professional corporation may submit to the Registrar an executed Articles of Incorporation,
     containing the name approved by the Registrar of Corporations, and if the Registrar is
     satisfied that

            (a)     each of the incorporators signing the Articles of Incorporation is a registered
                    practitioner of the College,

            (b)     the name contained in the Articles of Incorporation is the name by which a
                    professional corporation may be known, and

            (c)     there is no restriction on the business which the professional corporation may
                    carry on which would in any way restrict its ability to engage in every phase
                    and aspect of rendering medical services to the public that a registered
                    practitioner of the College is authorized to render, and the professional
                    corporation has, by law or by virtue of its incorporating documents, the
                    capacity to carry on the business and exercise the powers set out in the
                    Schedule to the Medical Profession Act,

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                                            Issued January 2, 2006
                                        Replaces January 4, 2005 Issue                           66
       he shall endorse on the original and duplicate copy of the Articles of Incorporation, the
       following:
               "Each of the incorporators signing the within Articles of Incorporation is a
               registered practitioner of the College of Physicians and Surgeons and the
               within Articles of Incorporation for this professional corporation are
               satisfactory in form and in substance to the Registrar of the College of
               Physicians and Surgeons of the Province of Alberta."

       (2)    After the Registrar has endorsed the Articles of Incorporation in accordance with
       subsection (1), he shall return them to the registered practitioner or practitioners who
       submitted them.

90     Information to Registrar
       (1)     An applicant for a permit under section 75 of the Act shall furnish to the Registrar

               (a)    an application in Form D in the Schedule,

               (b)    a copy of the Certificate of Incorporation certified correct by the Registrar of
                      Corporations, and

               (c)    payment of the fee, the amount of which is prescribed by section 32.

       (2)     A professional corporation shall inform the Registrar of any change in the particulars
       set forth in the application furnished pursuant to subsection (1) by providing to the Registrar
       a Statement of Particulars in Form E in the Schedule within 15 days of the change.

       (3)    A Statement of Particulars in Form E may be submitted to the Registrar by electronic
       format that is satisfactory to the Registrar.

91     Certificate
       When the Registrar has issued a permit pursuant to section 75 of the Act, he shall furnish to
the permit holder a Certificate in Form F in the Schedule.
92     Renewal of permit
       (1)    The Registrar shall, on or before November 1 in each year, mail to each professional
       corporation then holding a permit, a written notice in Form G in the Schedule respecting the
       renewal of its permit.

       (2)    Every professional corporation that wishes to have its permit renewed for the
       following calendar year shall submit to the Registrar on or before December 31 in each year.

               (a)    a Statement of Particulars in Form E in the Schedule, and

               (b)    the renewal fee in the amount prescribed by section 32 (16).

       (3)     When a corporation has filed the material under subsection (2) and has paid the
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                                               Issued January 2, 2006
                                           Replaces January 4, 2005 Issue                          67
       required renewal fee, the Registrar shall, if he is satisfied with respect to the matters
       described in section 75 of the Act, issue an annual renewal certificate to the professional
       corporation in Form H in the Schedule.

       (4)     The Registrar shall promptly

               (a)     enter on the register a memorandum with respect to the name of a
                       professional corporation whose permit has expired, and

               (b)     notify the professional corporation and registered practitioners concerned and
                       all other parties considered necessary by the Council that the permit of the

       professional corporation has expired.

93     Names
       (1)    The name of a professional corporation shall contain only the surnames, or the
       surnames and any combination of the given names or initials, of one or more members of the
       College, living or deceased, who are or were shareholders of the corporation, or whose
       names appeared in the name of any practice acquired by the corporation, followed by
       "Professional Corporation".

       (2)     Except as provided in subsection (3), a professional corporation shall carry on the
       practice of medicine under its corporate name.

       (3)     A professional corporation may carry on the practice of medicine in partnership
       under a firm name that does not contain its full corporate name, if the firm name is in
       accordance with the standards of professional conduct promulgated by the Council and the
       full corporate name of each professional corporation that is a member of the partnership is
       shown on the letterhead used by that professional corporation.

