Dr. Anne-Marie MacLellan - Le Conseil médical du Canada

December 2008
Echo
The Medical Council of Canada Newsletter
Dr. Anne-Marie MacLellan
2009 President
T
he Medical Council of Canada is proud to announce its new President, Dr. AnneMarie MacLellan. Having worked in a wide variety of roles, Dr. MacLellan has a diverse
background full of rich experiences and knowledge acquired from all over the world.
“I feel privileged to be a part of Council and to bring the experience of an educator,
physician and director of a medical regulatory authority to the position of President. It
will be very exciting to lead such an interesting organization full of dedicated staff and
volunteers all working towards a prestigious and honourable cause.”
Dr. MacLellan’s experience gained while in different positions at several organizations
helps her appreciate the Council’s role within Canada’s medical system. “It will be great to
see up close Canadian medical regulatory authorities, physicians, and medical faculties
coming together… it is truly a pan-Canadian affair.”
Dr. MacLellan’s time spent throughout the world has helped shape the direction of her
medical career and brought her to where she is today. “Living in many different areas in
the world, I witnessed many wonderful things, but also some very sad things. I chose to
become a physician in order to make a difference.” A visit to Laos caring for malnourished
children helped Dr. MacLellan decide to specialize in Pediatrics. At L’Hôpital de Montréal
pour enfants, Dr. MacLellan worked as a pediatrician from 1983 to 1987 and became
involved with many committees and units during her time at the hospital.
Her career as a medical educator began in 1983 at McGill University where she taught
several courses on pediatrics and pediatric emergencies within small group settings.
When asked to identify some of the issues facing medical education today, Dr. MacLellan
replied: “The potential lack of teachers to address increasing class size is an important
issue. Governments have greatly increased the number of students and more teachers
and resources are needed to ensure the highest standards of medical education are being
met.”
Being in a position that requires leadership and responsibility is nothing new to Dr.
MacLellan as she has sat as president, director and head of many committees, departments
and programs throughout her career. Dr. MacLellan is joining the MCC from the Collège
des médecins du Québec where she was appointed Associate Director of Medical
Education in 2005.
Asked if switching between the different roles of physician, educator and director is
difficult, Dr. MacLellan stated that, “it might be difficult at times, but I see it more as an
excellent opportunity to work with and learn from a wide variety of people.”
In her new role as MCC President, Dr. MacLellan is excited to “build upon what my
predecessors have accomplished, continue to address professionalism in medicine and to
bridge the gap between medical organizations in Canada.” A large focus on partnerships
and improving relationships is also something Dr. MacLellan looks forward to achieving.
Welcome, Dr. MacLellan, as the President of the Medical Council of Canada for 2008-2009.
MCC
Annual
Meeting
2
National
Assessment
Collaboration
5
Outstanding
Evaluating
Achievement
Examination Award Recipient
7
8
W. Dale Duphinee Int'l Medical Sister
CAIR's Resident
R&D
Fellowship
Graduate
Elizabeth Conference &
Grants Recipient
Symposium Davis
Competition
10
11
12
13
14
Dr. Anne-Marie MacLellan
President
Medical Council of Canada
Highlights from the
Medical Council of Canada
Annual Meeting
T
he Medical Council of Canada held its Annual Meeting
in Ottawa from October 19 to 21, 2008 where it
discussed professionalism in medicine, set its policy
direction for the upcoming year, and affirmed the 2009
fees for its examinations.
The Council also approved in principle a governance
model for the National Assessment Collaboration. This will
help create a simplified, co-ordinated national approach
to assessing international medical graduates at the
regional level. The Collaboration is currently focusing on
developing an Objective Structured Clinical Examination
that will assess the competency of international medical
graduate candidates competing for postgraduate
residency positions with the ultimate goal of assessing
competency for entry into practice. Parallel processes are
underway to have approval from provincial and territorial
2
governments through the Advisory Committee on Health
Delivery and Human Resources and to finalize a business
plan involving the existing seven regional International
Assessment Programs.
The examination fees that had been projected at the 2007
Annual Meeting were affirmed by Council: the 2009 fee for
the Medical Council of Canada Qualifying Examination Part
I will be $700 CAD and the 2009 fee for the Medical Council
of Canada Qualifying Examination Part II (MCCQE Part II)
will be $1650 CAD. Council also recognized the need for a
significant increase in the 2010 fees.
The Council honoured Dr. Glenn Regehr with its
Outstanding Achievement Award for his extensive body
of work in medical education, assessment and in refining
the understanding of professionalism and how it relates to
medical practice. Dr. Gordon Page was awarded the Dr. Louis
Levasseur Award for his contributions over the past 25 years
to the Medical Council of Canada.
Council announced the award of the first W. Dale Dauphinee
Fellowship, which was given to Dr. Claire Touchie. Other
business included modifying the Council’s by-laws to allow
students in their final year of osteopathic medicine from a
school accredited by the American Osteopathic Association
to apply to the Medical Council of Canada Evaluating
Examination and to the Qualifying Examination Part I, and
the decision to appoint an additional public member of
Council to the Finance Committee.
 2007 – 2008 Executive Board. From left to right: Dr.
