Specialty Committee Chairs’ Update

March and April 2022

Welcoming back our volunteers

April 1 marked the return of in-person/hybrid meetings at the Royal College – both for staff and for our volunteers. The Specialties Unit will welcome five specialty and advisory committees back to headquarters here in Ottawa, Ontario from April to June. The Council Room at the Royal College has been temporarily fitted to ensure that hybrid meetings can take place successfully and allow participants in the room and online to work collaboratively. More permanent and advanced systems will be installed in all serviced meeting rooms throughout the spring and summer in time for (what we expect) to be a return to regular activities and in-person meeting volumes this fall.

In-person attendees this spring will notice that masking, vaccination, and physical distancing policies are still in place here at the Royal College. You will be asked to complete a COVID-19 screening questionnaire prior to entering the Royal College facilities and provide proof of vaccination once on site. There are several meetings that are taking place in cities across Canada in conjunction with national specialty society meetings. All public health guidelines will be followed for each city and province the Royal College helps to support meetings in. Royal College staff will be fully-vaccinated and masked for events that are held off-site. Physical distancing, vaccination, and masking policies will vary from province-to-province and venue-to-venue; we encourage our volunteers to continue practicing proven public health safety measures at meetings supported by the Royal College.

Balancing travel and operational requirements

The Royal College will continue to balance travel required to carry out Royal College activities with other operational requirements such as equity, financial stewardship, and environmental stewardship. Senior leadership has indicated that travel budgets will be significantly reduced compared to pre-pandemic levels and all units at the Royal College will plan for a balanced approach. This may present a shift for some of our committees, and impacts will be communicated to each committee as they arise. For now, your specialty committee administrator will work with you and senior leadership to determine which meetings will be held in-person and which will remain virtual.

Competence by Design (CBD) Workshops

The Specialties Unit anticipates that on-site CBD workshops will resume in fall 2022. The projected funding allocated to the workshops is anticipated to be sufficient for the number of workshops forecasted. CBD workshops will have a virtual option for those unable to attend in-person.


Specialty Committee Chairs’ mid-year call

Every year the Specialties Unit facilitates a webconference with all committee chairs and chair-elects to provide updates on Royal College projects and initiatives that impact the work of specialty committees and AFC committees and subcommittees. This year the webconference will be via Zoom and is scheduled for June 8 from 1200 to 1400 eastern. An invitation has been sent to you and an agenda will be sent closer to the meeting. If you have topics that you would like to hear more about, please reach out to your administrator via email at specialtycommittees@royalcollege.ca.


Specialty Committee Chairs’ Workshop 2022

The 2022 Specialty Committee Chairs Workshop will take place November 14 and 15, 2022. A save-the-date has been delivered to your inboxes to hold the time in your calendars. We have not confirmed whether the workshop will be in-person or a virtual event. The Specialties Unit is working with our hotel partners in Ottawa, Ontario to obtain quotes for meeting and hotel room space, as well as quotes on the technology that will be available to allow for a truly hybrid event; all of which must fit within a reduced budget. Once we have the information we need to make a decision, we will reach out to chairs and chair-elects over the spring and summer.


CanMEDS and Faculty Development

Learn more about CBD and the role of “Coach over Time” – and earn MOC credits!

As CBD continues to be implemented across Canada, both residents and faculty say there is still a significant need for knowledge and skill development around the concept of “coaching”. In 2019, the Royal College released five online activities around the concept of Coaching in the Moment; now, a small group of educators and physicians have released Module 1 in a series devoted to Coaching over Time.

Learn the Basics of Coaching over Time provides an understanding around this essential role and the value it adds for resident professional development. The module also includes a video interaction that demonstrates the key components for successful Coaching over Time interactions.

Please feel free to share the information widely. And let us know if you find this module helpful and what other modules you would like to see in this series by completing the evaluation at the end. Your feedback is always helpful as we continue to refine CBD faculty development resources.

