Cover story New MOC puts your practice at the centre of your learning

Transcription

1 Vol. 11, No. 3 - April 2011 Cover story New MOC puts your practice at the centre of your learning Royal College Fellows and CPD participants can now benefit from a revitalized MOC Program that is streamlined, flexible and offers a wider range of learning activities for managing your continuing professional development (CPD). "The new MOC Program represents a transformative change in continuing professional development that places each Fellow and their professional practice at the centre of a lifelong learning strategy," said Craig Campbell, MD, FRCPC, the Royal College's director of professional affairs. The new program draws upon two streams of evidence: a comprehensive survey of 3,000 Fellows and an extensive review of CPD research. As such, it has been informed by the needs of Royal College members and the best evidence available in the CPD research literature. A learner-centred framework One of the most substantial changes to the new MOC Program is the reduction in the number of learning sections from six to three: group

2 learning, self-learning and assessment. You will have more choice of learning activities, more control to plan your professional development and greater incentives to participate in self-learning and assessment activities. More choice and flexibility in earning credits The new MOC Program has developed a blended credit system in which some credits are earned by the hour and others after the completion of specific activities. You can earn up to 75 per cent of your cycle credits under any one section. This change reflects the prevailing evidence in the CPD literature that any learning plan addressing a range of needs relevant to practice must use multiple learning strategies. You will have more flexibility in choosing activities that best suit your learning style and the needs you identify for your practice. New MOC Program now in effect The changes to the MOC Program are effective as of January 1, 2011, which means that you are eligible to earn credits for activities that qualify under the new framework from this time forward. You can enter your activities at any time in the current MAINPORT or wait until the new MAINPORT launches in May. Any activities you entered prior to launch will be automatically transferred into the new framework and credit system by the Royal College. Looking for support? To assist you further, the Royal College has established 12 CPD educators who practice in each region of Canada and who can assist you in understanding and using the new MOC Program in your practice. Visit our website to find the CPD educator for your region and for more information about the MOC Program. Or contact the Membership Services Centre by phone at from Monday to Friday, 8:00 a.m. to 5:00 p.m. EDT, or by to cpd@royalcollege.ca.

3 New MAINPORT launching May 2011 To support the revised MOC Program, the Royal College is launching a new MAINPORT web application in May. You'll find a novel CPD planning tool and the capability to "document as you learn." You'll also be able to save incomplete activities, and return later to reflect on your learning and complete them. A new resource corner will facilitate access to online databases, journals and other learning tools that are available by personal subscription. In addition, some MAINPORT functions will be supported by your iphone, ipad and BlackBerry. Watch for more details in the May 2011 issue of Dialogue. Save the date: April 28 Learn about the Royal College's new MOC program in a session with CPD educator Amer Burhan, MD, FRCPC, at the Canadian Respiratory Conference (April 28 to May 1, Niagara Falls, Ont.). Click here for details on the session, which will take place Thursday, April 28, from 4 to 5 p.m.

4 President's Corner Stimulating innovations in 21st century PGME This month, I would like to highlight one in a series of forward-thinking, provocative white papers the Royal College recently submitted to the Future of Medical Education in Canada - Postgraduate Phase (FMEC-PG) project, a partnership that is preparing the Canadian postgraduate medical education system for the century ahead. The Continuum of Medical Education, authored by a committee led by Jocelyn Lockyer, PhD, and Ivan Silver, MD, FRCPC, hones in on the transition period between residency education and independent medical practice. In particular, it explores ways to narrow the chasm in lifelong learning skills between these two periods of learning. The paper's recommendations are some of the more revolutionary in the series, and provide an excellent example of how the Royal College's innovations are protecting the Fellowship designation by ensuring high standards along the continuum of medical education. One of the most ground-breaking recommendations is to move the timing of the Royal College certification exams to earlier in the final year of training. This would allow every residency program to provide more structured support during the transition period prior to entering practice, such as a "junior physician" stage supported by mentorship and supervision. Another is to blur the boundary between residency education and continuing professional development in practice. This would provide opportunities for practising physicians to re-enter structured training to upgrade their skills or acquire new competencies as disciplines emerge. For example, ultrasound competencies are a relatively new addition to the training standards for Emergency Medicine, so physicians in practice need to find a way to acquire these in independent practice. Surgeons similarly

5 require a mechanism for rapidly adopting proven new technologies and tools emerging in their disciplines. One way the Royal College may facilitate these is to create a mechanism that encourages and implements pilot projects to test some of these concepts in practice. In fact, this will be proposed to the Education Committee next month to enable us to work with our partner organizations in postgraduate medical education to enact innovative concepts. I hope that this has given you a taste of how your Royal College is stimulating innovations in 21st century health care. Postgraduate medical education is at a precipice and we are guiding it's evolution to ensure our future physicians meet the increasingly complex health needs of Canadians. The conversation is just getting started and it's not too late to get involved. These first drafts, such as The Continuum of Medical Education, will continue to be revised based on feedback from members. I strongly encourage you to provide your insight and input into this or any other white paper by joining one of our e-panels today.