Trevor Theman, Dr. Anne-Marie MacLellan, Dr. Rocco
Gerace, Sister Elizabeth Davis, Dr. Dennis Kendel, Ms.
Nancy MacBeth and Dr. Ian Bowmer. Absent: Dr. Paul
Grand’Maison
2008 – 2009 Council members ▶
New faces on the Medical Council of Canada
Executive Board and Council
T
he Medical Council of Canada is welcoming new faces on its Executive Board following the election at its
Annual Meeting on October 21, 2008.
Dr. Anne-Marie MacLellan is the Medical Council of Canada President for 2008-2009. Dr. MacLellan, MDCM,
CSPQ, FRCPC, was appointed Director of Medical Education and Assistant Registrar at the Collège des médecins
du Québec in February 2006. Dr. MacLellan qualified for her Licentiate of the Medical Council of Canada in 1977.
After completing her residency training in Pediatrics in Québec, she obtained her certificate as a specialist in
Pediatrics from the Collège des médecins du Québec and became a Fellow of the Royal College of Physicians
and Surgeons of Canada.
3
After her term as Program Director for the McGill Pediatric residency program, she was appointed Associate Dean for
Postgraduate Medical Education and Professional Affairs at McGill University from 1993 to 2002. From 2002 to 2005, she was
the Director of the Pediatric Network of the McGill University Health Centre. In October 2005, she was appointed Assistant
Director of Medical Education at the Collège des médecins du Québec. In these positions, she has had the privilege to chair
or to serve on numerous committees.
Joining her on the Medical Council of Canada Executive Board are:
• Dr. Rocco Gerace, Past-President
• Dr. Oscar Casiro, Vice-President
• Dr. Dennis Kendel, Chair of the Finance Committee
• Ms. Nancy MacBeth
• Dr. Trevor Theman
• Dr. Paul Grand’Maison
The Medical Council of Canada also welcomes new members on its Council: Dr. Christian Bourdy from the Université de
Montréal, Dr. Milli Gupta from the Canadian Association of Internes and Residents, Dr. Shawn Mattas from the Northwest
Territories, Dr. Heidi Oetter from the College of Physicians and Surgeons of British Columbia, Ms. Éliane Raymond-Dufresne
from the Fédération médicale étudiante du Québec, Dr. Anthony Sanfilippo from Queen’s University, Dr. Gill White from the
University of Saskatchewan and Dr. Chris Watling from the University of Western Ontario.
▶ Standing Committees 2008 – 2009
EXECUTIVE
President
BOARD
Dr. Anne-Marie MacLellan
L E G I S L AT I O N
COMMITTEE
Vice-President
Dr. Oscar Casiro
Chair
Past-President
Dr. Rocco Gerace
Vice-Chair
TBD
Treasurer
Dr. Dennis Kendel
Members
Dr. Bruce Beaton
Members
Dr. Paul Grand’Maison
Dr. Geoffrey Bond
Dr. Donald Chadsey
Ms. Nancy MacBeth
Dr. Edmund Collins
Dr. Trevor Theman
APPEALS
Dr. Patricia DeMaio
Dr. Theresa Farrell
COMMITTEE
Chair
Dr. Robert Young
Vice-Chair
Dr. Markus Martin
Members
Ms. Rose Carter
Dr. Oscar Casiro
Dr. Geraldine Johnston
Dr. William Lowe
Dr. John McCrea
Dr. Robert Menzies
Dr. Jay Rosenfield
Dr. Joyce Pickering
Dr. Cathy Vardy
Dr. Peggy Sagle
Dr. Cameron Little
Dr. Dan Small
Dr. Edward Tsoi
FINANCE
COMMITTEE
Dr. Morris VanAndel
Chair
Dr. Dennis Kendel
Vice-Chair
Dr. Cameron Little
Members
Dr. Anne-Marie MacLellan
Chair
Dr. Rocco Gerace
Dr. Michael Marrin
Members
Dr. Marc Blayney
Dr. Dan Small (Observer)
N O M I N AT I N G
COMMITTEE
Dr. Donald Chadsey
Dr. Simon Field
Dr. Heidi Oetter
4
R&D
COMMITTEE
Chair
Dr. Bruce Wright
Vice-Chair
Dr. Trevor Theman
Members
Dr. Simon Field
Dr. Joyce Pickering
Dr. William Pope
SELECTION OF MEMBERS OF TEST
COMMITTEE
Chair
Dr. Geraldine Johnston
Vice-Chair
Dr. Don Chadsey
Members
Dr. Geoffrey Bond
Dr. Paul Grand’Maison
Dr. Jay Rosenfield
Dr. Edward Tsoi
Dr. Anthony Sanfilippo
MCC Staff Service Awards
The Medical Council of Canada was delighted to award a certificate
in recognition of years of service to:
Ms. Tanya Bennett, Test Development Officer, MCCQE Part I . . . . . . . . . . . . . . . . . . . . . 5 Years
Mr. Robert Lee, Director, Evaluation Bureau . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 Years
Ms. Lin Ma, National Site Coordinator, MCCQE Part II . . . . . . . . . . . . . . . . . . . . . . . . . . 5 Years
Ms. France Provost-Dagher, Receptionist . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 Years
Mr. Don Rutherford, National Site Coordinator, MCCQE Part I . . . . . . . . . . . . . . . . . . . . 5 Years
Ms. Suzanne Deschamps, Credentialing Agent, MCCQE Part I & II . . . . . . . . . . . . . . 10 Years
Mr. Mark Kennedy, Int’l Site Coordinator and Project Support . . . . . . . . . . . . . . . . 10 Years
Ms. Michelle Leclair, Credentialing Agent, MCCEE . . . . . . . . . . . . . . . . . . . . . . . . . . . .15 Years
The Staff Service Awards were presented by Dr. Rocco Gerace and Dr. Ian Bowmer to the employees on
October 19 during a reception prior to the Annual Dinner.
