Presented to: CLEAR Conference Presented by: Sharon Saberton, Registrar, M.R.T.(R.), M.A.(Ed.) College of Medical Radiation Technologists of Ontario Date: September 12, 2003 Magnetic Resonance Technologists Regulated by the College of Medical Radiation Technologists of Ontario (CMRTO) S uccess May 29, 2003

Agenda Magnetic Resonance Defined The Problem The Process – Regulation of Magnetic Resonance (MR) Technologists The Sunrise Criteria Implementation Summary

Magnetic Resonance Defined What is it?  Magnetic resonance imaging (MRI) is an imaging technology that provides detailed images of the human body using electromagnetism and radiofrequency waves. Who does it?  MRI units are located in or associated with medical imaging departments in a hospital or independent health facility. The technologists who are selected by a department to be trained to operate an MRI unit are medical radiation technologists – usually in the specialty of radiography or nuclear medicine.

The Problem The magnetic resonance (MR) technologists spent most of their careers as medical radiation technologists (MRTs), being accountable to the public and their patients through the College of Medical Radiation Technologists of Ontario (CMRTO). By virtue of becoming more specialized in their practice and becoming proficient in MR, these individuals were no longer accountable to the public through self-regulation.

The Process – The Regulation of Magnetic Resonance (MR) Technologists On February 19, 1999 the Minister of Health and Long-Term Care (MOHLTC) referred the Regulation of MRI to the Health Professions Regulatory Advisory Council (HPRAC). In May 1999 HPRAC asked the CMRTO and other stakeholders to respond to the document ‘Request for Regulation under the Regulated Health Professions Act, 1991’.

The Process – The Regulation of Magnetic Resonance (MR) Technologists (cont’d.) On November 30, 1999 the CMRTO submitted their response to HPRAC. In September 2000 HPRAC provided advice to the MOHLTC with respect to the regulation of MR technologists. On February 7, 2001 MOHLTC accepted HPRAC’s advice that MR technologists be regulated by the CMRTO.

The Sunrise Criteria Introduced By HPRAC In June 2003 The Sunrise Criteria introduced by HPRAC in June 2003 included the following:  public intent / public need  economic considerations  education  collaborative scopes of practice All four of the Sunrise Criteria were addressed in the CMRTO submission to HPRAC in 1999.

Scope of Practice (addressed in CMRTO submission ) Included with the submission to HPRAC was a separate detailed document entitled ‘Request for a change in the Scope of Practice under the Regulated Health Professions Act, 1991 Medical Radiation Technologists’.

Scope of Practice (addressed in CMRTO submission ) cont’d. The fundamental principles of the RHPA were used as the underpinnings of this document:  protection from harm  quality care  accountability In addition the common features of medical radiation technology and magnetic resonance imaging were described

Scope of Practice (addressed in CMRTO submission ) cont’d. The submission set out the proposed scope of practice for MR technologists and explained how the scope of practice related to the core body of knowledge of the MR technologist. The submission also proposed that the Medical Radiation Technology Act be amended and that the MRT scope of practice be changed to include electromagnetism as a form of energy to produce diagnostic images and tests.

By 2002, the entire MRI landscape had changed It became apparent that there would be a significant increase in MRI installations in Ontario, both in hospitals and independent health facilities, by It appeared that the increase in MRI units might impact training and education, as well as access for patients, to this valuable health care service.

By 2002, the entire MRI landscape had changed (cont’d.) In a letter to the CMRTO College President, received just before the end of 2002, the Minister of Health and Long-Term Care asked for the cooperation of the CMRTO “in the regulation of MR technologists via regulation amendment.” The Minister’s letter was, in one sense, the culmination of many years of work, and in another sense, only the beginning of a period of intensive focus in creating the necessary regulatory framework for self-regulation of MR technology.

Implementation On May 29, 2003 the necessary regulations made under the Medical Radiation Technology Act came into force to regulate MR technologists by the CMRTO. An amendment to the registration regulation of the College sets out the registration requirements in order for an MR technologist to be issued a certificate of registration by the College which authorizes the practice of the specialty of MR. A further regulation changes the scope of practice for medical radiation technology so that the use of electromagnetism to produce diagnostic images and tests is included as part of the scope of practice.

Summary The process of regulating MR technologists through the submission to HPRAC and subsequent referral to MOHLTC was a necessary and important step to facilitate implementation of the regulatory framework for self-regulation of MR technologists. The goal was achieved but the process put in place to meet the goal changed, based on an identified need by the MOHLTC in 2002.