Specialty Standards Review Committee Update
The Specialty Standards Review Committee (SSRC) assesses and approves the specialty-specific standards documents developed by each Royal College-recognized discipline. In the period September 2017 to July 2018, SSRC approved 52 standards documents from 20 disciplines, including new standards for the Area of Focused Competence in Sleep Disorder Medicine, and new competency-based standards for 13 primary or subspecialty disciplines.
The Specialties Unit hosted 20 two-hour SSRC web conferences in 2017-18, which represented approximately 770 volunteer hours from the members of SSRC. A report with full details of the committee’s activities can be found by clicking on this link.
Anyone interested in learning more about the invaluable work of the SSRC or the approval process for standards documents should contact Jennifer Stewart, manager, Specialties Unit, at firstname.lastname@example.org.
Specialty Committee Chairs’ Workshop 2018
The 2018 Specialty Committee Chairs’ Workshop will take place November 26 - 27, 2018 at the Fairmont Chateau Laurier, Ottawa. This workshop is by invitation only to current specialty committee chairs and chair-elects stepping into the chair role in 2019. The workshop will provide an important opportunity for networking with key Royal College staff as well as with other new and experienced chairs. Participants will learn and share best practices, expertise and experiences; gain a deeper understanding of the roles and expectations of committees and functions of various Royal College units; and learn about new Royal College initiatives and activities.
Travel and accommodation expenses are covered for participants in accordance with the Royal College travel policy. We encourage chairs who cannot attend the workshop to assign a delegate, such as the committee vice-chair, to ensure that each discipline is represented.
If you have received an invitation to attend the workshop and are yet to confirm your attendance, please RSVP now. For more information, contact email@example.com.
Elimination of the Final In Training Evaluation Report (FITER)
(The following information was contained in a memo sent to program directors on June 1, 2018 from the Office of Specialty Education (OSE)).
On June 1, 2018, the OSE announced changes to FITERs and the elimination of deliberations that will affect the 2019 exam season.
Program directors will not be required to submit the itemized ratings within each CanMEDS Role on the FITER. Only summative attestation of training is necessary for the candidate to be credentialed by a Royal College accredited training program.
This decision was based partly on the removal of the borderline deliberation category, as well as concerns that the submitted information is not used for decision making. Additionally, the value of FITERs as a feedback tool for program directors and candidates declined as they became homogenized in order to protect the identification of the candidate.
The Royal College continues to support completion of a valuable final assessment of training that provides information to the program and candidate on any relevant tool but these will not be collected by the Royal College with the summative attestation from the program director to confirm the candidate’s exam eligibility.
The borderline classification defines candidates who failed to meet the expected standard but whose performance was judged to be close enough that their entire exam performance was reviewed. The deliberation process consists of reviewing a candidate’s performance on all components of the examination followed by reading the FITER (where applicable) and lead to a vote with the candidate either being elevated to a pass or remaining a fail. In recent years, only a small number of exams use this process. As of 2019, this process will be stopped across ALL exams, and will coincide with the FITER decision above.
If you have any questions regarding this decision, please contact firstname.lastname@example.org.
As a result of this decision, the Specialty Standards Review Committee (SSRC) will no longer review and approve newly written or revised FITERs. FITERs will continue to be available on the Royal College Information by Discipline site as long as the discipline has residents adhering to the OTR standards for training (i.e. on CBD).
