Emergency Class Supervision Policy

The Registration Regulation under the Massage Therapy Act gives the College of Massage Therapists of Ontario (CMTO) the authority to temporarily permit Emergency Class registration when CMTO’s Board or the Ministry of Health has declared an emergency that requires the accelerated registration of Registered Massage Therapists (RMTs).

Individuals in the Emergency Class of registration will have met all the requirements for a General Certificate of registration except successfully completing the Objectively Structured Clinical Evaluation (OSCE) certification examination.  For this reason, an Emergency Class registrant must practise under the supervision of an RMT (Registered Massage Therapists) in the General Class.

Emergency Class registrants are full registrants with CMTO and are responsible for the care they provide.

Purpose

This policy comes into effect when CMTO’s Board or the Ontario Ministry of Health determines that there is a healthcare emergency and it is in the public interest to open the Emergency Class of registration due to an insufficient number of Registered Massage Therapists (RMTs). This policy describes the supervision requirements for registrants in the Emergency Class.

Scope

This policy applies to Emergency Class registrants and Supervisors of Emergency Class registrants.

Policy

Upon declaration of a healthcare emergency requiring the opening of Emergency Class registration due to an insufficient number of Registered Massage Therapists (RMTs), the Registration Committee will review this policy to ensure it appropriately addresses the needs and circumstances specific to the emergency situation.

  1. Supervisor Qualifications
    1. Must hold a General Certificate in good standing.
    2. Must have experience practicing Massage Therapy in Ontario or another regulated Canadian jurisdiction for a minimum of 5 years.
    3. Does not have any current practice concerns and has no history of any practice concerns within the previous three years.
    4. Does not have any terms, conditions, or limitations on their certificate of registration that prevent them from supervising another RMT.

If an approved Supervisor ceases to meet the Supervisor qualifications in this policy, CMTO will remove their authority to provide supervision.

  1. Supervision Requirements
    1. The Emergency Class registrant and their proposed Supervisor must sign the Emergency Class Supervision Agreement. CMTO will confirm that the proposed Supervisor meets the requirements of this policy; supervision must not begin until the Emergency Class registrant and their proposed Supervisor receive this confirmation from CMTO.
    2. The Emergency Class registrant is responsible for ensuring that their clients:
      1. Are informed that the Emergency Class registrant must practise under supervision, and
      2. Are provided with the Supervisor’s contact information so they may report any concerns.
    3. The Supervisor must be on-site at all times the Emergency Class registrant is providing Massage Therapy services.[1]
    4. A consultation must take place between the Supervisor and the Emergency Class registrant at least once every day that the Emergency Class registrant provides Massage Therapy services. These consultations must include the following:
      1. Disclosure from the Emergency Class registrant of every time they have provided treatment of a sensitive area as defined in CMTO’s Consent Standard, and
      2. A review of treatments provided since the last consultation.
  1. Roles and Responsibilities of Supervisors and Supervisees
    1. Supervisors must:
      1. Comply with legislation, regulations, by-laws, and standards governing the practice of Massage Therapy in Ontario.
      2. Ensure that there is no conflict of interest with the Emergency Class registrant they are supervising; they are prohibited from supervising family or friends.
      3. Ensure they are available to assist/consult the Emergency Class registrant as needed.
      4. Ensure that the supervised Emergency Class registrant has the knowledge, skill, and judgement to deliver safe and competent care.[2]
      5. Report any workplace concerns arising in the workplace about an Emergency Class registrant to CMTO. Supervisors must report to CMTO if the privileges of an Emergency Class registrant are revoked, suspended, or have imposed restrictions on them for reasons of professional misconduct, incompetence, or incapacity.
      6. Provide supervision for no more than two (2) Emergency Class registrants per day if they are also treating their own clients, and no more than five (5) Emergency Class registrants per day if they are not also treating their own clients.
      7. Follow up directly with every client who is treated by the Emergency Class registrant to confirm that they felt the care they received was professional and that they felt safe. The follow-up must occur within two business days after the client’s first appointment and at the discretion of the Supervisor thereafter.
    2. Emergency Class registrants must:
      1. Comply with legislation, regulation, by-laws, and standards governing the practice of Massage Therapy in Ontario.
      2. Secure a Supervisor for approval by CMTO; the Emergency Class registrant may have one Supervisor per workplace.
      3. Notify CMTO if their current Supervisor is no longer able to fulfill their Supervisory responsibilities and stop practising unless/until they secure a new Supervisor approved by the College.
      4. Practice in accordance with the terms, conditions, and limitations on their certificate of registration.
      5. Inform clients that they are practising under supervision and obtain consent from every client that they are comfortable receiving treatment from an Emergency Class registrant who is being supervised prior to initiating treatment.
      6. Only practice Massage Therapy when competent to do so safely and effectively, and within the limits of their knowledge, skills, and judgment.
  1. Documentation
    1. The Emergency Class Supervision Agreement document must be signed by the Supervisor and Emergency Class registrant and approved by the College before the Emergency Class registrant begins practice.
  1. Accountability
    1. If an Emergency Class registrant is the subject of a complaint or investigation, the College will investigate the Emergency Class registrant for the practice concerns and may also investigate the Supervisor to determine if their supervision of the Emergency Class registrant was appropriate.

Approved by the Registration Committee on June 30, 2025

 

 

[1] There are several ways this requirement may be met. The Supervisor may:

  • Choose not to treat clients at the same time as the Emergency Class registrant,
  • Inform their clients of possible interruptions
  • Have a fixed schedule for the Emergency Class registrant so supervision can also be scheduled
  • Have a full-time Supervisor role

[2] To meet this requirement, the Supervisor may choose to review the Standards of Practice with the EC registrant prior to them initiating treatment, and incorporate Standards review into their ongoing monitoring of the EC registrant.

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