Registration Policies & Guidelines

Policy RC-2 Full Registration – Educated in Canada

Date created: April 8, 2004
Date last approved: October 29, 2018
Date last reviewed (RC): October 1, 2018, September 13, 2019
Date last reviewed (Board): October 29, 2018, November 4, 2019
Category: Registration
File code: RC19/Policies/Rc-02_Full_Reg_Educated_In_Canada
Authority: HPA s.20; Bylaws s. 41(1) (2)

Purpose:

to clarify the full registration requirements for applicants educated within Canada, as outlined in section 41 of the CDBC bylaws.

Background:

Registration is granted through Registrar/Deputy Registrar review and approval of information submitted by the applicant, in accordance with policy Rc-08: “The Registrar’s Limited Authority to Act for the Registration Committee”.

Applicants who do not meet the requirements for CDBC bylaws section 41(1) or (2), may be considered for registration under:

  • bylaws section 41(3), and as outlined in the Registration Committee policy Rc-03: Full Registration – Substantial Equivalence; or
  • bylaws section 43, and as outlined in the Registration Committee policy Rc-04: Temporary Registration.

Applicants, during an emergency declared by the Registrar according to the criteria set by the Board, will be considered for emergency registration under section 42(1)(b) of the bylaws, as outlined in the Board policy Bd-24: Emergency Registration.

The Partnership on Dietetic Education and Practice (PDEP) oversees the Dietetics Education Accreditation Program in Canada, according to the Integrated Competencies for Dietetic Education and Practice (ICDEP).

Policy:

1) All applicants must demonstrate currency of dietetic knowledge, skills abilities and judgement as per policy Rc-06: Currency of Dietetic Knowledge, Skills, Abilities & Judgement

2) The application for registration must be fully completed using the CDBC’s online platform.

3) The completed application must include personal and contact information for the public register (per HPA section (21.2 (a))).
a) Name change documentation (such as an original, notarized or photocopied marriage certificate) is required if the applicant’s name is different from the name on the applicant’s transcript or practical training documentation.

4) Applicants must submit evidence of successful completion of a program listed in Schedule “E” of the bylaws. To be approved, programs must be:
a) at minimum, a bachelor’s degree, with a focus in dietetics, and
b) accredited by the PDEP Accreditation Council, at the time of an applicant’s graduation;
c) Evidence of successful completion includes authentic documentation for all years of post-secondary education for the dietetics degrees granted. Accepted “authentic” documentation include:
i) official transcripts sent directly to the College, from the academic institution; or
ii) official transcripts sent directly to the College from another Canadian dietetic regulator.

5) Applicants must submit evidence of successful completion of dietetic practical training programs.
a) Program granting institutions must be listed in Schedule “E” of the bylaws.
b) Program granting institutions must have Canadian dietetic accreditation status, awarded by the PDEP Accreditation Council, at the time of an applicant’s graduation.
c) Proof of an internship or practicum program includes:
i) official verification of internship completion sent directly to the College, from the Director of the accredited practical training program; or
ii) official verification of internship completion sent directly to the College, from another Canadian dietetic regulator where an applicant is currently registered; or
iii) inclusion, on an applicant’s transcript, of an accredited Canadian dietetic program.
d) Applicants whose practical training programs are not listed in Schedule “E” of the bylaws but have completed official Canadian self-directed programs which are pre-approved by Canadian dietetic regulatory bodies, must provide verification of completion of practical training in all practice areas, as listed in the ICDEP.

6) Evidence of successful completion of the Canadian Dietetic Registration Examination (CDRE). includes:
a) official exam results document sent by the testing agency; or
b) official copy of the exam result document sent to another Canadian dietetic regulator, by the testing agency, and forwarded to the College

7) Evidence of successful completion of the Jurisprudence Examination for Dietitians (JED) is a 100% score, in the CDBC’s online platform.

8) Applicants must submit evidence of good character as outlined in policy Rc-11: Good Character.
When applicable, applicants must apply to register for restricted activities, including proof of meeting qualifications in Schedule B and specific competencies, and report on continuing competence annually

9) A statutory declaration form must be signed, dated, and notarized by a notary public or lawyer registered, licensed or commissioned in Canada.

10) The criminal record check authorization section of the online application for registration must be completed and corresponding payment must be received, by the CDBC.

11) All fees, as specified in Schedule “D” of the bylaws, must be paid in full, prior to registration being reviewed and granted.

Policy RC-3 Full Registration – Substantial Equivalence

Date created: June 11, 2004
Date last approved: October 29, 2018
Date last reviewed (RC): October 1, 2018
Date last reviewed (Board): October 29, 2018
Category: Registration
File code: Rc18/Policies/Rc-03_Full_Reg_Substantial_Equivalence_Oct_29_18-FINAL
Authority: HPA s.20; Bylaws s. 41(3)

Purpose:

to clarify the registration eligibility requirements for applicants educated outside of Canada.

Background:

Registration is granted through Committee review and approval of a summary of the information submitted by the applicant, as compiled by the Registrar/Deputy Registrar.

  • All applicants who have successfully completed academic and practical training programs that are not listed in Schedule “E” of the bylaws must have their dietetic knowledge, skills, abilities and judgement assessed for currency and substantial equivalence to the Canadian Integrated Competencies for Dietetic Education and Practice (ICDEP). Such applicants will be granted Temporary Registration for up to one year (renewable once) if they:
  • have a combination of knowledge, skills, abilities and judgement which satisfy substantial equivalence to the academic and practical training programs listed in Schedule “E” of the bylaws; and
  • have successfully completed any academic and/or practical upgrading requirements as determined by policy Rc-15: Assessment for Substantial Equivalence and approved by the Registration Committee; and
  • meet all other requirements as specified in section 41(1) of the bylaws.

Policy:

1) All applicants must demonstrate currency of dietetic knowledge, skills abilities and judgement as per policy Rc-06: Currency of Dietetic Knowledge, Skills, Abilities & Judgement.

2) The Registration Committee will review and approve a summary of information submitted by an applicant, as compiled by the Registrar/Deputy Registrar. The summary will include details of an applicant’s:
a) Assessment for Substantial Equivalence results
b) academic education program; and
c) practical training program; and
d) volunteer or work experience relevant to dietetics.

3) Official application for registration documents that are not written in English must be translated into English by a certified translator, at the expense of the applicant.
a) To ensure authenticity, applicants must arrange for translated and official documents to be submitted by translators and institutions, directly to the College.
b) When official documents are not available from the applicant’s university or internship program due to war, political instability, civil unrest, catastrophic events, etc., the College will accept verified or notarized copies of official documents.
c) In very rare circumstances, if these documents are not available, CDBC staff must verify that documents are not attainable. Findings will be presented to the Registration Committee for review to determine if an Assessment for Substantial Equivalence may proceed.

4) An applicant’s academic credentials must be verified by a credential evaluation agency as being authentic and showing successful completion of post-secondary education equivalent to, at minimum, a Canadian bachelor’s degree, with a focus in dietetics.
a) Accepted credential evaluation agencies include the International Credential Evaluation Service (ICES), the International Qualifications Assessment Service (IQAS) or the World Education Services (WES).
b) To ensure authenticity, credential evaluation reports must be sent directly from the evaluating agency to the CDBC.

5) Academic education will be assessed as being substantially equivalent to programs listed in Schedule “E” of the bylaws if the Registration Committee determines that:
a) the academic program was assessed by a member of the Alliance of Canadian Dietetic Regulatory Bodies, as being equivalent to Canadian dietetic education.
i) Copies of official transcripts, translations, credential evaluations and education assessments containing the Regulatory Body’s official seal must be received directly from the Alliance member;
or
b) the academic program was previously assessed by the College’s Registration Committee as being substantially equivalent to a degree granted by a program listed in Schedule “E” of the bylaws. Copies of official transcripts, translations, credential evaluations and education assessments must be included in the application.

6) Practical training/internship programs will be assessed as being substantially equivalent to programs listed in Schedule “E” of the bylaws if the Registration Committee determines that:
a) the practical training/internship program was previously assessed by a member of the Alliance of Canadian Dietetic Regulatory Bodies as being substantially equivalent to Canadian practical training/internship programs.
i) Copies of official practical training/internship verification containing the Regulatory Body’s official seal must be received directly from the Alliance member;
or
b) the practical training/internship program was previously assessed by the College’s Registration Committee.
i) Copies of the official practical training/internship verification/attestations completed within three years of the Committee’s review date must be included in the applicant’s file.

7) The Registration Committee will determine requirements for academic upgrading for applicants who meet the minimum passing requirements of the Competence Self-Verification portion of the Assessment for Substantial Equivalence process (see policy Rc-15: Assessment for Substantial Equivalence).
a) Academic upgrading requirements must be completed according to policy Rc-06: Currency of Dietetic Knowledge, Skills Abilities and Judgement
b) Academic upgrading courses in clinical nutrition, population and public health nutrition and nutrition management must be completed prior to beginning practical training upgrading in these practice areas.

8) The Registration Committee will determine that academic upgrading requirements have been met by reviewing official transcripts and/or certificates for successfully completed courses.
a) Official transcripts and/or certificates must be sent directly from the granting institutions, to the CBDC.

9) The Registration Committee will determine requirements for practical training upgrading based on:
a) results of the Practical Assessment Interview portion of the Assessment for Substantial Equivalence (see policy Rc-15: Assessment for Substantial Equivalence); and
b) relevant work experience listed in the applicant’s current resume, that demonstrates completion of performance indicators of the ICDEP; and
c) formal practical training reports submitted by the applicant’s internship provider.

10) Practical training upgrading requirements must be Canadian experiences under the supervision of current, Canadian registered dietitians granted privileges equivalent to full registrants of the CDBC.
a) The number of practical training upgrading hours and areas of focus for this experience (clinical, management and population & public health) will complement the applicant’s practical training/internship and work experience.

11) The Registration Committee will determine that practical training upgrading requirements have been met by reviewing:
a) official documents verifying completion of the ICDEP (i.e. Professional Practice, Communication and Collaboration, Nutrition Care, Population and Public Health and Management); or
b) official CDBC attestation documents verifying that ICDEP and upgrading practice hours have been met.
i) attestation documents are completed by the applicant and signed by the dietitian supervisor.
c) all official documents must be sent directly from the granting supervisor or institution, to the CDBC.

12) All upgrading must be completed within the timeframe set by the Registration Committee, up to a maximum of 3 years.
a) In extenuating circumstances, an extension to the assigned upgrading period may be granted by the Registration Committee upon receipt and review of a written request from an applicant.

