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Indigenous Health in Specialty Post-Graduate Medical Education Steering Committee

Background

The Indigenous Health Specialty Post-graduate Medical Education (PGME) Steering Committee is an independent Royal College committee that guides and supports Royal College Committees and management responsible for implementing Council’s resolution, “that Indigenous health become a mandatory component of postgraduate medical education, including curriculum, assessment and accreditation” (October 2017).

The Steering Committee, which is led by Indigenous educators and scholars, held its first meeting on February 6, 2019 and was guided during this day by Elder, Paul Skanks.

Meeting objectives

  • Establish a common understanding of rules of engagement and decision making process.
  • Review Vision Statement and draft Competencies Guide.
  • Clarify a high-level work plan that maps the process including community engagement.

Communication

Steering Committee members agreed to communicate back to their constituencies the key points, directions and decisions made at the meetings.

The Steering Committee agreed to produce common key takeaways at the end of each meeting to:

  • confirm the key points, directions and decisions made by the SC before close of the meeting to ensure common agreement on key takeaways;
  • provide Steering Committee members with a tool to support their reporting back to their constituencies.

The takeaways message will be posted on the Royal College website.

Terms of Reference

The terms of reference were approved with additional clarification on the functioning of the committee:

  • The Steering Committee will establish the direction, approach and key principles for Indigenous health education. Royal College management and various committees, under guidance of the Steering Committee, will produce specialty postgraduate medical education (PGME) standards, processes, guidance documents and other outputs as needed.
  • The Steering Committee will operate by consensus (added to the terms of reference).
  • The following additional perspectives are needed on the Steering Committee: clinical/hospital settings, clinical leaders, medical regulators, and the First Nations and Inuit Health Branch (added to the terms of reference). Others may be added over time.
  • The constituencies already included on the Steering Committee should be explicitly listed within the terms of reference (e.g., Indigenous Physicians Association of Canada and Canadian Federation of Medical Students).

The Steering Committee also established additional structures and resources to support its work:

  • Expert advisors: two or three Indigenous expert advisors drawn from or as identified by Steering Committee members to provide expert advice in each area of accreditation, assessment and curriculum.
  • Working groups: may be created to support the work in each area outlined above to advance development of documents, resource materials, etc.; these may include the expert advisors and Royal College staff leads for the area.

Engagement Activities

Given the importance of early, effective, respectful, consistent and meaningful engagement with and accountability to Indigenous communities, the Steering Committee identified a number of partners/advisors that could be included in the Committee’s work. The list included Indigenous and non-Indigenous bodies, and confederated entities to connect with at the community and regional levels (e.g., Network Environments for Indigenous Health Research).

These prospective partners/advisors will be asked if they are interested in supporting this initiative, and how they would like to be involved and work together.

The Steering Committee also drafted the following statement on partnerships:

Royal College partners and Indigenous partners agree to engage in respectful, equitable relationships as they reach agreement on their shared work and processes that define the change in competencies we hope to achieve through PGME.

Given the many concurrent efforts to enhance Indigenous health and fatigue within many of the identified organizations, the Royal College, the College of Family Physicians of Canada and the Association of Faculties of Medicine of Canada will discuss at a special meeting in April 2019 how best to harmonize efforts. This information will be provided to the Steering Committee for further consideration and development.

Setting the Stage (Background)

The Steering Committee was briefed on the foundational work accomplished to date that serves as a starting point to include Indigenous health in all aspects of residency education, including:

  • a consensus vision statement developed by the Indigenous Health Advisory Committee;
  • the revised Indigenous Health Values & Principles statement;
  • the draft Indigenous Health Entry-to-Practice Competencies Guide; and
  • the Indigenous Health Primer.

The Steering Committee was also provided a high level orientation on the functions of the Royal College education committees, the functioning of the Faculties of Medicine and AFMC, and the College of Family Physicians of Canada’s current work to gain a better understanding of the context in which the Steering Committee’s work is being done.

Draft Entry-to-Practice Competencies Guide

The draft Indigenous Health in Specialty PGME Entry-to-Practice Competencies Guide lists competencies that guide the implementation of Indigenous health in residency education based on three different sources: the IPAC-AFMC Indigenous Health Competencies, the TRC and the Indigenous Health Values and Principles Statement produced by the Indigenous Health Advisory Committee at the Royal College. Steering Committee members worked to:

  • draft a one-sentence summative description of each CanMEDS Role that captures the essence of the practice of a “competent physician”;
  • revise and refine the competencies under each Role;
  • discuss who should be involved in teaching and assessment.

Feedback will be integrated into the draft Competencies Guide and circulated to the Steering Committee for verification. The Steering Committee will subsequently collect broader input to ensure that the competencies are appropriate and comprehensive.

Next meeting – Fall 2019