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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

September-October 2019

Clarifying the Specialty Committee Chair’s Role in Examinations

The Exams Unit receives occasional enquiries regarding the roles and responsibilities of the specialty committee chair (SCC). The specialty committee chair is responsible for:

  • Appointing the Examination Board Chair (EBC)
  • Appointing members of the Examination Board in consultation with the Examination Board Chair

The SCC and the EBC work collaboratively to make recommendations (of new and returning members) that meet the needs of the Exam Board considering factors such as:

  • assessment/education expertise
  • regional representation
  • succession planning using a balance of both new and experienced members
  • prior performance as a member of the EB.

The SCC and EBC may choose not to renew, or even to reduce the term of Exam Board members when performance is an issue.

The SCC also serves as an ex-officio member of the Exam Board. Where possible they should participate in planning and developing of the exam, and in some cases, even as an examiner. The SCC and the EBC can collectively decide the extent of that involvement.

Specialty Committee Chairs’ Workshop, November 25-26, 2019

Topics include

  • Updates, successes, and challenges of CBD implementation
  • CanAMS demonstrations and simulations
  • New accreditation status decision categories
  • AFC category reforms

Five reasons to attend the Specialty Committee Chairs’ Workshop:

  • Connect with Royal College volunteer leaders – your peers – for information sharing and wisdom
  • Connect with Royal College staff for policy and logistics guidance
  • Recharge while immersed in a dynamic, supportive, engaged learning environment
  • Discuss challenges with peers and enjoy the camaraderie of Fellowship
  • Earn Maintenance of Certification credits

Whether you are a first-time chair, a chair-elect, or an experienced chair, there’s something for you at the workshop. Join us November 25-26 in Ottawa.

If you haven’t yet RSVP’d to the Chairs’ Workshop, please use this link.

AFC Program Evaluation Implementation Update

Work continues on a collaborative response to the AFC Program Evaluation conducted in 2018. Over the last eight months, an internal staff team entitled the AFC Program Evaluation Implementation Working Group (AFC PE IWG) has met regularly to coordinate the reform activities of the respective operational units, in accordance with the directions and recommendations approved by the Committee on Specialty Education.

In June, the Executive Directors’ Committee (EDC) approved resources for a new staff role to coordinate the proposed changes to the AFC program. Linda Rumleski was hired as AFC program manager and started the position on September 24. Many chairs know Linda from her time in the Specialities Unit and more recently in the role of policy analyst in the Educational Strategy, Innovations and Development unit.

The following are updates on the implementation of the four key recommendations:

  1. Prioritize reforms of the assessment strategy for AFC-diplomas

    Web conference consultations on the proposed changes to the assessment strategy for the in-training route are being planned for late October. A second round of consultation will take place at the chairs’ workshop in November.

    The proposed changes to the Practice Eligibility Route (PER-AFC) were shared with AFC chairs by web conference on September 6. Feedback is expected by the end of September.

  2. Re-launch efforts to reform the accreditation policy and process

    As a next step in the iterative implementation of the new AFC accreditation system, in alignment with the approach to implement the Canadian Excellence in Residency Accreditation system (CanERA), a prototype test is anticipated to take place during the regular accreditation review of AFC programs at the University of Toronto (November 2020) and the Université de Montréal (March 2021). AFC disciplines with accredited programs at these sites met with staff from the Educational Standards Unit (ESU) in September to convert their current AFC-Standards of Accreditation (AFC-SA) to the required format.

    Those disciplines with accredited programs at other sites will begin the conversion process in early 2020.

  3. Formulate a plan to increase the category’s visibility and value

    A communications strategy has been developed by senior staff in the Communications Unit and will be deployed in stages over the short to medium-term, to align with the stages of reform implementation. Initial work has also begun to reorganize the website to improve access to information relating to AFCs.

  4. Consider how to continue to provide and improve upon the support currently offered

    Operational units continue to identify opportunities to improve or enhance existing supports provided to those in the AFC community. Proposed changes to streamline the discipline recognition process, including the national consultations, are being considered and focus on creating transparency for stakeholders.