Policy RC-4 Temporary Registration

Date created: July 22, 2004
Date approved: July 28, 2004; June 26, 2017, March 19, 2018
Date last reviewed (RC): June 11, 2005, Jan 28, 2013; Sept 26, 2016, May 1, 2017, January 15, 2018, September 13, 2019
Date last reviewed (Board): June 26, 2017, March 19, 2018, November 4, 2019
Category: Registration
File code: RC19/Policies/Rc-04_Temp_Reg
Authority: HPA s.20; Bylaws s. 43, 45 and 55

Background:

In accordance with section 20 of the Health Professions Act, the Registration Committee must grant registration to every person who satisfies the requirements of the bylaws, applies for registration, and pays the required fees. Registration is granted through Committee review and approval of a summary of the information submitted by the applicant, as compiled by the Registrar.
The following policy is intended to clarify the temporary registration requirements outlined in sections 43, 45 and 55 of the bylaws.

Policy:

1) The application for registration form (Form #3) must be fully completed, including:
a) Personal and contact information for the public record.
b) Original or notarized name change documentation is required if the applicant’s name differs from the name on the applicant’s official transcript or practical training documentation.

2) Applicants must submit authentic evidence that the academic and practical training requirements have been met.
a) Authentic evidence of successful completion of an approved academic program is outlined in Board policy Bd-07; Criteria for Board Approval of Education Programs, and includes:
i) official transcripts sent directly to the College from all post-secondary academic institutions where courses or degrees were earned that contributed towards the degree granted in dietetics. The accredited dietetics education program that granted the degree must be listed in Schedule “E” of the bylaws; or
ii) official verification that the applicant’s academic education, including any required academic upgrading, is substantially equivalent to the Integrated Competencies for Dietetic Education and Practice (see Registration Committee policy Rc-03: Full Registration – Substantial Equivalence).
b) Authentic evidence of successful completion of a practical training program is outlined in Board policy Bd-07;Criteria for Board Approval of Education Programs, and includes
i) inclusion on the applicant’s official transcript of an accredited integrated (staged, coordinated) undergraduate program in dietetics that includes practical training. The integrated program must be listed in Schedule “E” of the bylaws; or
ii) inclusion on the applicant’s official transcript of an accredited combined masters or doctorate post-graduate program in dietetics that includes practical training. The combined program must be listed in Schedule “E” of the bylaws; or
iii) official verification that the applicant’s practical training, including any required academic upgrading, is substantially equivalent to the Integrated Competencies for Dietetic Education and Practice (see Registration Committee policy Rc-03: Full Registration – Substantial Equivalence); or
iv) from applicants who completed a Canadian “academic-only” bachelor, master or doctorate degree in dietetics:
(1) official verification of internship completion sent directly to the College, from the authorized signatory or head of an accredited Internship program listed in Schedule “E” of the bylaws; or
(2) official competency attestation documents that indicate completion of the practical competencies in the Integrated Competencies for Dietetic Education and Practice.
c) Applicants from integrated (also known as staged or coordinated) academic and practical training programs listed on Schedule “E” of the bylaws are considered eligible for Temporary registration if, prior to official transcripts being available:
i) an official letter is received from the education institution stating that the applicant has successfully completed all academic program requirements; and
ii) an official letter is received from the education institution, signed by the Director of the internship program or Course coordinator of the practical training courses, stating that the applicant has successfully completed all practical training requirements.

3) Determination of the applicant’s ability to “practice as a temporary registrant without any risk to public health and safety” will be made by the Registration Committee based on any information provided by the academic institution and/or practical training agencies.

4) A fully completed and signed criminal record check authorization form, with the correct payment, is required.

5) Fees, as specified in Schedule “D” of the bylaws, must be paid in full prior to the processing of the application.

6) Terms and conditions for practicing in the Temporary Registration class include:
a) not supervising dietitians in the Full Registration class as per section 43 (5) of the bylaws; and
b) not being appointed to or serving on any committee or panel of the College; and
c) not practicing as sole and private practitioner
d) using the title “Registered Dietitian – Temporary,” with the initials “RD (T),” as per section 43 (7) of the bylaws.

7) A Temporary Registrant wishing to practice as a sole and private practitioner may be permitted to do so under the mentorship of a CDBC Full Registrant only, according to policy Rc-19: Sole and Private Practitioner.

8) A Temporary Registrant wishing to practice Restricted Activities may be permitted to do so according to requirements outlined in policy Rc-13: Application and Declaration to Practice Restricted Activities.

9) Eligible applicants may be registered in the Temporary Registration class for up to one year.
a) Temporary registration may be renewed once as per section 43 (2) of the bylaws.
b) registration is transferred to the Full Registration class upon successful completion of the Canadian Dietetic Registration Examination and the Jurisprudence Examination for Dietitians as per section 43 (3) of the bylaws.

10) A temporary registrant who fails the Canadian Dietetic Registration Examination (CDRE) is permitted practice only under direct supervision of a full CDBC registrant, according to policy Rc-20: Supervision After CDRE Failure.

11) The statutory declaration (Form 4) must be completed, signed dated, and notarized by a notary public or lawyer registered, licensed or commissioned in Canada.

Definitions:

1) Sole and Private Practitioner
a) A registrant of the CDBC, working in any sector (i.e. private, public or not-for-profit sector ) who is functioning independently, and in isolation, and without oversight by a CDBC Full registrant
i) Private Sector
(1) the segment of the economy that is run by individuals and companies, rather than government. This includes small businesses and consultants/contractors. Most private sector organizations are run with the intention of making profit.
ii) Public Sector
(1) the segment of the economy under control of government.
iii) Not-for-profit Sector
(1) the segment of the economy run by charities and non-profit organizations. Note: Such organizations are more commonly considered part of the private sector.

2) Mentorship
a) A process for the informal transmission of knowledge and the psychosocial support perceived by the recipient as relevant to work, career, or professional development. Mentoring entails informal communication, usually face-to-face and during a sustained period of time, between a person who is perceived to have greater relevant knowledge, wisdom, or experience and a person who is perceived to have less.

3) Supervision
a) A situation in which a person’s practice is overseen by a full registrant; the scope, the nature and form of that supervision is to be applied in accordance with relevant policies, standards or guidelines approved by the board.

Policy RC-5 Examination – Third Attempt

Date created: September 10, 2004
Date approved: October 21, 2011, March 14, 2014
Date last reviewed (RC): October 31, 2004, October 4, 2008, September 30, 2011, September 23, 2013, January 27, 2014, September 26, 2016, May 10, 2019
Date last reviewed (Board): October 25, 2008, March 14, 2014 and February 27, 2015, September 13, 2017, June 17, 2019
Category: Registration
File code: Rc19/Policies/RC_Policy_Revisions/Rc-05_Examination_3rd_Attempt_FINAL_Jun_19
Authority: CDBC Bylaws section 47 (2, 3, 4 & 5).

Purpose:

To clarify the conditions which must be met to be eligible to apply for a third and final attempt at the Canadian Dietetic Registration Examination (CDRE).

Background:

The Board has approved the CDRE as one of the examinations that qualifies applicants to be eligible to apply to register in the Full Registration class.
The Alliance of Canadian Dietetic Regulatory Bodies (Alliance), through a third-party testing agency, manages the CDRE and sets policies and procedures for administration of the CDRE. According to these policies, the regulatory bodies assess and register qualified candidates to write the CDRE. The College monitors the number of times a candidate has unsuccessfully attempted the examination and the time-frame in which these attempts were made. After the second failure of the examination, the College must determine additional education and/or practical training required, before a candidate is considered current in dietetic knowledge, skills abilities and judgement to be eligible to take a third and final attempt at the CDRE.

Policy:

1) The Alliance’s policies and procedures for the administration of the Canadian Dietetic Registration Examination (CDRE) are accepted by the Registration Committee of the CDBC.
2) A current or former temporary registrant who has failed a second attempt at the CDRE, must:
a) be assessed by the Registration Committee for currency in dietetic skills, knowledge, abilities and judgement using the Assessment for Substantial Equivalence process (see policy Rc-15: Assessment for Substantial Equivalence).
b) complete any academic and/or practical training upgrading requirements identified by the Registration Committee, prior to being eligible to apply to take the third and final attempt at the CDRE.
3) Any upgrading required will be identified using aspects of the Assessment for Substantial Equivalence process (see policy Rc-15) and the individual’s CDRE Performance Reports provided by the CDRE testing agency. Upgrading may include:
a) successful completion of CDBC Registration Committee Approved Upgrading Courses; and/or
b) successful completion of practical training upgrading that is:i) approved by the Registration Committee prior to implementation;ii) a minimum number of hours set by the Registration Committee;iii) designed in consultation with a Registered Dietitian who is familiar with:
(1) the Integrated Competencies for Dietetic Education and Practice (ICDEPs); and
(2) entry-to-practice level knowledge, skills, abilities and judgement; and
(3) assessing dietetic practicum students;
iv) completed in British Columbia; and
v) supervised by a CDBC Full Registrant in good standing.
(1) Direct supervision is required for the first portion of the practical upgrading.
(2) As the practicum placement progresses, candidates transition to more independent practice. Supervision by the RD evolves from direct monitoring and guidance to indirect oversite and mentoring, as candidates’ knowledge, skills, abilities and judgement reach entry-to-practice levels of competence.
(3) The supervising RD must submit a signed Attestation of Competence form for Practical Training Upgrading (attached Appendix), along with the practical training upgrading plan designed with the individual.
(4) The supervising RD must declare any conflict of interest prior to accepting the placement.
4) Practical training upgrading may be obtained concurrently with academic upgrading.
a) Upgrading candidates must meet the requirements of each facility where practical training upgrading is undertaken, including professional liability coverage.
i) any costs related to practical training placements are the responsibility of the candidate (e.g. liability insurance, criminal records checks, travel, etc.)
5) The Registration Committee will set the deadline for candidates to complete any identified upgrading.
6) The Registration Committee will determine that academic and practical training upgrading requirements have been met by:
a) reviewing official transcripts of successfully competed academic course(s);
b) reviewing official CDBC Competency evaluation form(s), that are signed by the supervising RD, detailing the Performance Indicators successfully achieved, and
c) determining that all aspects of the individual’s upgrading plan have been successfully completed and that required practice hours have been met.
7) In extreme or unusual circumstances, current or former temporary registrants who are unable to complete upgrading requirements by the assigned deadline, may request an extension in writing. Circumstances may include, but are not limited to:
a) Accidents
b) Bereavement
c) Illness or injury
d) Weather or travel disruption
e) Family or Personal Crisis
f) Lack of course availability
8) Extensions should not alter the regulatory body’s ability to determine whether the candidate is eligible to write the CDRE.
a) Extensions may be granted by the Registration Committee upon receipt and review of a written request from an individual. The Registration Committee may require supporting documents to provide evidence for the extreme or unusual circumstance.