6 CPD educator Emergency physician will lead MOC support for New Brunswick No stranger to change management In her role as CPD educator, Jo-Ann Talbot, MD, FRCPC, is personally committed to making the new Maintenance of Certification (MOC) Program as relevant as possible to the Fellows of New Brunswick, starting with the different specialists she works with every day at the Saint John Regional Hospital. "Practicing in Emergency Medicine has given me an understanding of the learning needs of my colleagues," said Dr. Talbot, who is site academic head at the Saint John Regional Hospital Emergency Department, and also an assistant professor in Dalhousie University's Department of Emergency Medicine. Dr. Talbot's unique skill-set includes strong evidence-based medicine skills and a proven record in knowledge translation. Her residents graduate not just with clinical skills, but also the ability to overcome resistance to change. "I can show a resident the current best practice for treating myocardial infarctions (MIs)," she said. "But the most valuable skill I can teach them is how to continually question their own choices and show leadership in closing the evidence-to-practice gap." One of her own greatest achievements in closing the gap has been her leadership in negotiating and implementing an academic funding plan (AFP) at Saint John to recognize emergency physicians for their significant contributions to education and administration. Prior to implementing the AFP, some emergency physicians at the hospital were working hours a week or more without compensation to deliver the medical education programs and work with administration to a high standard of care for emergency patients. Due to the fee structure and the difficult work environment, the department was terribly understaffed.

7 "Since introducing the AFP, we've recruited a full complement of well-trained emergency physicians who are now providing continuing professional development to interprofessional teams across the province," said Dr. Talbot. Not only did the success of the AFP stabilize staffing and solidify the academic program, it also allowed the Saint John Regional Hospital Emergency Department to remain an accredited site in the Royal College's Emergency Medicine residency program. Spreading the word about MOC To communicate the changes to the Maintenance of Certification program to the Fellows and CPD participants in New Brunswick, Dr. Talbot plans to recruit champions in each hospital and university department through the local Medical Advisory Council meetings. She hopes the majority of Fellows will start documenting their learning in MAINPORT more often throughout the year rather than cramming in January. She also wishes to see more personal learning projects and assessment strategies in the average Fellow's learning mix. "My goal is to inspire Fellows to adopt lifelong learning as a core value," she said. "The whole culture behind lifelong learning is just fascinating, and the idea of promoting that is what drew me to this role."

8 Discipline recognition AFC (diplomas) set standards for small disciplines The Royal College's approval of areas of focused competence (AFC diplomas) has been enthusiastically received by the postgraduate medical education community in Canada. Five interested disciplines - sports and exercise medicine, cardiac electrophysiology, interventional cardiology, echocardiography, and transfusion medicine - have already applied for this new category of discipline recognition that was approved by the Royal College's Council in February. "This overwhelming response from the first cadre of applicants speaks to the great interest in this new category among Canadian specialist physicians," said Jason R. Frank, MD, MA(Ed), FRCPC, associate director of the Office of Education. Support for applying AFC (diplomas) will enable small, supplemental disciplines or fellowship areas that do not meet specialty or subspecialty criteria to apply for Royal College recognition and benefit from a high national educational standard. More information on how to apply for an AFC (diploma) - including an application form and checklist of required documents - is available on the Royal College's website. There are also criteria available by which applications will be considered. We encourage potential applicants to contact the Office of Education at cos@royalcollege.ca for more information, and guidance and support throughout the application process. Track your application Disciplines whose applications pass the first cut of initial consideration by the Royal College's Committee on Specialties (COS) will be the subject of a national consultation by the Office of Education over the summer of Applications that pass the second cut - endorsement by the COS in the fall of will proceed to the Education Committee in November 2011 and may be implemented as early as 2012.

9 Plans are in the works for the COS to make a second call for AFC (diploma) pilot applications with an August 1, 2011, deadline. Dialogue will keep you up-to-date on the progress of all applications.

