The Medical Council of Canada embraces a new governance structure

The Medical Council of Canada (MCC)’s 108th Annual Meeting took place virtually on October 3-4, 2020. The primary focus of this year’s meeting was our governance review. We are pleased that the review concluded with an agreement and a transformational decision regarding the MCC’s governance model made by Council members. During the October 4 session, Council voted to move to a smaller and skills-based Council and approved a new set of bylaws. As of October 5, 2020, we have begun the process of moving to this more modern, agile and responsive governance model that will facilitate creative collaboration within Council, within the organization, with stakeholders and ultimately, will benefit everyone living in Canada. The information that follows summarizes the governance review process, including the benefits of adopting this new structure, where we go from here, and why stakeholder engagement remains of critical importance to the MCC and to medical assessment in Canada.  

The governance review process

Our journey began at the September 2018 Annual Meeting, when Council mandated the MCC to undertake a formal governance review. The objectives of the governance review were to improve transparency, improve public accountability, promote diversity and adopt best practices for governance of a not-for-profit organization.

A working group was formed by Council, along with members of the MCC’s staff, to determine the principles, scope of work and deliverables for an RFP soliciting an external firm to conduct the governance review. In April 2019, a contract for the activities to be included in a governance review was signed with KPMG.  

The goal of the KPMG-led review was to consult broadly, with a focus on best practices for governance of a not-for-profit organization, provide feedback on the MCC’s current governance structure and function, present the findings and facilitate a discussion on necessary changes.  

Recommendations that resulted included multiple areas for improvement with respect to governance, options for change to the MCC’s governance structure including determination of the type and size of an effective governing board and areas of the bylaw requiring modification. KPMG also sought to the key challenges facing the MCC and its governance structure as it carries out its vision and mission. 

At the 2019 MCC Annual Meeting, KPMG reported their findings, provided an overview of best practices in governance for not-for-profit organizations and engaged Council during a facilitated workshop focused on determining the type and size of governing board most appropriate for the MCC. In a closed Council session, Council members agreed unanimously that the MCC should move to a Policy Board type model, consider a medium-sized range for the new Council and identify robust mechanisms to receive, consider and respond to stakeholder input.  

Following this session, the Executive Board was given the mandate to review the options and bring a recommended model to Council. This summer, we held a series of webinar sessions to continue the efforts towards development and implementation of a new governance model. Nearly two years of thoughtful discussions and workshops led and culminated in a vote by Council on October 4 to transition Council to a Policy Board type model.  

A Policy Board: Structure and benefits

A Policy Board focuses on strategic direction setting, allows members to truly live their fiduciary duty and confirms their accountability to the organization.   

The new Council will now consist of no more than 12 Councillors and must include:  

• three individuals with regulatory experience in health professions  
• three individuals who are current registrars of provincial or territorial medical regulatory authorities   
• three individuals who are experienced medical educators  
• three members of the public

To the greatest extent possible, at least half of the Councillors will be licensed to practise medicine in Canada or have held a license to practise medicine in Canada in the past three years at the time of their initial nomination and appointment. In order to recruit new dynamic and diverse members and allow the Governance and Nominating Committee to review the skills-matrix on a regular basis, a member will sit on Council for a maximum of nine years.  

In keeping with best practices of having fewer Committees of Council, the MCC will move from the current eight Committees of Council to two Committees which better reflect specific Roles and Responsibilities of Council:  

1. Finance, Audit and Investments
2. Governance and Nominating  

Members of the current Executive Board have agreed to make up the Transition Council and will guide our organization until the full membership of the new Council can be appointed. They are: 

• Dr. Jay Rosenfield: President 
• Dr. Bruce Wright: Vice President 
• Dr. Heidi Oetter: Chair, Finance, Audit and Investments Committee  
• Dr. Scott McLeod 
• Dr. Theresa Farrell 
• Dr. Cyril Moyse 
• Ms. Kate Wood
• Mr. Brian Mazer 

Dr. Karen Shaw will Chair the Governance and Nominating Committee.    

The prior Council will sit as the first advisory forum to the Transition Council in this first year to ensure continuity. 

Adopting this new robust and effective governance structure ensures that the MCC will meet its vision, mission and strategic goals, with identified areas for improvement, while continuing to foster stakeholder engagements and relationships.

Next steps

To build next year’s Council, the Governance and Nominating Committee will use a formal selection process to identify and recommend new members for appointment to the Council according to their skills, experience, and personal qualities and gap areas of expertise currently identified at the governance level.

The Council will seek a balance of skills, expertise and experience of its members, while considering any unique or special requirements of the MCC at the current time, and with consideration being given to principles of diversity. The Council will ensure all members possess the behavioural qualities necessary to perform their role as Councillors.

The path forward

As a prelude to our path forward, the MCC has increasingly engaged with its stakeholders during 2019–2020. From frequent discussions on today’s significant issues with fellow members of the Canadian Medical Forum, increased coordination and collaboration with the certifying colleges, to fostering true partnerships with learner organizations across the country and exchanging lessons learned with international medical councils, we have been reaching out to partners in medical care to a degree this organization has not seen before. The MCC truly values the breadth of skills and backgrounds that make up the inspired people it has the privilege of working with every day—staff, stakeholders and members of Council alike.  

We would like to thank our volunteers, the Universities, the Medical Regulatory Authorities, the learner organizations and public members for their contributions. 

We are looking forward with great enthusiasm and we eagerly anticipate engaging with stakeholders even more actively on the committees that will be defined as part of the new governance structure we are building together. We welcome input and invite you to contact us via our Get involved page.

Clarification of the role of learners in the new MCC governance structure