Table of Contents
- Web conference technology change
- Volunteer input on the Royal College workplace design
- Committee on Specialties update
- New policy on appointing program directors
- Accreditation update
- Upcoming Royal College virtual conferences
- Area of Focused Competence update
Web conference technology change
The Royal College has heard feedback from specialty and Area of Focused Competence (AFC) committee chairs and members, along with Fellows that volunteer for other roles at the regarding the preferred web conference service. As of April 1, 2021, the Royal College will use Zoom for most committee meetings.
As indicated at the Specialty Committee Chairs Workshop in November we will also be rolling out Microsoft Teams for committee meetings. Currently, there is no date for when that will take place. Once Microsoft Teams is made available, we will likely use a mix of Zoom and Microsoft Teams for committee meetings depending on the nature of the meeting. The Specialties Unit will keep you updated as information and dates become available.
Volunteer Input on the Royal College workplace design
COVID-19 has permanently changed the way the Royal College will conduct business in a post-pandemic era. Preparing long-term solutions that meet the needs of both the workforce and volunteers is a priority. A cross-functional team was struck in fall 2020 to look at how the Royal College can support business units and volunteers moving forward.
Our objective is to optimize the Royal College workplace to reflect staff and volunteer expectations, needs, and desires. When we eventually move back to onsite work, and welcome back our volunteers, we want to be certain that we consider all of our stakeholder opinions. The Royal College will continue to maintain our meeting spaces, and further-equip those rooms to support hybrid meetings.
In collaboration with 4té, Inc., we are inviting volunteers to share ideas via a ten-minute survey. The purpose of this survey is to gather input on enhancing the volunteer experience here at the Royal College. The survey will close on May 14, 2021 and can be found here. Please keep in mind that your responses ought to be based on a post-pandemic environment.
Committee on Specialties Update
The Committee on Specialties (COS) met on April 15 and 16, 2021. The following specialty reviews took place:
- Geriatric Medicine
- Gynecologic Oncology
- Medical Genetics and Genomics
- Pain Medicine
- Solid Organ Transplantation
The COS will also review the following items:
Part I AFC
- Spine surgery
- Applicants for an AFC in neuromusculoskeletal point of care ultrasound, and the Specialty Committee in Diagnostic Radiology
New policy on appointing program directors
The Committee on Specialty Education (CSE) recently approved a new policy clarifying acceptable qualifications for program directors of Royal College-accredited specialty and subspecialty programs. This policy does not apply to Clinician Investigator programs, Surgical Foundations, or AFC programs. The policy provides enhanced clarity and flexibility regarding acceptable qualifications for program directors, and the importance of other qualifications to support high-quality residency education to maintain a contemporary understanding of the evolution of the relevant discipline. As such, all new program directors must undertake program director training and/or active coaching by a current or recent program director. The policy also codifies requirements around the appointment of interim program directors.
A key element of the policy is that, prospectively, program directors must be certified by a recognized body in the same discipline as the program of which they are the director, but Royal College certification is no longer required. This provides greater flexibility to institutions to appoint program directors who have relevant training experience outside of Canada. This policy change will also standardize the requirements across all disciplines. For those disciplines that currently require a program director to be a Fellow of the Royal College in their Standards of Accreditation; the Fellow requirement will be superseded by the new policy.
The Royal College will work with the specialty committees of newly-recognized disciplines – those recognized between March 2011 and now – to determine the timeline by which a program director would be expected to be certified in the discipline and the interim qualifications.
A memorandum and the full policy were sent by email to specialty committee chairs on March 16, 2021. Questions may be directed to firstname.lastname@example.org
Regular Accreditation Reviews
The regular accreditation review of the University of Toronto, which was conducted virtually in late 2020 and for which specialty committee post-review input was collected in the spring, will be considered at the upcoming Residency Accreditation Committee (Res-AC) meeting in May. At that time the final accreditation decisions for University of Toronto and its programs will be rendered.