94      Reinstatement after suspension
        When the Council has ordered the permit of a corporation to be suspended for a stated
period of time under section 82(3)(b) of the Act, the permit shall be reinstated at the conclusion of
that period if the Registrar is satisfied that the corporation has
               (a)     paid the fine or costs, if any, that the Council has ordered it to pay within the
                       period of time fixed by the Council for the payment,

               (b)     paid the renewal fee for the year in which the permit is reinstated if the fee
                       has not already been paid by it, and

               (c)     complied with all conditions set by the Council for the reinstatement.

95     Reissue after revocation
       A permit revoked by order of the Council may be reissued if the Registrar is satisfied
               (a)     that all conditions prescribed by the Council pursuant to section 66(6) of the
                       Act have been complied with, and
                                      _____________________________________
                                               Issued January 2, 2006
                                           Replaces January 4, 2005 Issue                            68
            (b)     as to all matters described in section 75(1)(b) to (g) of the Act.

96   Liability for payment of fees
     (1)     Every professional corporation is primarily liable for the payment of the annual
     licensing fee prescribed in section 32 (16) in respect of each member of the College who is a
     shareholder in the corporation.

     (2)    Except as otherwise provided in subsection (3), a registered practitioner who is a
     shareholder in a professional corporation is not liable to pay the annual licensing fee.

     (3)     If a professional corporation fails to pay the annual licensing fee within the
     prescribed time, each registered practitioner who is a shareholder in the professional
     corporation and in respect of whom the corporation is primarily liable under subsection (1),
     shall, notwithstanding subsection (2), be liable for payment of that fee.

     (4)     If a professional corporation has paid an annual licensing fee in respect of a
     registered practitioner who is a shareholder of that corporation, that registered practitioner is
     not liable, on ceasing to be a shareholder in that corporation, to pay an annual licensing fee
     for the year for which that corporation has paid the fee in respect of him.

     (5)    If a registered practitioner has paid an annual licensing fee before becoming a
     shareholder in a professional corporation, that professional corporation is not liable to pay
     an annual licensing fee for the year for which he has paid the fee.

                   PRACTICE OF MEDICINE BY TELECOMMUNICATION
                       ACROSS PROVINCIAL BOUNDARIES

97   Operation
                                               Definitions

     (1)    In this section “telemedicine” means:

            (a)     The provision of a medical opinion concerning diagnosis or treatment of a
                    patient in Alberta by a physician located outside of Alberta as a result of
                    transmission of individual patient information by electronic or other means
                    from within Alberta to such physician or his or her agent; or

            (b)     The provision of treatment to a patient in Alberta by a physician located
                    outside of Alberta as a result of transmission of individual patient information
                    by electronic or other means from within Alberta to such physician or his or
                    her agent.

                                                Licensing

     (2)     When a medical opinion or treatment are provided by means of telemedicine to a
     patient in Alberta, that medical opinion or treatment is deemed to have been provided at the

                                    _____________________________________
                                             Issued January 2, 2006
                                         Replaces January 4, 2005 Issue                           69
patient's geographic location.

(3)     No person shall engage in the practice of telemedicine in Alberta or shall hold
himself or herself out as qualified or licenced to practice telemedicine in Alberta unless he
or she is actually so licensed in accordance with the provisions of these bylaws.

(4)    In order to practice telemedicine in Alberta, a registered practitioner's name must
appear on the Alberta Medical or Special Register.

(5)    The Registrar shall enter in the appropriate Register the name, address, telephone
number and facsimile number of each physician who wishes to practice telemedicine in
Alberta upon that physician fulfilling the requirements of sections 20 and 29 of the Medical
Profession Act (Alberta).

                           Conditions of Practice of Telemedicine

(6)     In addition to the ethical and professional duties and obligations of a registered
practitioner, each registered practitioner permitted to practice telemedicine in Alberta shall
unconditionally attorn to the jurisdiction of the College concerning any and all matters
arising from or relating to that registered practitioner‟s practice of telemedicine in Alberta.

(7)    The failure or refusal by a registered practitioner to attorn to the jurisdiction of the
College for any matter arising from or relating to the registered practitioner‟s practice of
telemedicine may constitute unbecoming conduct.

(8)     A registered practitioner located in Alberta who provides a medical opinion or
treatment by electronic or other means to a patient located outside of Alberta shall do so
only in conformance with any licensing or registration requirements of the jurisdiction
where the patient is located, and the failure to do so may constitute unbecoming conduct in
Alberta.