Update on the National Assessment Collaboration
▶ Background on the NAC
T
he purpose of the National Assessment Collaboration
(NAC) is to create a streamlined process to assess an
international medical graduate (IMG)’s medical knowledge
and clinical skills accurately and efficiently. Qualified IMGs
will be eligible for supervised and independent practice
while IMGs who need to improve their clinical skills and
medical knowledge will be identified and provided
the opportunity for additional education and training
including postgraduate residency training.
The National Assessment Collaboration is comprised
of Health Canada, the Medical Council of Canada, the
provincial and territorial governments, the provincial and
territorial medical colleges, the Federation of Medical
Regulatory Authorities of Canada, the Association of
Faculties of Medicine of Canada, the Royal College of
Physicians and Surgeons of Canada and the College of
Family Physicians of Canada.
The Collaboration is currently focusing on one part of the
continuum of assessment of an IMG – that of creating a
national clinical “OSCE” examination (Objective Structured
Clinical Examination). This hands-on examination simulates
clinical scenarios where standardized patients are trained
to portray patients with specific problems. In each station,
a physician examiner looks on while the candidate interacts
with the standardized patient.
By having a single, national, standardized set of
assessments for IMGs, including the NAC OSCE examination,
the NAC aims to reduce duplication of efforts undertaken
by the individual provincial IMG assessment programs,
and to provide more mobility for IMGs with a portfolio of
nationally recognized credentials.
5
▶ NAC update
T
he National Assessment Collaboration (NAC) met on
October 2, 2008 in Ottawa to address the report from
the working group it had created. The NAC approved the
amendments the working group had suggested to the
principles related to the NAC OSCE including the addition
of a principle, that the individual IMG assessment programs
and/or residency programs may require additional
performance assessments for entry into residency that are
not examined by the core content of the NAC OSCE.
The NAC discussed various proposed governance
models and recognized that the selected model should
be transitional. It was agreed that, after the NAC OSCE
will have been delivered twice, a formal evaluation of the
governance structure will be undertaken in preparation for
establishing a more permanent model.
However, the group agreed that the NAC should fall under
the permanent governance responsibility of the Medical
Council of Canada, and that accountability to the public will
be achieved through this structure. The group proposed
that the central body of the NAC would be the NAC Central
Coordinating Committee, and that certain committees
responsible for the assessment tools would fall under its
jurisdiction, including the NAC OSCE test committee.
The NAC participants also accepted the working group’s
recommendation that the eligibility criteria for taking
the NAC OSCE would be the same as the eligibility
criteria required for applying to the CaRMS match, that
is, the candidate must be attending or have graduated
from a school listed in the International Medical
Education Directory published by the Foundation for the
Advancement of International Medical Education and
Research and the candidate must have written and passed
the Medical Council of Canada Evaluating Examination. It
was decided that the NAC OSCE eligibility criteria would
be the same as the CaRMS match application criteria given
that the examination is intended for IMG entry into the first
year of postgraduate training. It was recognized that some
jurisdictions may wish to add region-specific criteria such
as a language requirement or time since graduation.
Additionally, the group discussed the basic assumptions
underlying the development of a financial model for the
NAC OSCE. One of these assumptions is that even though
the costs for the delivery of the NAC OSCE will vary across
the country, individual candidates should have to pay the
same fee regardless of where they take the examination.
It was agreed, however, that provincial and territorial
governments may provide subsidies to individual
candidates to offset their fees, and that these subsidies
may vary from jurisdiction to jurisdiction.
The Medical Council of Canada brought forward the NAC
proposal to its Annual Meeting on October 21, 2008. The
Council approved in principle the governance model for
the NAC. The Advisory Committee on Health Delivery and
Human Resources, made up of representatives from the
federal, provincial and territorial governments, also agreed
in principle with the direction being taken.
A group comprising of representatives from the IMG
programs met on November 10 and 11, 2008. This
group, tentatively called the Council of Leaders, will
begin meeting on a regular basis. One of their roles will
be to elect members to the NAC Central Coordinating
Committee. As part of the meeting, the Council of Leaders
discussed the terms of reference of their committee
as well as the terms of reference of the NAC OSCE test
committee in anticipation of the acceptance of the terms
of reference for the Central Coordinating Committee.
Planning commenced immediately for the NAC OSCE pilot.
