Position Statement – Interjurisdictional Practice

Registration Requirement for Interjurisdictional Practice

Approved by the Board: March 22, 2024

Position Statement

Externally registered Canadian dietitians must hold a certificate of registration to practise in Ontario to use the title dietitian in Ontario and/or provide dietetic services in Ontario. This includes:

• Dietitians who are externally registered and located outside of Ontario providing virtual dietetic services¹  to individual clients, or groups of clients, in Ontario, 
  and
• Dietitians who are externally registered and are physically in Ontario providing dietetic services in Ontario or using the title dietitian in Ontario. 

Exceptions²

The College does not require registration in Ontario for externally registered Canadian dietitians under the following circumstances ³:

• Virtual Continuity of Care*: When dietetic services were initially provided to a client who was physically located in the externally registered Canadian dietitian’s primary jurisdiction, the client then returns home to Ontario or is temporarily located in Ontario, and:
  • it is in the client’s best interests to receive follow-up dietetic services virtually, 
  • follow-up care is not readily available from a dietitian registered in Ontario, and
  • the client urgently needs ongoing dietetic care 

*The exception for continuity of care does not permit externally registered Canadian dietitians to circumvent the College’s registration requirements and primarily practise virtually in Ontario.

This exception is intended to allow for the delivery of limited virtual care by dietitians registered in other Canadian jurisdictions in circumstances where there is an urgent need, services are not readily available from an Ontario dietitian, and virtual care is in the Ontario client’s best interests. 

• Occasional Meetings/Conferences/Media Events: When an externally registered dietitian is attending occasional meetings, speaking at conferences, or attending media events relating to the practice of dietetics in Ontario,
• Resource Development/Communications Work: When an externally registered dietitian is developing print/online resources or engaging in communications work relating to the practice of dietetics in Ontario, and not seeing individual clients or groups of clients directly, or
• General Nutrition Education: When an externally registered dietitian is providing general online education (e.g., webinar) that does not include individualized nutrition assessment and/or treatment.

These exceptions require the externally registered dietitians to be clear and transparent with all parties about where they are registered as a dietitian and with respect to the fact that they are not registered in Ontario. 

Non-Compliance

Failure to comply with the requirements may constitute a breach of the following provisions of the Dietetics Act, 1991:

Restricted titles
7. (1) No person other than a member shall use the title “dietitian”, a variation or abbreviation or an equivalent in another language.

Representations of qualification, etc.
(2) No person other than a member shall hold himself or herself out as a person who is qualified to practise in Ontario as a dietitian or in a specialty of dietetics.

If the College becomes aware of concerns about virtual services provided to a client in Ontario, or circumstances under which an externally licensed dietitian is not appropriately complying with the registration requirements or exceptions, it may share that information with the regulatory authority where the dietitian is licensed or take such action as authorized under the Regulated Health Professions Act, 1991. 

Nothing in this Position Statement is intended to limit the application of the provisions regarding use of title or representation of qualifications in section 7 of the Dietetics Act, 1991.

[1] Virtual dietetic services (also referred to as telepractice, telehealth, e-health, e-services) provides dietetic services, including nutrition assessment and/or treatment/intervention, to clients, groups of clients, substitute decision-makers, and caregivers, using technology (such as telephone, videoconferencing, or other electronic communication). Refer to the College’s Virtual Care Standards and Guidelines for more information.

[2] Exceptions are only permitted if an externally registered dietitian’s connection to Ontario is minimal. If the connection to Ontario is substantial, registration in Ontario is required.

[3] Dietitians must also comply with the rules of the Canadian jurisdiction in which they are registered – the regulator in that jurisdiction may prohibit practice outside of that jurisdiction unless the dietitian is also registered in that second jurisdiction.

PLEASE CONTACT THE COLLEGE IF FURTHER CLARIFICATION IS NEEDED

Registration Program
registration@collegeofdietitians.org
416-598-1725/1-800-668-4990, ext. 395