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Specialty Committee Chairs’ Update

Mises à jour pour présidents des comités de spécialité

Mises à jour pour présidents

des comités de spécialité

Specialty Committee

Chairs’ Update

March - April 2018

Thank you to volunteers

We want to take a moment to thank you for all the work you’ve done this past year, as a Royal College volunteer. Together, we have accomplished many goals that directly impact trainees and the future of medical care in this country. Notably, your efforts ensured that specialty training standards in our recognized disciplines remain world class.

In recognition of National Volunteer Week (April 15-21, 2018) we want to extend our deep gratitude to you for your willingness to step away from your personal and professional obligations to help us fulfil our mandate. Even in the midst of an ever-evolving medical training system, residents can be assured of a high quality education — and that is something you can’t put a price on.

Thank you for giving your time and expertise.

If you have ideas for how to improve your volunteer experience or other general feedback, please do not hesitate to contact us at volunteers@royalcollege.ca.

Specialty Committee resources now available on-line

A comprehensive collection of information has been assembled on the Royal College website to help you and your members navigate your volunteer role on AFC-diploma and specialty committees. Everything you need to know about the functioning of committees is there, such as

This area will be particularly useful for voting members new to their roles. We encourage you to direct Fellows to this site. Your comments are always welcome and if you cannot find something in this section, do let us know at specialtycommittees@royalcollege.ca so we can work to meet your needs.

Residency Accreditation update

Canadian Excellence in Residency Accreditation (CanERA)

Recent and upcoming CanERA-Related activities

The Canadian Residency Accreditation Consortium (CanRAC) continues the further development and iterative testing of the new accreditation system, CanERA. The implementation of CanERA includes a multi-phased approach of prototype testing prior to full implementation, which is planned for all accreditation reviews July 1, 2019 and onwards. Updates and activities related to the development, implementation, and ongoing evaluation of CanERA include:

How are specialty committees affected by CanERA?

CanERA will be fully implemented for the upcoming regular accreditation reviews of Dalhousie and McGill University, and thereafter for all accreditation reviews at all universities as of July 1, 2019. Specialty committees with programs at Dalhousie (November 2018) and/or McGill University (March 2019) will be first to transition to CanERA. Specialty committees will need to:

How can specialty committees prepare for these changes?

Specialty committees require training, tools, and support to help with the transition to the new accreditation system. Development of a robust training plan is underway, and will be deployed to enable specialty committee readiness for the upcoming regular accreditation reviews in the new accreditation system (e.g. Dalhousie November 2018). In the meantime,

International residency program accreditation

To date, there are seven international accredited institutions in five countries. Programs under the jurisdiction of these institutions are now eligible to apply to the Royal College for program accreditation. The international program accreditation application process involves the submission of an application form and an onsite review to verify and validate information before a final decision is made on accreditation status. Specialty committees will be asked to review both the application form and the onsite review report to inform the decision of the International (residency) Program Review and Accreditation Committee (IPR-AC). The process will be comparable to the specialty committee review of a Pre-Survey Questionnaire (PSQ) and accreditation review report in the Canadian accreditation system. Royal College has received the first applications for accreditation of international residency programs. Specialty committees will be well-supported in this process, including tailored briefings for individual specialty committees as applications are received.

Area of Focused Competence (AFC) accreditation

To date, there have been 29 applications for accreditation of Areas of Focused Competence (AFC-diploma) programs that have been approved by the Areas of Focused Competence – Accreditation Committee (AFC-AC). These applications are in the following disciplines: Adult Interventional Cardiology (8), Adult Cardiac Electrophysiology (5), Adult Echocardiography (4), Adult Hepatology (1), Adult Thrombosis Medicine (3), Brachytherapy (1), Clinician Educator (1), Cytopathology (4), Solid Organ Transplantation (2). In addition, there are four accredited AFC (diploma) programs in Transfusion Medicine that transitioned from an Accreditation without Certification (AWC) program in 2012. Thus, in total, there are 33 AFC (diploma) accredited programs.

General Standards of Accreditation

The new general standards are available now online at www.canera.ca.

Residency accreditation reviews/onsite visits

The post-onsite accreditation review specialty committee activities for the University of Alberta (onsite review took place the week of November 26, 2017) are currently underway for review at the June 2018 meeting of the Residency Accreditation Committee.

