In late February, my two-year term as Royal College President came to an end. What a privilege it has been to lead this organization that I have worked with closely for more than three decades. And what an extraordinary and surprising experience it has been realizing positive change at the Royal College through one of the most challenging periods in the history of Canada’s health system.

When I started my term, I assumed the President’s core role as chair of Council and anticipated many other important duties: lots of travel, ceremonial functions performed in the President’s full regalia and in-person meetings about Royal College business. I enjoy the kind of work that involves socializing and connecting, so I was excited, but my pandemic-era presidency was not at all what I had expected. What I experienced instead was something far more profound and, in many ways, more rewarding. 

A transformation in how we communicate and engage

As the entire world shifted online during the early days of the pandemic, the Royal College of course had to do so as well, which transformed how we meet and communicate. I don’t mean to diminish the difficulties we have all faced over the past two to three years and, to be sure, I am a very strong advocate of in-person meetings. But, the adage about challenge leading to positive change has never been more apparent to me than in the context of my term as President.  

In shifting to a video conference model, we realized some major efficiencies that I’m convinced improved our work. As one example, because I couldn’t bump into Council members and staff in corridors during work breaks, my encounters with Council members were more deliberate and therefore more enriching. To ensure I heard from everyone, I set up three rounds of hour-long, one-on-one video conferences with each of our 30 members of Council over my two years in office. Meeting in a more structured way reminded me that people less inclined to approach colleagues in person have rich ideas that need to be captured. If we are to create the most engaged, responsive and effective Council, we need to hear from everyone, in detail. 

Another benefit was my close contact with standing committees. With everything happening online, I had the luxury of attending nearly every standing committee meeting over a two-year period.  

The effect of all this virtual face time? What I witnessed during the pandemic was a Council more engaged than I could have ever expected. My colleagues and I were able to identify priority topics for the Royal College more accurately and clearly than if our face-to-face meetings had happened more casually. For example, we discovered together that, with Canada’s health care system under such stress, there is a strong desire on Council for the Royal College to become more involved in issues not squarely situated in the educational domain. Some of these priority issues will take shape in our upcoming strategic plan.

Delivering on core functions of the Royal College 

Perhaps the Royal College’s greatest pandemic challenge was the need to pivot almost overnight on examination delivery. We had to enable trainees to sit their exams remotely, and as safely as possible, which resulted in two innovations: we switched our paper and pencil exams to an electronic format and we began to conduct oral and applied exams over video conference, committing to safety by having candidates take their examinations in a private hotel room. In normal circumstances, such a shift might have taken three or four years. During the early days of lockdown, we got it done in a couple months.

These little miracles of efficiency happened all around the world during the lockdowns — I’m extremely proud of the success across the entirety of Royal College functions throughout these last challenging three years. We all owe a huge debt of gratitude to the Royal College volunteers and staff who worked behind the scenes to pull it off. 

Major strides implementing EDI

We also made major improvements during my term as President in areas not related to the pandemic. As one outstanding example, we moved the needle substantially on our priority to integrate equity, diversity, inclusion, anti-racism and reconciliation at the Royal College — an improvement that has been long in the making.  

Largely due to the leadership of our CEO, Susan Moffatt-Bruce, MD, FRCSC, our Council and committees have become more diverse over the past two years. Our process for recruiting volunteers today is also far more inclusive than it was pre-pandemic. It involves reaching out to our 50,000 members, actively encouraging interest from equity-deserving groups and using an interview process to recruit for the most important posts — something we never did in the past. 

Today, we have a Royal College working hard to modernize, trying to get every Fellow engaged and shifting from a process of appointments happening by virtue of “who knew whom,” to one that is far more open and inclusive.  

Tackling challenges and reimagining the member experience

Looking to the future, the Royal College continues to invest a great deal of effort to improve how we train residents through Competence by Design, or CBD (our response to implementing competency-based medical education). I’ve been an evangelist for CBME for many years and feel very proud that the Royal College has established itself as a leader. Although I recognize that we need to do a better job implementing CBD, I would also note that almost a decade into our journey, many countries, including the U.S., are now moving in the same direction and are actively learning from our experience.

As for our progress technologically, we are working on a multi-year investment to change and improve our electronic platforms. The vision — which we’re referring to as a digital member experience transformation— is for all Fellows to enjoy a seamless, state-of-the-art experience engaging with the Royal College. This includes how our volunteers interact with the organization and also how Fellows manage their professional development. We have not spent enough time in the past thinking about the Fellow interface and lifelong professional journey. We’re addressing this meaningfully over the next three to four years, which is a sea change I’m particularly excited about. 

Thanks to a remarkable CEO

Finally, I want to take this opportunity to thank our CEO, Susan, for her indefatigable work during her time with us, and wish her the very best as the new president at Lahey Hospital and Medical Center in Boston, Massachusetts. Susan cared deeply about the Royal College and she is leaving to her successor a legacy of exceptionally strong leadership, as well as an organization that has embraced its responsibility to modernize. We’re well poised for a new CEO to carry on Susan’s excellent work as well as make their own mark on the organization. 

And, I have every confidence that that our interim CEO, M. Ian Bowmer, MDCM, FRCPC, who started this month, will do a terrific job leading this organization while our search committee identifies our next permanent CEO.

I am also very confident that the governance side of the Royal College will be in great hands with one of Canada’s most exceptional and highly regarded educators, Brian Hodges, MD, FRCPC, who has taken over as President. 

For my part, I’m confident that I’m leaving the presidency with a Royal College in great shape to take on the future. We have an extremely active and engaged Council and a strong contingent of contributing Fellows who are increasingly reflective of our broader society. When we post a major committee opening or a spot on Council today, we are seeing unprecedented interest to fill the vacancy; I am pleased to see this growing interest in the Royal College among our Fellowship.

To say my time as President has been enriching is to understate things pretty dramatically. Thank you all for this opportunity to serve. 

Richard

Richard Reznick, MD, FRCSC, MEd, FACS, FRCSEd (hon), FRCSI (hon), FRCS (hon) 
Past-President

Richard K. Reznick was the 46th President of the Royal College of Physicians and Surgeons of Canada. He is the founding director of the Wilson Centre and previously served as chair of the Department of Surgery at the University of Toronto, as well as vice president, education, at the University Health Network, and professor emeritus of surgery and dean emeritus of the Faculty of Health Sciences at Queen’s University.