Dear colleagues,

Each year, my standard midsummer update seems to come quicker and quicker. I’ll forego what they say about how we experience time as we get older and choose to see this as a reflection of the increased productivity at the college, including headway on a number of key strategic initiatives designed to make our organization more adaptable and reflective of the current health care and medical training environments.

Rather than provide a full recollection of all the efforts that made up January until present, I’ve instead listed those projects that are representative of the scope and diversity of our work.

If there are any among you who would prefer a broader or lengthier account, I invite you to visit our website, to review past issues of our member newsletter or follow along with one of our social media channels — accessible from our website homepage. You are also welcome to contact me at, if your request is of a more particular nature.

Topics for future CEO Messages: We want to hear from you

As you read through the scope of our work below, I’d be interested in knowing which topics most interest you and for which you would like additional information. In addition, what are the issues most impacting your practice environment that you would like to see discussed in an upcoming CEO Message? Please feel free to reply to or leave a comment on our blog.

I hope you enjoy these final few weeks of summer, and I look forward to engaging with you throughout the second half of 2015.

Best wishes and warm regards,

Andrew Padmos, BA, MD, FRCPC, FACP
Chief Executive Officer



Quick links

Competence by Design:
CanMEDS 2015

Responsible stewardship

MAINPORT ePortfolio

History and heritage

Practice Eligibility Route

Value of Fellowship campaign




Valued partnerships

Physician employment

Volunteer base

Royal College Advocacy

Royal College honourees

Early childhood and
brain development



Competence by Design: CanMEDS 2015 — ready for a fall launch

Competence by Design (CBD) is well underway. Our first two specialty adopters (Medical Oncology and Otolaryngology – Head and Neck Surgery) are steadily preparing for a July 2016 implementation; and our second cohort group of six disciplines has begun drafting their specialty-specific milestones, Entrustable Professional Activities and document suites.

A major achievement under this umbrella initiative is that our three-year project to update the CanMEDS Physician Competency Framework is coming to fruition. At our February Council meeting, the revisions to the CanMEDS Framework and Milestones Guide were unanimously approved (their official launch will take place this October at ICRE 2015). These documents were created through extensive consultation and with the input of over 100 Expert Working Group members. For Fellows who haven’t yet taken a closer look at this project, I invite you to consider Dr. Imrie’s “President’s Corner” challenge or to familiarize yourself by way of our growing list of CBD resources.



MAINPORT ePortfolio

Also part of our Competence by Design initiative, we have been working to improve the functionality of MAINPORT. We anticipate calling the forthcoming competency-based version of this system “MAINPORT ePortfolio” — a small change for members, but one that reflects our vision of supporting learning, assessment and reflective practice during training and beyond. There is still a lot of work to be done to achieve this vision. We have several working groups established to provide recommendations on data integration standards and data transfer strategies, as well as guidance related to privacy and legal issues. In the interim, we remain committed to improving the user-experience for our members as they document their continuing professional development activities. A first round of updates to MAINPORT will launch in several days, as well as a new version of the iPhone app and new Android-supported app to help reduce the time-burden of documenting activities.



Practice Eligibility Route (PER) to certification

Our targeted route to assess internationally-educated physicians who are already licensed and practising as specialists in Canada, but who are not certified by the Royal College, is running smoothly. Route A – the certification examination in its current format – is now open to all specialties for the upcoming 2016 examination cycle; Route B – an equally rigorous assessment of knowledge of the specialty in conjunction with an assessment of a candidate’s skills and competence in practice – was launched this March for candidates in Psychiatry.



Forthcoming changes to accreditation

Since 2013, we have been working in partnership with our sister colleges, CFPC and the CMQ, to develop a residency accreditation system which responds to current challenges, meets 21st century needs and supports the outcome focus of competency-based medical education.

To this end, we collectively developed a proposal to reengineer accreditation. This proposal reflects in-depth stakeholder feedback, and aims to preserve our current systems’ strengths while

  • reducing the burden of work on schools,
  • promoting continuous evaluation and improvement, and
  • eliminating paper-based processes.