The Queen’s University onsite accreditation review occurred the week of March 4, 2018. The post-onsite accreditation specialty committee activities are expected in May 2018 for review at the June 2018 meeting of the Residency Accreditation Committee.

Specialty Standards Review Committee (SSRC) activity in 2017

The SSRC has been delegated authority by the Committee on Specialty Education to review and approve all Royal College discipline-specific standards documents in order to maintain the highest standards of postgraduate medical education.

The SSRC is comprised of current or former members of specialty committees, or the Office of Specialty Education (OSE) standing committees or their subcommittees. The SSRC welcomed one new member in 2017, and two members retired, leaving a total of 11 active members on the committee for 2018.

In the 2017 calendar year, the SSRC reviewed 44 new or revised standards documents from 19 recognized disciplines and Areas of Focused Competence (AFCs). The OSE approved an additional 23 documents (from 12 disciplines) that did not require SSRC review (i.e., AFC PER Portfolios or editorial revisions). Documents for the following disciplines were approved in 2017:

The Specialties Unit hosted 17 2-hour SSRC web conferences in 2017. The 12 members of SSRC devoted approximately 400 volunteer hours to reviewing, discussing, and approving discipline-specific standards documents. By comparison, there were 11 web conferences and one full-day meeting in 2016, which required about 375 volunteer hours. The increased time and effort SSRC devoted to reviewing several new CBD document suites enabled the Specialties Unit to meet the strict deadlines for disciplines aiming to implement CBD in 2017 and 2018.

Throughout 2017, SSRC members contributed their expertise to fine-tuning the Competencies and Training Experiences CBD document templates. The committee also recommended clarifications and improvements to the new discipline-specific Standards of Accreditation that will be used in conjunction with the new General Standards of Accreditation for Residency Programs by all primary specialties and subspecialties in 2018.

To learn more about the SSRC or the approval process for standards documents, please contact Jennifer Stewart, manager, Specialties Unit, at jstewart@royalcollege.ca.

Program evaluation for the AFC category

The Office of Specialty Education (OSE) has now launched its plan to undertake a program evaluation of the Areas of Focused Competence Diploma Category at the five year mark. As part of this evaluation, consultations (in the form of surveys, focus groups, and interviews) have been taking place throughout the months of March and April to gather important feedback from key AFC stakeholders. The information collected through this initial evaluation will be used to formulate recommendations for improvements to the category, and to determine priority areas for future evaluation. If you would like the opportunity to provide feedback and haven’t yet been approached as part of this evaluation, please contact the Educational Strategy, Innovations, and Development Unit (educationstrategy@royalcollege.ca) for further information.

Area of Focused Competence (AFC-diploma) update

Since the last update provided in fall 2017, the Specialties Unit has appointed the working group for the newly recognized Area of Focused Competence (AFC) in Hematopoietic Stem Cell Transplantation and dates for the first workshop are being considered. A document development workshop for the new AFC in Pediatric Urology will take place in mid-April while Acute Care Point of Care Ultrasonography (Acute Care POCUS), Emergency Medical Services and Patient Safety and Quality Improvement continue to meet regularly to complete drafts of the national standards. The new standards for Addiction Medicine will likely be considered by the SSRC in the coming months.

Since January 2018, two new AFC disciplines went ‘live’ with their document suites being distributed nationally to stakeholders. Sites are now able to apply for accredited AFC training programs in the areas of Sleep Disorder Medicine and Sport and Exercise Medicine.

Including the above noted disciplines, the Specialties Unit supports 24 AFCs, 18 of which have approved standards that are ‘live’. As of the last meeting of the AFC Accreditation Committee in 2018, there are now 33 accredited AFC training programs in Canada made up from the following 10 disciplines: Adult Cardiac Electrophysiology, Brachytherapy, Adult Echocardiography, Adult Hepatology, Adult interventional Cardiology, Adult Thrombosis Medicine, Cytopathology, Clinician Educator, Solid Organ Transplantation and Transfusion Medicine. For many of these disciplines, it was their first training program to be accredited.