ATTESTATION OF COMPETENCE
DIETITIAN SUPERVISOR – PRACTICAL TRAINING UPGRADING

  • As a Registered Dietitian (RD) you may be asked to attest to the competence of a candidate who is pursuing registration with the CDBC. This may include attestation of competence for:
  • an individual seeking re-entry to the dietetics profession who needs to complete practical training upgrading to meet the current competencies;
  • an internationally educated individual seeking entry to the profession who must complete practical training upgrading to meet the current competencies for practicing dietetics in Canada;
  • a current or former temporary CDBC registrant who must complete practical training upgrading requirements set out by the CDBC Registration Committee, in order to re-attempt the Canadian Dietetic Registration Examination; or
  • an individual who must complete practical training upgrading to meet requirements set out by the CDBC Inquiry Committee.

Your signature on an Attestation of Competence form indicates that:

1. you will personally supervise and evaluate a candidate in his/her overall performance of practical training upgrading activities;
a. if you will not conduct daily supervision of a candidate, you will delegate an appropriate and experienced RD preceptor(s) to supervise and evaluate the candidate’s upgrading activities.
2. you are a full registrant of the CBDC, during the supervised the practical training upgrading;
3. the activities performed by the candidate will be fully and accurately described in the Self-Directed Practicum Placement Guide above your signature; and
4. candidates will be evaluated as performing practicum activities independently, legally, safely and competently to the level expected of an entry-level Dietitian who poses no risk of harm to the public.
5. the supervising RD must declare any conflict of interest prior to accepting the placement. Please refer to the Standards of Practice Indicators & Outcomes: Standard 8. A Dietitian identifies and manages any real, perceived or potential conflict of interest.
It is the responsibility of the CDBC Registration Committee, or the Inquiry Committee, to determine the acceptability of a planned practical training upgrading program. Committee members look for proof of competence attainment for the Integrated Competencies for Dietetic Education and Practice (ICDEP) (2013).

Signing an Attestation of Competence form carries significant responsibility. It is a serious offence to sign an Attestation of Competence Form for a candidate if you are not confident this candidate is competent to practice dietetics to the level expected of an entry-level Dietitian who poses no risk of harm to the public. The CDBC Registration and Inquiry Committees review attestations and rely on the attesters to confirm that candidates have attained safe and competent levels of practice.

The Dietitian responsible for supervising a practical training has the discretion to require additional hours of upgrading to ensure the candidate is competent to practice dietetics to the level expected of an entry-level dietitian who poses no risk of harm to the public.
If you have any questions about the applicant or the attestation of competence process, please contact the CDBC.

FORM

Policy RC-6 Currency of Dietetic Knowledge, Skills, Abilities and Judgement

Date last approved: October 29, 2018
Date last reviewed (RC): October. 1, 2018
Date last reviewed (Board): October c9, 2018
Category: Registration
File code: Rc18/Policies/Rc-06_Currency_Oct_29_18_FINAL
Authority: HPA sections 16 (2) (c) & (e), CDBC bylaws sections 41, 50, 51, 52 and 56.

Background:

As part of quality assurance, it is the duty of dietitians to maintain currency in dietetic knowledge, skills, abilities and judgement in order to practice safely, ethically and competently.

Policy:

CURRENCY REQUIREMENTS FOR APPLICANTS

1. All academic and practical training requirements for any application for registration must be completed less than three years prior to the date that registration is granted.

CURRENCY REQUIREMENTS FOR REINSTATEMENT

SUMMARY OF CURRENCY REQUIREMENTS – CURRENT & FORMER REGISTRANTS

REGISTRATION TYPE: CURRENCY REQUIREMENT: CDBC BYLAWS REFERENCE:
Full Registrant 1. Completion of Continuing Competence Program Section 56
Ceased to be registered for less than 3 years 1. Completion of Continuing Competence Program Sections 50(1) & 56
Ceased to be registered for more than 3 years but less than 6 years 1. Completion of the Canadian Dietetic Registration Examination (CDRE); and
2. the Jurisprudence Examination for Dietitians (JED)
Section 51
Ceased to be registered for more than 6 years 1. Assessment for Substantial Equivalence; and
2. Upgrading (if required); and
3. Successful completion of the CDRE;
4. and JED
Section 52
Former CDBC Registrant with current registration in other Canadian Jurisdiction 1. Current registration, in good standing from other jurisdiction,
2. Completion of Continuing Competence Program
Section 50(2)
Within the 36-month currency period

2. Former or non-practicing registrants who are applying for reinstatement will be considered current if:
a. the application for reinstatement is within 36 months of the last registration with the CDBC, and
b. evidence of successfully meeting the Continuing Competence Program requirement for reinstatement is provided

After the 36-month currency period; less than six years

3. In order to be eligible for reinstatement, former and non-practicing registrants whose registrations have expired for more than 36 months, but less than six years, must demonstrate currency by completing the Canadian Dietetic Registration Examination and the Jurisprudence Examination for Dietitians.
4. Such candidates for reinstatement must submit:
a. a completed Canadian Dietetic Registration Examination Application form via the CDBC’s online platform;
b. the CDRE application fee per Schedule D;
c. a completed Application for Reinstatement via the CDBC’s online platform; and
d. the Application for Reinstatement fee per Schedule D.

More than six years

5. In order to be eligible for reinstatement, former or non-practicing registrants, whose registration have expired for more than 6 years, must:
a. be assessed by the Registration Committee for currency in dietetic skills, knowledge, abilities and judgement using the Assessment for Substantial Equivalence process (see policy Rc-15: Assessment for Substantial Equivalence): and
b. successfully complete any academic and/or practical training upgrading as determined by the Registration Committee

6. Such candidates for reinstatement must submit:
a. a completed Application for Assessment for Substantial Equivalence using the CDBC online platform; and
b. the Assessment for Substantial Equivalence fees per Schedule D

7. The Registration Committee will determine that academic and/or practical training upgrading requirements for currency have been met by:
a. reviewing official transcripts and/or certificates of successfully competed course(s); and
b. reviewing official attestation documents completed by the applicant and signed by the CDBC registrant supervisor that Integrated Competencies for Dietetic Education and Practice and upgrading practice hours have been met.All Official documents verifying completion of upgrading must be sent directly from the granting institutions and/or supervisors to the CBDC.

8. All required upgrading for currency must be completed prior to applying for the Canadian Dietetic Registration Examination and the Jurisprudence Examination for Dietitians.

9. Upon completion of all required upgrading, candidates must submit:
a. a completed Canadian Dietetic Registration Application Form, using the CDBC online platform; and
b. the CDRE application fee per Schedule D
c. a completed Application for Reinstatement Form, using the CDBC online platform; and
d. the Application for Reinstatement fee per Schedule D

Policy RC-8 Registrar’s Limited Authority to Act for the Registration Committee

Date created: January 24, 2006
Date last approved by the RC: October 1, 2018
Date last approved by the Board: October 29, 2018
Category: Registration
File code: Rc18/Policies/Rc-08_Reg_Limited_Auth_Act_RegC_Oct_29_18_FINAL
Authority: HPA s. 20(2.1), 20(2.2) and 20(6); CDBC Bylaws sections 41 (1) & (2), 42, 44 and 50

Purpose:

to authorize the Registrar to act on behalf of the Registration Committee, and to describe in which situations the Registrar may act.

Policy:

1) The Registrar has limited authority to act in the Registration Committee’s stead when the applicant is applying for Temporary Registration and has:
a) successfully completed an approved academic degree and internship program in dietetics listed in Schedule E of the bylaws; OR
b) successfully completed academic and/ or practical training upgrading requirements previously determined or approved by the Registration; OR
c) submitted forms and documents that do not require any explanatory notes.

2) The Registrar may act in the Registration Committee’s stead when the applicant is applying for Full Registration under:
a) section 41(2) of the CDBC bylaws for applicants who practice dietetics in another Canadian jurisdictions;
b) section 42 of the CDBC bylaws in the event of a disaster; and
c) section 50 of the CDBC bylaws for reinstatement when returning to practice within 3 years.

3) The Registrar may act in the Registration Committee’s stead when the applicant is applying for Non-practicing Registration under section 44 of the CDBC bylaws.

4) Even with written authority, in accordance with sections 20(2.1) and 20(2.2) of the Health Professions Act, the Registrar may not grant registration under the following circumstances:
a) If registration is refused, granted for a limited time period or granted with terms and conditions when:
i) a person’s registration has been cancelled or suspended,
ii) an investigation is under way, or
iii) the person has been convicted of an indictable offence.

5) At every in-person meeting of the Registration Committee, the Registrar provides a status report on registration applications approved since the last meeting. The Registration Status Report includes:
a) approved applicants’ names,
b) registration class, and
c) date of approval.

Policy RC- 9 Good Character

Date created: April 29, 2013
Date approved: June 7, 2013
Date last reviewed (RC): April 29, 2013, September 26, 2016
Date last reviewed (Board): October 21, 2016
Category: Registration
File code: Rc16/Policies/Rc-11_Good_Character_Oct_21_16_FINAL
Authority: Health Professions Act section19; CDBC bylaws section 41(1)(e)

Background:

In accordance with Bylaws section 41(1)(e), an applicant for registration with the College must demonstrate good character.
This policy identifies the criteria used to determine evidence of good character for registration with the CDBC.

Policy:

1) An applicant applying for registration demonstrates good character by::
a) completing Good Character Evidence on the Application for Registration Form (Form #3), and
b) completing the Statutory Declaration in the presence of a Notary Public or Commissioner for Taking Affidavits, and
c) meeting the Criminal Record Check requirement established by the Ministry of Justice by submitting the Authorization form for a Consent to Criminal Record Check with their CDBC application.

2) An applicant applying for registration via a recognized labour mobility agreement demonstrates good character by:
a) providing evidence as noted above, and
b) CDBC receiving verification of the applicant’s registration in good standing from the sending jurisdiction.