    In the coming weeks, we hope to provide more detailed information about the potential impact of the proposed changes and timelines for each discipline. The chairs workshop will also be an opportunity to learn more as plenaries have been proposed for both an update on the AFC program evaluation implementation and an introduction to the Accreditation Management System (AMS). To register for the workshop, please contact the Specialties Unit (

If you have questions or require more information, please contact Linda Rumleski, AFC program manager, ESID ( Previous reports on the AFC program evaluation results and recommendations are available in the online archives.


Just-in-Time Project

The CanMEDS and Faculty Development team is bolstering the Royal College’s support to Competency Based Medical Education (CBME) leads, program directors, and other Competence by Design (CBD) stakeholders by way of a new outreach program. The goal of this Just-in-Time project is to support CBD implementation processes as early and as consistently as possible by delivering tailored resources to CBD workshop attendees between CBD workshops.

Capitalizing on both existing and new CBD resources, the Royal College is coordinating an email release to coincide with pivotal activities of the CBD transition process. This initiative is intended to assist those who are supporting the change of CBD by deploying the resources they need, when they need it. The first outreach occurred on September 5th and the second release is due in early 2020.

Introducing: A New Resource for Teaching Role Modelling to Residents

In case you missed it at ICRE: we released a new FREE resource to teach residents how to become more effective role models.

We all know the important role that residents play as teachers: whether they are good or bad role models, they are setting an example for the next generation of physicians. Studies show that residents spend up to 25% of their time in residency engaging in teaching, but few know how to role model effectively.

While Resident-as-Teacher curricula have become commonplace in virtually all Canadian residency programs, they typically do not include sessions that focus on role modelling.

With this in mind, the Royal College is proud to offer an all-in-one module to teach residents how to become more aware and deliberate role models. Based on the winning ICRE 2018 “What Works” submission by Robert Sternszus, MD, FRCPC, and developed by Dr. Sternszus and a team at McGill University, this resource includes everything you need to educate residents on being efficient role models. The resource kit includes a facilitator guide, a pre-developed PowerPoint presentation, evaluations and much more! All you need is two hours (or an academic half-day) and a facilitator to lead the session.

All materials are provided electronically via the Royal College website at (French:

New Coaching to Competence Module: RX-OCR

“Coaching to Competence” consists of five interactive activities that allow you to practice applying the RX-OCR coaching process. The activities are meant to help you identify gaps in skills and knowledge related to coaching so that you can work to close these gaps through further practice, reflection and other learning opportunities.

Access the first of five RX-OCR activities here.

Residency Accreditation Update

Regular Accreditation Reviews

  • The post-accreditation review specialty committee input for McGill University is currently being sought to inform the final accreditation decisions at the October 2019 Res-AC meeting.
  • The Western University regular accreditation review is scheduled to take place November 2019; the associated specialty/area of focused competence discipline committee pre-accreditation review input will be sought early fall 2019.
  • The University of British Columbia regular accreditation review is scheduled to take place March 2020; the associated specialty committee pre-accreditation review input will be sought in late fall 2019.

Canadian Excellence in Residency Accreditation (CanERA)

Recent and Upcoming Activities
As of July 1, 2019, CanERA was fully implemented; all future accreditation reviews conducted will be based on the new system of accreditation.

While CanERA is fully implemented, CanRAC (the Canadian Residency Accreditation Consortium) will continue collaborative efforts with respect to the ongoing development, evaluation, and continuous improvement of CanERA.

What CanERA transition support is available to Specialty Committee members?
To support the ongoing transition to CanERA, training specific to the pre-accreditation review speciality committee input process was delivered via webinar and an interactive online training module during the prototype testing phase (i.e., as part of the regular accreditation review process for Dalhousie University and McGill University).

While all voting members of specialty committees were invited to attend the webinars above, this training was developed based on the CanAMS functionality available during the prototype testing phase. CanAMS functionality will evolve as will the associated training. The link to the webinar and online training has been provided to all voting members via email. The online training module is also available at under the Training, Tools and Support tab.

