Alberta · College of Physicians & Surgeons of Alberta

What Happens During a CPSA Investigation?

10 min readLast updated July 14, 2026

A CPSA investigation can restrict your practice permit before any hearing, can begin without a patient ever complaining, and can end in a fine of up to $50,000. But it can also end quietly — and for the overwhelming majority of physicians it does. What determines which of those happens is largely what you put in front of the Complaints Director while the investigation is still running.

Cooperation is a statutory duty, not a courtesy. Failing or refusing to cooperate with a CPSA investigator is itself unprofessional conduct. Contact the CMPA, take advice on what to say — and then say it, on time.

Where an investigation comes from

Most CPSA investigations follow a complaint from a patient or family member. But the Complaints Director can also act on information from hospitals, employers, other regulators, mandatory reports, the courts and CPSA’s own monitoring. A physician can be under investigation without any patient having raised a concern.

What investigators can do — and what you must do

An investigator appointed under the Health Professions Act can compel records, interview you and other witnesses, and gather evidence relevant to the allegations. The report goes back to the Complaints Director, who decides what happens next.

Your duty to cooperate is a statutory one, and its breach is a free-standing form of unprofessional conduct. The HPA definition expressly captures failing or refusing to cooperate with investigators, inspectors or competence reviews.

Cooperation and legal advice are not alternatives. Contact the CMPA, take advice on what to say and how to say it, and then engage properly and on time. Physicians damage otherwise defensible cases in both directions — by refusing to engage, and by engaging without advice.

Conditions on your permit while the matter is live

The College can impose interim conditions on a practice permit, or suspend it, before any hearing has taken place, where that is necessary to protect the public. A chaperone requirement, a restriction on the procedures you may perform, a limit on patient numbers, or a suspension can all be in force while the investigation is still running.

This is a point at which representation is essential, and at which the speed of your response matters. Interim measures shape not only your practice but the tenor of everything that follows.

The charging standard

For the Complaints Director to refer a matter to a hearing, two things must be true. The evidence must reasonably support that the physician engaged in unprofessional conduct as defined in the HPA, meeting CPSA’s charging standard — the test applied to decide whether there is enough evidence to charge. And referral must be in the interest of public safety.

Two conditions, both of which must be met. That is why so many investigations end without a hearing, and why the material you put before the Complaints Director during the investigation is doing more work than physicians generally realise.

How an investigation ends

After the investigation report, the Complaints Director may dismiss the matter, resolve it through alternative complaint resolution, or refer it to the Hearings Director’s Office for a disciplinary hearing.

A dismissal can still be reviewed. A complainant has 30 days to ask a Complaint Review Committee to consider whether the dismissal was reasonable; the CRC can confirm it, send the matter back for further investigation, or refer it directly to a hearing. CRC decisions are not published.

The Hearing Tribunal

If the matter is referred, it is heard by a Hearing Tribunal convened by the Hearings Director. A panel is made up of an equal number of physician and public members — typically four in total. Counsel for the Complaints Director presents the allegations, much as a prosecutor would; you may call witnesses and lead evidence in your defence.

The standard of proof is the balance of probabilities, not the criminal standard. Hearings are usually held virtually and, under the HPA, are open to the public.

Note also that under CPSA’s bylaws, information about an ongoing disciplinary proceeding is published on the CPSA website. The reputational consequences can begin before any finding is made against you.

Sanctions, and the right of appeal you still have

Where unprofessional conduct is found, section 82 of the HPA sets out what a Tribunal may order: a reprimand; conditions on the practice permit; suspension or cancellation of the permit; mandatory training, a practice review or a fitness-to-practise assessment; costs; and fines of up to $10,000 for each finding, to a maximum of $50,000 at any one hearing.

Unlike British Columbia — which abolished the statutory right of appeal to the courts in April 2026 — Alberta retains a full appeal route. Either the physician or the Complaints Director may appeal a Hearing Tribunal decision to CPSA Council within 30 days. An Appeal Panel of four Council members, two physicians and two public members, hears it. From there, an appeal lies to the Alberta Court of Appeal.

