Specialty Committee Chairs’ Update – September-October 2021

2021 Specialty Committee Chairs’ Workshop

The 2021 Specialty Committee Chairs’ (SCC) Workshop is taking place Monday, November 15 and Tuesday, November 16. The SCC workshop will be again be hosted virtually. Committee chairs and chair-elects should have the details in your calendars. If you haven’t yet submitted your RSVP, or if you aren’t sure, please reach out to your committee administrator specialtycommittees@royalcollege.ca. The Specialties Unit will again be using Chime, so login information will be sent to the account (email) you registered with, and you will need it to participate. We are in the process of finalizing the agenda based on the needs assessment that was conducted earlier this year. The agenda will be circulated to you by email in the coming weeks. We look forward to seeing you virtually and learning with you at the workshop this year.

Specialty committee members will receive an update on the SCC workshop in the November-December edition of the SCC Update. Space can also be made on meeting agendas so that chairs may update your committee on specific topics of interest and discussions.

Update on the resumption of in-person meetings

In-person meetings will resume after April 1, 2022

Royal College leadership has made the decision that April 1, 2022, will be the target date for the resumption of in-person meetings at the Royal College Headquarters in Ottawa, Ontario.

Postponing until April; a difficult decision

The Royal College is aware of the strong desire to resume in-person activities with our Fellows. As inter- and intra-provincial travel restrictions ease and public health directives evolve, the Royal College will support staff, volunteers and Fellows virtually for all committee business to ensure that we adhere to all public health requirements and limit all non-essential travel.

Royal College meeting spaces are currently being updated with improved technology to better-facilitate hybrid meetings for those that join meetings virtually. In the past, all committee meetings, with the exception of Competence by Design (CBD) workshops, allowed for full committee engagement in-person or via tele-/webconference, but at times could be limiting to those participating virtually. We are working to ensure that future hybrid meetings held at the Royal College are more interactive and well-supported. We are uncertain at this time whether it will be possible or practical to support CBD workshops as hybrid events.

Our ability to hold in-person meetings after April 1, 2022 will continue depend on the public health guidelines as well as meeting space and budget availability. Currently the capacity of our meeting rooms is limited by physical distancing requirements. If these guidelines are still in place in April, they will have a significant impact on the number of meeting rooms we have available to host meetings.

We hope this provides clarity to participants and helps with planning your meetings from now until March 31, 2022.

Protecting the safety of our staff and committee members.

As we actively plan for how best to hold onsite meetings, we are also in the final steps of developing a vaccination policy designed to safeguard the health of our employees, contractors, volunteers, and visitors. Further information on our vaccination policy, which will outline the requirements of anyone coming onsite, will be coming in the weeks ahead.

More information will follow to support you in the conduct of Fellow-focused activities, and we will continue to evolve our supporting resources to ensure alignment with our operating realities. Thanks again for your ongoing dedication to the Royal College and for your tolerance of these ongoing adjustments.

Committee terms of reference and policy updates

The terms of reference documents for specialty committees, Area of Focused Competence (AFC) committees and AFC subcommittees have all been updated to add new wording being applied to all Royal College committees around committee work product and the volunteer code of conduct and confidentiality.

The policies have also been updated for specialty committees and AFC committees and AFC subcommittees. All three documents have been updated to harmonize the appointments wording, and update the language around in-person, virtual, and hybrid meeting support. In the specialty committee policies reference to international program directors as non-voting members have been added. In the AFC committee and subcommittee policies the language has been updated regarding the appointment of non-Fellow members and the timelines for seeking the diploma through the new PER-AFC process. The length of time allowed to achieve the diploma has been reduced from six to two years given the changes in the process.

Any questions about these changes can be directed to your committee administrator.

CanMEDS and Faculty Development

Coming soon: Workshop for New Program Directors

The Office of Specialty Education (OSE) is pleased to sponsor a virtual Workshop for New Program Directors on Friday October 29, 2021. Designed and run by current and past program directors, the various sessions will assist new program directors in understanding and preparing for their new roles. As you may know, this popular annual workshop is typically a pre-conference event to the Royal College’s International Conference on Residency Education (ICRE). As a result of the ongoing pandemic, we’ve made a number of adjustments including a decision to redesign and offer this important workshop virtually in 2021.

