The Royal College’s reputation for excellence in postgraduate medical education (PGME) has enabled us, with great success, to engage internationally. As President, I highly value this international work. I believe it is an emerging source of strength for the Royal College while, at the same time, providing great value for our international collaborators.

Some of you are aware that the Royal College has a strong international presence and that we’re recognized as advancing some of the best medical education standards in the world. In fact, supporting our Fellows’ passion for engaging internationally is written right into our strategic plan. But for those of you who are less familiar with what we do around the world, let me explain a bit about how our work is organized and administered — and why it’s so important. 

Two units support our international engagement

We have two separate units that support Fellows, academic partners, health organizations and clients in other countries: our Office of International Collaboration (OIC) and Royal College International (RCI). OIC works closely with sister colleges around the world to help build communities of practice in medical education on such topics as the best ways to promote physician wellness and new approaches in continuing professional development. By collaborating globally, we stay current with trends and practices and strengthen Canada’s and other countries’ medical education systems.

RCI is our international business unit. Through RCI, Fellows bring our expertise in medical education to more than 40 countries that share our passion for excellence. RCI’s services, which the Royal College provides on a cost-recovery basis for wealthier countries, run the gamut from faculty development to accreditation. We may provide a workshop on medical education, help establish a medical education conference, or provide a simulation course on sepsis or trauma resuscitation. It depends on what the client country needs.

Funding Fellows’ humanitarian work

One of the great benefits of the RCI business model is that it helps fund the humanitarian work close to the hearts of many Fellows. It does this by supporting our International Development, Aid and Collaboration (IDAC) program. IDAC has been awarding grants to Fellows since 2019 for their work to improve health profession education and local capacity in low- and middle-income counties. IDAC has funded some 20 humanitarian projects in regions as far afield as the Caribbean, South America and East Africa. 

For example, Dr. Zahira Khalid and team are using an IDAC grant to create a first-of-its-kind clinical educator fellowship program in Guyana that will foster local capacity to train postgraduate residents.

Another notable example is Dr. Andrew Toren who is co-leading a team to help improve glaucoma care in Côte d'Ivoire.

Hundreds, if not thousands of our Fellows across Canada are engaged in collaborative work around the world. Each experience is unique, and all are enriching. I know, firsthand, just how grateful I have been to be personally involved in a project in Eastern Ethiopia, which to date has been successful in launching two new residency programs in the region.

Three reasons why international engagement is important

Personal anecdotes aside, I’ve been a strong supporter of the Royal College’s international work for a good 15 or 20 years. I believe our international engagement activities are vital for three key reasons.

First, I strongly support global thinking in general. If we peer into the future, we see how unlikely it is that every country in the world will have the resources, expertise and other means to develop world-class medical education frameworks without significant support from outside. Globalism teaches us that when we take advantage of economies of scale, we can achieve greater things than when we act on our own. 

Second, in the debate that often ensues about whether or not to collaborate internationally, especially when there are questions about whether or not we share the same values with client countries, I would posit that it is better to engage than not engage. In that regard, I would suggest that the work we do is about improving health, and we are committed to helping improve the health and care of patients, no matter where they live. 

Third, I want the Royal College to lead in medical education—and we have every reason to believe that if we are proactive in bringing our expertise to other countries, we can build on our strong leadership position. Canada already punches above its weight in medical education research and has for decades. Since the CanMEDS Physician Competency Framework was first introduced in 1996, it has become the most widely accepted and applied physician competency framework in the world. Today, it is being used in dozens of countries and on every continent except Antarctica.

Canada is a strong leader, and can be stronger

If you have any doubt that Canada is a world leader in medical education, consider as just one example, the Latin American Conference on Residency Education (LACRE), a biennial learning event in Chile that the Royal College developed nearly a decade ago in partnership with Pontificia Universidad Católica de Chile. LACRE is modelled after the Royal College’s International Conference on Residency Education and is devoted to promoting high standards of PGME in the region. It attracts hundreds of attendees from a dozen neighbouring countries.

One measure of Canada’s pre-eminence in the sphere of medical education relates to the prestigious Karolinska Institute Prize for Research in Medical Education. Since it was initiated in 2004, 11 individuals have been awarded the prize. Six of them have been Canadians, including the University of British Columbia’s Professor Kevin Eva, who won this year’s award. 

In a shrinking world, it is entirely possible that in 20 or 30 years, there may only be a few recognizable names in the world-wide community of medical education. I’d like one of those names to be ours. As a world leader in PGME, the Royal College should continue to move forward as a globally minded organization. I invite every Royal College Fellow to consider how they might participate in international engagement, which is an enriching endeavour in so many ways. 

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

Richard K. Reznick, MD, MEd, FRCSC, FACS, is 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 University of Toronto and dean of the Faculty of Health Sciences at Queen’s University.