New Physician Wellness report

Now more than ever, physicians are at high risk of experiencing adverse effects on their health and well-being, including burnout. Physician health and wellness was added to the 2015 CanMEDS Physician Competency Framework. Since then, Leslie Flynn, MD, FRCPC, has taken this work further by leading a task force and advisory group into a deeper dive of physician wellness, in particular the physician wellness competencies within the Professional Role.

The work that has been completed includes:

  • an environmental scan of wellness programming at Canadian medical schools for learners and faculty as well as existing wellness resources available through provincial and national physician organizations;
  • a scoping literature review of evidence-based practices n physician health published between 2010 and 2018;
  • regular meetings of both groups to ensure targets are being met;
  • repeated surveys with stakeholders;
  • the presentation of the work at multiple national and international medical conferences;
  • the development of a template to categorize information about existing and aspirational physician health practices in Canada; and
  • a 2021 review of recommendations to include examples relevant to the COVID-19 pandemic and its challenges.

The work so far has culminated into a report that includes a set of five guiding principles and 15 recommendations with several examples of programming. The content of this report will be published online shortly.

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

Upcoming CBD Webinar

Royal College CBD stakeholders asked us to engage them more, make it easier for them to find relevant CBD information and to be more transparent about our progress. Since 2017, the CanMEDS and Faculty Development team and content expert leads have presented over 30 CBD webinars. Upcoming webinars include:

  • Resident orientation: May 11, 2022 from 1100 to 1230 eastern time. Register.

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

Virtual ASPIRE Essentials Workshop

ASPIRE (Advancing Safety for Patients in Residency Education) is an intense, high impact, comprehensive program to develop patient safety and quality improvement educators. The program was traditionally held as a four-day course; however, with the current pandemic, we are offering half-day virtual courses. The next one will be held on June 16, 2022 from 1000 to 1430 eastern time. Topics include culture of patient safety, disclosure and quality improvement. Register soon, as places are limited!

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


New Competence by Design Technical Guides

The following technical guides have been developed to clarify expectations regarding the fundamental elements required to implement a CBD program. The guides – created in collaboration with CBME leads across the country – also identify where programs have flexibility to proceed with implementation in a way that acknowledges local context, is feasible, and encourages innovation. Each technical guide also includes tips on accreditation.

  1. Guide 1 – Requirements for EPA observation forms (September 2020)
  2. Guide 2 – Standards for time-based and CBD trainees (September 2020)
  3. Guide 3 – Competence committees (September 2020)
  4. Guide 4 – What is required when a resident transfer to another university for training, or a different program within the same university? (March 2022)
  5. Guide 5 – When is a resident ready to sit the Royal College specialty examination? (March 2022)
  6. Guide 6 – What is required when a resident takes a leave from a program? (March 2022)


Area of Focused Competence Update

Our work continues to reform the AFC Program following the program evaluation in 2018. The focus in 2022 will be on completing the remaining enabling actions found in the Management Action Plan (AFC PE MAP) and continuing to improve and streamline processes where possible. The following are some highlights of our current work and we encourage you to visit the SCC Update archives for previous reports on AFC reform.

Additional reformed practice routes (PER-AFC) are open

Since January, five reformed practice routes have opened, for a total of 13 new routes for AFC disciplines. Three disciplines have completed the assessment of their first applicants, leading to ten new Diplomates. The following disciplines have new practice routes:

  • Addiction Medicine (opened March 7, 2022)
  • Solid Organ Transplantation (opened March 7, 2022)
  • Advanced Heart Failure and Cardiac Transplantation (opened February 8, 2022)
  • Adult Echocardiography (opened January 25, 2022)
  • Adolescent and Young Adult Oncology (opened January 4, 2022)
  • Child Maltreatment Pediatrics (opened November 15, 2021)
  • Cytopathology (opened August 15, 2021)
  • Brachytherapy (opened July 14, 2021)
  • Pediatric Urology (May 26, 2021)
  • Clinician Educator (opened March 26, 2021)
  • Hyperbaric Medicine (opened March 18, 2021)
  • Prehospital and Transport Medicine (opened February 9, 2021)
  • Sleep Disorder Medicine (opened February 4, 2021)

For planning purposes, please note that once a route opens and an application is ready for assessment, the Credentials Unit will meet with the AFC committee to provide guidance on the standardization and calibration of assessments, an important step in the process.

