In a recent decision, the Health Professions Appeal and Review Board (HPARB) reviewed the situation of a prospective registered practical nurse (RPN) who had become ineligible for registration into the profession after she failed the required Canadian Practical Nurse Registration Examination three times.
Registration as a nurse in Ontario is governed by Regulation 275/94 made under the Nursing Act. The Regulation requires the successful completion of a specified exam in order to become registered as a practical nurse. A prospective applicant is allowed three attempts to do so. This requirement is non-exemptible.
In 2017 the applicant in question (TS) sought to be registered as a registered practical nurse in the general class with the College of Nurses of Ontario. The College determined that she was eligible to write the required examinations being the Canadian Practical Nurse Registration Examination (the CPNRE). She tried on three occasions but failed each attempt. As a result, she was no longer eligible to write the CPNRE and become registered.
The College referred the application to the Registration Committee. TS was advised that she could make written submissions if she wished. She did so advising that she had been consumed by her personal situation. First, she was the primary caregiver to family members with serious health issues. Secondly, she advised that while preparing for her second attempt that her brother had died. His death caused a significant disruption in her life and affected her ability to prepare and focus for that exam.
The Committee considered her submissions but concluded that she had exhausted her three attempts and that they were not prepared to annul the second, or any other, attempt. She was accordingly refused registration as an RPN. Extenuating circumstances which would lead to the annulment of an exam must be conditions or situations that the applicant could not have predicted would occur or be unable to fully understand at the time of writing the exam.
TS sought a review of the College’s decision before HPARB. HPARB may, under the Health Professions Procedural Code (HPPC), being schedule 2 to the Regulated Health Professions Act (RHPA), make any of the following orders:
- Confirming the order below
- Direct the Registrar to issue a certificate of registration and to impose any terms, conditions and limitations if deems appropriate;
- Refer the matter back for further consideration together with reasons or recommendations it feels are warranted.
The second power above may only be exercised by the HPARB where it finds that the applicant has substantially qualified and finds that the Committee exercised its powers improperly. Secondly, the HPARB must not do so for an applicant who does not meet a non-exemptible registration requirement.
Submissions of TS
The applicant repeated her personal commitments and problems. She had passed a practice exam before her third attempt. She further had computer problems during the second and third attempt which caused her to lose focus, although she was still given the full time to complete her answers. She also provided evidence of good care and wished her education not to be wasted. Lastly, she described her ethnicity and the language and cultural problems that created for her.
The College was not persuaded that TS’s personal circumstances amounted to extenuating circumstances sufficient to annul the exam in that they were known to her when she was preparing and writing the exam. In response to the computer issues, the College advised that it hired invigilators to provide irregularity reports for each exam including any technical or personal issues. No such reports were made for TS during her final two exams. Further, they provided evidence from the invigilators that TS did not report any incidents during those two exams.
It is the College’s duty to protect the public interest. The College does so in part by establishing and maintaining the standards of qualifications for applicants to be issued a certificate for registration. The exam requirement was non-exemptible. There were no extenuating circumstances as defined by the College.
As for the extenuating circumstances, it is the responsibility of every applicant to assess their own ability and readiness to write the examination and when to write the exam. As for the computer difficulties, there was no evidence they had occurred. Further, they were raised for the first time before the Board. The Committee’s order below was therefore confirmed.
If you are a RPN or other regulated health professional and have questions about registration requirements, or would like to appeal a registration or other College decision contact Wise Health Law. Our exceptional Toronto health law lawyers focus exclusively on health and administrative law. We have significant trial and appellate experience and are passionate about helping medical professionals across the province understand and protect their legal rights. Contact us online, or at 416-915-4234 for a consultation.