Dear Colleagues,

Every year, I like to provide Fellows with an update on the Royal College’s international work. Without diminishing our efforts in Canada, this work allows us to strengthen the Royal College brand internationally and to contribute to the health of populations globally, by sharing our expertise in educational standards and professional learning. A recent restructuring of Royal College International has allowed us to streamline and focus these efforts, facilitating some exciting developments in Asia-Pacific.

A focused evolution for Royal College International

As I touched upon in my last message on this topic, 2013-14 has been a transitional year for Royal College International (RCI). Last fall, the RCI board refined their business approach and model to now focus on long-term academic partnerships, rather than short-term product and service provision. This reorganization and renewed focus aligns with the Royal College goal of making lasting and positive change. Within longer-term partnerships, we are able to foster collaboration that is consistent with Royal College values, yet also culturally-sensitive and reflective of context-specific realities.

We have identified three regions where we will focus our efforts: Gulf States; Latin America, including Mexico; and Asia-Pacific (the table below provides a concise overview of our recent projects and collaborations in the first two regions).

Recent work in Asia-Pacific exemplifies our international approach

I would like to focus the remainder of this message on some exciting developments in Asia-Pacific — the result of efforts led by Susan Brien, MD, FRCSC, vice president, Asia-Pacific, RCI. These efforts nicely mirror the Royal College’s three aims with respect to our international work:

  1. Establish Royal College International as a known leader and trusted partner (e.g. our work with the Peking University First Hospital).
  2. Enhance and support work in residency education, such as through our series of residency education conferences (e.g. CCRE).
  3. Pursue and provide for Fellow-driven humanitarian projects (e.g. support for Critical Care training program in Nepal).

All of our work in other countries upholds the quality, spirit and integrity of our standards, yet with some flexibility in application and practice to reflect cultural or environmental contexts. This flexibility means that we can build sustainable local capacity in medical education, training and care. Let me illustrate with some examples from our work in Asia-Pacific.

Peking University First Hospital (PUFH)
Since signing a collaborating centre agreement in 2011, the PUFH has become one of our most valuable partnerships in the region. Our work there focuses on standardizing the hospital’s training programs. In January 2014, we completed a monthly series of faculty development lectures on the CanMEDS Roles — most led from a distance using virtual meeting software. One lesson we learned is that context is important in China and we must be cognizant of that in the delivery of workshop materials. To help manage interactions with faculty, we leveraged WeChat – a popular mobile messaging application in the country. This service facilitated private conversation and interactions, which was of particular value in a hierarchical culture where a reluctance to speak up is common.

China Conference on Residency Education (CCRE)
Chinese medical training programs vary by both hospital and region. This April, we co-led the first residency education conference in mainland China, modeled after our successful International Conference on Residency Education (ICRE). A robust group of 375 participants from 31 hospitals in 10 provinces participated in the event, which was supported by the national Ministry of Health and the Canadian embassy. This conference was an invaluable opportunity to share scholarship and the CanMEDS Framework for residency education, as well as discuss, analyze and initiate improvements in residency education standards. We have been encouraged by the positive feedback CCRE received and planning for the second edition of this conference, for late summer 2015, has already begun.

Critical Care training program in Nepal
Over a year ago, Fellows Rédouane Bouali, MD, FRCPC, and Laura Hawryluck, MD, FRCPC, approached Dr. Brien with a proposition for the Royal College to formally lend its support for the first Critical Care training program in Nepal. I am pleased to report that the first trainee in the resultant program is currently pursuing his training, building up the country’s internal capacity and expertise in Critical Care — that both reflects the Royal College standards, but is also sensitive to the realities and practice settings in the largely poor country. As Dr. Hawryluck explained in this Dialogue article from March 2014, “…there’s going to be differences in practice, even if there aren’t differences in knowledge.” Many other Fellows are doing great work across borders. Our hope is to continue to support similar Fellow-driven efforts.

International efforts enhance, not detract, from Fellow-focused efforts at home

The Royal College is Canada’s national standard for specialist medical expertise; the work described above is one way that the Royal College is sharing this standard with other regions through collaboration with institutional partners who want to progress their residency programs, to the benefit of patients worldwide. I hope you share in my optimism about our progress to-date and I look forward to keeping you informed of our international efforts as they unfold and mature.

Warm wishes and kind regards,
Andrew Padmos, MD, FRCPC, FACP

Update on activities in the Gulf States and Latin America

  • Two-year agreement with the Supreme Council of Health of Qatar to develop a continuing professional development methodology for all health professions in the country.
  • Three-year agreement with the Kuwait Institute for Medical Specialization to provide diagnostics, consultations and program assessment of the country’s 22 specialty programs, to create a roadmap of steps to meet Canadian standards.
Saudi Arabia
  • Plans are underway for a third Saudi Arabian Conference on Residency Education.
  • Held several more CanMEDS courses, with more planned for the future.
  • Members of our Practice, Performance and Innovation unit recently presented the Acute Critical Events Simulation (ACES) course in several cities.
  • Program consultation visits are being planned for the future.
  • Provided a diagnostic assessment of 13 residency programs at the Pontificia Universidad Católica de Chile (Santiago), and are pursuing formal discussions for a Collaborating Centre Agreement with the school.
  • Co-led the first Latin American Conference on Residency Education last October, and are planning the second edition for April 2015.

CCRE Photo Album