FOREIGN. RECOGNITION Occupation-specific approaches -physicians. M. Ian Bowmer Executive Director ibowmer@mcc.c.a



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FOREIGN QUALIFICATION RECOGNITION Occupation-specific approaches -physicians M. Ian Bowmer Executive Director ibowmer@mcc.c.a

Medical Council of Canada was founded in 1912 by act of parliament Licentiate of the Medical Council of Canada (LMCC) a qualification acceptable to all jurisdictions - one of the requirements for medical licensure MCC is unique - 52 members (MRAs, Medical Schools, public, residents and students Maintain a national registry of physicians and their qualifications Examinations provided in two official languages Over 100 000 names inscribed in the registry since 1912 Striving for the highest level of medical care for Canadians through excellence in evaluation of physicians

Canada s Physician Resources

12000 10000 8000 6000 4000 Total Men Women 1st year 2000 0 1970 1980 1990 2000 2010 Canadian Medical School Enrolment

10000 9000 8000 7000 6000 5000 4000 3000 2000 1000 0 2002 2004 2006 2008 2010 Source:http://www.caper.ca/ CMG IMG Ministry Funded Residency Posts

Physicians immigrating to Canada 2005 2006 2007 2008 2009 Specialists 517 581 685 880 977 GP/Family MD 516 497 584 688 723 Total * 1033 1078 1269 1568 1700 IMGs taking MCCEE n/a n/a n/a 1800** 2000** *Data source CIC **number is approximate and represents only the total #of MCCEE first time takers, minus Canadian born and Saudi Arabia nationals.

Standardizing the Licensing Process Agreement on Internal Trade as driver Regulated professionals who have a full license in one jurisdiction will be recognized in all other jurisdictions without further review of specific credentials Limited (provisional) licensure will be recognized in another jurisdiction without further review of specific credentials if the same restrictions can be applied Certificate of Professional Conduct Language and other requirements may apply

The Canadian Standard Physicians applying for the first time to become licensed to practice medicine in a Canadian jurisdiction may achieve full licensure only if they have: A Medical Degree [from a medical school listed in the FAIMER s International Medical Education Directory (IMED) or the WHO s World Directory of Medical Schools (WDMS) Seventh Edition (2000)], or a Doctor of Osteopathic Medicine (from a school in the United States accredited by the American Osteopathic Association Commission on Osteopathic College Accreditation); and Licentiate of the Medical Council of Canada; and Completed a discipline-appropriate postgraduate training programin allopathic medicine with an evaluation by a recognized authority; and Certification from the College of Family Physicians of Canada or the Royal College of Physicians and Surgeons of Canada or the Collège des médecins du Québec.

Challenges Exceptions to Full License number over 120 Provincial regulators balance societal need and optimal credentials No standard pathway from Provisional License to Full license AIT threatens that the province with the least requirements for licensure will become the norm

Developing a Standard for Provisional License for IMGs 1. MD Degree (WDMS 2000 or IMED)continues to be a standard and 2. MCC Evaluating Exam; preferably the MCC Qualifying Exam Part I and 3a.Completion of a nationally approved discipline-specificpost graduate training program + certification + registration /recognition or 3b. Completion of a national postgraduate training program accepted by one of the two National Colleges (CFPC or RCPSC) or 3c. Completion of specified time in discipline-specific postgraduate training and recognized discipline-specific independent practice in the country of origin AND 4. Competency-based, pre-practice assessment in Canada To Move from Provisional to Full License - requires formal assessment

MCC Evaluating Examination MCQ knowledge and problem-solving assessment at the minimum ability of a graduating Canadian MD student (CBT 73 countries, 500 sites) MCC Qualifying Examination Part I MCQ knowledge and clinical-decision-making assessment at the level of a graduating Canadian MD student entering supervised practice MCC Qualifying Examination Part II OSCE assessment of clinical skills, professionalism, communication, planning and clinical-decisionmaking ability expected of a Canadian postgraduate resident entering un-supervised practice EXAMINATIONS FOR LICENSURE

National Assessment Collaboration OSCE Assessing clinical skills, communication and therapeutics for entry into residency and? practice MCC Self Assessment for the Evaluating Examination Automated self assessment which is online which provides a score and feedback MCC Self Assessment for the Qualifying Examination Part I Automated self assessment which is online and provides both score and feedback NEW ASSESSMENTS