(9)    A physician shall not provide treatment and consultation recommendations,
including issuing a prescription, by way of electronic or other means, unless the physician
has obtained a history and physical examination of the patient adequate to establish a
diagnosis and identify underlying conditions and/or contrary indications to the treatment
recommended or provided except in the following circumstances:
               (i)     in an emergency
               (ii)    treatment provided in consultation with another physician who has an
                       ongoing relationship with the patient and who has agreed to supervise
                       the patient‟s treatment, including use of any prescribed medication; or
               (iii)   on-call or cross-coverage situations in which the physician has access
                       to patient records.

                                            Exemptions

(10)   A physician who practices telemedicine in Alberta in the case of an emergency or

                                 _____________________________________
                                          Issued January 2, 2006
                                      Replaces January 4, 2005 Issue                          70
     less than three times in a calendar year is not subject to the provisions of these bylaws, or

     (11) A physician who practices telemedicine in Alberta for which the physician receives
     no compensation of any kind is not subject to the provisions of these bylaws.

                   TRIPLICATE PRESCRIPTION PROGRAM COMMITTEE

98   Operation
     (1)   Pursuant to its duties under the Medical Professions Act to direct and regulate the
     medical profession, the Council has established a Triplicate Prescription Program.

            (a)     The mandate of the Triplicate Prescription Program (hereinafter referred to as
                    the Program) includes the following:
                    (i)     to provide relevant information to registered practitioners on the
                            prescribing of TPP Drugs;
                    (ii)    to liaise with other health and professional organizations with a stake
                            in the operation of the Triplicate Prescription Program;
                    (iii)   to collect and collate data, including information and clinical records
                            concerning the use of TPP Drugs for any patient or patients, in a
                            prescription database.

     (2)    The Council has established the Triplicate Prescription Program Standing Committee
     (hereinafter referred to as the Committee).

            (a)     The Committee shall consist of 3 voting members, who are appointed by the
                    Council in accordance with Section 24 of the Bylaws.

            (b)     The Committee shall advise Council on policies for the operation of the TPP
                    and report to Council as may be requested by council from time to time.

            (c)     The Committee shall, on behalf of Council, establish a list of drugs governed
                    by the Triplicate Prescription Program (hereinafter referred to as the TPP
                    Drugs), that may be amended from time to time.

            (d)     The Committee may release information to the public in a form that prevents
                    the identification of an individual patient or practitioner.

            (e)     The Committee shall develop policies modeled on the Health Information
                    Act for the disclosure of individually identifying health information.

     (3)     The Registrar may, on behalf of Council, review the prescribing of TPP Drugs by
     registered practitioners by reviewing the prescription database of TPP Drugs and the clinical
     records pertaining thereto created by any registered practitioner.

            (a)     A registered practitioner shall provide the Registrar with information and
                    clinical records concerning the prescribing of TPP Drugs to any patient or
                                    _____________________________________
                                             Issued January 2, 2006
                                         Replaces January 4, 2005 Issue                              71
                     patients when requested by the Registrar.

             (b)     A registered practitioner who fails or refuses to provide the information or
                     records requested by the Registrar may be guilty of unbecoming conduct.

             (c)     The Registrar may refer concerns that are not resolved between the Registrar
                     and a practitioner in regard to the prescribing of TPP Drugs by any
                     practitioner to the Investigation Chair for review.

             (d)     The Registrar may provide TPP drug profiles to practitioners who are
                     involved in the care of the patient to whom the information pertains.

             (e)     The Registrar may provide TPP drug profiles to other regulatory agencies
                     including but not limited to Alberta College of Pharmacists, the Alberta
                     Dental Association and College, and the Alberta Veterinary Medical
                     Association, and members of the Federation of Medical Licensing
                     Authorities of Canada where those profiles contain information relevant for
                     practitioners registered with those agencies.

