With midsummer upon us, I would like to take this opportunity to reflect on the first half of our calendar year and take stock of the progress the Royal College has made on the priorities set out in our strategic plan, The Goal that Matters Most. In effect since 2011, our plan sets out five key result areas, or KRAs, where the Royal College has committed to make significant headway over three years. I’m pleased with the progress we have made to date, as well as our increased efforts to make these improvements as collaborative a process as possible, and I would like to share with you some highlights.
In April, the Royal College officially began implementation of a multi-year initiative to usher in a new era in competency-based medical education, or CBME. The Royal College’s official program for CBME, called Competence by Design, encompasses a plan to design, develop, implement and sustain all components of a new medical education system for the future. We are in the very early stages of the planning process, which will include multiple consultations. Integral to this work is to align the CanMEDS Physician Competency Framework more closely with Competence by Design, the result of which will be CanMEDS 2015. Over the next few years, we will involve each specialty committee in the development of their specialty-specific Medical Expert role milestones. The process will be piloted by one or two early adopter specialties, before engaging others. We have received a great deal of feedback from Fellows and remain committed to working in a collaborative fashion as we move forward.
We are examining the future of general surgery and how it can adapt to new pressures and realities of our health care system. Recently, we hosted a daylong summit in which more than 50 participants – residency education stakeholders and surgical leaders – critically reviewed and debated the future direction for general surgery in Canada. Having consulted with stakeholders nationwide, the Royal College will release practical recommendations in the fall to advance the important dialogue around general surgery. I encourage Fellows to continue to provide their input via email at any time.
Do you remember your Royal College examination experience? This year a record-breaking 2,592 candidates sat for the spring 2013 examination, representing a 7.9 per cent increase over 2011–2012.
Health and health care systems
After thorough study on the issue of resident duty hours and fatigue, the National Steering Committee on Resident Duty Hours released Canada’s first comprehensive, collaborative and evidence-based report on the subject. The committee, made up of the Royal College and eight other health care organizations and experts, released a series of principles and recommendations that will help all jurisdictions in their efforts to ensure that regulations and practices on resident duty hours support the highest possible quality of care for patients — and the best health for residents.
Since April 2011, the Royal College has been collecting data for a comprehensive report on the causes and context of specialist unemployment. The report, to be released in fall 2013 after extensive study and consultation, delves into the contributing variables such as hospital infrastructure, the economy, changing demographics and scopes of practice. Our consultations included 50 in-depth interviews with such experts as national specialty society leaders, program directors, specialty committee chairs, physicians in practice, hospital executives, unemployed physicians, residents and health system experts. One telling finding was that more than 14 per cent of 2011 Royal College Certificants did not find staff appointments or employment within 4 to 12 weeks of writing their exams — a reality that serves neither the patients that our healthcare system represents, nor the highly trained specialists in whom it has invested so heavily. Stay tuned for our fall report.
Innovation, research and scholarship
We facilitated improved patient safety training in Canadian medical schools. This April, in partnership with the Canadian Patient Safety Institute (CPSI), the Royal College ran a successful Advancing Safety for Patients In Residency Education (ASPIRE) four-day educational event. The sold-out workshop was dedicated to providing Canadian medical schools with the knowledge and capacity to provide patient safety training. The program was designed by physicians for physicians and included a wide selection of patient safety topics relevant to helping residents acquire entry to practice abilities. We are committed to running a similar program next year in collaboration with the CPSI.
Meanwhile, planning for our fall conferences is well underway with the International Conference on Residency Education taking place September 26 to 28 in Calgary and our Simulation Summit taking place November 8 and 9 in Vancouver.
Value of Fellowship
The Royal College allocated $1 million again this year through our National and Regional Awards and Grants program to recognize the accomplishments of Fellows and encourage excellence in specialty medicine. Among the most prestigious of our prizes is the Teasdale-Corti Humanitarian Award, this year awarded to Dr. Joanne Liu of Montreal. Dr. Liu is an inspiration, having served with Médecins sans frontières (MSF; Doctors Without Borders) in some of the world’s most dangerous locales. Watch a video and hear directly from Dr. Liu on her humanitarian efforts.
The Teasdale-Corti is just one of the many awards that the Royal College provides to outstanding physicians every year. I invite you to consider nominating Fellows who you believe exemplify the qualities that we seek to recognize through such awards. Nominations for several awards close on August 30, 2013.
Royal College Canada International has made great progress on a number of fronts this year. RCCI continues its work to establish collaboration centre agreements that promote Royal College standards abroad and build our international partners’ capacity to deliver specialty education and professional learning and development programs. Our collaboration centres this year have focused on trainee and faculty development, assessment and evaluation, simulation-based training, and continuing professional development. In addition, Council has approved RCCI’s Policy on International Enhanced Program Review and Accreditation. This policy was driven by requests from international partners seeking to improve their medical education systems. Once developed, the program would enable the Royal College to provide a “seal of approval” to medical programs outside of Canada that meet Royal College standards. Next steps include formation of an International Program Review Committee and developing the program and processes to support the policy.
In addition to recognizing the Royal College’s successful work over the past six months, I would also like to take this opportunity to welcome the Royal College’s new President. Cecil Rorabeck, OC, MD, FRCSC, is the former chief surgeon at the London Health Sciences Centre, a Professor of Orthopedic Surgery (emeritus) at Western University and an Officer of the Order of Canada who was invested in 2012 for his advances in orthopedic care and prosthetics. In addition to practicing, researching and teaching for 30 years, Dr. Rorabeck started the Canadian chapter of Operation Walk, which is a non-profit organization that arranges free hip and knee replacement surgeries for people in need in South America. He has served on the boards of the Stratford Shakespearian Festival, the National Research Council and the Canadian Medical Hall of Fame. We are indeed very lucky to have the benefit of Dr. Rorabeck’s experience and expertise.
In closing, I would like to emphasize that over the past year the Royal College has worked hard to communicate more often and more effectively with Fellows. My regular CEO Message blog, our Twitter feed and Facebook account are the new ways in which we’re keeping Fellows abreast of Royal College business as well as enabling you to provide us with feedback and engage in dialogue and debate with one another. I’m pleased to report that we now have more than 1,000 followers on Twitter and Facebook. That number has been growing at 200 to 300 per cent per quarter since we launched these communication efforts. Click on the icons on the right-hand side of this page to follow the Royal College through either of these vehicles.
I encourage you to contact me personally on any of the issues I’ve covered here, and any other issues you may be pondering. I also invite you to send in your suggestions for topics that you’d like me to address in my monthly message. Please know that ideas sent by regular email and Canada Post are equally welcome!
I wish you all a happy summer.
Andrew Padmos, BA, MD, FRCPC, FACP
Chief Executive Officer