Manitoba · College of Physicians and Surgeons of Manitoba

What happens during a CPSM investigation?

9 min readLast updated July 14, 2026

A CPSM investigation is run by an appointed investigator and decided by a committee of three — two doctors and one member of the public. The committee has a ladder of outcomes available to it, from no further action up to a censure or a referral for a disciplinary hearing, and where you land on that ladder depends heavily on what you put in front of it.

Do this first: get CMPA assistance for the whole investigation, not just the first letter. Ask for the complete investigation material, answer every request from the investigator fully and on time, and start building your remediation evidence now — not after the committee has decided.

How a matter reaches the Investigation Committee

Three routes lead here. The Registrar’s triage sends a matter straight to the Investigation Committee where it raises concerns of a potentially more serious nature — complex care, a death, or a possible breach of fundamental ethical obligations. A complainant who is dissatisfied with a Complaints Committee decision can ask for the matter to be reviewed here. And the Registrar can refer information received about your care or conduct even where it does not come from the patient or their legal representative — a hospital, a colleague, or a report made under the reporting duty in s.138 of the RHPA.

Who decides — and who investigates

The Investigation Committee is made up of three people: two doctors and one member of the public who does not work in healthcare, chaired by a CPSM councillor. The committee does not gather the evidence itself. It appoints an investigator, who examines the complaint, the clinical records and your written response, and may go further — interviewing you, meeting the complainant, obtaining an independent expert opinion where the care in question is specialised.

The investigator reports back. The committee meets, discusses the report and your response, and decides the outcome.

The duty to co-operate

You are required to engage. Provide the records requested, answer the investigator’s questions, and meet the deadlines you are given. Two failures do more damage than almost any underlying allegation: an incomplete or curated disclosure, and a record altered after the fact. Both convert a question about your care into a question about your integrity, and integrity cases are the ones that end in an Inquiry.

Being asked to attend an interview is not an invitation to explain yourself unprepared. Prepare it with the CMPA, and take advice on what is being sought.

The outcomes available to the committee

The Investigation Committee has a graded set of powers, and it is worth understanding exactly what each one means:

No further action — your care or conduct met the expected standard.
Advice or constructive feedback — guidance to help you improve, without a disciplinary finding.
A censure — a public reprimand. This is formal discipline: it creates a disciplinary record, it is published under s.104 of the RHPA (usually naming you), and it can be taken into account by any CPSM committee in the future. Costs are often paid.
A written agreement — you agree to address specific concerns, for example by undertaking education or accepting restrictions on your practice.
Voluntary surrender of your registration.
Referral to the Inquiry Committee under s.102(1) RHPA — where the matter is serious enough to warrant charges and formal disciplinary action, or where you do not agree to what the committee proposes.

Read that last point carefully. Declining a censure or an agreement does not make the matter go away — it can send it to an Inquiry, which is a far higher-stakes forum. That decision needs legal advice, not instinct.

Interim suspension and conditions

Under s.110(1) of the RHPA, the Investigation Committee or its Chair can impose an interim suspension, or conditions on your certificate of practice, while the investigation is still running, where that is necessary to protect the public from exposure to serious risk. CPSM describes this as rarely necessary, and it must give you notice. If it is raised in your case, that is the moment to escalate to counsel immediately.

The Inquiry: what a referral means

If the matter is referred, the Inquiry Committee Chair selects a panel of three — two doctors and one public representative (RHPA ss.114–115). The hearing looks like a trial: if you plead not guilty, evidence is led and witnesses are questioned; if you plead guilty, the panel hears evidence going to penalty. As in Canadian regulatory proceedings generally, allegations are proved on the balance of probabilities.

A panel that finds professional misconduct can order a suspension, impose terms and conditions on your certificate of practice, require payment of the costs of the investigation and hearing (and sometimes a fine), or cancel your registration entirely. Where a physician is found guilty, CPSM is authorised to publish the decision including your name. A physician found not guilty is never named. Suspensions and erasures are reported onward — to Manitoba Health, the Medical Council of Canada, the Federation of Medical Regulatory Authorities of Canada and the relevant health authority. Either side can appeal an Inquiry Panel decision to the Manitoba Court of Appeal.

