Late-Career Practice Considerations in Regulated Professions

Alberta’s regulated professionals are aging along with the general population.  A growing proportion of practitioners are choosing to practice well beyond traditional retirement ages. This trend reflects increased longevity, professional identity, workforce shortages, and the value of accumulated experience. For regulators, however, it also raises questions about fitness to practice, maintenance of competence, and public protection as their members move into later stages of their careers.

It is well established that aging is not a uniform process. Many late‑career professionals practice safely and effectively, often bringing deep expertise, judgment, and mentorship capacity. At the same time, normal or pathological age‑related changes—particularly in cognition, sensory function, or physical stamina—can affect some individuals’ ability to stay on top of contemporary standards of practice.

The existing literature consistently emphasizes the importance of functional capacity rather than chronological age. Cognitive and physical changes vary widely between individuals, and age alone is a poor predictor of competence. For regulators, this variability underscores the need for individualized, evidence‑based approaches, rather than blunt age‑based assumptions.

Scope + Purpose

In this article, we explore some of the potential concerns that regulators should be cognizant of in the coming years. We then provide an overview of some common approaches regulators can consider to support an aging membership to fulfil their statutory mandate of protecting the public interest and maintaining confidence in their respective professions.

Late-Career Practice in Canada

While this topic is a live issue in many fields, it has perhaps understandably received greatest attention in medical practice. We nevertheless view these findings as broadly applicable to regulated professions overall.

In a recent assessment of this topic by Genevieve Casey et al, researchers examined closed civil and regulatory matters between 2012 and 2021, and identified 65 cases in which a physician’s cognitive ability to practice medicine was a contributing factor. While such cases were uncommon overall, their prevalence increased markedly with age. The proportion of cases associated with cognitive concerns rose from 0.2% among physicians aged 55–60 to 7.7% among physicians over 80, with an average physician age of approximately 71 in these cases.

Unfortunately, competence concerns may only come to the attention of regulators via complaints processes—a reactive rather than proactive mechanism.

Alberta’s Current Regulatory Approach

In Alberta, Part 3 of the Health Professions Act (“HPA”) requires every health profession college to establish and maintain a continuing competence program applicable to all regulated members. These programs typically emphasize self‑assessment, continuing professional development, reflective learning, and periodic audits or assessments. Comparable competence and professional development frameworks exist in many other Alberta regulatory regimes, though they vary in form, intensity, and statutory specificity.^[1]

Notably, Alberta regulators have generally not adopted age‑based screening or assessment thresholds. Instead, fitness to practice concerns are addressed through universal competence frameworks under, for example, Part 3 of the HPA or in Rules or Standards for members, and case‑specific interventions when concerns arise. This approach may reflect a latent effort to avoid age discrimination and to treat competence as an individual, practice‑based issue.

While this approach has strengths, it also raises the policy question of whether self‑directed competence mechanisms alone are sufficient to identify emerging functional decline in late‑career professionals, particularly where insight may be limited or where concerns are first noticed by third parties.

Approaches in Other Provinces

Other Canadian jurisdictions have taken differing approaches, particularly in medicine. For example, Ontario requires physicians to undergo a mandatory peer and practice assessment at age 70, with reassessments every five years thereafter.^[2] Québec uses targeted questionnaires for physicians aged 60 and over to identify risk factors that may warrant further review. British Columbia relies on a comprehensive, career‑long peer assessment program that eventually encompasses all medical practitioners, including those in late career.

These models differ in design, but they share a common objective: introducing structured oversight at later career stages, without presuming incompetence or mandating retirement. Importantly, in each case, age functions as a trigger for review, not as a conclusion about fitness-to-practice.

Future Regulatory Considerations

As Alberta’s regulated workforce continues to age, regulatory colleges may wish to reflect on the following considerations:

1. Whether current competence programs detect/address issues early enough
   • Evidence suggests that some cognitive‑related concerns surface late, through complaints or legal processes. Regulators may wish to assess whether existing competence frameworks adequately identify and/or address early signals of declining performance in late‑career professionals.
2. The role of practice‑based and peer‑informed assessment
   • Competence issues associated with aging in professionals often relate to documentation, currency of knowledge, or practice organization. These are areas well suited to peer review, chart audits (in health fields), or practice/site visits, rather than mandatory self‑attestation alone.
3. The potential value of proportionate, late‑career triggers
   • Without adopting rigid age cutoffs, regulators could consider whether certain milestones (e.g., extended duration of independent practice, practice isolation, or high‑risk fields) warrant additional structured review later in career.
4. Supporting dignity, insight, and transition
   • As noted by Dr. Casey and colleagues, research has indicated that there is reluctance or even unawareness on how to address concerns about fitness to practice.^[3]Effective regulation should therefore include clear, respectful pathways for remediation, scope adjustment, or transition from practice, where appropriate. Normalizing conversations about late‑career planning may reduce stigma and encourage earlier engagement with regulatory supports.
   • Regulators can consider advertising CPD opportunities for late-career practitioners based on the types of practice issues that are brought to their attention.

Conclusion

The aging of Alberta’s regulated professions is neither a crisis nor a problem to be solved, but a demographic reality requiring thoughtful consideration by regulators. Evidence from research and other jurisdictions suggests that while most late‑career professionals practice competently, age‑associated risks do exist and may be identified too late under purely complaint‑driven systems.

For regulators, the challenge is to design oversight mechanisms that are evidence‑based, proportionate, and respectful, emphasizing functional competence over age, and support over sanction. We also note the potential for age discrimination to result in increased, unfounded complaints being filed with regulators as their membership ages, and colleges should remain aware of potential bias in reviewing and investigating complaints. With appropriate attention, colleges can protect the public interest while honouring the contributions and dignity of experienced professionals who continue to serve Albertans.

To discuss how your regulatory framework can proactively address late-career practice considerations, please contact Chelsey Bailey, KC, Duncan Cameron, or any member of Field Law’s Professional Regulatory Group.