99   Disclosure of Confidential Information
     (1)    Notwithstanding Section 17 of the Act, the Registrar may disclose information,
     including records, to a custodian, as defined in Sections 1(f)(i), (iii), (iv) and (vii) of the
     Health Information Act, RSA 2000, for the purpose of an investigation, discipline
     proceeding, practice review or an inspection, if:

             (a)     The custodian has complied with any other enactment authorizing or
                     requiring the custodian to obtain or receive that information for that purpose;
                     and

             (b)     The custodian agrees in writing:
                     (i)       to not disclose the information to any other person except as
                               authorized by or under an enactment; and
                     (ii)      to destroy the information:
                                (A)      at the earliest opportunity if the investigation, discipline
                            proceeding, practice review or inspection is abandoned; or
                                (B)      at the earliest opportunity after a final decision has been made
                            relating to the investigation, discipline proceeding, practice review or
                            inspection, including any decision made by a body authorized to hear
                            appeals.
     (2)    Notwithstanding Section 17 of the Act, the Registrar may disclose information,
     including records, concerning a significant mishap, as that expression is defined in Section
     17(1) of the Health Care Protection Regulation, Alberta Regulation 208/2000, occurring at
     an approved surgical facility, as that expression is defined in Section 29(b) of the Health
     Care Protection Act, RSA 2000, to the regional health authority, provincial health board or
     the Alberta Cancer Board, as the case may be, with which the operator of the approved
                                       _____________________________________
                                                Issued January 2, 2006
                                            Replaces January 4, 2005 Issue                             72
       surgical facility has an agreement governed by the Health Care Protection Act, RSA 2000.

100    Reporting of Blood Borne Infections
       (1)    A registered practitioner who knows that he or she is positive for a transmissible
       blood borne infection shall notify the registrar immediately of that information.

       (2)    Applicants to any register of the CPSA who have tested positive for a transmissible
       blood borne infection shall report that information on their application form.

       (3)     Registered practitioners referred to in (1) or (2) above shall comply with the
       registrar‟s directions pertaining to the monitoring of their medical condition and restrictions
       on their practice.


101    Repeal

     The By-laws of the College of Physicians and Surgeons of Alberta (Alta. Reg. 23/88 with
amendments up to and including Alta. Reg. 336/90) are repealed.




                                      _____________________________________
                                               Issued January 2, 2006
                                           Replaces January 4, 2005 Issue                          73
                                               SCHEDULE
                                                 FORM A
                                         NOMINATION PAPER



        We, the undersigned, being eligible to vote in District No. _____ and members in good
standing of the College of Physicians and Surgeons of Alberta, hereby nominate
__________________________ of __________________________ for election as member of this
Council of the College of Physicians and Surgeons for District No. _____ at the election to be held
on the _____ day of ________________________, 20_____.

       Signed __________________________ Address _____________________________

       Signed __________________________ Address _____________________________

       Signed __________________________ Address _____________________________

        I, _______________________ of __________________________, being a resident
practitioner in good standing of District No. _____, accept the nomination and hereby authorize the
Registrar of the College of Physicians and Surgeons to place my name on the ballot paper for the
election of Councillor for the term beginning January 1, 20____.

       DATED __________________________ SIGNED ________________________________




                                     _____________________________________
                                              Issued January 2, 2006
                                          Replaces January 4, 2005 Issue                         74
                                         FORM B
                        COLLEGE OF PHYSICIANS AND SURGEONS
                            OF THE PROVINCE OF ALBERTA
                                     INSTRUCTIONS TO VOTERS
                                         DISTRICT NO. ________
       Attached is a ballot paper showing the list of candidates for election to Council for District
No. 2. For the purpose of election, the district includes the following:

                                    EDMONTON (or as the case may be)

       Only those members who have a mailing address as recorded in the office of the College,
which is within the district, and whose fees have been paid for the year 20___, and are in good
standing are entitled to vote.

        Ballots must be marked with an "X" indicating the choice of candidate or candidates.
        The ballot must be returned to the Registrar in the enclosed envelope not later than 4:00 p.m.
on the _____ day of ___________________________________________, 20_____.