Appeals from the Investigation Committee

Note the asymmetry, because physicians frequently misunderstand it. Under s.108(2) RHPA, a complainant who is dissatisfied with an Investigation Committee decision may appeal it to an Appeal Panel, in writing, within 30 days of being notified — a deadline CPSM has no power to extend. A closed file is therefore not always a finished file, and you should not assume a matter is over until the appeal window has passed.

How long it takes, and how to use the time

Expect several months, and longer where an expert opinion is commissioned. The waiting is the hardest part, but it is also the opportunity: the committee decides the outcome after it sees what you have already done about the concern. Remediation completed during the investigation is worth considerably more than remediation promised after it.

Key takeaways

The Investigation Committee is three people — two doctors and one public member — and it appoints an investigator to gather the evidence.
Outcomes run from no further action and advice, through a censure or written agreement, to referral to the Inquiry Committee under s.102(1).
A censure is formal discipline: it creates a disciplinary record and is published under s.104, normally naming you.
Refusing a proposed censure or agreement can send the matter to an Inquiry — take advice before you decline anything.
An Inquiry Panel (two doctors, one public representative) can suspend, impose conditions, order costs, or cancel registration; appeal lies to the Manitoba Court of Appeal.
A complainant can appeal an Investigation Committee decision within 30 days under s.108(2), so a closed file is not always final.

Related courses

Structured CPD you can complete now and put in front of the committee as evidence of insight.

Dealing with a Complaint or Investigation ProfessionallyCo-operating with an investigator without conceding what is not yours to concede. Insight for Fitness to PractiseWhat regulators mean by insight, and how to evidence it before a decision is made. Probity and Honesty for Healthcare ProfessionalsWhy disclosure failures and altered records escalate faster than clinical error. Fitness to Practise for Healthcare ProfessionalsHow a regulator frames impairment, competence and conduct.

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How to respond to a CPSM complaint Remediation and reflection for Manitoba doctors

Frequently asked questions

Who sits on the CPSM Investigation Committee?

Three people: two doctors and one member of the public who does not work in healthcare, chaired by a CPSM councillor. The committee appoints an investigator to examine the complaint, the records and your response.

What can the Investigation Committee do to me?

It can take no further action, give advice or constructive feedback, issue a censure, accept a written agreement (such as education or practice restrictions), accept voluntary surrender of your registration, or refer the matter to the Inquiry Committee for a disciplinary hearing.

Is a censure serious?

Yes. A censure is formal discipline. It creates a disciplinary record, it is published under section 104 of the RHPA and normally names you, it stays on the CPSM website for ten years, and it can be considered by any CPSM committee in the future.

What happens if I refuse a censure or a proposed agreement?

The matter does not end. Where you do not agree, or where further action is needed, it can be referred to the Inquiry Committee for a full disciplinary hearing — a much higher-stakes forum. Take legal advice before declining anything.

Can CPSM suspend me before any hearing?

Yes, under subsection 110(1) of the RHPA, where interim action is necessary to protect the public from exposure to serious risk. CPSM says this is rarely necessary and must give you notice, but if it is raised, escalate to the CMPA and counsel the same day.

Can the complainant appeal if the matter is closed?

Yes. Under subsection 108(2) of the RHPA a complainant may appeal an Investigation Committee decision to an Appeal Panel within 30 days of being notified. CPSM cannot extend that deadline, and a physician has no equivalent right of referral.

This guide is general information about the College of Physicians and Surgeons of Manitoba (CPSM) and is not legal advice. Regulatory processes turn on their facts, and the RHPA and CPSM by-laws change. Contact the CMPA before you write to CPSM, and take advice from a lawyer experienced in Manitoba regulatory matters. Healthcare Ethics Courses is an independent CPD provider and is not affiliated with CPSM. Last updated July 14, 2026.