Is swimmer’s ear really a minor ailment? OCP debates mandatory training and declarations as exploration of scope expansion continues

On Monday, the Ontario College of Pharmacists' Board of Directors wrestled with how prescriptive it should be with mandatory training and its respective disclosures, as its members prepare to take on an ever-extending scope of practice. Late last year, Ontario’s Minister of Health broadened pharmacists’ authority to treat an additional 14 minor ailments, including conditions such as acute insomnia, fungal nail infections and head lice.At its last meeting in December 2025, the board reviewed a series of safeguards in anticipation of those changes and directed staff to continue developing them for future consideration and eventual approval.At Monday’s meeting, board staff asked its directors to approve moving ahead with a 60-day public consultation on proposed learning requirements tied to four new areas of practice: acute pharyngitis (sore throat) otitis externa (swimmer’s ear), herpes zoster (shingles), as well as the administration of long-acting injectable buprenorphine—more commonly known as Sublocade—which is used to treat moderate to severe opioid use disorder. A risk assessment by college staff had found all three minor ailments, as well as the administration of Sublocade, to be worthy of extra scrutiny. All previously approved minor ailments had undergone the same risk assessment, said college staff at the board meeting.Debate arose on whether pharmacists should prove competence through specific mandatory training for each new condition, or through a broader self-declaration of competence in areas of practice.While he agreed with the motion in theory, director Simon Boulis pushed back on listing individual training requirements for each new clinical activity, warning that a condition-by-condition approach could create an increasingly complex and burdensome regulatory system.“Again, it goes back to are you comfortable? Do you think you have the competency to provide that?” Boulis said, comparing the requirements pharmacists are subject to with those of physicians. “[Physicians] email their college and say, ‘I want to do that procedure,’ and they provide their certificate that they got the training to do that procedure—but they don’t have to attest and post it on their website that they are okay to do that one and not the other.”Director Wilfred Steer agreed, saying that as the profession evolves, there are limits to what can be codified in rules. “I think there should be some sort of declaration,” said Steer. “But at some level, you need practitioners to wear their big boy pants and figure it out.”Director Siva Sivapalan had a counterpoint, specifically on training to treat swimmer's ear, noting the need for practitioners to be comfortable using an otoscope. “This is not a minor ailment, there is nothing minor about otoscopy," Sivapalan said. "There’s so many things that could go wrong, I’ve seen it go wrong in practice." “My recollection of the board meeting in December was the board gearing towards mandating the learning as opposed to just a one-time declaration. I don’t think it would discourage or limit the provision of the service. I think pharmacists will do it because it doesn’t cost a lot to do this kind of training.”Some Canadian jurisdictions, like Saskatchewan and New Brunswick, require pharmacists to demonstrate competence in using an otoscope in order to assess ear conditions such as swimmer's ear. When it came to discussing Sublocade, a long-acting injectable used in opioid-use disorder treatment, college staff recommended relying on manufacturer certification as the primary means of ensuring competency in order to avoid duplication and build on existing training pathways.After a brief break, the motion passed, with the chair noting that the proposal is not the final decision and will proceed to public consultation, with any substantive feedback from stakeholders and the public to be considered before final approval. The board also passed a motion to amend the Administering a Substance by Injection Guideline to require CPR training for pharmacy technicians, subject to government approval. On another topic, the board reviewed and provide feedback on proposed updates to the college's Standards of Operation, but there was no substantive public feedback on the proposed changes to date.Staff are currently conducting an ongoing in-depth review of the standards, which includes a jurisdictional scan, an assessment of options and a draft summary of potential amendments. A redline version of the current standards is available for members to review here in the latest meeting agenda.

Is swimmer’s ear really a minor ailment? OCP debates mandatory training and declarations as exploration of scope expansion continues

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