An overview of the assessment process for PER-AFC and instructions on how to apply for the practice eligibility route are available online. Please contact Tiffany Lynch, Credentials Unit, with any questions about PER-AFC.

Full implementation achieved!

Congratulations to the AFC in Addiction Medicine for completing the steps to implementation, opening both the in-training and practice eligibility routes for the discipline recently.

There are currently 26 AFC disciplines whose standards have been disseminated and are considered ‘live’. These standards can be found on the information by discipline page. Of the 26 AFC disciplines that are live, 14 are fully implemented.


What is full implementation?

Once the new standards of an AFC discipline are approved and disseminated, the discipline’s Royal College AFC committee focuses on opening the two pathways to the credential – by having their first training program accredited or developing the application for the practice route (PER-AFC). Once both pathways are open, the new discipline is considered “fully implemented”.

New publications coming in 2022

The first new publication in 2022 was the guidance document on the use of in-training evaluation reports (ITERS) in accredited training programs. Similar to CBD technical guides, the need for tech guides specific to AFC disciplines have been identified and are in development. Tech guides are an opportunity to provide commentary or additional guidance on the application of Royal College policies or standards. Publication of the first AFC tech guide is expected in late spring.

We welcome your feedback on these new publications as well as ideas for topics of future publications.

Committee on Specialties special review of AFCs

The first cohort of disciplines to undergo a special review was considered by the Committee on Specialties (COS) in November. The next cohort, consisting of the following disciplines, were reviewed by COS in April:

  • Acute Care Point of Care Ultrasonography
  • Aerospace Medicine
  • Adult Thrombosis Medicine
  • Advanced Heart Failure and Cardiac Transplantation

In November 2022, COS will review the last scheduled cohort of disciplines to undergo a special review (Hematopoietic Stem Cell Transplantation and Cellular Therapy). Shortly thereafter, a final report on the special review will be prepared for COS and will include COS’ findings and decisions, key themes from the consultation with fully implemented disciplines, as well as recommendations to improve implementation processes for stakeholders and operational units. Stakeholders can expect a briefing on the special review following COS’ consideration of the report.

Questions? Feedback? Let us know!

Our virtual doors are open. Please do not hesitate to contact the AFC program manager, Linda Rumleski, with questions or feedback.


Accreditation Update

Regular Accreditation Reviews

Over the last few months, pre-accreditation review input was collected from specialty committees for the regular accreditation review of the University of Manitoba, which took place in a virtual format on March 20 to 25, 2022. The Royal College will be reaching out for post-accreditation review input for these programs in late spring.

Meanwhile, post-accreditation review input is currently being collected from specialty committees following the of the Northern Ontario School of Medicine (NOSM) regular review in November 2021. This input will be considered at the Residency Accreditation Committee (Res-AC) meeting in May 2022, for final accreditation decisions for NOSM and its programs.

All external reviews continue to be delivered virtually.

Upcoming Regular Accreditation Reviews

UniversityReview DateRes-AC Review Date
University of ManitobaMarch 20-25, 2022Fall 2022
University of CalgarySeptember 18-23, 2022Winter 2023

Impact of COVID-19

The Canadian Residency Accreditation Consortium (CanRAC) continues to adapt accreditation activities to continue operations despite the impact of COVID-19. So far, regular reviews of the University of Toronto, the Université de Montréal, NOSM and the University of Manitoba were successfully conducted virtually. CanRAC has adopted several modifications to the accreditation process that will continue post-pandemic, including the virtual delivery of some aspects of accreditation (e.g., surveyor training). As the three Colleges begin to resume some in-person activities in the coming months, CanRAC will identify opportunities for hybrid and/or in-person delivery of accreditation activities in collaboration with volunteers and accreditation stakeholders.