Proposed changes include the

  • introduction of new general standards (which are currently being developed by several Working Groups),
  • creation of streamlined processes, and
  • digitization of the accreditation system.

Consistent with the current practices of introducing new standards and program requirements, the implementation of all changes will be gradual and iterative. Work is ongoing to determine the most thoughtful approach to this transition and the practical, phased implementation plan will be provided as soon as possible. However, the proposed changes will not affect schools with accreditation visits in 2015 or 2016. The earliest changes will not be piloted until mid-2017.



Diplomas fill societal needs, recognize and standardize skills

The Royal College’s Areas of Focused Competence (AFC – Diploma) category of discipline recognition has now recognized 18 disciplines — valuable areas of enhanced competence that complement established Royal College specialties and subspecialties. This year, we also reached a new milestone: the approval of our first graduate in an AFC (Diploma) discipline and subsequently, our first Royal College Diplomate bearing the designation DRCPSC (Diplomate of the Royal College of Physicians and Surgeons of Canada). I’d like to highlight that these AFC (Diploma) disciplines are driven by the professional community and fill important societal needs — find out more about this in our August newsletter.



Physician employment

Our physician employment study is ongoing and continues to generate a great deal of interest. Our preliminary analysis of 2014 specialists and subspecialists showed an improvement in the volume reporting issues finding employment compared to 2013, although trends are variable across disciplines. Survey respondents who previously reported being unable to find employment, and who answered our follow-up survey indicating that they were now successful in securing employment, listed a variety of factors that helped them to do so including the decision to pursue additional training, a willingness to relocate, assistance from personal contacts/recruiters, and so forth. Full findings are expected to be released next month and in November, we will host our second Physician Employment Summit that will dig deeper into these findings and possible solutions.



Defining our advocacy role with the help of our members

Some of you may recall an appeal we made this spring for you to fill out our advocacy survey. We are using that data to help refine the Royal College’s advocacy focus, such as what issues to pursue, what process to follow, and what our advocacy persona should be. Over the last few months, we have done an extensive review of advocacy policies, legislation and notes of historical significance; including, research with stakeholders and consultations with Council, our Health and Public Policy Committee and the Executive Directors Committee. We also conducted interviews with sister organizations, Regional Advisory Committee members, a cross-section of National Specialty Societies, in addition to the aforementioned member-survey.

Fellows’ survey responses clearly set out that the Royal College should play an important role in leveraging its expertise to support specialty medicine and sound patient care on key national educational, professional and public health issues. However, this work should be built on trusted data and evidence, rather than entering political debates. We will present a guidebook to Council this October, reflective of our full findings, to frame future efforts.



Contributing our support for the healthy development of Canadian children

In June, we sent an open letter to federal party leaders with regards to the importance of Early Brain and Biological Development and Early Learning. This letter served two purposes: to raise awareness of our Royal College position statement on this important issue, as well as to raise the profile of early childhood development interventions in advance of the October federal election.



Strategic plan 2015-2017: Responsible stewardship

We released our new strategic plan this March, which introduced a sixth key result area: Responsible stewardship. Responsible stewardship is something we’ve always highly-valued at the Royal College and its addition as a strategic focus ensures that we will continue to make effective and appropriate use of our resources. As evidence of this, at our June 2015 Council meeting, a motion to dissolve two existing committees and amalgamate them into one Financial Reporting and Risk Oversight Committee was approved, removing overlap and aligning the organization with recognized best practices.



Preserving history with conservation efforts and John McCrae memorial statue

The Royal College is committed to preserving its history and the history of specialty medicine in Canada, through its History and Heritage Committee and initiatives like our recent project to catalogue and re-shelve the organization’s History of Medicine library collection. With funds from the Macbeth Library and Archives Fund, we are also selecting some books of great significance to the Royal College for conservation; as well as cleaning and conserving some valuable metal artifacts.

The Royal College also helped sponsor a memorial statue for Lieutenant-Colonel John McCrae – famed author of In Flanders Fields – that was unveiled this May in Ottawa. Dr. McCrae was recently inducted into the Canadian Medical Hall of Fame, co-nominated by the Royal College and McCrae House.



