Insights from our CEO: Dr. Viren Naik discusses the MCC’s future

In early March, the Medical Council of Canada (MCC)’s Council and leadership team undertook a strategic session to determine the next steps in the organization’s evolution. They discussed several topics including the modernization of assessments and registries to better serve the system of licensure and enable access to safe care. This session, held just two months after Dr. Viren Naik assumed the role of Chief Executive Officer (CEO) on January 1, 2024, will guide the MCC for the next one to three years. We sat down with Dr. Naik to chat about his vision for the organization’s future.

What inspired you to take on the role of CEO of the MCC, and what is your vision for the organization?

The MCC is an amazing team and family with deep dedication and pride in delivering high-quality products and services for safe patient care. I wanted to continue to be part of this team and take my turn serving as the captain.

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Under your leadership, what are the top priorities for the MCC in the coming year(s)?

My priorities are to:

Make the MCC a valued, relevant, and trusted partner in the system of certification and licensure.
Serve our candidates and partners with increased transparency and put them at the centre of our decisions, products, and services.
Ensure that the entire organization takes pride in their work and continues to focus on positively impacting the health care system.

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Following the recent strategic session with the MCC Council, can you highlight some key takeaways or initiatives that emerged from the discussions?

We hope the underlying theme that resonates across our strategic plan is our commitment to serve and support the system of regulation and licensure, ultimately aiming to safely bring more physicians to patients in Canada. As part of our evergreen three-year strategic plan, there is an increased focus on international medical graduates (IMGs), upon whom the Canadian health care system has always relied, and how to bring innovations to assessments and pathways to licensure to integrate them more quickly into the health care workforce. This also requires us to reevaluate the experience of our candidates, helping them navigate the many steps and complexities involved in practising in the Canadian context.

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Given Canada’s reliance on international medical graduates (IMGs) that you noted, can you tell us more about how you plan to support their integration into the Canadian health care system?

The quality of medical education and postgraduate (residency) education is heterogeneous around the world. Unfortunately, there are no international accreditation standards to determine substantive equivalence between the postgraduate education received by IMGs and the Canadian standard. In the absence of such standards, assessments have served for the selection into Canadian postgraduate and workplace-based practice-ready assessment programs for international graduates, from which they proceed to independent practice.

There are IMGs who do not qualify for these traditional opportunities. We need to explore other pathways to integrate those IMGs including more graduated licensure. Supervised practice as a clinical assistant or associate physician in hospitals and clinics can provide significant help and relief from increasing patient volumes for a supervising physician. Also, these alternative supervised pathways provide an opportunity for exposure to emerging competencies (e.g., electronic health records) and cultural competencies (e.g., Indigenous health) that may be unique to Canada.

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What are your views on corporate social responsibility, and how do you envision the MCC contributing positively to society through its activities?

Corporate social responsibility is a lens that is applied to all our activities at the MCC.

Equity, diversity and inclusion (EDI), for example, is a key MCC value, but it is a journey – not a destination. We are currently on this journey with several of our initiatives and with gracious partners who are helping us learn. While we have growing diversity within the MCC staff, we must do the same within our governance and committees – to inform our IMG strategies through lived experience. To do so, we need open, transparent, and purposeful recruitment processes. We must challenge one another to consider the EDI lens whenever possible, and slow down to make sure we are doing so, as the MCC is an agile, high-functioning and outcome-oriented organization. We want to ensure we are engaging our partners and creating space for them to lead us, so that anything that touches them is for them and by them.

A growing aspect of our collective responsibility is planetary health. There is no health without attention to planetary health. As a responsible steward of the planet, the MCC has embraced many green- and carbon-reducing initiatives, including mitigating travel where possible. Our modern and state-of-the-art building is also designed to conserve energy in several ways.

As we prepare the next generation of physicians to appreciate the importance of EDI and planetary health as a contributor to patient and population health, we are working on integrating these important objectives into our upcoming assessment blueprints.

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Why are independent, objective assessments still important in the medical field, and what impact do assessment and licensure have on the quality of health care provided in Canada?

Graduation from an accredited medical school or training program is an important measure of competence. Accreditation measures the system of education in a program, but the nuances of the curriculum and clinical experiences can vary from school to school.

While an objective assessment can’t measure everything expected of a physician, it provides a sampling across the breadth of competencies, as determined by a blueprint, to ensure that a national standard has been met, regardless of where someone has trained. For high-quality training programs, successful performance on examinations confirms the education received. Correspondingly, a poor performance can signal that care by a candidate may compromise patient safety. There is strong and emerging evidence that performance on objective exams correlates with patient outcomes, including complaints, hospital length of stays, and mortality.

A program of assessment triangulates training and exam performance with objective assessment of clinical performance in the workplace, allowing a candidate to demonstrate the knowledge, skills, and attitudes with greater professional authenticity. Workplace-based assessment that samples a breadth of clinical encounters using validated assessment tools complements testing to better inform certification and licensure decisions regardless of the training program.

Importantly, objective assessments, much like a driver’s license, are a measure of safety, not necessarily quality. Quality in health care delivery comes with experience and continued professional development, both crucial in the career of all physicians.

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You are often credited with transparency as a leader, how will you foster transparency at the MCC?

MCC is committed to transparency, always putting our candidates and partners at the centre of our decisions and communications.

Transparency is one of our core values. We prioritize transparency across the organization for decisions and directions by ensuring candidates are informed throughout their journey of credentialing and assessment, and by engaging with our partners to share challenges and leverage opportunities. As individuals and organizations charged with regulatory responsibilities, our collective and generalizable goal is the same – to bring safe health care access to patients in Canada. I believe that transparency not only accelerates our progress by leveraging synergies, but also allows us to learn from mistakes and challenges we have experienced. Our commitment to transparency was demonstrated during our recent cyber security incident.

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Looking ahead, what do you hope your legacy will be when reflecting on your time at the MCC?

My three Big Hairy Audacious Goals (BHAG) are that:

MCC credentialing, assessments, and certifications are valued by regulators for licensure to practise, and by candidates to proudly display on their walls.
MCC is recognized for its innovative and adaptable programs of assessment and registries that maintain the Canadian standard and is viewed as responsive to the needs of patients in Canada.
MCC is a workplace of choice, where people “work hard and play hard.” I have been fortunate to work alongside, coach, and mentor the next generation of leaders here.

Current playlist: Current car time listens include The Daily (New York Times) podcast or Taylor Swift tunes (yes, I have been accused of being a Swiftie).
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Currently reading: I’ve read 7 books in my life cover to cover, and they all begin with “Harry Potter and…”
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Dream dinner guests: Any of the current or former cast of Saturday Night Live. I admire the effort to deliver the “hits and misses” of that show every week amidst the complexity of global events. The breadth of guests would be a fun, fascinating, and full of laughs dinner party.
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Best advice: As a leader, ask questions more than making statements (a 3:1 ratio is ideal).
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Joy: Beyond my family (dog included – not always), I would list playing golf and hockey, and travelling. Travel has taught me to recognize that the world is both big and small at the same time, and that “our way” is almost never the only way. Finally, as a leader, nothing makes me prouder than “sending the elevator back down” and seeing someone shine.
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We are grateful to Dr. Naik for sharing his insights. His dedication and innovative approach will help the MCC navigate changes and achieve its objectives. Stay tuned for future developments as the MCC responds to the changing needs of candidates and licensure requirements in Canada while ensuring safe patient care through the assessment of students and physicians and enhanced management of physician data.