Practice Eligibility Route (PER-AFC) portfolios have been approved for seven AFCs and are available on the Information by Discipline page for each of the following disciplines: Adult Hepatology, Advanced Heart Failure and Cardiac Transplantation, Aerospace Medicine, Brachytherapy, Child Maltreatment Pediatrics, Clinician Educator and Solid Organ Transplantation. Six other disciplines continue to develop PER-AFC portfolios while two have delayed development of the portfolio until an expression of interest is received by the Credentials Unit.

To date, there have been 16 approved competency portfolios assessed by Royal College assessors. Five of these assessments were completed during the paper-based era, whereas the other 11 were submitted and assessed through eDiploma. The first PER-AFC portfolio was achieved in 2018 by a physician practicing in Aerospace Medicine. There are now 14 Diplomate or Diplomate–Affiliate members of the Royal College.

CanMEDS and Faculty Development

New Competence by Design (CBD) resources

As you and your colleagues transition to CBD, you’ve asked for resources to help faculty understand and make the change.

We listened and we’re proud to announce the release of three new products (see below) to make your transition easier. Please check out these new resources on the Royal College website and share with your colleagues as well.

We invite you to send us your feedback and recommendations for other resources you’d like to see to: canmeds@royalcollege.ca

Introducing the CBD Coaching Model

The Royal College has developed a coaching model to support resident learning. In addition to the oversight of patient care, expectations of a clinical teacher now include more observation and coaching of residents.

Resident learning is positioned at the centre of this new model to reflect the importance of a learner-centred, developmental approach to competency acquisition.

In CBD, coaching is both a teaching method and an important element of workplace-based assessment where assessment is designed to be formative in nature.

The CBD Coaching Model includes two coaching components:

  1. Coaching in the Moment requires clinicians to establish rapport and set expectations with their residents, observe the residents doing their daily work, provide coaching feedback, and document the encounter. Frequent observation is a key ingredient in resident learning and assessment.
  2. Coaching over Time calls for a longitudinal relationship and educational partnership between clinician and resident that aims to facilitate the resident’s development as a competent clinician and as a self-regulated learner.

Learn more about coaching feedback and the coaching model by viewing these new coaching model resources on the CBD website:

Two new online modules

The Royal College is pleased to introduce two new online modules, one for competence committees and one related to workplace-based assessment.

  1. Case Scenarios: Competence Committee (CC) Discussions
    With CBD, we officially incorporate CCs into residency training in Canada, which is a new concept in many programs. This online activity is meant to provide direction and support for CC deliberations. It includes several case scenarios for CC members to review and discuss as a group. These cases represent common issues/concerns that a CC may encounter when reviewing and discussing resident files.
  2. Entrustability Scales: Workplace-based Assessment (WBA) Rating Anchors to Trust
    In CBD, clinical teachers observe residents in practice and document their feedback in various WBA tools. Completing WBA tools involves clinical teachers rating learners practice performance using entrustability scales and detailed narrative descriptors. This self-paced online module focuses specifically on entrustability and is designed to help you practice differentiating between the five levels of the entrustability scale and applying the scale to your own specialty.

Surgical Foundations

Surgical Foundations is one of six programs that will launch Competence by Design (CBD) in July 2018. In addition, Surgical Foundations has become an integrated special program which means Surgical Foundations programs will be granted a separate accreditation status from primary specialty programs and trainees will be progressing through their Surgical Foundations training concurrently with their base specialty training. Given these changes, we are happy to release three new resources for Surgical Foundations - a diagram, infographic and frequently asked questions to help explain this unique program. You will find them in the CBD Resource Directory.

Stay tuned for more information on Surgical Foundations in CBD Touchpoint coming out in mid-April!

2018 Simulation Summit

Online registration for the 2018 Simulation Summit is now available Join hundreds of international simulation educators, researchers, health care professionals and other individuals engaged in the field of simulation in Ottawa, Canada, September 28-29, 2018 for this unique and practical interprofessional medical simulation conference.

Through its dynamic lineup of workshops, presentations, and plenaries, the 2018 conference offers participants the opportunity to collaborate with international colleagues on knowledge translation as it relates to simulation in healthcare, examine new technologies in medical simulation, and investigate advances in medical simulation.

Click here to register for the 2018 Simulation Summit.

The early bird deadline for online registration is August 10, 2018.

Upcoming Meetings and Deadlines