Policy RC- 13 Restricted Activities

Date created: December 21, 2016
Date approved: June 13, 2017
Date last reviewed (RC): May 1, 2017, September 13, 2019
Date last reviewed (Board): June 13, 2017, November 4, 2019
Category: Registration
File code: Rc-19/Policies/RC_Policy_Development_2019/Rc-13 – Application and Declaration to Practice Restricted Activities
Authority: Health Professions Act section 19, Dietitians Regulation; CDBC bylaws section 45; Schedules A, B and D.

Background:

Restricted activities are a narrowly defined list of invasive, higher risk activities that must not be performed by any person in the course of providing health services, except
• members of a regulated profession that has been granted specific authority to do so in their regulations, based on their education and competence, and
• unregulated persons who have been delegated the authority to perform the restricted activity, or who have been authorized to perform the restricted activity, by a member of a regulated profession that has been granted the restricted activity 1.

Restricted Activities specific to BC Registered Dietitians are defined in the Dietitians Regulation of the Health Professions Act – “no person other than a registrant who meets the additional qualifications set out in the bylaws of the college may:

a) design, compound or dispense therapeutic diets if nutrition is administered through enteral means,
b) design therapeutic diets if nutrition is administered through parenteral means, or
c) administer a substance to a person by instillation through enteral or parenteral means.”

As per the CDBC Schedule A (Code of Ethics), principle 3 and Schedule B (Standards of Practice), it is the RD’s duty to ensure safe, competent and ethical practice. A Registered Dietitian must be practice ready when performing any Restricted Activity. Practice readiness is defined as confidence in the Registered Dietitian’s ability to independently fulfill the duties and responsibilities required in any area of dietetic practice – the Registered Dietitian is “ready to practice” independently as outlined in the Professional Practice Guidelines.

Policy:

Initial Registration of Restricted Activities (RA)s
1) Initial registration to practice RAs is required for anyone who intends to perform enteral and/or parenteral nutrition support as:
a) a first-time registrant; or
b) a former registrant newly reinstated with the College; or a current registrant who has not registered to practice enteral or parenteral nutrition support.

2) Any registrant who wishes to practice RAs for the first time, must apply for an initial registration for each RA that the registrant intends to perform.
a) Declare intent to practice, in the CDBC’s registration or renewal application, for each RA performed; and
b) Pay the initial RA application fee(s) per CDBC’s Schedule D

3) Registrants who practice Restricted Activities (RAs) must take steps to ensure practice readiness through the CDBC’s Quality Assurance Continuing Competence Program (CCP). If a RD declares intent to practice RAs but does not feel practice ready (for example, due to extended absence or lack of confidence, experience or opportunity), the RD must not practice the RAs. It is the RD’s responsibility to take steps to ensure practice readiness through CCP activities.

4) Initial registration to practice RAs must be complete prior to practicing RAs and may be applied for at any time during the current CDBC fiscal year.

Renewal of Declarations to Practice RAs

5) Intent to practice RAs must be declared annually in the CDBC registration renewal application.

6) Declarations to practice RAs expire on March 31 of the current fiscal year, regardless of the RA registration start date of.

1 Province of British Columbia – http://www2.gov.bc.ca/gov/content/health/practitioner-professional-resources/professional-regulation/scope-of-practice-reform

Policy RC-14 Examinations: CDRE and JED

Date created: December 22, 2016
Date approved: June 13, 2017
Date last reviewed (RC): January 23, 2017
Date last reviewed (Board): June 12, 2017
File code: Rc17/Policies/Rc-14_Examinations_June_13_17_FINAL
Authority: CDBC Bylaws sections 41, 43 and 47, Alliance CDRE Policies and Procedures

Background:

Sections 41 and 43 of the CDBC bylaws sets out the requirements for full and temporary registration.

Section 47 of the CDBC bylaws sets out the examination requirements.

The Alliance of Canadian Dietetic Regulatory Bodies (Alliance), through a third party testing agency, provides the CDRE. The policies and procedures approved by the Alliance for administration of the CDRE are accepted by the Registration Committee of the CDBC.

Policy:

1)Those wishing to apply to write the CDRE and access the JED must first complete all otherrequirements for registration (see policy Rc-02: Full Registration).

CDRE:

2)To apply to write the May or November sessions of the CDRE, a current and formertemporary registrant must submit:
a)a completed CDRE Application Form (Form #11), and
b)the CDRE fee
i)Applications will not be processed until CDRE fees are received.

3)Applications must be submitted by the application deadline indicated on the current Form#11.
a)Late applications will not be accepted.

4)In extenuating circumstances, a temporary registrant who is unable to take the firstscheduled CDRE after initial registration, may request an extension by making a formalwritten request to the Registrar. Extensions will be granted at the Registrar’s discretion.

5)A current or former temporary registrant who fails the CDRE must reapply to access theCDRE as in policy item #2 listed above.

6)The maximum number of attempts at the CDRE by any current or former temporaryregistrant is three (3).
a) A current or former temporary registrant who fails an initial CDRE is entitled to two (2) additional opportunities to re-take the CDRE.b) A failed exam that has been successfully appealed is not counted as a CDRE attempt.

7) For temporary registrants whose registrations expire due to failed CDREs; the CDBC will notify employers that such employees are no longer registered to practice dietetics.

8) A current or former temporary registrant may appeal the results of a failed CDRE according to the policies and procedures set by the Alliance.
a) Any request for appeal must be submitted, in writing, to the CDBC Registrar
b) Request for appeal must be received by the CDBC no later than 15 days after receipt of the CDRE results notification letter
c) Appeal decisions are relayed to the Alliance for consultation
d) Decisions are made by the CDBC Registrar and relayed to the applicant.

9) Unless an extension is granted (as set out in policy item #4), a current or former temporary registrant who fails the CDRE must re-take the next scheduled examination after meeting any conditions set by the Registration Committee.

JED:

10) After confirming that all other registration requirements are satisfied, the CDBC will provide JED candidates with online access.

11) Candidates must complete the JED within thirty days of being granted online access.

12) Candidates have unlimited attempts to successfully complete the JED.

13) Current or former temporary registrants must successfully complete the JED prior to being granted full registration status.

14) Full registrants must successfully complete the JED every five years, prior to subsequent registration renewal.

Policy RC-15 Assessment of Substantial Equivalence

Date created: August 18, 2016
Date approved: June 13, 2017
Date last reviewed (RC): October 1, 2018
Date last reviewed (Board): October 29, 2018
Category: Registration
File code: Rc18/Policies/Rc-15-Assessment_for_Substantial_Equivalence_Oct_29_18_FINAL
Authority: HPA s.20; Bylaws s. 41(3) and 52.

Background:

Registration is granted through Committee review and approval of a summary of the information submitted by the applicant, as compiled by the Registrar/Deputy Registrar.

The Assessment for Substantial Equivalence is the process by which the CDBC evaluates knowledge, skills, abilities and judgement of
• internationally educated dietitians wishing to apply for registration;
• former and non-practicing registrants, who have been off the public register for more than six years, who wish to be reinstated; and
• former dietitians who are registering with the CDBC for the first time (e.g. former members of the BC Dietitians and Nutritionist Association (BCDNA) who never registered with the CDBC).

This assessment process allows applicants to have their combined dietetic education, practical training and work experience compared to the recognized standards of current Canadian dietetic practice. It also enables the CDBC to verify competence in all areas of dietetic practice and determine self-directed learning needs to bridge any gaps in knowledge skills abilities and judgement necessary to meet the CDBC registration requirements.

Policy:

1) All candidates who require assessments of their dietetic knowledge, skills, abilities and judgement must compete the Assessment for Substantial Equivalence process.

2) All candidates must submit:
a) a completed Application for Assessment for Substantial Equivalence through the CDBC online platform; and
b) the Assessment for Substantial Equivalence fees listed in Schedule “D” of the CDBC bylaws; and
c) any official documents associated with the Application for Assessment for Substantial Equivalence; and
d) a completed Honesty Declaration Form.

3) All application submissions must be received by the CDBC within the timeline of policy Rc-21: Time Limitation for Open Applications.

4) The Assessment for Substantial Equivalence consists of 4 parts:
a) A Competence Self-Assessment using the Canadian Dietetic Practice, Orientation and Self-Assessment Tool (OSAT) – developed and shared by the College of Dietitians of Ontario to provide detailed information about Canadian dietetic practice. Candidates rate their own knowledge, skills, abilities and judgement against the Integrated Competencies for Dietetic Education and Practice (ICDEP).
b) A Competence Self-Verification (CSV) – designed to verify candidates’ self-ratings and assess knowledge, skills, abilities and judgement against the ICDEP. The CSV is an open-book, multiple-choice questions examination, that is completed independently and online. Answers are electronically graded.
c) A Practical Assessment Interview (PAI) – designed to help identify gaps in practical knowledge, skills, abilities and judgement, for entry-to-practice dietetics. Candidates are interviewed by Dietitians using six (6) case-based scenario questions. Responses are evaluated using a rubric.
d) A Self-Directed Learning (SDL) Plan – allows candidates to develop individualized upgrading plans based on CSV and PAI findings. Candidates choose academic upgrading courses from the CDBC’s List of Approved Upgrading Courses only. Candidates develop practical upgrading plans with CDBC staff guidance. These plans are approved by the Registration Committee and must be completed in order to be eligible to apply for registration.
Competence Self-Assessment:

5) Candidates must submit a completed OSAT to the CDBC.
a) All practice areas assessed in the OSAT must be included in the submission.
Competence Self-Verification Case Studies:

6) Once assessment documents, completed OSAT and the Substantial Equivalence Assessment fee are received, candidates are sent links to access the online CSV Case Studies via email.

7) Candidates must complete the CSV Case Studies within 60 days from the date that the links are sent by the CDBC, to ensure currency and reliability of results.

8) The CSV Case Studies address the 5 practice areas defined in the ICDEP. Minimum passing scores for the practice areas are:
a) Professional Practice = 50%
b) Communication & Collaboration = 50%
c) Nutrition Management = 50%
d) Population & Public Health = 50%
e) Nutrition Care = 65%

9) All candidates are advised of results in writing.

10) The assessment process is discontinued for candidates who do not meet the minimum passing score in any of the five dietetic practice areas, after two attempts. This is because gaps in knowledge, skills, abilities and judgement are considered too great to remediate through CDBC approved upgrading.
a) Options for unsuccessful candidates, after the first attempt include:
i) self-study in the unsuccessful practice area(s) and take a final attempt at the CSV Case Studies . Fees are applicable for a second attempt (Substantial Equivalent Assessment fee as described in Schedule D).
b) After the maximum number of attempts permitted for the CSV Case Studies, options are;
i) successfully complete a Canadian accredited dietetics program to be eligible to apply for CDBC registration; or
ii) appeal the CDBC’s decision and/or the assessment process to the BC Health Professions Review Board.