The regular accreditation review of the Université de Montréal was conducted virtually in March; the post-accreditation review will be sought from specialty committees in the coming months. This input will be considered at the Res-AC meeting in October. The next regular accreditation review will be the Northern Ontario School of Medicine, also to be conducted virtually, in fall of 2021.
Impact of COVID-19
The Canadian Residency Accreditation Consortium (CanRAC) continues to meet frequently to adapt to the impact of COVID-19 on accreditation activities. Following a successful pilot test of the remote delivery of external reviews, the regular accreditation reviews of the University of Toronto and the Université de Montréal and their residency programs have been conducted virtually. This was a major collaborative effort between the Royal College, the College of Family Physicians of Canada, the Collège des medicines du Québec, as well as the universities and their stakeholders as well as the many volunteers who participated as accreditation surveyors and specialty committee members.
CanRAC is conducting a thorough evaluation and will use those results, along with observations and direct feedback from staff and stakeholders, to continue to improve the remote delivery of accreditation and to monitor when accreditation activities may return to an in-person delivery.
Canadian Excellence in Residency Accreditation (CanERA)
To support the ongoing transition to CanERA, an interactive online training module specific to specialty committee members is available at www.canera.ca under the Training, Tools and Support tab. Efforts are also underway to develop and pilot additional training to support specialty committee members.
Specialty committee members are also encouraged to visit the CanERA website (www.canera.ca) often, as it is updated with the latest CanERA news and information. The website includes the new general standards, frequently asked questions (e.g., Competence by Design (CBD) in the context of accreditation), and other CanERA-specific information that may be of interest.
A pilot test of the new accreditation system for AFC programs was implemented during the regular review of programs at the University of Toronto and the Université de Montréal. Feedback from this test is informing further development of resources ahead of the full launch of the new standards and processes on July 1, 2021. An FAQ regarding the changes is available on the Royal College website, including a link to the new general standards of accreditation. The new discipline-specific standards of accreditation for each AFC are available through the Information by Discipline database.
To date, 47 applications for accreditation of an AFC program have been approved by the Areas of Focused Competence – Accreditation Committee (AFC-AC). These programs are in the following disciplines:
- Acute Care Point of Care Ultrasonography (2),
- Addiction Medicine (2),
- Adult Cardiac Electrophysiology (6),
- Adult Echocardiography (5),
- Adult Hepatology (3),
- Adult Interventional Cardiology (8),
- Adult Thrombosis Medicine (3),
- Adult and Young Adult Oncology (1),
- Brachytherapy (1),
- Child Maltreatment Pediatrics (2),
- Clinician Educator (2),
- Cytopathology (4),
- Hyperbaric Medicine (1),
- Pediatric Urology (1),
- Sleep Disorder Medicine (1),
- Solid Organ Transplantation (4), and
- Trauma General Surgery (1).
In addition, there are three accredited AFC (diploma) programs in Transfusion Medicine that transitioned from an Accreditation without Certification (AWC) program in 2012. Thus, in total, there are 50 accredited AFC programs.
International Residency Accreditation
There are currently eight international accredited Institutions in five countries. Residency programs under the jurisdiction of these institutions are eligible to apply for Royal College accreditation, and to-date ten international program applications in six disciplines have been submitted. The current status is:
- Three New Accredited Programs [Anatomical Pathology (1), Internal Medicine (2)];
- Two programs with Accreditation in Progress in status [Pediatrics (2)];
- Two programs with Deferred status (i.e., additional information is required within one year before proceeding to an onsite review) (Emergency Medicine, Surgical Foundations); and
- One program application under review (Neurology).
The international residency program accreditation application two-step process involves the submission of an application form followed by an onsite review to verify and validate information before a final decision is made on accreditation status. Specialty committees are asked to review both the application form and the onsite review report to inform a decision of the International (residency) Program Review and Accreditation Committee (IPR-AC) at each step. The process is comparable to the specialty committee review of a pre-survey questionnaire (PSQ) and accreditation review report in the Canadian accreditation system. As applications in additional disciplines are expected, the Educational Standards Unit (ESU) will work directly with those specialty committees to provide a tailored briefing on the international program accreditation process, and provide support as needed throughout the process.
