The College of Physicians and Surgeons of Ontario (CPSO) regulates physicians under the Regulated Health Professions Act and its own Code. A complaint is reviewed by the Inquiries, Complaints and Reports Committee (ICRC), which can take no action, require remediation, issue a caution, or refer the matter to the Discipline Committee for a public hearing. Only a relatively small share of complaints progress to a full public hearing. Outcomes at a hearing range from no finding to reprimand, terms and conditions, suspension, or revocation, and certain findings — including sexual abuse findings — trigger mandatory revocation under the Act.
- A CPSO complaint is first reviewed by the Inquiries, Complaints and Reports Committee (ICRC), not sent straight to a public hearing.
- The ICRC can resolve a complaint through no action, remediation, a caution, or specified terms, without it ever becoming public in the same way a hearing decision would.
- Only a relatively small proportion of complaints are referred to the Discipline Committee for a full public hearing.
- Hearing outcomes range from no finding to reprimand, terms and conditions, suspension, or revocation, depending on the seriousness of the finding.
- Sexual abuse findings involving a patient trigger mandatory revocation under the Regulated Health Professions Act, with limited exceptions.
- How a physician responds at the ICRC stage — before any hearing referral — often determines whether the matter escalates at all.
The Short Answer
The College of Physicians and Surgeons of Ontario handles physician complaints through a staged process: initial review by the Inquiries, Complaints and Reports Committee, with only a minority of matters ever reaching a full, public Discipline Committee hearing. Understanding which stage a complaint is actually at — and that most never escalate to a hearing — changes how it should be approached.
Who Can File a Complaint
Complaints can originate from patients, colleagues, hospitals, or other institutions. Certain parties — including hospitals and, in specific circumstances, other health professionals — are also subject to mandatory reporting obligations that can trigger a CPSO review independent of a traditional patient complaint. See our general guide on employer reporting obligations in Ontario for how this reporting duty generally operates across regulated professions.
The ICRC: Where Most Complaints Are Resolved
The Inquiries, Complaints and Reports Committee is where the large majority of complaints are actually resolved. This committee can decide to take no further action, require the physician to undergo remediation such as additional education or training, issue a caution (oral or written), or impose specified terms, conditions, or limitations on the physician's practice — all without the matter necessarily becoming a public hearing decision.
Only a relatively small proportion of complaints that reach the ICRC are ultimately referred to the Discipline Committee. This matters practically: the ICRC stage is often where the real outcome of a complaint is actually decided, which is why the physician's response at this early stage carries significant weight.
Referral to the Discipline Committee
Where the ICRC considers the allegations serious enough, it can refer the matter to the Discipline Committee for a formal hearing. This follows a structure broadly similar to discipline hearings at other Ontario regulatory colleges, with the College required to prove the allegations and the physician entitled to respond and be represented.
Possible Outcomes at a Hearing
Outcomes range widely depending on the findings: no finding of misconduct at all, a reprimand, terms and conditions placed on the certificate of registration, suspension for a defined period, or, in the most serious cases, revocation. See our guide on what happens when a professional licence is revoked in Ontario for what that outcome specifically means going forward.
Mandatory Revocation for Sexual Abuse
Certain findings carry no discretion at all. Where a finding of sexual abuse of a patient meets the criteria defined under the Regulated Health Professions Act, revocation is mandatory, and an interim suspension typically applies immediately once such a finding is made, even before the penalty portion of the hearing concludes. Our dedicated guide on mandatory revocation for sexual abuse findings in Ontario covers this specific, serious category in depth.
What to Do If You Are Under Investigation
Respond to any ICRC inquiry carefully and completely, since this stage is where most complaints are actually resolved. Review our guide on responding to a college complaint in Ontario for general principles that apply across colleges, and get advice before submitting any written response. A serious finding also affects how long it stays on the public register, and if the matter involves a licensing question rather than discipline of an existing member, see our guide on good character hearings. Call 416-274-2222 for a free, confidential consultation.
Frequently Asked Questions
Complaints can come from patients, colleagues, hospitals, other institutions, or through mandatory reports that certain parties — including hospitals and other health professionals — are required to make in specific circumstances.
No. Most complaints are reviewed and resolved by the Inquiries, Complaints and Reports Committee without ever being referred to the Discipline Committee for a public hearing. Only a relatively small share of complaints progress that far.
The ICRC can take no further action, require the physician to complete remediation such as additional education, issue a caution (which can be oral or written), or impose specified terms, conditions, or limitations on the physician's certificate of registration.
The matter proceeds to a formal, generally public hearing process, similar in structure to other professional discipline hearings, where the College must prove the allegations and the Discipline Committee determines whether there was professional misconduct and, if so, what penalty applies.
Penalties range from no finding, to a reprimand, to terms and conditions on practice, to suspension, to revocation of the certificate of registration in the most serious cases.
For sexual abuse findings meeting the criteria set out in the Regulated Health Professions Act, revocation is mandatory, with very limited exceptions. An interim suspension can also apply immediately once such a finding is made, even before the penalty portion of a hearing is complete.
Given how much of the real resolution happens at the ICRC stage, before any hearing, getting advice early — rather than responding informally on your own — can meaningfully affect whether the matter escalates.