11) The scores of candidates who pass the CSV Case Studies are also reviewed for knowledge proficiency. Scores in all five practice areas are assessed against minimum threshold scores set by the Registration Committee. Threshold scores are currently set at:
a) Professional Practice = 60%
b) Communication and Collaboration = 60%
c) Nutrition Care = 70%
d) Population & Public Health Nutrition = 60%
e) Nutrition Management = 60%

12) Candidates who score below the set CSV Case Study threshold scores, in any practice area (i.e. less than 70% for Nutrition Care and less than 60% in all others), are required to complete academic upgrading in those practice areas.
a) These candidates develop Self-Directed Learning (SDL) Plans comprised of university level courses chosen from the CDBC’s List of Approved Upgrading Courses and any needed practical training upgrading.
b) SDL plans are submitted to the Registration Committee for approval, before upgrading begins.
All upgrading courses must be completed in order to be eligible to apply for registration.

13) Candidates who score above the set threshold scores for the CSV Case Studies are exempt from academic upgrading in the practice areas.
a) Candidates may be assigned academic upgrading in the following courses:
i) Orientation to Canadian Healthcare – Culture and Context; University of Toronto, as an introduction to healthcare practice for those with no healthcare experience in Canada; Note – this course has a minimum language proficiency requirement.
and/or
ii) Foodsafe Levels 1 & 2, Foodsafe BC, as an introduction to safe food handling expectations and requirements, in BC.
Candidate may complete these courses without prior Registration Committee approval. However, these assigned courses must be completed in order to be eligible to apply for registration.
Practical Assessment Interview:

14)Once all five practice areas tested in the CSV Case Studies are passed, and the practical assessment fee is received by the CDBC, candidates may access the Practical Assessment Interview (PAI).

15) The PAI is conducted in person.

16) The interview consists 6 case-based scenarios that will evaluate the five dietetic practice areas:
a) Professional Practice
b) Communication and Collaboration
c) Nutrition Care (2 scenarios required)
d) Population and Public Health Nutrition
e) Nutrition Management

17) The PAI is audio recorded for CDBC evaluation reference only. Consent is obtained at the beginning of each interview.

18) Candidates are permitted 45 minutes to prepare responses, before the PAI begins.
a) Candidates are not permitted to access study aids, or electronic devices during response preparation.

19) During the PAI, candidates have a maximum of 15 minutes, per case-based scenario, to provide verbal responses.

20) A minimum of two (2) and maximum of three (3) Dietitians will evaluate candidate responses using a rubric for each question asked.
a) Rubric scores range on a number scale of 0 to 3
0 = Did not meet expectations; missing crucial elements;
1 = Broadly understands questions; able to answer basic questions
2 = Understands the question and provides most of the key areas
3 = Analyzes situation; thoroughly answers question

Note: score descriptions vary slightly per question.

21) Practical upgrading is required in practice areas where the majority of PAI averaged response scores are below “2”.
Unsuccessful Applicants Who Wish to Re-apply

22) Candidates who fail the Assessment for Substantial Equivalence process may undergo a re-assessment for registration provided they:
a) submit proof of academic and practical training and/or work experience, that demonstrates substantial improvement in areas identified; and
b) demonstrates currency in dietetics within the 3 years immediately before the date of the request for re-assessment; and
c) fulfils all of the requirements specified in policy item #2 above.

Policy RC-16 CDRE – Appeals

Date created: January 19, 2017
Date approved: June 13, 2017
Date last reviewed (RC): January 23, 2017, September 13, 2019
Date last reviewed (Board): June 12, 2017, November 4, 2019
File code: Rc19/Policies/ Rc-16_CDRE_Appeals
Authority: CDBC Bylaws sections 41, 43 and 47; Alliance’s CDRE Policies and Procedures, Policy 12.

Background:

A temporary registrant who fails the CDRE may appeal the results on the basis of:

a) irregularities in the examination administration process, or
b) extraordinary, unforeseen, personal and not pre-existing circumstances that did not exist prior to the day of the exam (Alliance CDRE Policy #12).

The following circumstances may support an appeal request:

a) Exam procedures that vary significantly from the standard
b) Extraordinary circumstances (e.g. family emergency, bomb scare or fire alarm during exam which led to substantial interruption)
c) Illness on the day of the exam
d) Accommodation (approved by regulatory body in advance of the exam) not adequately implemented for the exam.” (Alliance CDRE Policy #12)

Policy:

1) An appeal must:
a) be received in writing within 20 calendar days of the CDBC sending the examination results to the candidate,
b) be in writing,
c) name of the examination site, and
d) include details of the circumstances that initiated the appeal.

2) The CDBC acknowledges receipt of the appeal within 5 business days, requesting more information if needed to clarify the circumstances.

3) The CDBC contacts the CDRE examination provider and requests information, including the:
a) Invigilator’s Report from the candidate’s examination site,
b) candidate’s login/logout times, and
c) candidate’s Post-examination Evaluation.

4) The registration committee investigates the appeal based on all the information available.

5)

6) Once received, the registration committee makes a determination on the appeal and the registrar notifies the candidate in writing. The Registrar may make determinations on the appeal without recommendation from the registration committee when the appeal is on the grounds of  “irregularities in the examination administration process”.

7) If the appeal is successful on the grounds of “irregularities in the examination administration process” (see background above):
a) the candidate is permitted to re-take at the next administration of the examination at no additional cost,
b) the examination that was appealed is not counted as a failed attempt.

8) If the appeal is successful on the grounds of “extraordinary, unforeseen, personal and not pre-existing circumstances that arise on the day of the exam” (see background above):
a) the candidate is permitted to re-take at the next administration of the examination at their expense,
b) the examination that was appealed is not counted as a failed attempt.

9) If the appeal is successful, the candidate must take the examination at the next scheduled administration.

10) The Registrar will report the results of the appeal to the Alliance and to the Registration Committee.

11) The CDBC tracks the failed attempt of the candidate.

Policy RC-17 Removed in Good Standing

Date created: December 4, 2017
Date approved: March 19, 2018
Date last reviewed (RC):
Date last reviewed (Board):
Category: Registration
File code: RC18/Policies/Removed_In_Good_Standing_March_18_FINAL
Authority: HPA s.20(2), 39, Dietitians Regulation; Bylaws s. 47, 50, 51, 52 and 56

Background:

A CDBC registrant who wishes to resign should do so in good standing. This is because only former registrants of the CDBC who were in good standing upon the expiry of their registrations, are eligible to apply for reinstatement with the CDBC (per bylaws, section 50, 51 and 52).

Definitions:

1. Removed
a. A registrant who has resigned from the CDBC and is no longer on the CDBC’s public register of dietitians.

2. In Good Standing:
a. A registrant who:
i. has complied with all the current, explicit obligations of the College, including:
1. payment of all statutory dues as per the CDBC’s Schedule D; and
2. filing of requirements for maintaining full registration including:
a. Quality Assurance Program requirements; and
b. Jurisprudence Examination for Dietitians; and
c. Criminal Records Check
and
ii. is not currently subject to any form of sanction, suspension, inquiry or disciplinary action.

The CDBC promotes the high standards of practice of dietitians through it’s quality assurance program. As per CDBC bylaws, section 56, the quality assurance program applies to full registrants and applicants for reinstatement. The program includes a continuing competence program which must be completed within a three year cycle.

As per CDBC bylaws sections 41 and 47, the Jurisprudence Examination for Dietitians is required for full registration and must be repeated every five (5) years.

In accordance with Dietitians Regulation, the title “dietitian” is reserved for exclusive use by registrants. Once resigned from the CDBC, former registrants must not use the title “dietitian”, “registered dietitian” or “RD”, or practice dietetics.
The following policy is intended to clarify the requirements for resigning, in good standing.

Policy:

1. In order to resign from the CDBC in good standing, a registrant must:
a. Advise the College in writing or online.
i. Written submissions are accepted by the CDBC via email or letter mail; or
ii. The registrant may complete the “Not Renewing” section of her/his CDBC online account.
and
b. Fulfill any applicable Continuing Competence Program (CCP) reporting requirements before registration expires.
i. A full or non-practicing registrant in the final year of a CCP reporting cycle, must:
1. submit a completed Professional Development Plan (PDP) as assigned and

2. satisfy the Quality Assurance Committee that the PDP fulfills the CCP requirements.
ii. A full or non-practicing registrant who is in the first or second year of a CCP reporting cycle must update her/his PDP to include the most current learning goals, learning activities, contributions to practice and learning plan progress stages.
1. This registrant is not required to submit the PDP to the CDBC.
iii. A temporary registrant is not required to complete the CCP in order to resign in good standing.
and
c. Fulfill the scheduled Jurisprudence Examination for Dietitians requirement, as assigned by the CDBC.
2. A registrant’s status will expire on March 31, of the current registration year, regardless of when the request to resign was submitted.

3. Once registration expires, the registrant will be removed from the CDBC public register of dietitians.

4. A registrant who resigns from the CDBC, but does not fulfill the requirements to be in good standing, will be identified in the CDBC database as “Registration Status – Inactive; Reason for Change – Lapsed”

Policy RC-18 Reinstatement of Former & Non-Practicing Registrants

Date created: August 18, 2016
Date approved: March 19, 2018
Date last reviewed (RC):
Date last reviewed (Board):
Category: Registration
File code: RC18/Policies/RC-18_Reinstatement_of_Former_&_Non-Practicing_Registrants_FINAL_March_2018
Authority: HPA s.20(2), 39, 52; Bylaws s. 41, 43, 44, 47, 50, 51, 52 and 56

Background:

In accordance with section 20 of the Health Professions Act [the Act], the Registration Committee must grant registration to every person who in accordance with the bylaws:
• applies for registration; and
• satisfies the Registration Committee that he or she is qualified to be a registrant; and
• pays the required fees.

Registration is granted through Committee review and approval of a summary of the information submitted by the applicant, as compiled by the Registrar/Deputy Registrar.