When international programs are accredited, the program directors for these programs will become non-voting members of the applicable specialty committee.
Mark your calendars for Royal College virtual conferences
Virtual International Conference on Residency Education (ICRE) 2021
Join medical education leaders, clinical educators, program directors, residents and policy makers from around the world for a virtual conference taking place October 20 to 22, 2021.
This year’s virtual conference explores the theme, A New World of Residency Education: Game Changers and Proven Practices, and will welcome plenary speakers, workshops and research presentations highlighting this topic and more.
More details on programming and registration are available at https://icre.royalcollege.ca/.
2021 virtual Simulation Summit
After a successful webinar series held in February, we are pleased to announce a full virtual conference taking place November 4 and 5, 2021.
We’re now accepting workshop and abstract submissions to be part of this exciting virtual conference featuring the theme, The Future is Now.
Visit the Simulation Summit website for more details on calls for submissions and programming announcements.
Content will be coming by Wednesday from the WOW committee inviting committee chairs to answer survey questions related to RC space design.
Area of Focused Competence Program Evaluation and Reform of the Discipline Category
Since the completion of the program evaluation of the AFC category in late 2018, we have been working to implement the four recommendations approved by the Committee on Specialty Education (CSE). Now into our second year of work to reform the category, we have made significant progress on operationalizing the enabling actions, with many of them already complete or close to completion. (Please visit the SCC Update archives or section D of the AFC Committee Resource site for information about the completed enabling actions.) The following are updates on each of the four recommendations since the January edition of the SCC Update:
1. Prioritize reforms of the assessment strategy
This recommendation was divided into two lines of work – one for the in-training route and the other for the practice route (PER-AFC).
1.1 In-training route
We are now one year into operationalizing the new model of assessment for trainees in accredited AFC training programs. The launch of the new model marked an end to external assessment of portfolios and the phasing out of the digital assessment platform, eDiploma. Based on feedback received from stakeholders when the new model was launched, we are considering whether to permit former trainees from accredited programs to come forward for the credential through their training program. We recently reached out to AFC directors and chairs for input on whether there is continued interest and capacity to implement this change. At this time, we are still synthesizing the feedback received.
Work has also begun on the development of a shuttering plan for eDiploma. No new users are permitted to enrol and the vast majority of those already enrolled no longer use it, having completed training in the new model of assessment. The shuttering plan will however take into consideration those programs who requested continued access to eDiploma for current trainees when the new model was launched. We wish to assure stakeholders that the shuttering plan will include a significant phase-out period, providing ample time for users to extract files from the platform. We will be reaching out to you for feedback on the shuttering plan prior to finalization and implementation.
More information about the new model of assessment for the in-training route as well as resources to support accredited programs and trainees remain available online on the AFC Committee Resource site.
1.2 Practice eligibility route for AFCs
The new model of assessment for the practice route (PER-AFC) was launched in July 2020 and was received with considerable enthusiasm by AFC Committees. As of the beginning of March, more than half of the 23 disciplines in the first cohort of disciplines to begin development have submitted documents for review by the Credentials Unit. Of these disciplines, 2 opened their new routes in February, and another 3 are expected to open by the end of April. Based on the current rate of development, it is expected that a majority of disciplines in the first cohort will have new routes before the end of 2021.
The Credentials Unit will continue to review submitted documents in the coming months and will be contacting chairs of these disciplines to coordinate. For those disciplines who have not begun development or who require assistance during the development of their documents, please contact Griffin Wild, policy analyst, Credentials Unit.
Disciplines who are currently in the working group phase make up the second cohort, and will be on-boarded to the new practice route following dissemination of their national standards and the transition to becoming a new, full AFC Committee, if not sooner.
2. Re-launch ongoing efforts to reform the accreditation policy and process
2.1 Streamline General Standards of Accreditation and associated evidence
With the new General Standards and policy manual approved and prototype implementation taking place at the regular review of accredited AFC programs at the University of Toronto (fall 2020) and Université de Montréal (spring 2021), this enabling action is complete.