(see Proposed Governance Structure next page)
▶ Next steps
T
he Medical Council of Canada is currently working on the terms of reference of the NAC Central
Coordinating Committee. A business plan will be presented to the Advisory Committee on Health
Delivery and Human Resources and the Conference of Deputy Ministers of Health in spring 2009. The
business plan will also be presented to the Medical Council of Canada Executive Board in April 2009.
6
PROPOSED
GOVERNANCE
STRUCTURE
Medical Council of Canada - MCC
Governing Body
Advisory
Committee
on Health Delivery
and Human
Resources
(ACHDHR)
AFMC
FMRAC
National Assessment
Collaboration (NAC)
RCPSC
CFPC
Council of Leaders
of IMG
Assessment
Programs
Central Coordinating
Committee (CCC)
CMQ
CMA
etc
NAC OSCE
Test Committee
Other Technical
Committees as Needed
Item
Development
Committee
MCC Central Services/Support
Regional
Delivery
Regional
Delivery
Regional
Delivery
Regional
Delivery
LEGEND
NOTES
1. The CCC will formally link with the external organizations through
exchange of information, requests for advice on strategic policy
matters, etc.
2. After two deliveries of the NAC OSCE, a formal evaluation on the
organizational structure will be initiated.
Regional
Delivery
Regional
Delivery
Regional
Delivery
Reporting
Information sharing
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Update on the ‘new’ Evaluating
Examination – a smooth deployment
of the computer-based test
A
major change happened this year at the Medical Council
of Canada (MCC). After years of planning and preparation,
the MCC is now offering its Medical Council of Canada Evaluating
Examination (MCCEE) as a computer-based test that can be taken in
over 500 examination centers around the world.
The MCCEE is offered to international medical graduates as well
as to international medical students in their final year prior to
graduation to assess their basic medical knowledge. For candidates
who obtained their diploma from a medical school not accredited
by the Committee on Accreditation of Canadian Medical Schools
(CACMS) or by the Liaison Committee on Medical Education (LCME)
in the United States, a pass on the MCCEE is required for eligibility to
the MCC Qualifying Examination Part I, with the exception of certain
candidates who can apply for an exemption to the MCCEE based on
Canadian or American board certification.
The MCCEE was previously offered three times a year in a paperand-pencil format in Canada and abroad. Since September, the
examination has been offered in a computerized format, which
allowed the MCC to reduce the length of the examination from a full
day to four hours. The change took place to provide candidates with
more flexibility, and since the examination is now delivered through
a service provider, Prometric, candidates can make an appointment
(or rebook their appointment) to take the examination at their
convenience, and can even book their examination up to five days
prior to the examination date.
The candidate has many more options on when and where he or
she will take the MCCEE as it is now offered in six, multi-day testing
windows, resulting in about 60 available testing days in over 70
countries worldwide.
Candidates who have been deemed eligible to take the MCCEE
now have a five-year window in which to schedule and take the
examination. Unsuccessful candidates to the computerized MCCEE
who are still within their five-year eligibility
window can re-apply to the MCCEE and their
application process will be significantly simplified
compared to their original application.
Overall, the September launch of the ‘new’
Evaluating Examination went very smoothly.
Only two per cent of candidates taking the
examination had technical problems, and the
MCC was satisfied with Prometric’s ability to
reschedule the candidates’ examination within
the September examination session. In November,
the percentage of candidates who encountered
technical problems decreased to one per cent.
So far, 1031 candidates have taken the
computer-based MCCEE (516 candidates in
September and 515 candidates in November).
The Evaluation Bureau observed that candidates
seem to be taking advantage of the additional
scheduling flexibility – many transactions have
been taking place with Prometric, with many
candidates scheduling their examinations and
then later changing their examination date and
time. Another observation is that candidates took
the examination in 96 centers in 24 countries in
September and in 100 centers in 35 countries
in November. The top two countries where
candidates took the examination were Canada
and the United States, representing 75 per cent
of the candidates at the September session, and
63 per cent at the November session.
The MCC included a survey at the end of the
computerized examination asking for specific
feedback from the candidates. This survey
included eight multiple-choice questions and four
open-ended questions. Overall, the comments
from the candidates at both the September
and November sessions were
overwhelmingly positive. The
suggestions for improvement
were also very helpful to MCC
employees. The candidates at
future examination sessions
will continue to be asked to fill
out the survey.
For more information on the
MCCEE, visit http://www.mcc
ca/en/exams/ee/.
Locations where candidates took
the MCCEE in September 2008,
the first MCCEE examination
session where the examination
was delivered via computer.

Dr. Glenn Regehr – winner of the 2008 Award for
Outstanding Achievement in the Evaluation of
Clinical Competence
“O
utstanding in every respect.” “His accomplishments are
extraordinary.” “A most deserving candidate.” These are just
some of the comments of the members of the Medical Council of
Canada Outstanding Achievement Award Selection Committee
upon unanimously deciding on Dr. Glenn Regehr as the winner of
the 2008 Award for Outstanding Achievement in the Evaluation of
Clinical Competence.
