Specialty Committee Chairs’ Update

January and February 2022

Important update regarding Resident ePortfolio

The Royal College will be phasing out Resident ePortfolio.  This is happening because the vendor that supports the platform, Premier, is moving away from supporting this tool.

Easing the impact to affected schools

This decision impacts The University of Calgary, Université de Montréal and Université de Laval.  We are in close contact with the three impacted schools and are committed to supporting them throughout this transition.

To help ease this transition, we are in the process of extending our contract with Premier to ensure Resident ePortfolio is available until June 30, 2025.  There are several other strong platforms available for these schools to track residents’ progression, and we are confident this will not place any programs or residents in a situation where accreditation or certification will be affected.

How the Resident ePortfolio evolved

The original vision for Resident ePortfolio was to provide a widely adopted tool that would support the fidelity of Competence by Design (CBD) implementation and facilitate data amalgamation for the benefit of programs and specialties.

Despite this being a freely available tool, uptake of the Resident ePortfolio only occurred in some universities and programs. Other institutions elected to adopt commercially available tools or locally develop their own electronic portfolio tools that addressed unique and varying school or program needs.  We do feel that with the range of platforms available, there will be options that work well for each of the three schools.

Ensuring a smooth transition

To share this information, we communicated on many levels with the medical education community, including calls and a memo that was distributed to affected stakeholders.   Overall, this decision has been well-received and we are confident this will be a smooth transition.

Additionally, the sunsetting of Resident ePortfolio allows us to allocate resources to priority areas of support identified by our stakeholders, including CBD data visualization and national benchmarking initiatives. We look forward to this next stage of CBD implementation.

If you have any questions, please feel free to reach out to cbd@royalcollege.ca.

2022 to 2024 appointment cycle

The membership renewal cycle for the 2022 to 2024 mandate will be underway in the coming weeks for the specialty committees and Areas of Focused Competence (AFC) committees and subcommittees on the even year cycle.  Chairs and chair-elects of the committees will be asked to:

  • Confirm renewal of your reappointment as chair (if eligible).
  • Confirm the committee membership renewals for those members that are eligible to renew for an additional two-year term.
  • Identify a chair-elect, if required, if the chair is entering the final two-year term or identify a vice-chair for chair-elects that will move to the chair role on July 1, 2022.

Regional representatives (voting members) that have mandates completing on June 30, 2022, will be identified for chairs/chair-elects and new representatives will be sought.  Your specialty committee administrator can assist with this process if required.  The job description for a voting member can be found here.  Please consider the how many potential renewals committee members have left and long-term continuity of committee knowledge.  If more than half of the committee are likely to end their terms on the committee, consider replacing some members early to better stagger end dates.

Guidance and support for applying equity, diversity, and inclusion principles to committee appointments will be forthcoming for the 2023 to 2025 appointment cycle.  If you wish to have an open call for new committee members, your administrator can provide support.

Discipline Status Report update

The Specialties Unit, in collaboration with all other Royal College units, compiles a Discipline Status Report for every discipline annually.  Each report covers the activities of the committees from January 1 to December 31 of each year.  The Discipline Status Report is sent to the chair and chair-elect only and is a confidential document, although verbal updates on the contents of the report – with the exception of examination data and some program-specific accreditation data – are typically shared with the specialty committee during the spring/summer committee meetings.  The Discipline Status Reports are used to assist standing committees of the Royal College, primarily the Committee on Specialties (COS), as one of the tools to monitor the function/engagement and overall health of each discipline.

The 2021 Discipline Status Report is expected to be finalized and disseminated to chairs in late-March 2022.  Chairs and chair-elects are welcome to request previous years’ reports by reaching out to their administrator at specialtycommittees@royalcollege.ca.

Accreditation update

Regular Accreditation Reviews

The regular accreditation review of the Northern Ontario School of Medicine (NOSM) was conducted virtually in November 2021 and the post-accreditation review input will collected from specialty committees in March/April 2022.  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.

External reviews continue to be delivered virtually, and the next regular accreditation review will be the University of Manitoba in March 2022. Following significant exploration regarding the possible use of a hybrid model, the decision was made to conduct this review in a fully-virtual format.

Upcoming Regular Accreditation Reviews

University Review Date Res-AC Review Date
University of Manitoba March 20-25, 2022 Fall 2022
University of Calgary September 18-23, 2022 Winter 2023
McMaster University January 29 – February 3, 2023 Spring 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, three regular reviews of the University of Toronto, the Université de Montréal, and NOSM were successfully conducted virtually. These were a major collaborative effort between the Royal College, the College of Family Physicians of Canada, the Collège des medicines du Québec, as well as the universities and their stakeholders and the many volunteers who participated as accreditation surveyors and specialty committee members.

CanRAC has been conducting a thorough evaluation of virtual reviews.  The results from this evaluation, along with observations and direct feedback from staff and stakeholders, have been used to improve the remote delivery of accreditation.  CanRAC will continue to monitor when accreditation activities may return to an in-person delivery and will evaluate the feasibility of incorporating certain aspects of virtual reviews in future accreditation processes, without compromising the integrity of the review.