Specialty committee members are encouraged to regularly visit the CanERA website (, as it is up to date 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.

Recent and Upcoming Activities
Efforts to reform the AFC accreditation system are currently under way, with an emphasis on addressing the recommendations identified through the recent evaluation of the AFC discipline as a whole (i.e., the digitization of the AFC accreditation process, increased training tools and supports relating to accreditation, and streamlining of the AFC accreditation standards, focusing on key markers of AFC program quality).

National consultations on the proposed new AFC accreditation system were held throughout June and July 2019. Stakeholders were invited to provide input through webinars and an online survey.

In alignment with the approach to testing and implementation of CanERA, prototype testing of all aspects of the new AFC accreditation system is anticipated to take place during the regular accreditation review of AFC programs at the University of Toronto and University of Montréal, in November 2020 and March 2021, respectively. Full implementation is anticipated for July 1, 2021, at which time the new AFC accreditation system will apply to all accreditation reviews.

Overview of Accredited AFC Programs
To date, there have been 32 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 (3)
  • 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. Thus, in total, there are 36 AFC (diploma) accredited programs.

International Residency Accreditation

There are currently eight international accredited institutions in five countries. Residency programs under the jurisdiction of these institutions are eligible to apply for Royal College accreditation, and to date nine international program applications in six disciplines have been submitted. The current status is:

  • One new accredited program (Internal Medicine)
  • Five programs with Accreditation in Progress in status (Anatomical Pathology, Internal Medicine, Pediatrics)
    • Three onsite reviews recently took place, the reports of which are under review by the specialty committees
    • Two onsite reviews have not proceeded to scheduling as they are at institutions in Saudi Arabia where all activities are currently on hold
  • Two programs with Deferred status (i.e., additional information is required within one year before proceeding to an onsite review) (Ophthalmology, Surgical Foundations)
  • One program application under review (Emergency Medicine)

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 (ESU) 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.

Federal Election Advocacy

The Royal College advocates for better health and health care, for the benefit of patients and populations and for Fellows who serve them. The 2019 federal election provided an opportunity for us to engage political parties on issues that are important to the delivery of specialty care. Following an extensive research and consultation process, the Royal College chose to focus on four priorities:

  • Investing in high-speed internet to improve access to health care in every part of Canada
  • Implementing National Pharmacare so no Canadian goes without treatment they need because of cost
  • Advancing reconciliation by acting on the Truth and Reconciliation Commission’s Calls to Action
  • Supporting a sustainable and diverse health research workforce

To advance these priorities, we have engaged Fellows, the public, and decision makers. We created a federal election webpage that communicated our advocacy priorities in an easy-to-read and visually-appealing way, emphasizing the importance of specialty care for patients and populations. The webpage also featured an easy-to-use tool enabling Fellows to send a letter to their local candidates, asking them to make our priorities their priorities. As part of our advocacy work, we supported Fellows who wrote Op-Eds for media outlets across the country, to educate the public on the important role of specialty medicine in their lives, and the issues that we hope to make progress on. We have also reached out and provided information to federal parties, and offered to meet and discuss opportunities for collaboration with each party. As we move forward, we plan to follow-up with the newly-elected federal government on the four priorities, to determine how we can work together in service of our Fellows and people living in Canada. In addition, we will be developing a comprehensive advocacy strategy which will include work at the provincial and territorial levels.

Chair and Specialty Committee Members’ Resource

The Specialties Unit home page has the same address and we encourage you to bookmark the appropriate Member Resource site for your committee:

The resources compiled on the Specialties Unit home page will help members navigate their volunteer role on AFC (diploma) or specialty committees. You’ll find everything you need to know about the functioning of the committee and its ongoing work to maintain its discipline standards. Additionally, information on the activities relating to the Committee on Specialties, accreditation, AFC application process, credentialing, and exams and assessment is housed here.

If you didn’t find something you were looking for on the site, please let us know. (

Upcoming Meetings and Deadlines 2019

  • Committee on Specialties – November 14-15
  • Specialty Committee Chairs’ Workshop – November 25-26, 2019