The Outstanding Achievement
Award is an internationally peerreviewed award bestowed on
individuals who made a significant
and vital achievement in the field of
assessment and evaluation of clinical
and professional competence in
the health professions. Previous
recipients have made a vital
impact in many areas including
in shaping medical curriculum,
improving the effectiveness of the
revalidation process for physicians,
and introducing a new clinical
examination to assess medical
practitioners’ competency.
▲
Dr. Regehr has been a leader in the
field of medical assessment. He has
published over 118 peer-reviewed
papers and has presented at over 180
scientific meetings. Dr. Regehr and
his collaborators have been granted
close to $3 million for their research. Dr. Regehr is Associate Editor
of Advances in Health Sciences Education, and part of the editorial
board at Medical Education and Academic Medicine in addition to
reviewing other research articles on an ad hoc basis for nine other
journals. He currently holds the Richard and Elizabeth Currie Chair
in Health Professions Education Research and is both the Associate
Director of the Wilson Centre in Toronto and the acting Assistant
Dean of the Academy for Innovation in Medical Education at the
University of Ottawa.
Dr. Glenn Regehr
Areas of his expertise include clinical examinations for medical
practitioners, the evaluation of professionalism in medicine, and the
capacity of physicians to learn and self assess their areas of strength
and weakness.
“Professor Glenn Regehr has dedicated his creative research career
to advancing the evaluation of health education. The result has
been a spectacular leap forward in the development of innovative
and improved models of education in health professions,” said Dr.
Catharine Whiteside, Dean of Medicine at the University of Toronto,
who nominated Dr. Regehr for the award. “We are extremely
proud of his leadership and accomplishments at the University of
Toronto in the Wilson Center for Research in Education. He is truly
deserving of this prestigious Medical Council of Canada Outstanding
Achievement Award.”
8
For more information on the Award for
Outstanding Achievement in the Evaluation of
Clinical Competence, visit http://www.mcc.ca/
en/awards/outstanding_achievement.shtml. The
deadline for nomination for the 2009 Award is
May 1, 2009.
The Medical Council of Canada also offers the
Louis Levasseur Award, which is presented to
a person whose collaboration has contributed
in an extraordinary manner to the mission and
vision of the Medical Council of Canada. The
2008 recipient of the Louis Levasseur Award
is Dr. Gordon Page. More information on the
Louis Levasseur Award can be found at http://
www.mcc.ca/en/awards/louis_levasseur.shtml.
The deadline for nomination for the 2009 Louis
Levasseur Award is also May 1, 2009.
What we are doing
right – and wrong – in
medical education: some
challenges from Dr.
Glenn Regehr
“T
here should be no ‘O’ in OSCE”, Dr. Glenn
Regehr challenged early on in my
conversation with him. Dr. Regehr, a top medical
education researcher, was kind enough to take
the time to sit down with me and share his views
during an early morning meeting in Ottawa.
His area of expertise encompasses many
different facets of medical education and among
other research interests, he has made great strides
researching effective assessment mechanisms
for Objective Structured Clinical Examinations or
OSCEs. These examinations are among the most
elaborate in medicine today – they involve a
series of stations, each with a physician examiner
who evaluates the candidate, and a standardized
patient who has been trained to portray a patient
with a specific problem.
The Medical Council of Canada Qualifying
Examination Part II is an OSCE examination, and
its administrators go to great lengths to ensure
that, after passing through its 14 stations, a
candidate will receive a score that is an objective
and statistically reproducible appraisal of his or
her performance.
9
Dr. Regehr has researched better ways to assess medical
professionals through the OSCE examination and his
conclusion sounds somewhat counter-intuitive at first. He
believes that the evaluation should not be so objective.
“When examiners use standardized checklists to assess
a candidate, you encourage thoroughness rather than
competence in the candidates. And even for examiners
filling out a checklist, they are making subjective
judgments,” he said.
“If, on an examination checklist, it says that the candidate
needs to introduce himself to the patient – and the
candidate walks in and avoids looking at the patient and
refuses to interact with the patient except to say ‘hi, I’m
Dr. Smith’ while looking at his papers – what should the
examiner do? Check off that the candidate has introduced
himself? Or not check it off since the candidate has done it
so poorly?”
Dr. Regehr favours the use of a global rating scale as
opposed to the use of standardized checklists. “Based on
our research, I believe that the right mechanism to assess
candidates is to use expert judgments based on multiple
observations from multiple observers. Inherently, that
process is more accurate, albeit also more ‘subjective’. ”
Also to be found on Dr. Regehr’s research radar is the
concept of self-regulation. “Our whole continuing medical
education system is based on physicians self-selecting
areas where they are strong and areas where they are
weak and redressing their weaknesses through continuing
education courses,” he explained. “But like all humans,
physicians do not seem to reflect upon their weaknesses
for the purposes of identifying gaps in their skills or
knowledge. So, we don’t effectively self-evaluate in the
manner expected by the continuing education model. And
yet, physicians, for the most part, are competent – how can
we explain this discrepancy?”
Dr. Regehr is building on research undertaken in
collaboration with Dr. Carol-anne Moulton and Dr. Kevin
Eva that focuses on how physicians self monitor as
opposed to self evaluate, on how they reflect in practice
as opposed to how they reflect on practice after the fact.