10 ICRE 2011 New plenary speakers and pre-conference events at ICRE 2011 Online registration now open With two prominent plenary speakers and a growing number of preconference events, a diverse program is taking shape for the 2011 International Conference on Residency Education (ICRE). Registration is now open for ICRE, which will explore the theme "Transitions in Residency Education" from September 22 to 24, in Quebec City, Que. "This year's plenary speakers have experienced medicine from the education, clinical and policy perspectives," said conference chair Jason R. Frank, MD, MA(Ed), FRCPC. "And the new pre-conference workshops will provide unique and focused learning opportunities for medical educators to enhance their skills. We expect them to fill up quickly." ICRE's unique pre-conference events on September 21 and 22 will provide development opportunities across the medical education spectrum, including ways to optimize teaching of the CanMEDS Roles, integrate assessment into training programs and help trainees develop a professional identity. New French-language workshops will also explore competence evaluation, patient safety and clinical modelling. All pre-conference workshops will conclude in time for an opening plenary lecture by health advocate Aidan Halligan, MA, MD, FRCOG, FFPHM, MRCPI. Professor Halligan has served as the National Health Service's first director of clinical governance and as England's deputy chief medical officer. He currently serves as the chief of safety at the Brighton and Sussex University Hospitals and the director of education at the University College London Hospitals. "Aidan Halligan is an exceptional speaker and an international leader in medicine who has insight across all aspects of health care and medical education in the United Kingdom," said Royal College CEO Andrew Padmos, MD, FRCPC.

11 Continuing the momentum will be awardwinning educator and innovative scholar Shiphra Ginsburg, MD, MEd, FRCPC. Dr. Ginsburg, an associate professor in the department of medicine and adjunct scientist at Toronto's Wilson Centre for Research in Education, is a highly soughtafter speaker. Her provocative closing plenary lecture will explore the critical challenges of both professionalism and professional transitions in medicine. Save the date Register for ICRE on the Royal College website. Book your attendance today for early-bird rates. Also, visit the ICRE blog to learn more about the pre-conference events and plenary speakers. Nominations for the Program Director of the Year and Resident Leadership Award close on April 29, Recognize an outstanding colleague or trainee today!

12 News Bites PER will preserve national standards of practice The Royal College has begun to implement its Practice Eligibility Route (PER) for specialists, an alternate route to certification for qualified international medical graduates (IMGs) who are not yet Royal College Fellows. The PER is of benefit to Fellows and societal health needs because it will ensure that all practising specialists across disciplines maintain a national standard of high-quality health care that Canadians have come to expect. To date, some 350 out of an eligible 1,400 IMGs across Canada have expressed interest in PER. The largest numbers are practising in Psychiatry, Internal Medicine, Anesthesiology, Pediatrics, General Surgery, Diagnostic Radiology, and Obstetrics and Gynecology. The competencies of PER candidates will be assessed at a rigorous national standard that is equal to that of the Royal College's traditional certification examination, which follows training at an accredited Canadian medical school. These assessments would be undertaken through a process of examination, observation and consultation based on a blueprint of competencies deemed essential for practice as a specialist in the discipline. The Royal College is currently seeking definitions of the essential competencies from all of its specialty committees as part of the steps toward implementation of PER. Psychiatry and Anesthesiology have already begun this process. For more information please contact credentials@royalcollege.ca.

13 News Bites CMQ-certified specialists will be invited into Fellowship In late February, the Royal College's Council approved a proposal to invite specialist physicians certified by the Collège des médecins du Québec (CMQ) into Royal College Fellowship. The Royal College and the CMQ have been harmonizing their certification examinations since However, a number of CMQ-certified specialists practising in Québec have not had access to Royal College certification because of a missing credentialing requirement, such as a screening examination through the Medical Council of Canada. Since CMQ-certified specialist physicians have already passed a Canadian certification examination, Council agreed to invite them into Fellowship without additional credentialing or membership requirements. Those who accept the invitation will be granted Royal College certification through a process that is currently being defined by the Royal College's Office of Education and CMQ. For more information, please contact credentials@royalcollege.ca.