                                                      _____________________________________
                                                      Registrar


       Edmonton, Alberta


       _____ day of ___________________________________________________, 20_____.




                                      _____________________________________
                                               Issued January 2, 2006
                                           Replaces January 4, 2005 Issue                          75
                                     FORM C


                                    BALLOT


DONALD, Edward Ferris                               Edmonton
KELLY, John Ross                                    Edmonton

                                                        (or as the case
                                                               may be)




                        _____________________________________
                                 Issued January 2, 2006
                             Replaces January 4, 2005 Issue               76
                                                 FORM D


                           COLLEGE OF PHYSICIANS AND SURGEONS
                            OF THE PROVINCE OF ALBERTA


                                   APPLICATION FOR A PERMIT


                                              (Section 75(1))
                                         Medical Profession Act



       ____________________________________________ Professional Corporation, with
Registered Office at _______________________, in the ___________________________
       of __________________________, in the Province of Alberta, hereby applies for a permit
under section 75(1) of the Medical Profession Act.

       1.     Annexed to this application are:
             (a)    a copy of the corporation's Certificate of Incorporation certified correct by the
                    Registrar of Corporations;
             (b)    payment of the fee prescribed by section Error! Reference source not
       found.Error! Reference source not found. of the By-laws.

2.     The name of the corporation is ______________________________________ Professional
       Corporation.

3.     There is no restriction on the business which the professional corporation may carry on
       which would in any way restrict its ability to engage in every phase and aspect of rendering
       medical services to the public that a registered practitioner of the College of Physicians and
       Surgeons of the Province of Alberta is authorized to render, and the professional corporation
       has, by law or by virtue of its incorporating documents, the capacity to carry out on the
       business and exercise the powers set out in the Schedule to the Medical Profession Act.

4.     The corporation is in good standing with the Registrar of Corporations under the Business
       Corporations Act.

5.     The persons who are the incorporators and shareholders of the corporation, each of whom is
       a registered practitioner of the College of Physicians and Surgeons of the Province of
       Alberta are:


            Name                              Address                        No. and Class of Shares
                                     _____________________________________
                                              Issued January 2, 2006
                                          Replaces January 4, 2005 Issue                               77
        6.      The persons for whom any issued shares of the corporation are held in trust, and the
trustee of them, each of whom is a registered practitioner of the College of Physicians and Surgeons
of Alberta, are:

     Trustee               Address          Beneficial Owner           Address          No. and Class of
                                                                                        Shares in Trust


7.      The persons who are directors of the corporation, each of whom is a registered practitioner of
the College of Physicians and Surgeons of the Province of Alberta, are:

                          Name                                                   Address


       8.       Each of the persons who will carry on the practice of medicine on behalf of the
corporation is a registered practitioner of the College of Physicians and Surgeons of the Province of
Alberta.

        9.      The corporation hereby undertakes with the College of Physicians and Surgeons of
the Province of Alberta that it will at all times, while it is the holder of a subsisting permit, well and
faithfully keep and perform all of its obligations as a medical practitioner and all of the rules and
requirements of the College of Physicians and Surgeons of the Province of Alberta.

       DATED AT__________________________________________, in the Province of Alberta,
this _____ day of ________________________________, 20_____.

                                                     ________________________________              C/S
                                                     Applicant


                                        MEMBER'S CERTIFICATE



        I, ___________________________________________________, a registered practitioner
of the College of Physicians and Surgeons of the Province of Alberta and a director of the above
named applicant, hereby certify to the College of Physicians and Surgeons of the Province of
Alberta that the information and particulars contained in sections 2 to 8, inclusive, of the within
application are true and complete.


                                                     _______________________________________



                                       _____________________________________
                                                Issued January 2, 2006
                                            Replaces January 4, 2005 Issue                             78
                                                    FORM E


                             COLLEGE OF PHYSICIANS AND SURGEONS
                              OF THE PROVINCE OF ALBERTA


                                    STATEMENT OF PARTICULARS
1.
     Name of Corporation:                                                            Professional Corporation
     Registered Address of Professional
     Corporation:
     Alternate Address:


     To which address do you wish to have your Professional Corporation invoice directed (choose
     one):
                                 Registered Address         Alternate Address

 2. There is no restriction on the business which the professional corporation may carry on which
    would in any way restrict its ability to engage in every phase and aspect of rendering medical
    services to the public that a registered practitioner of the College of Physicians and Surgeons of
    the Province of Alberta, is authorized to render, and the professional corporation has, by law or
    by virtue of its incorporating documents, the capacity to carry on the business and exercise the
    powers set out in the Schedule to the Medical Profession Act.