Drs. Moulton and Eva have found that physicians maintain
their competence by slowing down when they should and
knowing when to look up information in situations where
they don’t immediately know the answer.
In collaboration with Dr. Maria Mylopoulos, Dr. Regehr is
researching how physicians learn during these “slowing
down” opportunities. They were published on the topic
in Medical Education in December 2007 with another
article scheduled to appear in the Journal of Continuing
Education in the Health Professions in December 2008.
Another area of professional interest for Dr. Regehr
is assessing professionalism in collaboration with Dr.
Shiphra Ginsburg. They are critical of attempts to evaluate
professionalism based only on standard definitions. Rather,
they have taken the approach that you have to look at
professionalism in the context of daily medical practice,
where sometimes values are in conflict and the pressures
that a physician experiences are very different than what
he or she might have originally anticipated. “Take a quality
like altruism, for example, which is typically included in
definitions of professionalism,” Dr. Regehr theorized. “You
can’t evaluate altruism – this would mean finding a way
to isolate this quality and finding a way to measure it
independent of the contexts in which it is enacted.”
Dr. Regehr was recently awarded the Medical Council of
Canada Outstanding Achievement Award in the Evaluation
of Clinical Competence for 2008. This internationally
adjudicated award is bestowed on an individual who has
made a significant and vital achievement in the field of
assessment and evaluation of clinical and professional
competence in the health professions. Previous recipients
of the award include Drs. Richard and Sylvia Cruess,
Dr. Carlos Brailovsky and Dr. Geoff Norman.
“It feels very special to be acknowledged by my peers in
this way,” said Dr. Regehr. “I’ve always been proud of my
work but to be acknowledged in a formal way by my peers
is a very special honour.”
Recognition and accolades for Dr. Regehr’s work have
already come from across the medical community. He has
been awarded the prestigious John P. Hubbard Award from
the National Board of Medical Examiners in the United
States. He currently holds the Richard and Elizabeth Currie
Chair in Health Professions Education Research and is both
the Associate Director of the Wilson Centre in Toronto and
the acting Assistant Dean of the Academy for Innovation in
Medical Education at the University of Ottawa.
What does the future hold for this cognitive psychologist
at the forefront of research into how physicians learn
and how we can effectively evaluate them? Based on
the enthusiasm with which he speaks of his work, of his
discoveries, of how the mind works and of how we can
be better medical educators and assessors, one can only
surmise that medical education is exactly the niche in
which Dr. Regehr wants to carry on his illustrious career.
“Education is the interface of so many disciplines and
medical education is about researchers constantly
interacting with the real world. In this field, theory cannot
be disassociated from practice, and that is what makes it
so exciting.”
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Calling all medical education and
assessment researchers!
Since 1993, the Medical Council of Canada has funded research in the field of assessment of
clinical performance or clinical competence. Grant applications are peer-reviewed with a
steering committee making the final decision.
Fund for Research in Clinical Assessment
(a single-year grant)
Deadline: February 1, 2009
Purpose:
To encourage innovations in the assessment of clinical competence or performance of students,
postgraduate trainees or practitioners. The steering committee will give priority to proposals
that show promise in contributing to the knowledge and understanding of measurement in
clinical assessment and to clinical program evaluation methods for medical education.
Maximum grant:
The limit per application is $37,500, which can be spread over two years of support. Funding will
start July 2009.
For more information on the Fund for Research in Clinical Assessment, visit http://www.mcc.ca/
en/research/grants_apply_one_year.shtml.
Multi-Year Grant
Deadline: For the letter of intent: February 1, 2009. Full submission deadline: May 1, 2009
Purpose:
The Steering Committee will give priority to proposals that show promise in contributing to the
knowledge and understanding of the measurement of health professionals’ performance in a clinical
context. A primary factor in awarding the grant will be the extent to which the proposal encourages
and fosters a research program or collaboration between institutions.
Maximum grant:
The limit per application is $150,000 that can be spread over three years of support. The money
requested can be distributed across the three years in any manner as long as the yearly amount in any
single year does not exceed 40 per cent of the total amount.
For more information on the Multi-Year Grant, visit http://www.mcc.ca/en/research/grants_apply_
multi_year.shtml.
There is still time to apply for the Proposal Writing Assistance Initiative!
These grants may be used by a Principle Investigator to develop and write a research proposal for either the
Fund for Research in Clinical Assessment or the Multi-Year Grant. The Proposal Writing Assistance Initiative
consists of five grants of $2,000 each and the deadline is January 15, 2009. More information can be found
at http://www.mcc.ca/en/research/grants_apply_letter_of_intent.shtml
11
Trying to decipher what a physician needs to know
and when – the research aspirations of Dr. Claire
Touchie, the first recipient of the Medical Council
of Canada’s W. Dale Dauphinee Fellowship
W
hat makes a doctor a doctor?
This might be an impossibly broad question to answer, but
slowly and surely, Dr. Claire Touchie is chiseling away at that particular
conundrum.