Value of Fellowship: Millions of Canadians reached through our campaign

In the second phase of our campaign that ran from January until the end of May, we engaged almost 6.6 million Canadians in our promotions about the value of the Fellowship designation and the high standards that our members are required to meet. To support these efforts, we created a new public education video on the meaning of our designations, updated our Fellowship Matters microsite and continued our online advertising and social media campaigns on sites like Google,, Quebecor, CBC Health and Facebook.

Perhaps our greatest achievement during this phase of the campaign was our partnership with three national specialty societies to develop videos explaining what certain specialists do and why it matters to the health of Canadians. These pilot videos were very well-received and examined General Surgery, Internal Medicine and Psychiatry. In just four months since their release, they have been viewed more than 18,000 times combined.

A third phase of our highly-successful campaign is being planned for 2016.



International: Working with AFMC and CFPC, and conference series

In response to suggestions from members and other stakeholders, Royal College International (RCI) has now established a working relationship with the Association of Faculties of Medicine of Canada and the College of Family Physicians of Canada to collaborate with international partners who have a strong interest to learn from, adapt and integrate our Canadian medical education standards and values. This relationship will allow us to identify opportunities that meet our mutual objectives, while at the same time respecting our individual challenges and priorities.

We have also been busy this year with our international residency conference series. In April, we helped support the second Latin American Conference on Residency Education (LACRE) that was held in Santiago, Chile. Dr. Imrie and six RCI faculty members attended and observed firsthand the enthusiasm that attendees have for improving their countries’ residency education, and by extension, patient care. Also, earlier this month, I had the privilege of attending the 2015 China Conference on Residency Education (CCRE) in Beijing, hosted in partnership with the Peking University First Hospital. Again, the resolve of those in attendance to enhance and standardize their residency training (the theme of this year’s program) was overwhelming.



Valued partnerships

As the Royal College continues to advance its strategic priorities, the importance of partnerships has become all the more evident. As I’ve highlighted above, we recognize that our efforts are strengthened by working together. We closely value our partners in the Canadian Medical Forum and our collaborations like the Future of Medical Education in Canada – Postgraduate project. We frequently consult and dialogue with national and international partners on matters ranging from the introduction of competency-based residency education and lifelong learning, to improvements and alignment on accreditation and most recently, with our maturing worldwide efforts. Sharing learning, and learning from others, is foundational to our organization’s position as a leader and trusted collaborator.



Strong volunteer base

I’ve said it before, but I feel it’s worth repeating: the smooth running of the Royal College — and the range of activities represented in this update — would not be possible without the dedicated service and volunteerism of thousands of Fellows. For example, did you know that nearly 1900 volunteers support our exams each year? Volunteers fill a whole range of important roles on committees, working groups and with regards to conference planning; they create and deliver examinations, accredit residency programs, and represent the Royal College with international partners. Competence by Design is also, in part, a reflection of their tireless work. Our volunteers’ contributions not only serve the Fellowship, but also advance specialty medicine and our mission to improve the health and care of Canadians through leadership in medical education, professional standards, physician competence and the continuous enhancement of the health system.



Honouring Fellows’ commitment to service

Each year, we have the pleasure of recognizing Fellows that are emblematic of the Royal College’s commitment to service and quality of care for Canadians and the medical profession, through our awards series. If you aren’t already familiar with our 2015 national award winners — Drs. Bernard Charlin, William Wall and Peter Ferguson — I encourage you to read more about their achievements on our website. This year, we also recognized our first Indigenous health award winner, Dr. Karen Hill, and welcomed three new Honorary Fellows. Outside of our formal award adjudication, I also would like to recognize the countless Royal College members who are honoured annually for their service, through national and provincial orders, as well as military medical service and clinical, teaching and mentorship awards. Each year, several Fellows are also highlighted for their career-contributions to medicine, through induction into the Canadian Medical Hall of Fame or through international awards. I take pride in all of our members’ achievements and the ways in which our Fellows put into practice the high values and standards of care that the Royal College works hard to protect.