Specialty Committee Chairs’ Update

November and December 2022

Specialty Committee Chairs’ Workshop 2022

Thank you to all of those who participated in the Royal College’s first hybrid Specialty Committee Chairs’ Workshop held November 14 and 15. It was great seeing some of you in person again or meeting you for the first time without Zoom. There was great energy in the room and lots of networking happening during the breaks and meals. For those of you who joined online, we hope the experience was valuable for you. We wrestled with some technical issues as we sorted out how to work with the extra technology in the room and make sure everyone was seeing the same content at the same time. We appreciate your patience with us as we figured out this larger meeting.

Thank you to everyone who provided such valuable feedback through the post-meeting survey. We are applying some of the lessons learned to our hybrid Competence by Design (CBD) workshops and committee meetings and will put them to use at the workshop next year which is scheduled for November 13 and 14, 2023. You can expect to receive a save-the-date early in the new year. If you would like to provide feedback about your workshop experience and thoughts about improvements for next year, please feel free to send it in to specialtycommittees@royalcollege.ca addressed to Chris Farley Ratcliffe.

For those of you who didn’t get a chance to download the content from the workshop, including the presentation slide decks and other resources we prepared for you, you can get those through this link for the next 30 days (Specialty Committee Chairs’ Workshop). After that you can still request any of this content through your committee administrators.

Royal College reorganization

The Royal College is nearly a year into a new alignment project that has resulted in some changes here in the Specialties Unit. These changes are being made to better align our work processes and teams to the strategic objectives of the Royal College. Several of you asked for an organizational chart to help understand the changes underway. We will provide this to you in the next edition of this newsletter in February as there are still several manager-level positions being filled and confirmed and those should all be sorted out by the publication date.

In the meantime, there are some important updates to provide about the Specialties Unit and the support that we provide to you and your committees:

  1. Your committee administrator will not be changing as part of this reorganization. You will continue to receive the same support that you receive now. Your administrator will continue to serve as your first point of contact and advocate.
  2. Jolanta Karpinski, MD, MMed, FRCPC, is stepping down from her role as associate director of the Specialties Unit as of the end of 2022.
  3. The Specialties Unit will be dissolved as a single unit at the end of 2022.

The Specialty Standards team will be remaining in the Office of Standards and Assessment (formerly known as the Office of Specialty Education) under the leadership of Jennifer Stewart, MHS. Jennifer will be reporting to Damon Dagnone, MD, MMed, FRCPC, who will assume the role of director of Standards and Accreditation in mid-January.

The Specialty Support team will be moving to the Office of Learning and Connecting (formerly known as the Office of Membership Engagement and Programs) under the leadership of Chris Farley Ratcliffe. Chris will be reporting to Lisa Gorman and Steven Bellemare, MD, FRCPC. Lisa joins our team as the new associate director of Member Experience from her role as manager of the Education Strategy, Innovations and Development (ESID). Dr. Bellemare started with the Royal College in early December as the new director of Member Experience and External Relations.

The Specialty Support and the Specialty Standards teams will continue to work closely together to support you and your committee.

Coaching over time

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; and earlier in 2022, we released Learn the Basics of Coaching over Time, the first module in a series devoted to longitudinal coaching.

Co-creating resident learning plans is the newest module in the Coaching over Time series. This module helps identify ways to co-create goals and learning plans with residents, and to recognize barriers and enablers for engaging residents in developing their individualized learning plans.

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.

CanMEDS Leader resources

Incorporating the CanMEDS Leader Role competencies into teaching and assessment plans can be a challenge. Ensuring residents experience the realities of managing a busy professional practice to demonstrate leadership skills and abilities during residency training can be daunting for programs to implement. Leader Role experts across Canada have developed a new Royal College resource: a web-based collection of educational materials for medical educators seeking advice while implementing the Leader Role into postgraduate training.

Accessing the materials is easy – follow this link. For more information, contact CanMEDS at canmeds@royalcollege.ca.

Accreditation update

Regular accreditation reviews

The regular accreditation review of the University of Calgary took place in-person from September 18 to 23, 2022. This was the first in-person regular accreditation review since the declaration of the COVID-19 pandemic in March 2020. The Royal College began reaching out to specialty committees for post-accreditation review input for these programs in late fall.

The post-accreditation review input for programs at the University of Manitoba was considered by the Residency Accreditation Committee (Res-AC) at its meeting in October for final accreditation decisions for the university and its programs. Pre-accreditation review input for the upcoming regular review of l’Université de Sherbrooke will be sought in early 2023.

The Royal College is continuing to monitor the situation to evaluate the feasibility of continuing in-person regular reviews. All external reviews continue to be delivered virtually.

Upcoming regular accreditation reviews

University Review Date Res-AC Review Date
Université de Sherbrooke March 19–24, 2023 Fall 2023
McMaster University May 2023 Fall 2023
University of Saskatchewan Fall 2023 Spring 2024

Impact of COVID-19

After two years of exclusively virtual delivery, the ability to gather and meet in-person for the regular accreditation review of the University of Calgary in September was greatly welcomed by accreditation surveyors as well as university and program stakeholders. Informed by its experience since March 2020, the Royal College conducted some components of the process virtually (e.g., pre-survey sessions with stakeholders and surveyor training) for the Calgary review and will continue to identify opportunities to adopt a hybrid approach going forward.