In accordance with section 50 of the CDBC bylaws, former full or non-practicing CDBC registrants, whose registrations are not suspended or cancelled under section 39 of the Act, and who have been out of practice for less than 36 months, may be restored to full registration status where the applicants provide proof of:
• meeting the continuing competence program required, as though the applicant had not ceased to be registered, as outlined in the Quality Assurance policy Qac-02: Continuing Competence Requirement for Reinstatement and,
• completing the Jurisprudence Examination for Dietitians according to the CDBC assigned five year cycle.
In accordance with section 51 of the CDBC bylaws, former full or non-practicing CDBC registrants, whose registrations are not suspended or cancelled under section 39 of the Act, and who have been out of practice for more than 36 months after their last registration expired, but less than six years, may be restored to full registration status where the applicants successfully complete:
• the Canadian Dietetic Registration Examination less than 3 years prior to the date registration is granted; and
• the Jurisprudence Examination for Dietitians prior to registration being granted.

In accordance with sections 41(4), 44(3) and 52 of the CDBC bylaws, former full or non-practicing CDBC registrants, whose registrations are not suspended or cancelled under section 39 of the Health Professions Act, and who have been out of practice for more than six years after their last registrations expired, may be restored to full registration status where the applicants successfully complete:
• all academic and/or practical training upgrading required, by the Registration Committee, following assessment for currency in knowledge, skills, ability and judgement to practice dietetics.
• the Canadian Dietetic Registration Examination less than 3 years prior to the date registration is granted ; and
• the Jurisprudence Examination for Dietitians prior to reinstatement being granted.

As per CDBC bylaws, section 43, temporary registrants may renew registration once only, for a period of up to one year immediately following the period that the first temporary registration was granted. Registrants are granted temporary registration status for a maximum of up to two registration cycles only (i.e. the initial registration cycle plus one registration renewal cycle). Temporary registrants must write the Canadian Dietetic Registration Examination at the first scheduled sitting following their registrations.;

The following policy is intended to clarify the reinstatement requirements for former registrants depending upon their status at resignation, and the amount of time elapsed since their last registrations expired.

Policy:

1) All forms related to applications for reinstatement (forms #6, #9 and #11), must be fully completed, including personal information and contact information for the public record.
a) Name change documentation (such as an original, notarized or photocopied marriage certificate) is required if an applicant’s name is different from the name on the applicant’s transcript or practical training documentation.

2) Any former registrant seeking reinstatement must have resigned, in good standing, as per policy Rc-17 – Removed In Good Standing, at time that her/his registration status expired, is eligible to apply for reinstatement..

3) Any former registrant seeking reinstatement must fulfill the authorization for Criminal Records Check requirement according to the CDBC’s assigned schedule.

4) A former registrant seeking reinstatement, who did not resign in good standing, must demonstrate currency in dietetic knowledge, skills abilities and judgment by submitting the following requirements, prior to applying for reinstatement:
a) a current resume detailing any dietetic employment or education activities since the CDBC registration expired; and
b) any outstanding Continuing Competence Program requirements prior to registration expiry.
Former Full and Non-Practicing Registrants
Reinstatement within 3 years of registration expiry date:

5) A former full or non-practicing registrant who is applying for reinstatement must:
a) submit a completed Application for Reinstatement form (Form # 9);
i) the application for reinstatement must be submitted within 36 months of registration expiry date;
and
b) submit a Criminal Records Check (CRC) authorization; and
c) provide evidence of successfully meeting the Continuing Competence Program (CCP) requirement for reinstatement in accordance with policy Qac-02: Continuing Competence Requirement for Reinstatement; and
d) pay the Application for Reinstatement and CRC authorization fees.
Reinstatement after 3 years, but less than six years from registration expiry date

6) A former or non-practicing registrant who is applying for reinstatement, with expired registration for more than 3 years, but less than six years, must:
a) submit a completed Canadian Dietetic Registration Examination Application form (Form # 11); and
b) pay the current CDRE application fee.

7) Once the CDRE is successfully completed less than 3 years prior to the date registration is granted, this former registrant must:
a) submit a completed Application for Reinstatement form (Form # 9); and
b) submit a Criminal Records Check (CRC) authorization; and
c) pay the Application for Reinstatement and CRC fees.
Reinstatement after more than six years from registration expiry date

8) A former or non-practicing registrant who is applying for reinstatement, after more than six years of her/his registration expiry date, must:
a) submit a completed Application for Assessment for Registration Form (Form # 6); and
b) be assessed by the Registration Committee for currency in dietetic skills, knowledge, abilities and judgement. This assessment includes:
i) the Competence Self-Assessment Process (CSAP); and
ii) the Practical Assessment;
and
c) pay the CSAP and Practical Assessment fees; and
d) successfully complete any academic and/or practical training upgrading as determined by the Registration Committee.
i) The Registration Committee will determine that academic and/or practical training upgrading requirements for currency have been met by:
(1) reviewing official transcripts and/or certificates of successfully completed course(s); and
(2) reviewing official attestation documents that verify practical upgrading practice requirements have been met.
All Official documents verifying completion of upgrading must be sent directly from the granting institutions and/or supervisors to the CBDC.
ii) All required upgrading for currency must be completed prior to applying for the Canadian Dietetic Registration Examination and the Jurisprudence Examination for Dietitians.

9) After successful completion of all required upgrading, such applicants must:
a) submit a completed Canadian Dietetic Registration Examination Application form (Form # 11); and
b) pay the CDRE application fee.

10)Once the CDRE is successfully completed less than 3 years prior to the date registration is granted, this former registrant must:
a) submit a completed Application for Reinstatement form (Form # 9); and
b) submit a Criminal Records Check (CRC) authorization; and
c) pay the Application for Reinstatement and CRC fees.
Labour Mobility:

11) Former or non-practicing registrants of the CDBC, who are registered with Dietetic Regulatory bodies in other Canadian jurisdictions, are eligible for reinstatement if there is evidence of:
a) active registration, in good standing, with the other jurisdiction, and
b) resignation in good standing, as per policy Rc-17 – Removed In Good Standing, at the time the registration expired; and
c) successfully meeting the continuing competence requirements of the exporting jurisdiction.
All documented evidence must be sent directly from the exporting jurisdiction to the CDBC.

12) Such candidates for reinstatement must submit:
a) a completed Application for Reinstatement form (Form # 9); and
b) submit a Criminal Records Check (CRC) authorization; and
c) the Application for Reinstatement and CRC fees.
Former Temporary Registrants:
Reinstatement immediately after initial temporary registration:

13) A former temporary registrant who resigned in good standing, within her/his initial registration year, is eligible to apply for reinstatement, as a temporary registrant, for the period immediately following her/his initial registration year only.
i) This type of former temporary registrant must:
(1) submit a completed Application for Reinstatement form (Form # 9);and
(2) submit a Criminal Records Check (CRC) authorization; and
(3) pay the Application for Reinstatement and CRC fees.
Reinstatement after renewal of temporary registration:

14) A former temporary registrant who renewed her/his registration, prior to resigning from the CDBC, is not permitted to reinstate as a temporary registrant.
a) This type of former temporary registrant may be eligible to apply for reinstatement, as a full registrant, if she/he is able to demonstrate:
i) successful completion of the Canadian Dietetic Registration Examination (CDRE).
(1) The CDRE must be successfully completed less than 3 years prior to the date registration is granted.
b) Such applicants must:
i) submit a completed Canadian Dietetic Registration Examination Application form (Form # 11); and
ii) pay the current CDRE application fee; and
c) Once the CDRE is successfully completed less than 3 years prior to registration being granted, such applicants must:
i) submit a completed Application for Reinstatement form (Form # 9); and
ii) submit a Criminal Records Check (CRC) authorization; and
iii) pay the Application for Reinstatement and CRC fees.
Reinstatement of former temporary registrants after more than 3 years from registration expiry date:

15) A former temporary registrant seeking reinstatement after more than 3 years from registration expiry date, must:
a) submit a completed Application for Assessment for Registration Form (Form # 6); and
b) be assessed by the Registration Committee for currency in dietetic skills, knowledge, abilities and judgement. This assessment includes:
i) the Competence Self-Assessment Process (CSAP); and
ii) the Practical Assessment Process (PAP);
and
c) pay the CSAP and PAP fees; and
d) successfully complete any academic and/or practical training upgrading as determined by the Registration Committee.
i) The Registration Committee will determine that academic and/or practical training upgrading requirements for currency have been met by:
(1) reviewing official transcripts and/or certificates of successfully completed course(s); and
(2) reviewing official attestation documents verifying that practical upgrading practice requirements have been met.
All Official documents verifying completion of upgrading must be sent directly from the granting institutions and/or supervisors to the CBDC.
ii) All required upgrading for currency must be completed prior to applying for the Canadian Dietetic Registration Examination and the Jurisprudence Examination for Dietitians.

16) After successful completion of all required upgrading, such applicants are eligible to apply for full registration status. This former registrant must:
a) submit a completed Canadian Dietetic Registration Examination Application form (Form # 11); and
b) pay the CDRE application fee.

17)Once the CDRE is completed successfully, this former registrant must:
a) submit a completed Application for Reinstatement form (Form # 9); and
a) submit a Criminal Records Check (CRC) authorization; and
b) pay the Application for Reinstatement and CRC fees.

Policy RC-19 Sole and Private Practitioner

Date created: December 8, 2017
Date approved: May 1, 2018
Date last reviewed (RC): September 13, 2019
Date last reviewed (Board): November 4, 2019
Category: Registration
File code: RC19/Policies/RC_Policy_Development_2019/Rc-19_Sole&Private_Practitioner/Rc-19_Sole_Practitioner_Feb_19
Authority: CDBC Bylaws section 43.

Background:

The Canadian Dietetic Registration Examination (CDRE) verifies that a Dietitian is competent to practice dietetics across Canada. Until the CDRE requirement is fulfilled, it is in the public’s interest for the CDBC to establish measures and conditions for temporary registrants to ensure dietetic care is delivered safely, ethically and competently, in all situations With this in mind, the CDBC will permit temporary registrants to work as sole practitioners under the mentorship of CDBC full registrants only. This mentorship requirement is intended to provide guidance, direction and support to temporary registrants until they are granted full registration status by the College.

Definitions

1) Sole and Private Practitioner: A registrant of the CDBC, working in any sector (i.e. private, public or not-for-profit sector), who is functioning independently, and in isolation, and without oversight by a CDBC full registrant.

2) Private sector: The segment of the economy that is run by individuals and companies, rather than government. Most private sector organizations are run with the intention of making profit.

3) Public Sector: The segment of the economy under control of government.

4) Not-For-Profit Sector: The segment of the economy that is run by charities and non-profit organizations. Note: Such organizations are more commonly considered part of the private sector.

