The Medical Council of Canada newsletter The ECHO highlights, at a glance, an assortment of MCC activities and milestones, revealing the range of developments, and progress made over the past months. Happy reading! click interactive icons [double tap if on a mobile device] click page to zoom click side arrows OR swipe page to advance or return MCC HEADQUARTERS CONSTRUCTION WELL UNDERWAY MCCQE Part I International MCCQE Part II application process physiciansapply.ca UPDATE MCC 360 CCME recap BITS & BYTES 2 5 7 9 12 4 6 11 MCCQE Part I International MCCQE Part II application process physiciansapply.ca UPDATE MCC 360 CCME recap BITS & BYTES JUNE 2016
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The Med i ca l Counc i l o f Canada
news le t te r
The ECHO highlights, at a glance, an assortment of MCC activities and milestones, revealing the range of developments, and progress made over the past months.
Happy reading! c l i c k i n t e r a c t i v e i c o n s [ d o ub l e t a p i f o n a mob i l e d e v i c e ]
c l i c k p a g e t o z o o m
c l i c k s i d e a r r o w s O R s w i p e p a g e t o a d v a n c e o r r e t u r n
MCC HEADQUARTERS CONSTRUCTION WELL UNDERWAY
MCCQE Part I International
MCCQE Part II application process
physiciansapply.ca UPDATE
MCC 360
CCME recap
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MCCQE Part I International
MCCQE Part II application process
physiciansapply.ca UPDATE
MCC 360
CCME recap
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It is tied to the Blueprint project, a review of how MCC’s exams reflect the reality of medical practice and the health-care needs of society today.
“There is greater focus on health promotion, illness prevention and psychosocial factors. Also, in terms of physicians’ activities, there is greater emphasis not only on being able to collect data from the patient, make a diagnosis, and manage care, but on communication, with patient families and with other professionals and colleagues as well.”
MCCis developing new orientation supports — and revamping an existing tool — to help international medical graduates challenge the Medical Council of Canada Qualifying Examination Part I (MCCQE Part I) equipped with a clear understanding of the expectations for Canadian physicians. These orientation supports are part of the MCCQE Part I International initiative to expand the delivery of the exam, making it more accessible to candidates worldwide.
MCC’s Evaluation Bureau Director, Yves Lafortune, explains that orientation supports are needed because the expanded delivery is only part of what’s happening to the MCCQE Part I.
For more details on the full project, see the June and December
2015 issues of ECHO
This is where orientation supports for candidates come in, helping them understand the standards Canadian physicians are expected to meet as well as how the exam works. While the emphasis is on preparing international medical graduates who may be unfamiliar with Canadian standards, Canadian graduates will also benefit from high-quality supports.
“The current self-administered examination (SAE) for use as a self-study tool will be completely revamped”, said Magdalena Serwin, Candidate Resource Development Officer in MCC’s Evaluation Bureau. “It will have new content and be on a new platform.” Clinical decision-making questions will be added to the current format.
Yves LafortuneDirector, Evaluation Bureau MCC
More fundamentally, the exam is changing in what it measures.
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Helping internat ional and Canadian graduates meet the chal lenge of the newMCCQE Part I
MCCQE Part I and MCCEE. “A survey can only do so much,” said Ms. Serwin, “so we want to dig a little deeper with focus groups.” On April 15 in Montreal, it held the first of many planned focus groups.
“We took the opportunity to leverage the Canadian Conference on Medical Education for this one,” said Ms. Serwin, as medical students from across the country were coming to Montreal for the event. The focus group included seven students from different regions. “Our purpose was to seek feedback on some of the preparatory resources that we are working on and to validate our work to date on these resources.”
For an hour and a half, Ms. Serwin and MCC Production Coordinator
Anne Spratt asked the students a series of questions based on a proposed table of contents for the preparatory guide and showed them a presentation on various types of self-learning tools such as webinars. The response was positive, with participants welcoming a preparatory guide with all required information in one place.
“It provided confirmation that we were on the right track.”
Enhanced preparatory supports are planned to launch in 2017 and 2018, with the launch of the MCCQE Part I International expected in 2019.
Other “brand-new” tools are coming, said Ms. Serwin. The first is a preparatory guide to familiarize candidates with the exam content, the Blueprint, computer-based exams in general, and question types. In addition to the SAE, candidates can try to complete MCCQE Part I full preparatory exams, at their own pace or under simulated test and timing conditions. As well, other self-learning tools will be developed by MCC, and resources created by other organizations for the MCCQE Part I will be repurposed to help candidates prepare.