One caution about admissions. Admitting unprofessional conduct can be strategically sound — it often supports a joint submission on sanction and a materially lighter outcome. But an admission will largely prevent you from later appealing on the grounds that the facts were wrongly found. It is a consequential decision, and not one to take without counsel.

Key takeaways

Investigations can begin without a patient complaint — from hospitals, employers, other regulators, mandatory reports or CPSA’s own monitoring.
Failing or refusing to cooperate with investigators is itself unprofessional conduct under the HPA. Take advice from the CMPA, then cooperate.
Interim conditions or a suspension can be imposed on your practice permit while the investigation is still running.
To refer a matter to a hearing, the Complaints Director must meet the charging standard AND be satisfied that referral is in the interest of public safety. Both conditions.
Hearing Tribunals have equal numbers of physician and public members, apply the balance of probabilities, and are open to the public. Ongoing proceedings are published on the CPSA website before any finding.
Section 82 sanctions include reprimand, conditions, suspension, cancellation, mandatory training, costs and fines of up to $10,000 per finding ($50,000 aggregate). Alberta — unlike BC — retains an appeal to CPSA Council and then to the Alberta Court of Appeal.

Related courses

Practical, self-paced CPD courses that map onto the issues in this guide. These are educational courses. They are not accredited by the CPSA and are not a substitute for legal advice.

Dealing With a Complaint or Investigation Professionally

How to conduct yourself through an investigation, on the record and under scrutiny.

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Probity and Honesty for Healthcare Professionals

Honesty and candour under investigation. Concealment turns a care issue into a probity issue.

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Documentation for Healthcare Professionals

What investigators look for in the chart, and what strong records protect you from.

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Prescribing Guidance and Standards for Healthcare Professionals

Prescribing standards — a recurring subject of Alberta tribunal findings.

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Continue reading: Alberta doctors

How to respond to a CPSA complaint Remediation and reflection for Alberta doctors

Frequently asked questions

Can CPSA restrict my practice before a hearing?

Yes. The College can impose interim conditions on your practice permit, or suspend it, before any hearing where that is necessary to protect the public. Conditions can include a chaperone requirement, restrictions on procedures, or limits on patient numbers, and can remain in force while the investigation continues.

What is the charging standard?

The test CPSA applies to decide whether there is enough evidence to charge a physician with unprofessional conduct at a formal hearing. Referral requires both that the evidence reasonably supports unprofessional conduct as defined in the Health Professions Act, and that referral is in the interest of public safety. Both conditions must be met.

Who sits on a CPSA Hearing Tribunal?

A panel convened by the Hearings Director with an equal number of physician and public members — typically four in total. Counsel for the Complaints Director presents the allegations in a role similar to a prosecutor. The standard of proof is the balance of probabilities, and hearings are generally open to the public.

Can I appeal a CPSA Hearing Tribunal decision?

Yes. Alberta, unlike British Columbia, retains a full appeal route. The physician or the Complaints Director may appeal to CPSA Council within 30 days; an Appeal Panel of four Council members, two physicians and two public, hears it. A further appeal lies to the Alberta Court of Appeal.

Should I admit unprofessional conduct?

It can be strategically sound — admissions often support a joint submission on sanction and a materially lighter outcome, and Tribunals have expressly credited physicians who took steps to learn and improve. But an admission will largely prevent you from later appealing on the basis that the facts were wrongly found. Do not decide without counsel.

Will people know I am under investigation?

Possibly. Under CPSA’s bylaws, information about an ongoing disciplinary proceeding is published on the CPSA website. Reputational consequences can therefore begin before any finding is made. Complaint Review Committee decisions, by contrast, are not published.

This article is general information for physicians regulated by the College of Physicians & Surgeons of Alberta and does not constitute legal advice. Regulatory processes and the law change, and every case turns on its own facts. If you are the subject of a complaint or investigation, contact the Canadian Medical Protective Association (CMPA) or a lawyer experienced in professional regulation before you respond. Last updated July 14, 2026.