The past year has been difficult and devastating for many Albertans across all sectors. In this edition of Medical Matters, I want to discuss the pandemic’s impact on medical learners, who have experienced a significant disruption to their educational experience, and what that means with respect to licensing and the protection of the public.
Provincial and Territorial Medical Regulatory Authorities are the only organizations in Canada that have a legal mandate to ensure physicians are competent to practise medicine. We rely on our accredited medical schools to provide the learning environment and we rely on organizations like the College of Family Physicians of Canada (CFPC), The Royal College of Physicians and Surgeons of Canada (RCPSC) and the Medical Council of Canada (MCC) to assess the core competencies required to practise.
The MCC assesses the core competencies every physician should have and the CFPC and the RCPSC assess the competencies specific to those specialties. For regulators, these are important assessments that help us demonstrate to the public that we are confident a physician who holds a licence to practise has the knowledge and ability to do so safely and competently.
It’s fair to say the experience medical students and residents have had over the past 15 months has been different than in the past. There are some cases where residents have had very little opportunity to learn in face-to-face clinical settings, there has been far more virtual learning, and as a result of changes in healthcare delivery and demands brought on by the pandemic there have been different clinical experiences for learners. In addition, we’re now seeing significant changes in how learners are assessed for the core competencies required to practise medicine: the CFPC has removed the requirement for an oral exam and, more recently, the Medical Council of Canada Qualifying Examination (MCCQE) Part II was cancelled.
So, what does this mean for registration and licensure in Alberta? The reality is that we walked into an uncertain space that we are all trying to navigate. The MCC has announced that delivery of the MCCQE Part II is cancelled going forward. The Licentiate of the Medical Council of Canada (LMCC) will be granted based on completing a medical degree from a recognized medical school, having successfully completed the MCCQE Part I, completing at least 12 months of clinical postgraduate training and having the required medical credentials including verification of postgraduate training successfully source verified through the MCC. The CFPC is not doing their oral exam and not all RCPSC specialties will have their oral exams. This means several thousand doctors will be completing their residencies with a very different educational experience and assessment of competence.
On June 8, CPSA held an emergency Council meeting to discuss this issue and decided that despite the dramatically different experience these learners have had, we will still allow them to apply for the General Register based on the certifications granted, specifically the LMCC. This would mean they would all be eligible for an unrestricted licence to practise in Alberta if they meet all of CPSA’s other standard requirements.
Considering CPSA’s mandate is to protect the public, we must now look at whether this decision puts the public at any risk. Over the coming months, CPSA will be looking into ways we can support this unique cohort of doctors and help them start off their careers on the right foot. If someone is struggling, whether they’re in this cohort or otherwise, we want to support them instead of waiting until a complaint comes in or a patient is harmed. However, CPSA can’t do this on our own. This is where the entire profession can help out.
We all need to recognize the past 15 months have been challenging for all of us and the more we can support each other as colleagues in the coming months and years, before problems happen, the better it will be for the profession and the public. If you know someone who is just starting off, don’t be afraid to reach out as a mentor.
These are tough times for everyone, but this is also a time for seeing opportunities in education and assessment. There is no question we will be doing things differently moving forward, but what that looks like is still to be determined. I ask for everyone’s patience as we work through this.
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