British Columbia · College of Physicians and Surgeons of BC

What Happens During a CPSBC Investigation?

10 min readLast updated July 14, 2026

A CPSBC investigation can begin without anyone having complained about you. It can suspend your practice authority before you have said a word in your defence — and since 1 April 2026, it can do so without giving you notice or a chance to be heard. And when it ends, the appeal route to the courts that physicians relied on for thirty years no longer exists.

The record you build during the investigation is, for most purposes, the only record there will ever be. With the statutory right of appeal abolished, there is no meaningful second chance on the merits. Contact the CMPA the moment you become aware of an investigation — not when it concludes.

An investigation does not need a complaint

Under section 124 of the HPOA, the Investigation Committee may initiate an investigation without any regulatory complaint at all. Matters reach the College from hospitals, employers, other regulators, mandatory reports, the coroner, media coverage and the College’s own information.

The HPOA also widened the duty to report. Licensees must report another licensee where they have reason to suspect sexual misconduct, sexual abuse or discrimination, and in some circumstances that duty extends beyond regulated professionals to employers. In practice this means more matters now originate in workplace disputes rather than patient care, which is a real shift in where regulatory risk comes from.

The summary protection order — and why it should worry you

This is the single most significant change for a physician under investigation, and it is the part most doctors have not registered.

Under sections 259 and 260 (and section 126(c)), during an investigation the College may make a summary protection order: imposing or varying limits or conditions on your practice authority, or suspending it outright.

It can be made without notice to you, and without giving you an opportunity to be heard. Under the old Health Professions Act you were given notice and a chance to respond before limits, conditions or a suspension were imposed during an investigation. Under the HPOA, you may not be. This is a deliberate change, and it is the reason speed matters so much once you become aware of a serious allegation.

The threshold is that the Investigation Committee has reasonable grounds to believe your practice may present a significant risk of harm to any person — or that you are providing false or misleading information to patients or the public such that someone acting on it would be at significant risk.

Summary protection orders are published on your public profile. If one is made against you, you will need advice immediately: your route to challenge it is narrow, and it is not the one it used to be.

What investigators can do

The College may retain investigators under the HPOA with power to compel records, enter and inspect premises, and interview you and others. The Investigation Committee must investigate and assess the matter under sections 125 to 136. Everything gathered forms the basis on which the Committee decides what happens next.

Investigations are confidential. In limited circumstances the College may acknowledge that it has received or disposed of a complaint, in order to respond to public reporting.

How an investigation ends

The Investigation Committee may:

Take no further action, or dismiss the matter as unfounded;
Give advice or a warning;
Impose quality or practice improvement measures — education, supervision, audit;
Impose limits or conditions on your practice authority;
Request a citation from the Director of Discipline under section 137, sending the matter to the Health Professions Discipline Tribunal;
Settle a matter for which it has requested a citation, under section 137 and section 139 — subject to the approval of the Director of Discipline.

That last route matters more than it looks. The Director of Discipline has been explicit that he wants cases resolved without a hearing where that is appropriate. A negotiated resolution is a live and encouraged path — but you will only be in a position to take it if you have built a credible record.

The appeal route you no longer have

Under the old Act, a registrant could appeal a disciplinary decision to the BC Supreme Court, and Inquiry Committee dispositions could be reviewed by the Health Professions Review Board.

The HPOA abolished the statutory right of appeal to the courts. Decisions of the Director of Discipline and of discipline panels are expressed to be final and conclusive, and not open to question or review by any court. Your only recourse is judicial review — which examines procedural fairness, not whether the decision was substantively right.

Decisions of the Investigation Committee, including summary protection orders and disciplinary orders, are now reviewed by way of reconsideration through the College’s registrar, rather than an appeal to the court.

What this means in practice: there is no meaningful second chance on the merits. The record you build during the investigation is, for most purposes, the only record there will ever be. Get it right the first time.

Key takeaways

Section 124 lets the Investigation Committee open an investigation with no complaint at all — and the widened duty to report means more matters now start in workplace disputes.
A summary protection order under sections 259–260 can suspend your practice authority or impose limits DURING the investigation — and, unlike under the old Act, it can be made without notice and without an opportunity to be heard.
The threshold is reasonable grounds to believe your practice may present a significant risk of harm. Summary protection orders are published on your public profile.
Investigation Committee outcomes range from dismissal, advice and a warning, through education, supervision and practice limits, to a request for a citation under section 137.
Settlement without a hearing is available under section 139 with the Director of Discipline’s approval — and the Director has said he wants matters resolved that way where appropriate.
The statutory right of appeal to the courts has been abolished. Judicial review on procedural fairness is the only recourse; Investigation Committee decisions are reconsidered by the registrar.

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 CPSBC 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.

View course →

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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Professionalism and Professional Standards for Doctors

The professional conduct and standards expected of licensed physicians.

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Frequently asked questions

Can the CPSBC suspend me before any hearing?

Yes, and this is the biggest change under the HPOA. Sections 259 and 260 allow the College to make a summary protection order during an investigation, imposing limits or conditions on your practice authority or suspending it. Crucially, such an order may be made without notice to you and without an opportunity to be heard — which was not the position under the old Health Professions Act.

Can an investigation start without anyone complaining about me?

Yes. Under section 124 the Investigation Committee may initiate an investigation without a regulatory complaint. Matters commonly arise from hospitals, employers, other regulators, mandatory reports and the College’s own information. The HPOA also widened the duty on licensees to report other licensees for suspected sexual misconduct, sexual abuse or discrimination.

Can I appeal a disciplinary decision to the courts?

No. The HPOA abolished the statutory right of appeal. Decisions of the Director of Discipline and of discipline panels are final and conclusive and not open to review by any court. Your only recourse is judicial review, which considers procedural fairness rather than whether the decision was substantively correct. Investigation Committee decisions, including summary protection orders, are reviewed by reconsideration through the College’s registrar.

Can my case be resolved without a discipline hearing?

Often, yes. Under section 139 the Investigation Committee may settle a matter for which it has requested a citation, subject to the approval of the Director of Discipline. The Director has stated publicly that he wants to resolve cases without hearings where appropriate. But a negotiated resolution requires something to negotiate with — which is why the record you build during the investigation matters so much.

Are CPSBC investigations confidential?

Yes, complaint investigations are confidential. In limited circumstances the College may acknowledge that it has received or disposed of a complaint, in order to respond to public reporting. Disciplinary orders and summary protection orders, however, are published.

What happens if I am cited?

The Investigation Committee requests a citation from the Director of Discipline under section 137, and the matter leaves the College for the Health Professions Discipline Tribunal. A discipline panel of one licensee, one member of the public and a specialist in the area of concern will hear it. Hearings are public and may be recorded.

This article is general information for physicians licensed by the College of Physicians and Surgeons of British Columbia and does not constitute legal advice. The Health Professions and Occupations Act came into force on 1 April 2026 and the regime described here is new; processes, bylaws and practice are still settling, 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.