The revised general standards that will apply to all AFC programs after July 1, 2021, are available on the on the New Areas of Focused Competence (AFC) Accreditation System web page (see the section titled “What expectations do programs need to meet?”).
2.2 Revise discipline-specific AFC Standards of Accreditation
All AFC disciplines have now had their existing discipline-specific AFC Standards of Accreditation (AFC-SA) converted into the new format, making this enabling action complete. The new AFC-SAs are available on our Information by Discipline page.
With regards to applications for new accredited programs, prospective applicants are advised to consult with their postgraduate medical education (PGME) offices. PGME offices will coordinate timelines with ESU if there is an application being developed. At this time, the current process remains unchanged (paper-based) until full implementation of CanERA in July 2021 (digital).
2.3 Digitize the AFC accreditation process
As part of prototype testing at the on-site reviews at the University of Toronto and the Université de Montréal, the digital accreditation management system (CanAMS) will be used for AFC programs. All other accreditation activities (e.g. follow-ups by progress report, external review, etc.) will remain status quo until July 2021. In keeping with the Royal College’s commitment to accredited programs and PGME offices, access to the new standards and digital platform will be provided at least 12 months before accreditation activities.
2.4 Develop new training modules for accreditation
New resources are in development during the prototype testing phases and will be made available to AFC committees, university faculty and other stakeholders on an iterative basis as different groups begin to interact with the new system. Evaluation and further development are expected to continue up to, and following, the full launch July 1, 2021, as more feedback is received.
3. Formulate a plan to increase the visibility of the value of the category
This recommendation was divided into two lines of work – one focused on recognizing the participation of physicians from Family Medicine in the AFC program and the other on developing an “AFC campaign”.
3.1, 3.2 Physicians from Family Medicine
Having ceased using the phrase ‘Diplomate Affiliate’ in spring 2019 and Council’s approval of an exemption from the Royal College Maintenance of Certification (MOC) Program for Diplomates from Family Medicine, this enabling action is complete.
Please consult the SCC Update archives for more information about these changes or contact the AFC Program Manager, Linda Rumleski.
3.3 An AFC campaign
A communications plan for the reformed AFC program has been developed and a campaign intended to increase the profile and value of the credential among stakeholders is expected to launch in late April – May 2021. A new resource kit has been developed and will be distributed to AFC committees as part of the campaign.
Work continues to make AFC content on the Royal College website more accessible and relevant to key stakeholders. The updates to the website require multiple phases of work, with the first and second phase complete. The final phase has been delayed but is expected to coincide with the launch of the campaign.
And in case you missed it, AFCs were in the Royal College newsroom last month. The work of Alexandra Bastiany, MD, FRCPC, DRCPSC, a Diplomate of Adult Interventional Cardiology, was highlighted in the article Leading the Way as part of the Royal College’s campaign for International Women’s Day and Black History Month.
4. Consider how to continue to provide support, and improve upon the support already provided
1. Streamline the application process: National Consultations and interface with specialty committees and AFC committees, subcommittees and working groups
Changes to simplify and streamline the discipline recognition and national consultation processes are underway. Several initiatives, including a new application form for AFCs, began being piloted in spring 2020 with the intention of managing and monitoring their impact through fall 2020. Piloting will continue through spring and fall 2021 in order to allow a diverse group of applicants the opportunity to provide feedback.
2. Facilitate a better sense of community while building expertise and capacity among AFC program participants
Building expertise and capacity is an on-going and evolving reform, with the current focus being how to ensure stakeholders remain informed and are a part of the proposed changes. Ranging from regular and consistent consultations with stakeholders, both formally and informally, to the development of new, timely resources, our goal remains to keep you at the forefront of the AFC program and its reform. And as we continue to explore new ways to connect with you, we welcome any ideas you’d like share or suggestions to help us improve. We welcome your feedback at any time! Let us know how we are doing or what’s on your mind by contacting the AFC Program Manager, Linda Rumleski.