On November 1, 2018, Dr. Maureen Topps succeeded Dr. Ian Bowmer as Executive Director and CEO of the Medical Council of Canada (MCC). We asked her about her career in the medical field and her vision for the organization.
Q: You have experience as a family doctor, as a medical educator, in administration of medical education, in accreditation, as well as in physician evaluation. There are some themes that run through your career — you clearly care about rural medicine and medical education. Why have these been a focus?
A: I actually grew up in a very rural environment in Scotland; there were only 12 people in my high school class. My first Canadian experience in practice took place in a small town in Alberta, where I spent almost 10 years. From that time until I moved to Calgary in 2011, I hadn’t actually lived in a very large city before in my life. In rural medicine, I enjoyed the collaborative nature of the medical services, the fact that everyone has to rely on everyone else, and the tremendous relationships that you develop with individuals over time. You can’t beat a small rural town or regional centre for the team, patient and family interactions that occur in great depth in the provision of health services.
Q: Medical education and evaluation are a continuum, and there’s a lot of interest in how that plays out throughout the physician life cycle. Where do you think that’s going in Canada?
A: I think it’s a huge growth area. We train physicians to develop particular skill sets, but these need to be maintained and also adapted to the contexts in which they provide care throughout their career. The time physicians spend in formal education is quite short compared to the time they spend in practice and the provision of care. The Canadian public looks to the leaders in medical education and assessment, including the MCC as a key stakeholder, to attest that the physician who is taking care of you is well trained and has maintained their competence throughout their career.
Q: What drew you to the MCC?
A: I have had the opportunity to work on several MCC committees over the past few years, and I was very taken by how forward looking the MCC is. It is leading the way with changing models of physician assessment and engages extensively with multiple stakeholders through the work it is doing. I also very much like the fact that it is a very effective and efficient organization. In observing the tremendous capabilities of staff members supporting the various committees, it allowed me to develop so much admiration for how the MCC functions, and how it is organized and run. It always seemed to have such a positive culture, and that’s been validated by my brief experience as Executive Director and CEO.
Q: How do you see the role of the MCC evolving?
A: As a national and international leader in assessment, the MCC has tremendous capabilities with all our current models of assessment. We’ll be looking at expanding those capabilities — working to provide expanded feedback on any gaps identified through assessment and considering the introduction of novel methods of assessment. For instance: how do we assess physicians appropriately in this age of information technology? Why are we so focused on learned and retained book knowledge rather than looking at physician interactions with patients and the extended health care team and seeking out information about these activities in the way we would do in practice? There are many ways we can assess individuals, and the MCC is very well positioned to be a leader with innovative methods including leveraging how we integrate information technology as it is now used to augment clinical care, and considering how to best assess team based interactions.
Q: What do you see as your role in helping the MCC reach its goals? Do you have specific objectives for the MCC?
A: I see the need for extensive collaboration with multiple stakeholders. Also making sure the MCC keeps abreast of new mechanisms of assessment and is able to evaluate them critically. The MCC has a tremendous ability to do this, given its focus on research and development and the expertise found among its psychometricians and educational experts. We need to still use but move beyond the psychometrics of written assessments and determine how to make best use of qualitative and narrative components of assessment. So we’re looking at natural language processing and the use of qualitative feedback in tandem with current models of Clinical Decision Making and written answers to Multiple Choice Questions. We also need to look more at assessing outcomes and the process by which individuals come to certain decisions instead of simply assessing the decision itself.
Q: When you’re not working on medical excellence in Canada, how do you spend your time?
A: Flying around the country! In the summer, I like to get on my bike and, in the winter, I am a downhill skier. I have a great group of friends we call “the famous five” with whom I like to travel — last summer we went to Iceland. My husband, Dr. David Topps, Medical Director of Rural Education at the University of Calgary, will be on sabbatical next year, so he will spend a fair amount of time in Ottawa, and he will be bringing with him our two dogs and a cat. I will also be taking care of my daughter’s two cats, so we will have quite the menagerie of animals around us. When you’re living apart from other family members, having four-legged friends around the house is a good thing.