Competence by Design Update
On July 1, 2018, six disciplines launched Competence by Design (CBD) in their residency training programs. The following disciplines are now teaching and assessing residents with new CBD national standards and Entrustable Professional Activities:
- Otolaryngology – Head and Neck Surgery
- Emergency Medicine
- Forensic Pathology
- Medical Oncology
- Surgical Foundations
Following that momentum, efforts are being made by 12 other disciplines that are aiming to launch CBD on July 1, 2019. The following disciplines have CBD standards documents (Competencies, Training Experiences and Standards of Accreditation) as well as Entrustable Professional Activities (EPAs) approved and finalized in both English and French. These documents are either currently accessible to specialty committee members, postgraduate deans and competency based medical education (CBME) leads through the Alfresco site or will be posted to Alfresco by mid-October. It is anticipated that the EPAs of these 6 disciplines will be uploaded into Royal College ePortfolio by November 30, 2018:
- Internal Medicine
- General Internal Medicine
- Cardiac Surgery
- Radiation Oncology
In finalization process
The following disciplines have CBD standards documents approved in English and are in the process of being translated. Similarly, the EPAs are being finalized (either by Royal College staff/management or the specialty committee) and will be prepared for translation shortly. Posting to Alfresco for these documents and EPAs in English and French is anticipated by mid-November 2018 and the EPAs will be uploaded into Royal College ePortfolio by mid-December 2018:
- Geriatric Medicine
- Critical Care Medicine
In approval process
The disciplines below have submitted their final draft standards documents and EPAs to the Royal College. The standards documents will be reviewed by the SSRC by mid-October 2018. Pending approval and finalization, the documents and EPAs will be sent for translation by the end of October 2018. It is anticipated the documents and EPAs will be posted to Alfresco in English and French by mid-December 2018 and that the EPAs will be uploaded into Royal College ePortfolio by the end of February 2019:
- Obstetrics and Gynecology
- Anatomical Pathology
- General Pathology
All dates mentioned above are estimated timelines and are dependent upon the timeliness of progression through previous steps. There could be shifts to these timelines, particularly related to uploading content into ePortfolio.
If you have any specific questions regarding the status of disciplines or if you have any specific concerns about any of these disciplines’ progress, please do not hesitate to contact Jennifer Stewart, manager, Specialties Unit, at email@example.com.
Committee on Specialties Update
The following specialty reviews will take place at the November 16, 2018 meeting of the Committee on Specialties (COS):
- Forensic Pathology
- Public Health and Preventive Medicine
The COS will also review the following Part I and Part II applications for recognition of Area of Focused Competence (AFC-diploma):
- Adult congenital heart disease
- Targeted neonatal echocardiography
- Neuromusculoskeletal point of care ultrasound
In addition, the COS will consider the following application to change a recognized discipline:
- Pediatrics: request to eliminate the possibility of overlap training in postgraduate year (PGY) 4
The next deadline for interested AFC-diploma applicants to apply for Part I review is February 1, 2019, for consideration during the spring 2019 COS meeting.
CanMEDS and Faculty Development
New Competence by Design Resources
As more and more disciplines transition to Competence by Design (CBD), we have a better appreciation for the types of support and resources that help program directors design a local approach to CBD. Based on experience and feedback, the Royal College is working on the following:
Implementation Booster Webinars – We’re now piloting a new support model periodically bringing together several specialty committees at a similar stage of their CBD transition. These web-based sessions are scheduled between CBD workshops and are meant to “boost” local activities that focus on CBD capacity building. Attendees discuss common experiences and local successes. There’s also opportunity for troubleshooting and resource sharing.
CBD Implementation Planner – Have you ever asked yourself, “What exactly do I need to do for CBD and when do I need to do it?” If so, you’re not alone. While every program and institution has differing needs, priorities and resources, a small group of clinician educators, program directors, competency based medical education (CBME) leads is creating a CBD planner based on what they characterize as “fairly typical” patterns and strategies that enable implementation. Watch for this planner on the Royal College’s CBD Directory – coming soon.
Mock Competence Committee Cases for Practice Deliberation
The Royal College is pleased to announce the addition of four new cases to the online Mock Competence Committee Cases for Practice Deliberation.
With CBD, we officially incorporate competence committees (CC) into residency training in Canada, a new concept in many programs. This online activity is meant to provide direction and support for competence committee deliberations. It now includes six different 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.
See: /rcsite/cbd/assessment/competence-committees-e under Resources.
To learn more about any of this work, please contact firstname.lastname@example.org
Residency Accreditation Update
Residency Accreditation Reviews/Onsite Visits
The Dalhousie University accreditation review will take place the week of November 25, 2018. Specialty committee pre-review input is currently being sought, and post-review specialty committee input will be requested in spring 2019, which will inform the final accreditation decisions made at the June 2019 Residency Accreditation Committee (Res-AC) meeting. Dalhousie University is the first school to be reviewed in CanERA, the new system of accreditation, as part of prototype 3 (P3) of the multi-phased CanERA implementation plan.