Sessions available include: Assessment of Residents in Competence by Design (CBD); Accreditation Standards 101; Preparing for Accreditation; Conflict Management for Program Directors; Equity in Residency Education; Accommodations and Implicit Bias; Feedback and Remediation for the Learner in Difficulty; and Leading Change as a Program Director. All sessions will be recorded and made available to registrants after the workshop.

For more information, contact us at pdworkshop@royalcollege.ca

New Program Director Handbook

The Office of Specialty Education has been working on an eBook for new program directors. Designed and written by current and past program directors, the various chapters will assist new program directors with understanding and preparing for their role as a program director. Topics include: the role of the program administrator, succession planning and handing over; role modelling; coaching; workplace-based assessment; working with an electronic portfolio, and more. The serialized release of the handbook will start with six chapters to be released this fall.

For more information, contact us at canmeds@royalcollege.ca

Fall CBD Webinars

The CBD Webinar Series aims to engage a broad audience in CBD and support CBD-related learning. This series focuses on activities/topics that build readiness and address misconceptions/changing attitudes, all of which are meant to foster positive perceptions and experiences around CBD and the Royal College.

Upcoming CBD webinars include:

November 23: Teaching and Learning in CBD (French)
November 30: Competence Committees for Residents
December 8: Work-based Assessment in CBD

For more information, contact us at cbd@royalcollege.ca

The International Competency-based Medical Education Collaborators are pleased to announce their fifth CBME Webinar Series

The International Competency-based Medical Education (ICBME) Collaborators are a group of leading international experts who examine conceptual issues and current debates in competency-based medical education (CBME). As part of their engagement in ongoing discussions of CBME issues, they are hosting their fifth series of CBME webinars, scheduled to run monthly from October 2021 to June 2022. Each one of these FREE webinars will feature CBME experts in informal, high level discussion on key CBME topics.

October 26; 1200-1300 EDT - Coalition for Physician Accountability Recommendations for the Transition to Residency: the role of CBME
Registration
November 17; 1100-1200 EST - Learning from the learners: Trainees’ perspectives on CBME
Registration
December 9; 1300-1400 EST - Leveraging new capabilities. Use of Natural Language Processing in Support of CBME
Registration
January 10; 1100-1200 EST - International Perspectives on Entrustment in UGME
Registration
February 2022 - date & time to follow - EPA assessments: examining initial data collection for process improvement
Registration opening soon!
March 23; 1200-1300 EST - Social determinants of Health, Antiracism and CBME
Registration
April 21; 1300-1400 EST - Entrustment decisions: the question of validity
Registration
May 2022; date & time to follow - Competency committees in UGME
Registration opening soon!
June 2022 - date & time to follow - The tension between formative and summative assessment in CBME
Registration opening soon!

2021 Simulation Summit

This year’s Simulation Summit explores the theme, The Future is Now! through thought-provoking plenary sessions led by simulation leaders and researchers, including Dr. Victoria Brazil, PhD discussing translational simulation, Drs. Walter Tavares, PhD and Matt Lineberry, PhD covering assessment in simulation, and David Williams, MD, FRCPC, and Dr. Tanja Manser, PhD offering new perspectives on building successful high-performance teams.

Join simulation enthusiasts online this November 4-5, 2021. Register today!

Accreditation Update

Regular Accreditation Reviews

The regular accreditation review of the Université de Montréal was conducted virtually in March 2021 and the post-accreditation review input was collected from specialty committees in September. This input will be considered at the Residency Accreditation Committee (Res-AC) meeting in October, for final accreditation decisions for the Université de Montréal and its programs. External reviews continue to be delivered virtually as well, and the next regular accreditation review will be the Northern Ontario School of Medicine, also to be conducted virtually, in fall of 2021.

Upcoming Regular Accreditation Reviews

University	Review Date	Res-AC Review Date
Northern Ontario School of Medicine (NOSM)	Fall 2021	Spring 2022
University of Manitoba	Spring 2022	Fall 2022
University of Calgary	Fall 2022	Winter 2023

Impact of COVID-19

The Canadian Residency Accreditation Consortium (CanRAC) continues to adapt accreditation activities to enable operations despite the impact of COVID-19. In the fall of 2020 and spring of 2021, the regular reviews of the University of Toronto and the Université de Montréal and their residency programs were successfully conducted virtually. This was a major collaborative effort between the Royal College, the College of Family Physicians of Canada, the Collège des medicins du Québec, as well as the universities and their stakeholders and the many volunteers who participated as accreditation surveyors and specialty committee members.