Equity, Diversity and Inclusion (EDI)

The conjoint Accreditation Working Group on Anti-Black Racism (led by Black residents and faculty and chaired by Kannin Osei-Tutu, MSc, MD, CCFP) and the Indigenous Health in Specialty Postgraduate Medical Education Accreditation Expert Working Group (chaired by Ryan Giroux, MD, FRCPC) have been meeting regularly to continue ongoing EDI work related to accreditation.

A conjoint meeting of the Royal College Residency Accreditation Committee (Res-AC) and the College of Family Physicians of Canada (CFPC) Residency Accreditation Committee (RAC) was held on February 11, 2022. Members of the Res-AC and RAC were joined by representatives from both working groups to discuss the proposed initiatives and recommendations, which will influence changes to the accreditation standards, policies, and processes. This meeting has laid the foundation for further work on developing the formal recommendations of the working groups.

Detailed recommendations are expected to be brought forward to those committees, as well as the Comité des études médicales et de l'agrément (CEMA) of the Collège des Médecins du Québec (CMQ) and the conjoint Accreditation Standards Improvement Committee (ASIC). Broad consultation on any changes to the accreditation standards would then take place later this year.

Canadian Excellence in Residency Accreditation (CanERA)

Specialty committee members are encouraged to visit the CanERA website (www.canera.ca), to access the general standards, frequently asked questions (e.g., CBD in the context of accreditation), and other CanERA-specific information that may be of interest.

Review of Specialty Committee Processes

As a part of the ongoing commitment to continuous improvement and in response to feedback about the current process, Royal College staff have prioritized work focused on improving the process for gathering specialty and AFC committee input into the accreditation process. The Educational Standards Unit is aiming to communicate proposed changes and pilot some components of the process in 2022 and will be reaching out in the near future for volunteers to participate in consultations and pilot testing. Stay tuned!

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 PGME institutions and residency programs. The first round of AFC program applications in the new system, via CanAMS, was successfully submitted to the AFC Accreditation Committee for review at their meeting on March 10, 2022.

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 DeadlineAFC-AC Review Date
May 31, 2022Fall 2022
October 15, 2022Winter 2023
January 31, 2023Spring 2023

AFC Programs

There are currently 59 accredited AFC (diploma) programs that have been approved by the Areas of Focused Competence – Accreditation Committee (AFC-AC) in 19 disciplines. These programs are in the following disciplines:

  • Acute Care Point of Care Ultrasonography (3),
  • Addiction Medicine (3),
  • Adult Cardiac Electrophysiology (6),
  • Adult Echocardiography (5),
  • Adult Hepatology (3),
  • Adult Interventional Cardiology (8),
  • Adult Thrombosis Medicine (3),
  • Adolescent and Young Adult Oncology (1),
  • Brachytherapy (3),
  • Child Maltreatment Pediatrics (2),
  • Clinician Educator (2),
  • Cytopathology (4),
  • Hyperbaric Medicine (1),
  • Pediatric Urology (1),
  • Prehospital and Transport Medicine (1),
  • Sleep Disorder Medicine (3),
  • Solid Organ Transplantation (5),
  • Transfusion Medicine (3), and
  • Trauma General Surgery (2).

International Residency Accreditation

Through the Royal College International (RCI), our more than 20 international partners may apply for consultation, recognition, or accreditation services for their institutions and programs. There are currently six international accredited institutions in five countries. Residency programs under the jurisdiction of these institutions are eligible to apply for Royal College accreditation. There are currently 3 accredited programs, with several additional applications that are still in progress or under review. Aligned with the processes for accreditation in Canada, international partners have been brought on to CanAMS and several institution-level reviews have been conducted with the new system.

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 program profile instrument 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.