Health Law Blog

Clearing up the Confusion in Regulating Ontario’s Traditional Chinese Medicine Practitioners and Acupuncturists

September 23, 2015

In the Chinese culture, grandparents play an important and valued role. The time, support and care they extend to their families benefit not only those in their immediate care but the greater community as a whole. The same holds true in the practice of Chinese medicine when older generations of Chinese medicine practitioners, many of whom have learned their practice from ancestors and have honed their skills through years of experience, share their knowledge and expertise with patients as well as with younger colleagues. Unfortunately, in the process of regulating these health professionals, confusion abounds and puts some older practitioners at risk of losing the legal right to practice.

On April 1, 2013, Ontario became the second Canadian province to regulate traditional Chinese medicine when the College of Traditional Chinese Medicine Practitioners and Acupuncturists of Ontario (CTCMPAO), a self-regulatory body similar to the College of Physicians and Surgeons of Ontario, came into force. In line with their mandate to serve and protect the public, and in accordance with the laws of Ontario as defined by the Regulated Health Professions Act, the CTCMPAO requires that every practitioner be a registered member of the College. In order to legally use the titles of “traditional Chinese medicine practitioner” and/or “acupuncturist”, members must pass exams and meet rigorous educational requirements determined by the College, as well as meet registration requirements laid out in Ontario’s Traditional Chinese Medicine Act, 2006

From the outset, the CTCMPAO realized they faced a potential problem.  Ontario’s traditional Chinese medicine practitioners are a culturally diverse group who hail from all over the world and collectively speak over 78 different languages. For many, neither of Canada’s two official languages, English and French, is their first language. At the same time, both the Regulated Health Professions Act and the Traditional Chinese Medicine Act mentioned previously require registered health professionals, to speak, read and write, with reasonable fluency in either English or French. The College recognized that many practitioners, particularly older individuals, who are not fluent in either English or French would need some sort of accommodation. The solution was to devise various classes of registration including a Grandparented class. Rather than having to demonstrate language proficiency at time of registration, applicants who were grandfathered were permitted to use translators in order to meet other regulation requirements. One of these requirements is submitting a written language plan.

Despite many Chinese medicine practitioners having registered under the Grandparented classes, there remains a great deal of confusion as to what this entails and what needs to be done in addition to registering under this class. It is important that individuals who have applied for a Grandparented class certificate understand the following:

  • The Grandparented class of registration is only a temporary registration.
  • March 31, 2014 was the deadline to apply for certificates of registration in the Grandparented class.
  • If a member cannot fluently read and write and keep practice records in English or in French before April 1, 2018, their license will automatically be revoked and they will not be eligible under the current Regulations to continue to practice.
  • Because the Grandparented class of registration is only a temporary registration, in order to continue practicing, grandfathered members must transfer to a General class certificate.
  • In order to transfer to a General class certificate, members must:
  1. Successfully complete the Prior Learning Assessment (PLAR) Process no later than July 1, 2017.
  2. Submit their transfer application, once they have successfully completed PLAR, to the College no later than November 1, 2017.
  • Members who intend to transfer to the General class must do so no later than March 31, 2018. If Members have not transferred to the General Class by this date, their Grandparented class certificate will expire on April 1, 2018 and they will no longer be a member of the College.
  • For more detailed information, Members should consult the CTCMPAO website or refer to the Guide to Transfer from Grandparented Class to General Class and Guide to Complete PLAR.

Roughly one-fifth of the 2,100 individuals who have met the rigorous requirements to become registered Members of the College of Traditional Chinese Medicine Practitioners and Acupuncturists of Ontario hold a Grandparented class certificate. What a shame it would be if their experience, insight and skills were lost to their patients and to the profession as a whole simply because they failed to clear the final hurdles in this registration process.


Several years ago I was fortunate enough to have been selected as a Tremayne-Lloyd Fellow here at Western Law. I used the funds to finish a book and to begin work on a new one. It dawned on me far too late that I had never thanked you for that splendid gift. The new book is to be published by Harvard Press in 2010. The TTL Fellowships provided ritual seed capital for this project, which required me to spend a good deal of time and money at The National Archive in Washington. Again, with many thanks.

R. W. Kostal Professor of Law and History

Tracey Tremayne-Lloyd Health Law