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Areas of Focused Competence (Diploma) Program

Among the many challenges currently facing postgraduate medical education, one ongoing tension is how to best support the growth and advancement of specialty education with national standards of excellence, while trying to ensure an appropriate blend of generalist and specialist physicians to meet the health human resource needs of Canadian society, and without causing harm to the existing system.

A draft proposal for the creation of new category of Royal College discipline recognition, driven by feedback from Fellows from the Core Competency Report was first presented to the Royal College Committee on Specialties (COS) in April 2009.

After embarking on a broad national consultation with Fellows and key stakeholders, the Royal College Council approved the Areas of Focused Competence (Diploma) Program on February 25, 2011.


Areas of Focused Competence (Diploma) Programs

The format for diploma programs:

  • Typically 1-2 years of additional training, but competency-based
  • Built upon training in a broader discipline
  • Supported within the existing Specialty Committee of the primary discipline (unless one does not currently exist)
  • Assessed through summative portfolio
  • Training programs accredited by the Royal College (C Standards)
  • A separate annual dues fee and Maintenance of Certificate (MOC) requirements

Candidates successfully completing all requirements of an approved program and who annually maintained their status as a Diplomate or Diplomate Affiliate of the Royal College would receive an added qualification known as a Diploma of the Royal College of Physicians and Surgeons of Canada, or DRCPSC. Members with a DRCPSC will be known nationally, and internationally, as individuals who have sought to advance their knowledge and expertise with additional complementary skills and competencies.

Implications for Royal College Fellows and Other Stakeholders

By introducing a mechanism to recognize established disciplines of medicine that enhance scope of practice, the diploma programs will:

  • Establish national standards for training and specialist competence, thereby improving quality of care and patient safety;
  • Avoid unnecessary fragmentation of specialty training, care and practice by mitigating the recognition of subspecialties;
  • Provide Fellows with another opportunity to acquire nationally and internationally portable credentials, DRCPSC;
  • Offer universities opportunities to enhance the academic environment, with new nationally accredited programs; and
  • Provide a mechanism for the Royal College to formally recognize disciplines that meet a legitimate societal health need, but that do not meet the current criteria for a primary specialty or subspecialty.

Current Status

The Committee on Specialties will consider diploma applications two times per year, at their fall and spring meetings.

As of April 2015, the following AFC (diploma) disciplines have been formally approved by the Education Committee of the Royal College:

Addiction Medicine
Advanced Heart Failure and Cardiac Transplantation
Adolescent and Young Adult (AYA) Oncology
Adult Cardiac Electrophysiology
Adult Echocardiography
Adult Hepatology
Adult Interventional Cardiology
Adult Thrombosis Medicine
Aerospace Medicine
Brachytherapy
Child Maltreatment Pediatrics
Clinician Educator
Cytopathology
Hyperbaric Medicine
Solid Organ Transplantation
Sport and Exercise Medicine
Transfusion Medicine
Trauma General Surgery

Click here for more information about how to apply for recognition as a diploma discipline.

Click here to read our Frequently Asked Questions about the AFC (diploma) category.