 3. The corporation is in good standing with the Registrar of Corporations under the Business
    Corporations Act.

 4. The persons who are the incorporators and shareholders of the corporation, each of whom is a
    registered practitioner of the College of Physicians and Surgeons of Alberta, are:

             Names of Incorporators/Shareholders:                     Number and Class of Shares Held:




 5. The person for whom any issued shares of the corporation are held in trust, and the trustee of
    them, each of whom is a registered practitioner of the College of Physicians an Surgeons of
    Alberta, are:

     Trustee:                      1)                                           2)

                                        _____________________________________
                                                 Issued January 2, 2006
                                             Replaces January 4, 2005 Issue                          79
   Address of Trustee:

   Beneficial Owner:

   Address of Beneficial
   Owner:

   Number and Class of
   Shares in Trust:

6. The persons who are directors of the corporation, each of whom is a registered practitioner of the
   College of Physicians and Surgeons of the Province of Alberta, are:

   Name:                                                   Address:




7. Each of the persons who will carry on the practice of medicine on behalf of the corporation is a
   registered practitioner of the College of Physicians and Surgeons of the Province of Alberta.



I, __________________________________, a registered practitioner of the College of Physicians
and Surgeons of the Province of Alberta and a director of the corporation, hereby certify to the
College of Physicians and Surgeons of the Province of Alberta that the within contained
information and particulars respecting the corporation are true and complete.


DATED AT ___________________________________ , in the Province of Alberta, this
________________ day of _______________________________________ , 20 _____ .




                                                                             Director




                                              NOTE:
        PERMIT WILL NOT BE ISSUED UNTIL WE ARE IN RECEIPT OF YOUR
                        PAYMENT AND THE COMPLETED FORM E.

                                     _____________________________________
                                              Issued January 2, 2006
                                          Replaces January 4, 2005 Issue                         80
                                                FORM F
                          COLLEGE OF PHYSICIANS AND SURGEONS
                           OF THE PROVINCE OF ALBERTA
                                            CERTIFICATE


       I, ________________________________________________________, Registrar of the
College of Physicians and Surgeons of the Province of Alberta, HEREBY CERTIFY that
_______________________________________________________________ Professional
Corporation has become entitled to practise medicine and has complied with the provisions of the
Medical Profession Act and the Rules of the College of Physicians and Surgeons of the Province of
Alberta.

      IN WITNESS WHEREOF I have hereunto affixed the seal of the College of Physicians and
Surgeons of the Province of Alberta this _____ day of ___________________________, 20_____.



                                                    _________________________________
                                                    Registrar of the College of Physicians
                                                    and Surgeons of the Province of Alberta




                                    _____________________________________
                                             Issued January 2, 2006
                                         Replaces January 4, 2005 Issue                       81
                                               FORM G
                          COLLEGE OF PHYSICIANS AND SURGEONS
                           OF THE PROVINCE OF ALBERTA
                         NOTICE RESPECTING RENEWAL OF PERMIT


       TAKE NOTICE that your permit issued pursuant to section 75 of the Medical Profession
Act expires on December 31st, 20_____.

       AND FURTHER TAKE NOTICE that if you wish to have your permit renewed for the next
calendar year, you must furnish to the Registrar on or before the 1st day of December, 20_____,

            (a)      a Statement of Particulars in Form E, and
            (b)      payment of the renewal fee in the sum of $______________ per physician
       member.



                                                   _____________________________________
                                                   Registrar




                                   _____________________________________
                                            Issued January 2, 2006
                                        Replaces January 4, 2005 Issue                        82
                                             FORM H
                        COLLEGE OF PHYSICIANS AND SURGEONS
                         OF THE PROVINCE OF ALBERTA
                            ANNUAL RENEWAL CERTIFICATE



      THIS IS TO CERTIFY THAT

        __________________________________________________ Professional Corporation is
entitled to practise medicine in the Province of Alberta for the year 20_____


                                         ___________________________________________
                                         COLLEGE OF PHYSICIANS AND SURGEONS
                                         OF THE PROVINCE OF ALBERTA



                                        PER:     ______________________________________
                                                            Registrar




                                 _____________________________________
                                          Issued January 2, 2006
                                      Replaces January 4, 2005 Issue                 83