Equity, Diversity and Inclusion (EDI)

The conjoint Accreditation Working Group on Anti-Black Racism continues to meet regularly, led by Black residents and faculty and chaired by Kannin Osei-Tutu, MSc, MD, CCFP.  This group is working to identify ways to address anti-Black racism through mechanisms of accreditation in both the short- and long-term and has begun to explore changes to accreditation standards and policies that can be recommended to the accreditation committees of the three CanRAC colleges.

The Indigenous Health in Specialty Postgraduate Medical Education Accreditation Expert Working Group, chaired by Ryan Giroux, MD, FRCPC, is also engaged in similar efforts to identify levers for change within accreditation with the goal of bringing forward recommendations to the relevant committees.

A conjoint meeting of the 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.

Canadian Excellence in Residency Accreditation (CanERA)

Specialty committee members are encouraged to visit the CanERA website (www.canera.ca), to access 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.

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 soon 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. 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 Deadline AFC-AC Review Date
January 31, 2022 Spring 2022
May 31, 2022 Fall 2022
October 15, 2022 Winter 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 three accredited programs, with several additional applications that are still in progress or under review.

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.

CanMEDs update

New Program Director Handbook

The Office of Specialty Education (OSE) has been working on an eBook for new program directors.  Designed and written by current and past program directors, the various chapters assist new program directors in understanding and preparing for the role as a program director.  The serialized release of the Program Director Handbook started with six chapters released in the fall of 2021 and covered topics such as the role of the program administrator, succession planning and handover, role modelling, coaching, workplace-based assessment and working with an electronic portfolio.

We are pleased to announce the release of the next four chapters on:

  • Curricular change with CBD and CanMEDs as an example;
  • Curriculum mapping;
  • Selecting the best residents for your program; and
  • Identifying and supporting the resident in difficulty.

Follow this link the Program Directors Handbook.

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

Support for 2021 and 2022 Launch Disciplines

Pre-launch and post-launch booster webinars were held on January 31, 2022 and February 2, 2022 respectively.  These booster webinars were designed to provide targeted support for CBD Implementation to all disciplines that launched in July 2021and those that will be launching in July 2022.  Recordings of these webinars with Adelle Atkinson, MD, FRCPC, clinician educator and chair, Specialty Committee in Pediatrics, are available via SharePoint or through your specialty committee administrator.  For access to the recordings please contact canmeds@royalcollege.ca or specialtycommittees@royalcollege.ca.

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 this work since December 2021, and we encourage you to visit the SCC Update archives for previous reports on AFC reform.

A focus on opening the reformed practice routes (PER-AFC)

In 2021, eight AFC disciplines opened new, application-based practice routes and three disciplines assessed their first applicants.  Ten applicants have been deemed eligible for the AFC credential through the reformed practice route; nine have already become Diplomates.  In early January, Adolescent and Young Adult Oncology and Adult Echocardiography opened their new route, and an additional eight disciplines are expected to open their practice routes in 2022.

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.

The standard of assessment set during the first assessment is an important step in the process. If the committee intends to use external assessors in the future (in addition to the members of the AFC committee) or for the assessment of French applications, we encourage you to identify potential assessors, including bilingual assessors, as soon as possible so that arrangements can be made for them to attend the meeting when assessment is standardized and calibrated.  Please provide the name and contact information of potential assessors to Tiffany Lynch, Credentials Unit, and an invitation will be sent.  An overview of the assessment process and instructions on how to apply for the practice eligibility route are available online.

Full implementation achieved!

Congratulations to the AFC disciplines in Prehospital and Transport Medicine, Pediatric Urology and Adolescent and Young Adult (AYA) Oncology, and Adult Echocardiography for completing the steps to implementation, opening both the in-training and practice 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, 13 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

Our communications strategy this year seeks to identify and clarify operational areas where more information can be provided for stakeholders, facilitating knowledge- and capacity-building across the Program. The long-term goal is to make information more accessible and applicable to the diverse stakeholder roles across the category. Our aim is to maintain the level of communications with Royal College AFC committees, while enhancing communications for AFC directors, postgraduate medical education (PGME) offices and other stakeholders, partners, and allies.

Last month, the guidance document on how to meet Royal College AFC training requirements in the era of COVID was recirculated to PGME offices and AFC directors.

The first new publication in 2022 is a guidance document on the use of in-training evaluation reports (ITERS) in accredited training programs.  By the time this edition of the SCC Update is published, this new guidance document should be in your inbox.  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 early November.  The next cohort, consisting of the following disciplines, will be reviewed by COS at the meeting 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 (Addictions Medicine and 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.

Reformed AFC accreditation

Since July 1, 2021, AFC accreditation has been digitized, and uses the Canadian Accreditation Management System (CanAMS) with training provided to AFC committees as needed, to align with scheduled accreditation reviews.

Note, applications for new accredited AFC training programs are to be submitted via CanAMS. PGME offices may request access to a discipline-specific application in the digital platform by contacting the Education Standards Unit.

More information about accreditation reform can be found in the Accreditation Update above.

Thank you

This past year has been challenging in so many ways and we want you to know how much we value and appreciate your service and contributions.  Your dedication, commitment, and passion for your discipline and the AFC category is recognized widely throughout the Royal College.  Thank you.  If there is a way that we can better support you, please do not hesitate to contact the AFC program manager, Linda Rumleski.