5) Mentorship: A process for the informal transmission of knowledge and the psychosocial support perceived by the recipient as relevant to work, career, or professional development. Mentoring entails informal communication, usually face-to-face and during a sustained period of time, between a person who is perceived to have greater relevant knowledge, wisdom, or experience and a person who is perceived to have less.

6) Supervision: A situation in which a person’s practice is overseen by a full registrant; the scope, the nature and form of that supervision is to be applied in accordance with relevant policies, standards or guidelines approved by the board (per CDBC Bylaws – Definitions).

Policy:

1) The CDBC will permit a temporary registrant to work as a sole and private practitioner, under the mentorship of a CDBC full registrant only.
a) Approval of mentorship is determined by CDBC staff.
b) The CDBC’s Decision Map – Sole and Private Practitioner offers a series of pathways to help determine the temporary registrant’s need for mentorship and to identify appropriate sole and private practitioner situations (see Decision Map in the Sole and Private Practitioner Interpretive Guide).
c) Mentorship is a tool that enhances dietetic knowledge, skills, abilities and judgement. It is highly encouraged by the CDBC. Identifying that a mentor is not required should not preclude temporary registrants from seeking mentorship to strengthen dietetic practice.

2) Mentorship and CDBC approval is not required when a private, public or not-for-profit sector employer has an organizational structure in place where the temporary registrant is accountable to a full registrant of the CDBC.

3) Acceptable mentorship for a sole and private practitioner occurs when the temporary registrant has a signed Mentorship Agreement for Private Practitioners (see Appendix 1) between herself/himself and a CDBC full registrant. This signed agreement must be approved by the CDBC, prior to the start of the mentorship.

4) The mentor must be:
i) a current, full registrant, of the CDBC, in good standing; and
ii) actively working in a dietetics field that supports the temporary registrant’s intended practice area, as a sole and private practitioner.
iii) registered to practice the required restricted activities if the temporary registrant’s intended practice area includes enteral or parenteral nutrition support.
iv) free from conflict of interest, including personal relationships and family.

5) Mentorship must be in place for the entire duration that temporary registrant is working as a sole and private practitioner

6) Under the Mentorship Agreement for Sole and Private Practitioners:
a) Permission is granted by the CDBC, to a temporary registrant, after review and approval of a submitted Mentorship Agreement for Sole and Private Practitioners.
b) A temporary registrant must not work as a sole and private practitioner until the CDBC has granted permission in writing.
c) Mentorship must include regular, communication (in-person, telephone and/or or internet) between the CDBC full registrant and the temporary registrant.
i) Communication between the mentor and the temporary registrant may include, but is not limited to:
(1) reviewing dietetic practice, practice issues and activities that the temporary registrant had undertaken since the last communication.
(2) discussing client charts
(3) reviewing and discussing client billing (if applicable)
ii) Communication should occur biweekly, at minimum. However, more frequent communication is highly encouraged in order to facilitate a meaningful mentorship experience.

7) If the Temporary registrant fails the Canadian Dietetic Registration Examination, direct supervision will be required and the Mentorship Agreement for Sole and Private Practitioners will not be considered sufficient. Please refer to the policy RC-20 – Supervision After CDRE Failure.
Note: Please refer to the Sole and Private Practitioner Interpretive Guide for additional information for temporary registrants and mentors.

APPENDIX 1
MENTORSHIP AGREEMENT FOR SOLE AND PRIVATE PRACTIONERS

Purpose:

The College of Dietitians of BC’s (CDBC’s) Mentorship Agreement for Sole and Private Practitioners establishes appropriate mentorship expectations between temporary registrants, who wish to pursue employment as sole and private practitioners, and full registrants of the CDBC.

Instructions:
1. Please complete Section 1 – Temporary Registrant and Section 2 – Dietitian Mentor.
2. Submit the completed agreement to the CDBC – info@collegeofdietitiansbc.org
3. The temporary registrant must not work as a sole and private practitioner until the CDBC has approved the agreement in writing.

Section 1 – Temporary Registrant:

Name: CDBC Registration #

Anticipated Dates for Mentorship: Start: End:

Primary area of sole and private practice:

Responsibilities of the Temporary Registrant

1. I am responsible for organizing my Mentorship Agreement for Sole and Private Practitioners.

2. My conduct as a sole and private practitioner is in accordance with the CDBC’s bylaws, Schedule A – Code of Ethics and Schedule B – Standards of Practice.

3. I will provide the College with the name of a full registrant, working in a dietetics practice area that supports my work as a sole and private practitioner, who has agreed to mentor me.

4. I shall initiate a first meeting with my Dietitian Mentor to set mentorship expectations. At minimum, the mentorship expectations will include:
a. regular, biweekly contact with the CDBC full registrant
i. this may be increased at the discretion of the mentor
b. orientation to any applicable legislation, policies and procedures relevant to working as a sole and private practitioner (e.g. Personal Information Protection Act).
c. discussion of practice issues and challenges, such as:
i. Client charting;
ii. Record keeping;
iii. Billing;
iv. Patient relations;
v. Evidence based decision making.

5. I will seek the advice from my Dietitian Mentor biweekly and as necessary and will follow her/his direction.

6. I will co-operate with my Dietitian Mentor and provide her/him with access to all billings that I render, if applicable, and I agree to review the billing for the services I provide.

7. If for any reason my Dietitian Mentor is not able to provide mentorship, I will notify the College immediately and provide the name of another CDBC full registrant who is willing to mentor me.

8. In the event that my dietitian mentor is away on vacation, because of illness, or for any other reason, for a period greater than three weeks, I will ensure that another full registrant of the College is available, in my mentor’s place, to carry out the terms of this agreement. I will first obtain approval from the CDBC for another full registrant of the College to act as a mentor.

9. I am aware that this mentorship agreement must be in place until I am granted full registration by the CDBC, or I am no longer working as a sole and private practitioner.

10. I will register for the first available Canadian Dietetic Registration Examination after being granted registration with the CDBC.

11. I understand my responsibilities as the temporary registrant in this agreement.

Signature: Date:
Section 2 – Dietitian Mentor:
Name: CDBC Registration #
Primary area of private practice:

Responsibilities of the Dietitian Mentor

1. I will mentor the temporary registrant listed above in accordance with the CDBC’s Bylaws, Schedule A – Code of Ethics and Schedule B – Standards of Practice.

2. I will ensure that I will have proper liability insurance in place when the mentorship is to be provided outside of my work responsibilities.

3. I will notify the College immediately if the temporary registrant is not compliant with the mentorship requirements or any other conditions on her/his practice permit.

4. Before the temporary registrant begins work as a sole and private practitioner, I will orient her/him to any applicable legislation, policies and/or procedures relevant to working as a sole and private practitioner (e.g. Personal Information Protection Act).

5. I will discuss and advise her/him regarding relevant practice issues, client relations, proper charting and record keeping, billing, evidence based decision making, etc., in accordance with the CDBC’s Code of Ethics and Standards of Practice.

6. I will connect with the temporary registrant (frequency) . When I am not physically present, I will be available for consultation and advice via telephone or internet.

7. I will provide reasonable notification to the temporary registrant if I am away on vacation, because of illness, or for any other reason, for a period of greater than three weeks.

8. In the event that I have concerns regarding the temporary registrant’s competency to practice dietetics in any respect, I will report my concerns immediately to the CDBC.

9. I understand the responsibilities of the Dietitian Mentor in this agreement.

Signature: Date:
CDBC use only:
Approved by:

Policy RC-20 Supervision After Canadian Dietetic Registration Examination Failure

Date created: December 12, 2017
Date approved: March 19, 2018
Date last reviewed (RC): September 13 2019
Date last reviewed (Board): November 4 2019
Category: Registration
File code: RC19/Policies/RC-20_Supervision_After_CDRE_Failure
Authority: CDBC Bylaws section 43.

Background:

In accordance with the CDBC bylaws, section 43, the CDBC grants temporary registration to applicants for a period of up to one year (renewable once) who have not met Full Registration examination requirements but who:
a) have proven to the satisfaction of the Registration Committee that they can be reasonably expected to successfully complete the Canadian Dietetic Registration Examination and the Jurisprudence Examination; and
b) in the opinion of the Registration Committee, may practice without any risk to public health; and
c) meet all other registration requirements

The Canadian Dietetic Registration Examination (CDRE) verifies that a Dietitian is competent to practice dietetics across Canada. Temporary registrants of the CDBC must write the CDRE at the first scheduled sitting following their registration and pass the CDRE, in order to satisfy the College that they fulfill all of the qualifications for full registration.

A temporary registrant who fails the first official CDRE attempt may practice only under direct supervision by a full registrant, unless otherwise specified by the Registration Committee.

Policy:

1) The CDBC will inform temporary registrants who failed the exam in writing as soon as CDRE results are available.

2) The CDBC will permit a temporary registrant, who has failed the CDRE, to practice only under the direct supervision of a CDBC full registrant only.
a) Permission to resume practice is granted by the CDBC, to a temporary registrant, after review and approval of a submitted Attestation of Competence Agreement for Supervised Dietetic Experience form (see appendix 1).
i) Approval of supervision is determined by CDBC staff.
b) A temporary registrant must not resume practice until the CDBC has granted permission in writing.

3) The temporary registrant must have a signed Attestation of Competence Agreement for Supervised Dietetic Experience between herself/himself and a CDBC full registrant.
a) The temporary registrant is responsible for ensuring that an appropriate supervision agreement is in place between herself/himself and the supervisor

4) The supervisor must be:
i) a current, full registrant, of the CDBC, in good standing; and
ii) actively working in the temporary registrant’s area of practice; and
iii) available for daily, in person oversight and evaluation and for the temporary registrant to consult and or collaborate as needed; and
iv) Registered to practice restricted activities if the temporary registrant’s practice area includes enteral or parenteral nutrition support; and
v) willing and able to evaluate the temporary registrant as performing dietetic activities independently, legally, safely and competently to the level expected of an entry-level Dietitian, who poses no risk of harm to the public; and
vi) free of any conflict of interest regarding the temporary registrant, including personal relationships such as friendships or family.

5) The temporary registrant is supervised according to the:
a) Integrated Competencies for Dietetic Education and Practice; and
b) CDBC bylaws, Schedule A – Code of Ethics; and
c) CDBC bylaws Schedule B – Standards of Practice

6) Direct supervision must be in place until the temporary registrant successfully completes the CDRE.