Dr. Touchie is the first recipient of the W. Dale Dauphinee Fellowship,
offered by the Medical Council of Canada to applicants who are members
of a Canadian faculty of medicine who have received formal leave in
order to pursue further studies in assessment for medical education,
certification, continuing professional competency or psychometrics, or to
pursue a formal graduate program in education.
The fellowship will allow Dr. Touchie to pursue a Master of Health
Professional Education at the University of Illinois at Chicago and to
collaborate with renowned researchers Dr. Georges Bordage and Dr.
Steve Downing. For the first six months of the program, she will be on
sabbatical from her clinical and academic roles at the University of Ottawa.
During those six months, she will be gathering data about what it is that
physicians need to know, and then applying that information to validate
the Medical Council of Canada Qualifying Examination Part I.
“There are a number of databases across Canada that I can draw from,”
said Dr. Touchie. “The Canadian Institute for Health Information gathers
statistics on the diagnoses of people who are hospitalized, who are
receiving ambulatory care, and who are receiving mental health care. I
want to look, for example, at the 50 most common diagnoses in each of
these areas. There are also other data banks including Statistics Canada’s
health surveys of the public. These types of surveys look at the burden on
the health care system. For example, diabetes has a huge impact on the
health care system although it is a low prevalence disease. I want to look
at what physicians are seeing in their practice and the impact it has on the
health care system.”
With a clearer definition of the top diagnoses and impact of the
pathologies on health care delivery, Dr. Touchie will then map the
knowledge required for entry into supervised practice and compare
that information to the blueprint and objectives that currently form the
backbone of the Qualifying Examination Part I.
“The Medical Council of Canada uses committees of physicians to create
its content based on the Medical Council of Canada Objectives. For the
Qualifying Examination Part I, the computer-adaptive examination is then
constructed based on discipline content and psychometric parameters.
However, are there important conditions and concepts not adequately
represented on this examination? Are we testing the candidates on those
things we expect them to know when they complete their training?”
Dr. Touchie aspires to answer those very questions as part of her
research project. While many might be daunted at the scope of such a
large endeavour, which she hopes will eventually lead her to validate the
blueprints for all Medical Council of Canada examinations, Dr. Touchie
emanates a true enthusiasm for the subject matter. “I love the knowledge
I acquire through research, love the impact I can have on the system.
Research complements my clinical life well.”
When asked what interested her about
examination development, Dr. Touchie
responded: “I work with medical students
and residents all the time. I have always
been interested in their education from the
start, in how they achieve the knowledge
that they do. For me, it’s important to make
sure that examinations are representative of
what they should know.”
What advice does she have for other
researchers who might be interested
in applying for the W. Dale Dauphinee
Fellowship? “Find a project you are
passionate about, get some mentors who
will be able to guide you through the
project, and then go for it.”
The W. Dale Dauphinee Fellowship was
established in recognition of Dr. W. Dale
Dauphinee’s contributions to the Medical
Council of Canada from 1970 to 2006.
For more information on the fellowship,
visit
http://www.mcc.ca/en/awards/
dale_dauphinee.shtml. The application
information for the 2009 W. Dale Dauphinee
Fellowship is now posted. The submission
deadline is May 1, 2009.
10
12
First ever International
Medical Graduate Information
Symposium draws over 500
participants
T
he Canadian Resident Matching Service (CaRMS)
hosted the first annual International Medical Graduate
Information Symposium at the Metro Toronto Convention
Centre on October 30, 2008. Over 500 international medical
graduates from across the country attended this event to
find out more about the Canadian medical system and the
steps they need to take to become medical practitioners in
this country.
“We are very pleased with the enthusiastic reception
we received from international medical graduates,” said
Sandra Banner, CEO of CaRMS. “This event provides
participants with the opportunity to meet the key players
in the medical community and ask face-to-face questions
applicable to their specific situation. I hope participants
left the Symposium with a clearer understanding of how to
navigate through the system to obtain residency positions
and ultimately licenses to practice medicine.”
The organizations involved in medical education,
evaluation and licensing participating in this Symposium
in addition to CaRMS included the Association of Faculties
of Medicine of Canada, the College of Family Physicians of
Canada, The Federation of Medical Regulatory Authorities
of Canada, Health Force Ontario, the Medical Council of
Canada and the Royal College of Physicians and Surgeons
of Canada. Workshops hosted by CaRMS as well as by the
other Symposium partners focused on such themes as
the application process for the CaRMS match, an overview
of Medical Council of Canada examinations, information
on postgraduate medical education, and the process and
requirements for specialty certification.
“As a representative of IMGs from Nova Scotia, I was
thrilled to attend this event and bring back information
that is most needed,” said Dr. Suha Masalmeh, President
of the Association of International Physicians
and Surgeons of Nova Scotia and a participant
at the event. “This information session has been
a great opportunity to learn new things, meet
stakeholders, and meet other IMGs and learn
from their experiences. I hope that the comments
and suggestions shared at the symposium
will help to shape a better future for the IMG
licensing process and for the creation of training
opportunities. We applaud CaRMS and the other
participating organizations’ efforts and time to
arrange this event and look forward to hearing
about next steps.”
