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Medical Council of Canada
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On September 23 and 24, the Medical Council of Canada (MCC) Council and leadership team welcomed more than 80 participants from its partner organizations to the 2024 Annual Meeting. The event, which was held in Ottawa at the MCC’s headquarters, welcomed special guests including The Honourable Mark Holland, federal Health Minister, youth knowledge keeper Kyrstin Dumont, and Dr. Kwadwo Kyeremanteng, Department Head of Critical Care at The Ottawa Hospital, who provided an inspiring keynote address.
The 2024 Annual Meeting also included a series of breakout sessions, each addressing a theme from the 2024-2027 Strategic Plan. The MCC is grateful to the facilitators for sharing their expertise and to our partner representatives for their participation in the following sessions:
In this session, participants had the opportunity to identify barriers that international medical graduates (IMGs) frequently face on their journey to practising medicine in Canada, and to brainstorm potential solutions. Dr. Bhuiyan, an immigrant health professional who holds academic positions with Toronto Metropolitan University, University of Memphis, University of Toronto, and Bangladesh University of Health Sciences, highlighted the challenges IMGs face when arriving in Canada, including the need to secure paid work while pursuing licensure, and the lack of access to residency positions. “Ninety per cent of internationally trained physicians who have passed their qualifying exams are still unable to secure residency positions due to their limited number and inequitable distribution,” Dr. Bhuiyan told the audience. His co-presenter, Dr. Douaré, an IMG currently serving as the director of registration at the College of Physicians and Surgeons of New Brunswick, stressed the important role internationally trained physicians have in addressing Canada’s physician shortages, particularly in underserved, rural, and remote areas.
Attendees highlighted the fact that IMGs wanting to practise medicine in Canada lack a clear roadmap to guide them along the path to licensure, alongside the challenge of maintaining recency of practice when arriving in a new country. The fact that not all provinces have Practice Ready-Assessment (PRA) programs was also flagged as a challenge. Workshop participants agreed that more mentorship for IMGs would be helpful, along with one-stop-shop resources to better support immigrant doctors as they navigate the path to practising in Canada.
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Workplace-based assessment (WBA), a method for evaluating what doctors do in practice, was the focus of a session led by Dr. Eric Holmboe, CEO of Intealth and adjunct professor of medicine at Yale University School of Medicine, and Dr. Maxim Morin, director of Assessment at the MCC. Although described as a “young science,” the presenters emphasized that WBA is critical for enhancing medical training and ensuring that physicians can deliver safe, patient-centred care.
Dr. Holmboe explained that while many assessors rate performances based on a self-framework, in other words, what they would do themselves, WBA may provide more accurate and reliable objective ratings. “We need to know what the desired outcomes are,” Dr. Holmboe explained. “We have often relied on proxies like years of training, and processes, but these may not guarantee competence. We have challenges when we make inferences.” A revealing exercise had the workshop participants watch a brief physician-patient interaction and rate the candidate on a nine-point scale; the results in the room ranged from three to seven, though all had observed the exact same encounter.
To address this challenge, Dr. Holmboe and Dr. Morin outlined strategies for developing shared mental models suggesting that specific skills being assessed can play an important role in consistent and objective ratings. Assessors must also be trained to use assessment forms accurately and must clearly understand what they are looking for when making an assessment. “If people don’t know what they are looking for, they will only attend to certain things,” Dr. Holmboe said. The presenters argued that building a shared mental model requires a growth mindset, along with faculty acknowledging that they are not always an expert in every skill they are asked to assess and that they indeed may have their own deficiencies in history-taking, physical exams, counselling, or patient-centered communication. A growing body of evidence indicates that WBA may improve the quality and validity of results.
The session concluded with a discussion on the impact of well-trained assessors on the defensibility of WBA results, reinforcing the idea that rater training and shared mental models are key to achieving accurate, reliable, and defensible assessments.
Overall, Dr. Holmboe and Dr. Morin’s workshop highlighted the evolving nature of WBA and the ongoing need to refine assessment strategies through research, training, and practical application.
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Annual meeting attendees had their first opportunity to learn more about the National Registry of Physicians (NRP) and to see a working demonstration of the tool that will improve collaboration across Canadian jurisdictions by consolidating physician credential data in a centralized location. Ms. Turner, director of the Repository and Registration Centre at the MCC, and Mr. Osmond, associate registrar at the College of Physicians and Surgeons of Newfoundland and Labrador, described a tool that will revolutionize healthcare access in Canada by improving the accessibility, accuracy, and searchability of physicians’ credential data. The platform is the initial step towards physician portability and offers the potential of a national locum pool. The registry will list physicians’ demographic information, practice location, contact information, and Medical Identification Number for Canada (MINC), and will also list medical degrees and certifications, as well as any disciplinary actions. While the NRP platform is managed by the MCC, all data is owned by individual medical regulatory authorities (MRAs). Eleven out of 13 MRAs are now joining the NRP, with full onboarding anticipated to take approximately 12-18 months, beginning in April 2024.
1021 Thomas Spratt Place
Ottawa, ON Canada, K1G 5L5
T : 1-613-521-6012
F : 1-613-248-5234
E : [email protected]