CanRAC is conducting a thorough evaluation of virtual reviews and will use those results, along with observations and direct feedback from staff and stakeholders, to continue to improve the remote delivery of accreditation. CanRAC will continue to monitor when accreditation activities may return to an in-person delivery, and will evaluate the feasibility of incorporating certain aspects of virtual reviews in future accreditation processes, without compromising the integrity of the review.

Equity, Diversity and Inclusion (EDI)

A conjoint Accreditation Working Group on Anti-Black Racism has been struck, led by Black residents and faculty and chaired by Dr. Kannin Osei-Tutu, MSc, MD, CCFP. This working group is meeting regularly to identify ways to address anti-Black racism through mechanisms of accreditation in both the short- and long-term, and has begun to explore changes to accreditation standards and policies that can be recommended to the accreditation committees of the three CanRAC colleges.

Building on work already underway by the Royal College Indigenous Health Advisory Committee (IHAC), the Indigenous Health in Specialty Postgraduate Medical Education Accreditation Expert Working Group has renewed similar efforts to identify levers for change within accreditation with the goal of bringing forward recommendations to the relevant committees. To guide and support this work, Ryan Giroux, MD, FRCPC and Jillian Roberge, MD, FRCPC will be working with the Royal College in new positions as Indigenous Educators.

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., CBD in the context of accreditation), and other CanERA-specific information that may be of interest.

Area of Focused Competence (AFC) Accreditation

The new accreditation system for AFC programs was fully launched on July 1, 2021. This includes new standards, processes, and the use of the digital accreditation management system, CanAMS, for all accreditation activities thereby further aligning AFC accreditation with the processes and platform already in place for postgraduate medical education (PGME) institutions and residency programs. 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.

New Program Application Deadlines

AFC program applications will be reviewed by the AFC-AC according to the table below.

Application Submission Deadline	AFC-AC Review Date
October 15, 2021	Winter 2022
January 31, 2022	Spring 2022
May 31, 2022	Fall 2022

AFC Programs

There are currently 51 accredited AFC (diploma) programs that have been approved by the Areas of Focused Competence – Accreditation Committee (AFC-AC) in 18 disciplines. 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),
Transfusion Medicine (3), and
Trauma General Surgery (1)

International Residency Accreditation

There are currently seven international Accredited Institutions in five countries. Residency programs under the jurisdiction of these institutions are eligible to apply for Royal College accreditation. To-date ten international program applications in six disciplines have been submitted and there are currently three accredited programs. The remainder are still in progress or under review.

Status	Programs	Total
New Accredited Programs	Anatomical Pathology (1), Internal Medicine (2)	3
Accreditation in Progress	Surgical Foundations (1), Pediatrics (2)	3
Deferred¹	Emergency Medicine	1

¹ A deferred status indicates that additional information is required within one year before proceeding to an onsite review.

International Residency Program Accreditation Application Process

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 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.

Program Director Policy

The new policy on appointing a program director of a Royal College-accredited program, which was approved by the Committee on Specialty Education in December 2020, is in effect. This policy clarifies the acceptable qualifications for directors of Royal College-accredited residency programs (specialty and subspecialty), to help postgraduate medical education offices in appointing program directors, and provide consistency across disciplines.

As a reminder, the program director policy does not apply to program directors currently in the position, and will be applied only for the appointment of new program directors. Additionally, as the policy has additional implications for PGME offices, namely the training and/or coaching of newly appointed program directors, these requirements will be included in accreditation reviews of PGME institutions as of July 1, 2022 for any program directors appointed after July 1, 2021.

As per the new policy, all program directors must be certified in the same discipline as the program of which they are director. The Royal College Office of Specialty Education will work with each specialty committee for those disciplines that have been newly recognized by Royal College Council within the past ten years (i.e., since March 2011) to determine the timeline by which a program director would be expected to be certified in that discipline. Subsequently, this information for each discipline will be communicated to PGME offices and accreditation committees.