13
Participating organizations were also very pleased with the
outcome. “I thought the symposium was excellent,” said
Dr. Paul Rainsberry, Director of Education at the College of
Family Physicians of Canada. “I think the event has gone a
long way to moving us in the right direction and my team
looks forward to being involved in any future event.”
Since 2006, more than 1500 international medical graduates
compete every year for postgraduate training positions
through CaRMS after passing the appropriate examinations
and possible assessments.
Congratulations to Sister
Elizabeth Davis!
F
ormer Medical Council of Canada President Sister Elizabeth Davis has been
recognized this fall with two important awards in honour of her dedication,
passion and leadership in the field of health care.
On September 26, 2008 Sister Elizabeth was conferred an honorary fellowship of
the Royal College of Physicians and Surgeons of Canada alongside Ms. Louise Arbour,
Dr. James Garden, Dr. Louise Nasmith and Ms. Eva Olsson. The Royal College honours
‘’distinguished physicians, surgeons and others for outstanding performance in a
particular vocation or a specific area of professional activity by awarding honorary
fellowship. The 2008 recipients are exceptional individuals whose contributions through their commitment to human
rights, leadership and collaboration at all levels of society, are exemplary.’’
Sister Elizabeth was also chosen as the 2008 recipient of the Lifetime Achievement Award and 2008 Alumna of the Year by
Memorial University of Newfoundland. Memorial’s Lifetime Achievement Award “recognizes an individual’s contribution
to and distinction in their chosen professional fields. It honours individuals who inspire others by displaying exceptional
human values.’’
Sister Elizabeth’s distinguished career in health care and theology encompassed a wide variety of roles in a wide variety
of organizations. She has been a President, CEO, innovator, teacher, lecturer, professor, mentor, member of the board, and
chairperson. She has improved the health care system not only for the people of Newfoundland and Labrador, but also for
Canadians as a whole. For her lifetime of achievements, she has received numerous awards including Member of the Order
of Canada in 2005.
At the Medical Council of Canada, her vision and
guidance have made a tremendous impact. She
has been a passionate advocate in her role as public
member, and a tireless proponent of making the
assessment of medical professionals as fair and as
effective as possible.
Past Presidents Dr. Louise
Samson (left) and Dr. Richard
Baltzan (right) present Sister
Elizabeth Davis with the
honorary fellowship of the
Royal College of Physicians
and Surgeons of Canada.
▶
Photo credits:
Royal College of Physicians and Surgeons of Canada and Taylor Photography
14
Licentiate to Heal: A History of
the Medical Council of Canada
A
ttention all history buffs – Licentiate to Heal, the
Medical Council of Canada history book, has been
distributed to all Members of Council as well as to the
individuals who work on behalf of Council including all test
committee members and Deputy Registrars.
Additionally, copies of the book were sent to the Deans,
Undergraduate Deans, Postgraduate Deans, Continuing
Medical Education Deans, Research Deans and university
libraries at each Faculty of Medicine in Canada. Partner
organizations and members of the National Assessment
Collaboration also received a copy.
The History Book has been included in the results
packages of recipients of the Licentiate of the Medical
Council of Canada in June, and the same will be done for
the results packages in December 2008.
If you would like a copy of Licentiate to Heal, please
contact jhertzog@mcc.ca
Duking it out in the name of medical
knowledge prowess
O
n Saturday, September 27, teams of residents
competed against each other in the quest to
demonstrate their medical and surgical knowledge as
part of the Canadian Association of Internes and Residents
(CAIR)’s Resident Conference and Competition (CRCC).
The Medical Council of Canada (MCC) partnered with
CAIR to hold the Knowledge Challenge competition, and
provided the rules and the multiple-choice questions for
the game. The MCC also lent the Turning Point software
polling devices that were used during the Challenge.
Dr. Ian Bowmer, Executive Director of the Medical Council
of Canada, attended the event and CAIR President Dr. JeanPierre Martel presided as quizmaster for the Knowledge
Challenge.
Although the competition was collaborative, in the end,
the team from the University of Manitoba with Dr. Joanne
Hamilton, Dr. Talia Freedman and Dr. Corinne Hajer won
the Challenge.
“The CRCC was envisioned to be a national event that
was designed for residents by residents. We would like to
thank the MCC for supporting Canadian residents through
their involvement as partners with CAIR for the Knowledge
Challenge competition event,” said Dr. Jerry M. Maniate, cochair of the inaugural CRCC. “This great event was very well
received by the residents who were in attendance. And the
questions were challenging – so much so that many of us
were grappling to come up with the right answer.”
“We were happy to support the first resident-organized
forum,” said Dr. Bowmer. “The participants were extremely
enthusiastic and we look forward to seeing this forum
grow over time.”

▲
Dr. Jerry Maniate, 2008 CRCC Co-Chair, (right)
poses with the winning team of the Knowledge
Challenge from the University of Manitoba
comprised of (from left to right) Dr. Joanne Hamilton,
Dr. Talia Freedman and Dr. Corinne Hajer.
▶
MCC Executive Director Dr. Ian Bowmer
chats with CAIR’s Executive Director
Ms. Cheryl Pellerin at the Resident
Conference and Competition.
Photo credit: Denis Drever Photography 