P3 also includes the McGill University accreditation review scheduled to take place the week of March 17, 2019. The pre-review specialty committee input is scheduled for early winter 2019 while the post-review specialty committee input window will be summer or early fall 2019, which will inform the final accreditation decisions made at the fall 2019 Res-AC meeting.
Canadian Excellence in Residency Accreditation (CanERA)
Recent and Upcoming CanERA-Related Activities
Canadian Residency Accreditation Consortium (CanRAC) continues the further development and iterative testing of CanERA, with efforts currently focused on preparation for the upcoming regular accreditation review of Dalhousie University (November 2018) and McGill University (March 2019), which will be the first two universities to transition to CanERA (as part of P3). P3 is the final phase of testing prior to full implementation of CanERA on July 1, 2019, after which all accreditation reviews will be conducted based on CanERA.
In preparation for P3, voting members of specialty committees with programs being reviewed as part of the upcoming P3 Dalhousie accreditation review have been provided with access to the new digital platform, CanAMS. The remaining specialty committees will receive access in advance of their first participation in an accreditation review in CanERA.
What CanERA transition support is available to specialty committee members?
To prepare for the transition to CanERA, a phased approach to training has been developed, covering the various aspects of a specialty committee member’s role in the accreditation process.
Initial training, delivered via webinar and an interactive online training module in September 2018, focused on familiarization with the new standards and how to provide pre-accreditation review input (e.g. how to navigate CanAMS). While all voting members of specialty committees were invited to attend, this training was developed specifically for P3, based on the CanAMS functionality available at this time. CanAMS functionality will evolve, as will the training.
All specialty committee members are encouraged to regularly visit the CanERA website (www.canera.ca), as it is a great way to stay up to date with the latest CanERA news and information. The website includes the new general standards, frequently asked questions, and other CanERA-specific information that may be of interest.
Areas of Focused Competence (AFC-diploma) Accreditation
To date, there have been 31 applications for accreditation of an Areas of Focused Competence (AFC-diploma) program 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 (2), Adult Thrombosis Medicine (3), Brachytherapy (1), Clinician Educator (1), Cytopathology (4), Solid Organ Transplantation (2) and Trauma General Surgery (1). In addition, there are four accredited AFC (diploma) programs in Transfusion Medicine that transitioned from an Accreditation without Certification (AWC) program in 2012. In total, there are 35 AFC (diploma) accredited programs.
International Residency Program Accreditation
There are currently eight international accredited institutions in five countries. Residency programs under the jurisdiction of these institutions are now eligible to apply for Royal College accreditation, and to date eight international program applications in five disciplines have been submitted. Of the seven applications that have been reviewed, five are proceeding to the next step of the international program application process which is an onsite review; two applications have been deferred pending further information/clarification from the program. One application is pending consideration by the relevant specialty committee and International (residency) Program Review and Accreditation Committee (IPR-AC) in the fall.
The international residency 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 are 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 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 with those specialty committees to provide a tailored briefing on the international program accreditation process, and provide support as needed throughout the process.
Discipline Name Change Update
In the spring this year, the COS reviewed the request for a name change for the AFC-diploma program in Emergency Medical Services to Prehospital and Transport Medicine, or Médecine préhospitalière et de transport. The COS deemed the request a minor change and the Office of Specialty Education (OSE) conducted a public notice of intent toward this change over a period of 60 days. Feedback indicated that the new name better reflected the full breadth of the discipline’s expanded scope. The name change request has been approved and the Royal College has implemented it in accordance with its internal processes, including communication with staff, the AFC Working Group in Prehospital and Transport Medicine, committees and stakeholders.
Upcoming Meetings and Deadlines
- Royal College Council – October 25-26, 2018
- Committee on Specialties – November 16, 2018
- Specialty Committee Chairs' Workshop – November 26 and 27, 2018
Useful information for specialty committee chairs can be found in the Specialties Unit Member Resources section of the Royal College website.