As we return to in-person delivery of certain activities, the Royal College is carefully considering all factors including planetary health, equity and access, and the stewardship of financial resources. The Royal College corporate Accreditation Committee has drafted a set of principles to help guide decision-making regarding the virtual delivery of accreditation activities. These are being brought forward to the various accreditation committees under the purview of the corporate Accreditation Committee and used to inform decisions about future accreditation activities.

Equity, diversity, and inclusion (EDI)

Priority initiatives related to anti-racism and EDI are well underway in collaboration with accreditation partners at the College of Family Physicians of Canada (CFPC) and Collège des médecins du Québec (CMQ). Two key groups are driving the first wave of changes: the conjoint Accreditation Working Group on Anti-Black Racism (AWG-ABR), 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 (IH-EWG), chaired by Dr. Ryan Giroux, MD, FRCPC. Both the AWG-ABR and IH-EWG have developed comprehensive and transformative recommendations to ensure that the next revision of the General Standards of Accreditation for Institutions with Residency Programs is inclusive of racialized perspectives and addresses anti-Black racism, anti-Indigenous racism, and Indigenous health consciousness.

The recommendations from the AWG-ABR and IH-EWG have been embedded within the penultimate drafts of the General Standards of Accreditation for Institutions with Residency Programs. Drs. Osei-Tutu and Giroux attended the February, May, and September 2022 meetings of the Accreditation Standards Improvement Committee (ASIC) to participate in the discussions of the latest iterations. Additionally, the Accreditation Standards Improvement Committee for Family Medicine (ASIC-FM) reviewed and provided input on the integration of the recommendations within the general standards as part of its preparation for revisions to the Standards of Accreditation for Residency Programs in Family Medicine (the “Red Book”).

Members of the accreditation committees of the three Colleges are currently reviewing these drafts and will ultimately be asked to approve changes to accreditation standards in February 2023. In November 2022, national consultation began to allow all accreditation stakeholders to hear and comment on major changes. Throughout the process, there will be opportunities for further input by the working groups and accreditation committees along the way.

Work is also underway to outline the key criteria for safe and effective reporting mechanisms regarding experiences of racism. Institutions do not currently have effective means of reporting race-based harm or trauma and current structures can marginalize, deny, and erase the experiences of Black and Indigenous residents. Furthermore, the scale of anti-Black and anti-Indigenous racism within PGME is unknown. Safe and effective reporting mechanisms are crucial in operationalizing an anti-racism policy and provide the practical means for accreditation to drive change.

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 Area of Focused Competence (AFC) committee input into the accreditation process. The Educational Standards Unit has begun piloting some of the new components of this mechanism with external reviews this year, with the help of some volunteer committees. Feedback is being sought as each component is piloted and used to inform updates. As this mechanism develops and we continue to pilot test more components, we will reach out for additional volunteers as needed. Thank you to all those who have contributed their feedback so far!

Update to the General Standards of Accreditation

ASIC is nearing completion of the final draft for the next update to the General Standards of Accreditation for Institutions with Residency Programs and the General Standards of Accreditation for Residency Programs. As noted above, ASIC is particularly focused on incorporating recommendations from the AWG-ABR and IH-EWG, as well as other input from a conjoint working group on assessment decision-making and the Royal College Physician Wellness Task Force.

Under the CanRAC governance model, ASIC makes recommendations that are then considered, refined, and endorsed by the accreditation committees of the three Colleges, a process which is currently underway. The draft revisions will be shared for detailed consultation with a broad range of stakeholders, including specialty committee members, in late 2022, with approval from the accreditation committees of the three Colleges to be sought in early 2023 for an anticipated launch date of July 1, 2023.

Area of Focused Competence (AFC) Accreditation

Updated training modules

To supplement the “just in time” training provided to AFC (sub)committees in line with scheduled reviews, a series of online training modules is being developed outlining the role of AFC (sub)committees and process for providing input for various accreditation activities. These modules will be divided by accreditation activity and accessible to AFC (sub)committee members at any time. It is expected that the new training modules will be available to all AFC committees in December 2022.

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
January 31, 2023 Spring 2023
May 31, 2023 Fall 2023
October 15, 2023 Winter 2024

AFC programs

There are currently 71 accredited AFC (diploma) programs that have been approved by the Areas of Focused Competence – Accreditation Committee (AFC-AC) in 22 disciplines. These programs are in the following disciplines:

  • Acute Care Point of Care Ultrasonography (5),
  • Addiction Medicine (3),
  • Adolescent and Young Adult Oncology (1),
  • Adult Cardiac Electrophysiology (6),
  • Adult Congenital Heart Disease (1),
  • Adult Echocardiography (6),
  • Adult Hepatology (3),
  • Adult Interventional Cardiology (10),
  • Adult Thrombosis Medicine (3),
  • Advanced Heart Failure Cardiac Transplantation (1),
  • Brachytherapy (3),
  • Child Maltreatment Pediatrics (2),
  • Clinician Educator (2),
  • Cytopathology (4),
  • Hyperbaric Medicine (1),
  • Pediatric Urology (1),
  • Prehospital and Transport Medicine (2),
  • Retina (2),
  • Sleep Disorder Medicine (4),
  • Solid Organ Transplantation (6),
  • 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.