Physician Credential-Verification and Repository A digital repository for documents that can be source-verified or obtained from source stored and sent to any regulatory authority in Canada More than 16,000 clients since 2008 Application for Medical Registration in Canada (2013 release) Building on the repository a standardized webbased application to meet all the regulatory authorities requirements Assessment Review Task Force emerging themes Purpose(CanMED roles, throughout MD career), Flexibilityto meet needs of stakeholders, Collaborationwith other examining bodies and Development of new methods NEW INITIATIVES MCC

Canadian Resident Matching Service (CaRMS) Annual IMG Symposium in partnership with MCC, CFPC, RCPSC and others College of Family Physicians of Canada (CFPC) Mutual Recognition of training and certification for Australia, New Zealand, Ireland and UK CaRMS& CFPC INITIATIVES

Royal College of Physicians and Surgeons of Canada approved training (RCPSC) Australian Medical Council Australian and New Zealand College of Anaesthetists 1992 - Australasian College for Emergency Medicine 1993 - Australasian College of Dermatologists 2000 - The Royal Australian and New Zealand College of Radiologists 1975 - Royal Australasian College of Physicians 1990 - Australasian Faculty of Rehabilitation Medicine 2000 - Australasian Faculty of Occupational Medicine 2000 - Australian Faculty of Public Health Medicine 2000 - Royal Australian and New Zealand College of Ophthalmologists 1995 - Royal Australian and New Zealand College of Obstetricians and Gynecologists 1996 Royal College of Pathologists of Australia 2000 - Royal Australian and New Zealand College of Psychiatrists 2000 - RCPSC INITIATIVES Royal Australasian College of Surgeons 2000 -

MCC EE candidates by country of birth top 10 (2008-10) Country of Birth Number Percent Pass Rate Canada 935 15.2 SAUDI ARABIA 579 9.4 82% IRAN 402 6.5 85% INDIA 398 6.5 86% PAKISTAN 370 6.0 73% EGYPT 352 5.7 79% SOUTH AFRICA 352 5.7 95% IRAQ 196 3.2 87% NIGERIA 181 2.9 74% UNITED KINGDOM 148 2.4 97%

MCC EE candidates by country of birth top 20 (2008-10) Country of birth Number Percent Pass Rate SRI LANKA 141 2.3 91% KUWAIT 121 2.0 76% PHILIPPINES 116 1.9 57% LIBYA 111 1.8 76% CHINA 90 1.5 76% BANGLADESH 73 1.2 n/a COLOMBIA 71 1.2 n/a USA 66 1.1 95% ALGERIA 65 1.1 76% UNITED ARAB EMIRATES 62 1.0 n/a

IMGs by United Nations Candidates Geographical Region Number Percent Pass Rate Australia and New Zealand 163 2.7 98.8 Caribbean 684 11.1 93.1 Central America 71 1.2 67.6 Central Asia 16.3 68.8 Eastern Africa 35.6 88.6 Eastern Asia 120 2.0 78.3 Eastern Europe 314 5.1 71.3 Europe 133 2.2 82.7 Middle Africa 24.4 70.8 Northern Africa 646 10.5 76.9 Northern America 2.0 Northern Europe 476 7.7 96.0 South America 171 2.8 72.5 South-Eastern Asia 135 2.2 60.7 Southern Africa 366 6.0 95.4 Southern Asia 1149 18.7 82.0 Southern Europe 41.7 78.0 Western Africa 190 3.1 72.1 Western Asia 1082 17.6 84.2 Western Europe 326 5.3 94.2 Total 6144 100.0 84.2

Medical Council of Canada Evaluating Examination Predicting Success MCCEE* MCCQE Part I No. attempts to pass MCCEE Pass on 1st try Pass > 1 try Pass: 1 try 5,912 (73%) Pass> 1 try 709 (34%) Total 6,621 (65%) 1,160 (14%) 696 (34%) 1,856 (18%) MCCEE is offered in 73 countries, 500 sites

Canadians Studying Abroad new issue (2008-11) Country of Graduation Number Frequencyof IMGs taking EE Pass Rate Grenada 241 3.9% 99% Netherland Antilles 259 4.2% 94% St. Kitts Nevis 121 2.0% 90% Dominica 113 1.8% 98% Other Caribbean 66 1% 93% Ireland 254 4.1% 96% Australia 157 2.6% 99% Poland 133 2.2% 90%

THANK YOU M. Ian Bowmer Executive Director ibowmer@mcc.c.a