14 News Bites Royal College speaks to government on injury prevention Last December on behalf of the Royal College, President Louis Hugo Francescutti, MD, PhD, MPH, FRCPC, FACPM, CCFP, submitted a brief on injury prevention to the House of Commons Standing Committee on Health (HESA). Entitled Injuries are not accidents - they are a preventable disease, the brief highlights leading practices in injury prevention proven to save lives, improve the well-being of Canadians, cut hospital visits and reduce health care costs. It also includes a set of recommendations that call for establishing and funding a national injury prevention and safety promotion strategy. The strategy's cornerstones include a Canadian injury prevention network to facilitate knowledge exchange and an education and intervention campaign that leverages and supports federal/provincial/territorial, local and grassroots initiatives. The recommendations were well received and a subsequent meeting with the HESA chair is being planned. The Royal College will play a partnership role as advocate and collaborator with a number of stakeholders. There will be opportunities for interested Fellows to get involved as these initiatives unfold. Please contact us at healthpolicy@royalcollege.ca for more information.

15 News Bites Simulation Summit 2011: Strengthening interprofessional teams through simulation The 2011 Simulation Summit invites health care professionals to experience and share the latest innovations in simulation-focused learning opportunities. This year's event will explore the theme "Interprofessional Teams," with the following program objectives: advance the use of simulation for the assessment and evaluation of teams promote the use of simulation to define learning gaps in teams identify opportunities to use simulation creatively to develop teams This year's Simulation Summit will be hosted by McGill University and the Arnold and Blema Steinberg Simulation Centre, and will feature three inspiring keynote speakers: Eduardo Salas, PhD, will share insights on simulation-based team training and evaluation. Gerald M. Fried, MD, FRCSC, will speak about how individual taskoriented skills drive team performance. Elizabeth Hunt, MD, MPH, PhD, will discuss in-situ simulation: the key to work-based assessment. For more information, please visit royalcollege.ca/simulation.

16 Eduardo Salas, PhD Pegasus Professor & University Trustee Chair Department of Psychology, Institute for Simulation & Training University of Central Florida Gerald M. Fried, MD, FRCSC Adair Family Professor and Chairman, Department of Surgery McGill University Surgeon-in-Chief McGill University Health Centre Elizabeth Hunt, MD, MPH, PhD Assistant Professor of Anesthesiology and Critical Care Medicine Assistant Professor of Pediatrics Johns Hopkins School of Medicine Director of the Johns Hopkins Medicine Simulation Center

17 News Bites Call for Indigenous physicians and residents for survey The Indigenous Physicians Association of Canada (IPAC) is currently conducting a survey targeted at Indigenous physicians, residents and medical students. The association's goal is to capture a more accurate record of the number of Indigenous health professionals in Canada to use in human resource planning. The survey may be found at this link (on page two following a letter of introduction). The deadline to submit is April 30, More information is available by contacting info@ipac-amic.org or

18 News Bites Name changes better reflect discipline scopes The Royal College has approved proposals to change the name of "Community Medicine" to "Public Health and Preventive Medicine" and "Clinical Pharmacology" to "Clinical Pharmacology and Toxicology." The Public Health and Preventive Medicine name change better reflects the discipline's scope of practice and ensures consistency of terminology across jurisdictions. Similarly, the name Clinical Pharmacology and Toxicology is more representative of the discipline's training objectives, including its advanced toxicology training path, and scope and expertise in toxicological aspects of practice. It also brings the discipline's name in line with numerous academic university units that carry the term toxicology in their name.

19 News Bites New home for Queen's School of Medicine A long-awaited dream for faculty and students alike will come true this fall at Queen's University. A brand-new, state-of-the-art School of Medicine is under construction and scheduled for completion in time for the class of 2014's first lecture in September. The four-storey, $77-million building has been designed to facilitate small-group learning and accommodate cuttingedge technologies, including an entire floor dedicated to surgical skills and simulation labs and a clinic with 20 examination rooms. More details are available on the website dedicated to the new medical school, and in Queen's Alumni Review, which also contains a Q-and-A with Richard Reznick, MD, FRCSC, dean of the Faculty of Health Sciences and a member of the Royal College's Council.

20 News Bites CMAJ celebrates 100 years The Canadian Medical Association Journal will commemorate a century of publishing leading-edge knowledge for physicians with a special 100th anniversary tribute issue on April 19, Engaging anniversary content will look back on the journal's impact on Canadian medicine and society in the last century. Weekly online anniversary content, such as arresting archival photos, profiles of prominent health care professionals and excerpts from CMAJ's archives, is featured at In addition, the newly redesigned print journal includes more practice-related content, such as reviews, guidelines and short clinical articles. Subscribers may be pleased to hear that CMAJ also plans to meet the needs of its increasing online community by expanding delivery to smart phones and providing more interactive online opportunities for readers and authors in future.