Policy RC-21 Time Limitation on Open Applications

Date created: August 27, 2018
Date approved: October 29, 2018
Date last reviewed (RC): October 1, 2018
Date last reviewed (Board): October 29, 2018
Category: Registration
File code: RC18/Policies/Rc-21_Time_Limitation_Open_Application_Oct_29_18_FINAL
Authority: HPA s.20(2), 39, 52; Bylaws s. 41

Purpose:

The following policy is intended to clarify the period for which applications for registration may be considered open and active by the CDBC. This is to ensure the College makes decisions based on current and accurate information and mitigates related risks, in the public interest.

Background:

The processes by which applications for registration are completed are outlined in policies Rc-02 – Full Registration and Rc-04 – Temporary Registration.

Internationally educated applicants must apply for an Assessment for Registration, prior to being eligible to apply for registration with the CDBC. This assessment considers whether the applicant’s knowledge, skills, abilities and judgment are substantially equivalent to the standards of academic or technical achievement and the competencies (per CDBC bylaws section 41(3)). The processes by which applications for Assessment for Registration are completed are outlined in policy Rc-03 – Full Registration Substantial Equivalence.

Policy:

1) All applications to the CDBC are created and submitted via the CDBC’s online platform.

2) All applications are closed after six (6) months of inactivity, immediately following the date of last documented correspondence.

3) Once an application is received, and the CDBC determines that additional information and/or fee payment is needed to fulfill application requirements, the applicant must submit this information and/or fee within the six-month time frame.
a) CDBC staff will notify the applicant, in writing, of the required information and/or fee, and the deadline for submission.
b) CDBC staff will consider a written request, by the applicant, to extend the deadline for submitting the required information.

4) If the applicant fails to contact the CDBC:
a) the CDBC will attempt to notify the applicant, in writing, of the impending closure; and
b) the application will be closed according the established timeline.

5) Closed applications will be handled and stored according the CDBC’s Record Retention and Destruction policy.

6) Once the application is closed, candidates who wish to reapply to the CDBC, must submit a new application, including fees, according to the bylaws in-force, at the time that the new application is submitted. Prior assessments and decisions will still be considered in any new application, as will any relevant information related to the requirements set out in CDBC bylaws section 41.

Restricted Activities Interpretive Guide

Purpose

Restricted Activities for Registered Dietitians are stated in the Dietitians Regulation. They are further defined in this Interpretive Guide to clarify registrants’ practice and the need for registration with specific Restricted Activities.

Legislation

Dietitians Regulation: Sections 1 and 5:

Section 5 states:

“Subject to section 14 of the Act [Health Professions Act], no person other than a registrant who meets the additional qualifications set out in the bylaws of the College may:
a) design, compound, or dispense therapeutic diets if nutrition is administered through enteral means,
b) design therapeutic diets if nutrition is administered through parenteral means, or
c) administer a substance to a person by instillation through enteral or parenteral means”.

Note: For registration purposes, the Registration Committee separated section 5(c) of the Dietitians Regulation into two Restricted Activities.

Restricted Activities C and D are defined as:
c) administer a substance to a person by instillation through enteral means.
d) administer a substance to a person by instillation through parenteral means.

Section 1 includes the following definitions:
• “compound” means to mix ingredients for enteral or parenteral nutrition.
• “design” means the selection of appropriate ingredients for enteral or parenteral nutrition.
• “dispense” means to fill a prescription for enteral nutrition.
• “enteral” means administration of a nutritional substance to a patient by means of a feeding tube into the gastrointestinal tract.
• “parenteral” means administration of a nutritional substance to a patient directly into the blood stream.

Background Information
“Administer” is not defined in the Dietitians Regulation. To assist registrants, the following definition has been approved by the CDBC Registration Committee and Board:
• “administer” means to physically provide a nutritional or non-nutritional substance via an enteral or parenteral access device or system or provide instruction for same.

Practice setting: The Restricted Activities may be performed in all practice settings (for example: community, residential care, acute care, critical care) and in both the paediatric and adult population.

Registration and Competence: When the Registered Dietitian (RD) practices one or more of the aspects of any of the Restricted Activities, he/she is required to be registered with that Restricted Activity. A Registered Dietitian (RD) practicing a Restricted Activity is competent to perform each aspect of the Restricted Activity.
o Example: An RD who designs and compounds enteral products even though she/he never supervises the dispensing of such products by non-registered staff members, must be registered with Restricted Activity A.

 

Education/Instruction: An RD who instructs others to perform a Restricted Activity is required to be registered with the Restricted Activity.

Supervision: An RD who supervises a registered health care professional who performs the Restricted Activity (for example another RD who is registered with the Restricted Activity) is not required to be registered with the Restricted Activity. An RD who directly supervises a non-regulated health care worker (for example a food service worker) is required to be registered with the Restricted Activity and is responsible for that person’s practice.
o Example: An RD who does not design or compound enteral products, but who is responsible for the supervision of a non-registered staff member who dispenses enteral products, must be registered with Restricted Activity A.

Interpretive Guideline
Registered Dietitians registered with Restricted Activities A, B, C or D may legally perform the actions outlined below:

Restricted Activity A – Enteral Nutrition (EN)

Action Interpretation and Practice Guidelines
“Design” If enteral nutrition is indicated, the RD selects or recommends:
• appropriate available commercially prepared formulations.
• appropriate macro and micronutrient mix to provide for the client’s specific nutritional requirements (for example, recommend enteral ingredients).
• modular products to add to available enteral formulas (for example, addition of protein powder, MCT oil, fibre or specific amino acids).
• mixing of enteral products (for example, taking a high protein formula and mixing it with a concentrated formula to modify the caloric and protein content to match the needs of the patient) or adding water to reconstitute a powdered formula.
• appropriate EN feeding route and delivery method (for example, intermittent or continuous infusion, volume, rate).
The RD also:
• monitors tolerance and adjusts EN as required and,
• communicates (verbally or in writing as appropriate) with the patient/caregiver and the interdisciplinary team.
Example A: An individual with high serum potassium levels is not eating well. The client’s physician writes the following order: “enteral nutrition as per dietitian”. The RD:
• identifies the metabolic concerns that influence the nutritional requirements
• selects a commercially prepared formula that meets the client’s energy, macronutrient (protein, carbohydrate, fat and fluid) and micronutrient (vitamins, minerals and trace elements) needs or
• selects a commercially prepared formula and determines modifications needed to meet the client’s specific macronutrient requirements (for example, addition of protein powder to the feeding regimen) or
• recommends that the client’s needs be met through the mixing of 2 commercially prepared formulas, and the appropriate ratio (for example, one container of product X to one container of product Y) and/or,
• identifies the need for a multi-vitamin and mineral supplement.
Example B: The RD analyzes a patient’s formula adequacy with respect to macro and micronutrients and the total volume per 24 hours to meet the client’s nutrient needs.
“Compound” The RD:
• physically mixes enteral ingredients to enhance one or more component of the nutrition formula.
Example A: The RD physically adds protein powder to an enteral formula.
Example B: The RD physically adds water to a powdered formula.
• supervises food service staff who mix enteral ingredients (for example, addition of modular products or reconstitution of powdered formulas).
Example A: The RD supervises a kitchen staff member who physically adds protein powder to an enteral formula or water to a powdered formula.
Example B: The RD advises kitchen staff to mix two commercial enteral products to create a new formula that best meets the patient’s needs.
• instructs clients who are being trained to mix ingredients.
Example: The RD instructs a client to add protein powder to his or her enteral formula.
“Dispense” The RD:
• physically fills a physician’s order (like a pharmacist dispensing a medication as per the physician’s prescription).
• supervises staff who distribute or deliver the physician prescribed product to a client.
Example: The release from a controlled distribution area (for example, kitchen or stores) of the enteral product (commercially packaged or RD modified specialty product) in the required amount for the required time frame, as ordered by the prescribing physician.

Restricted Activity B – Parenteral Nutrition (PN)

Action Interpretation and Practice Guidelines
“Design” If parenteral nutrition is indicated, the RD selects or recommends:
• appropriate available products/solutions.
• appropriate macro and micronutrients to provide for the client’s specific nutritional requirements.
• individual components to add to the available parenteral solution (for example, additional injection of multiple vitamins to a pre-mixed solution).
• appropriate PN infusion site and delivery method (for example, cyclical or continuous infusion, volume, rate).
The RD also:
• monitors tolerance and adjusts PN as required.
• communicates (verbally or in writing as appropriate) with the patient/ caregiver and the interdisciplinary team.
Example: An individual with high serum potassium levels requires parenteral nutrition. The client’s physician writes the following order: “dietitian to assess”. The RD:
o identifies the metabolic concerns that influence the nutritional requirements and selects the appropriate energy, macronutrient (protein, carbohydrate, fat, and fluid) and micronutrient (vitamins, minerals, and trace elements) for the parenteral solution to meet the client’s nutritional needs and/or,
o recommends that the client’s needs be best met through a modification of the vitamin, mineral and/or trace element components of the parenteral solution.

Restricted Activity C – Administration of Enteral Nutrition (EN)

Action Interpretation and Practice Guidelines
“Administer” If a substance is being administered by instillation through enteral means, the RD:
• physically manipulates or adjusts the enteral delivery device or system.
Example: An RD connects the feeding bag to the enteral delivery device and sets the appropriate volume and rate on the pump.
• physically changes an enteral feeding bag to infuse a nutritional or non-nutritional substance to a client.
Example A: An RD flushes a feeding tube with water in order to prevent tube obstruction.
Example B: An RD instills pancreatic enzyme when the tube is obstructed.
• instructs clients, caregivers, RDs or other health care professionals to infuse a nutritional or non-nutritional substance to a client.
Example A: The RD instructs the client and/or caregiver to connect the feeding bag to the enteral pump, adjust the delivery system as required and flush the enteral feeding tube with water or deliver other non-nutritional substances.
Example B: The RD demonstrates to the client and/or caregiver in simulation or directly how to clear a feeding tube occlusion.

Restricted Activity D – Administration of Parenteral Nutrition (PN)

Action Interpretation and Practice Guidelines
“Administer” If a substance is being administered by instillation through parenteral means, the RD:
• physically manipulates or adjusts the parenteral delivery device or system.
• physically changes a parenteral feeding bag to infuse a nutritional substance or non-nutritional substance to a client.
• instructs clients and/or caregivers, RDs or other health care professionals to infuse a nutritional or non-nutritional substance to a client.
Note: RDs do not administer a substance to a person by instillation through parenteral means unless they have had additional supervised education and practice. This procedure is generally performed by Registered Nurses.

Sole and Private Practitioner Interpretive Guide