To ensure these supports are meeting candidates’ needs, MCC has been conducting surveys of students who have completed the
The Government of Canada (Foreign Credentials
Recognition Program - Labour Market Integration) has approved $6.7 million in funding over 3.5 years to the Medical Council of
Canada for Streamlined and Equitable Assessment for
Foreign-Trained Physicians, it was announced March
31, 2015. This funding will be used to support
an international and more flexible delivery of the
MCCQE Part I, including the development of
new tools supporting exam development and
administration. The project also involves the creation
of new orientation supports.
Magdalena SerwinCandidate Resource Development Officer, Evaluation Bureau, MCC
We asked, is this what they would want? Would they find it beneficial?
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1of 30 top
employers
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The National Capital Region’s Top Employers is an annual competition recognizing employers in the Ottawa-Gatineau metropolitan areas that have created exceptional workplaces. The competition has been run since 2006 by the editors of Canada’s Top 100 Employers. The winners are published in an annual magazine by partner publication the Ottawa Citizen.
The Medical Council of Canada (MCC) has once again been selected as one of the National Capital Region’s Top Employers for the 5th consecutive year. Employers are compared with other organizations in their field to determine which offer the most progressive and forward-thinking programs, in categories such as:
• physical workplace• work and social atmosphere• health, financial & family benefits• vacation and time off• employee communications• training and skills development• community involvement
The designation reflects MCC’s commitment to fostering an inclusive environment where employees contribute to the health and wellbeing of Canadians.
The MCC selected as a Top Employer in the
National Capital Region for 2016
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T h eapplication process for the Medical Council of Canada Qualifying Examination (MCCQE) Part II is changing to enhance access and fairness for potential candidates and to respond to feedback from the community, given continuing limited capacity for the exam.
Application for a spot in the next exam is no longer “first come, first served” for sessions with limited capacity. Instead, for registration for the fall 2016 exam, MCC has piloted a new process that involves a “pre-application” period, during which potential candidates can
indicate their interest in applying through their physiciansapply.ca account. Their names are added to a pre-application list.
The MCC then randomly selects candidates from the pre-application list. The number of selected candidates is determined by exam capacity that has been allocated across candidate groups. Those selected receive invitations to apply to the exam.
This change will help MCC manage continuing limited capacity at the spring and fall exams, despite efforts to expand capacity wherever possible at both sessions. Among these efforts, in September 2015, MCC approved a by-law change that allows PGY-1 candidates to challenge the MCCQE Part II just before completing their first year of residency. This change, to allow candidates to challenge the exam earlier in their residency, will lead to a more even distribution of examinees between the spring and
fall sessions. Residents can now take the spring exam if they are expected to finish their PGY-1 by June 30 and are selected through the registration process. Those who pass are awarded their Licentiate once completion of 12 months of postgraduate training is confirmed.
Capacity has been expanded by opening additional sites, and reallocating spots previously reserved for Certification Examination in Family Medicine candidates. But physical limitations of exam sites and the number of physician examiners available continue to constrain capacity.
Information about the change to the application process has been communicated through various channels — existing distribution lists, postgraduate medical education offices, and the MCC website — to reach stakeholders and potential candidates.
Changes to application process for the MCCQE Part II give candidates a fair shot at an exam spot
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Additional details coming soon.
All candidates who pre-apply have an equal opportunity to be selected. Their chance of being selected is not affected by signing up early in the pre-application period or by adding their name to the pre-application list multiple times (only the latest pre- application attempt is registered).
BUILDING TRUST THROUGH TRANSITIONS: A PROFESSIONAL RESPONSIBILITY
coming to A d d i n gCanadian graduates’ medical degree information to the online portal at physiciansapply.ca will bring it a step closer to becoming a “one-stop shop” for Canadian physicians’ credentials. But Canadian graduates will need to upload an image of their diploma to round out their credential file.
While medical degrees from international medical graduates are now deposited, authenticated through source verification, and stored in the physiciansapply.ca system, the same has not been true of all Canadian graduates’ degrees. But that is changing.
Each year, MCC gets a convocation list from each Canadian medical school, said Pierre Lemay, Director of the Repository and Registration Centre at MCC. Those lists will be uploaded, creatinga source-verified record of graduation anda “placeholder” for the degree in physicians’accounts in physiciansapply.ca.
Some provincial/territorial medical regulatory authorities (MRAs) require documentary proof of the medical degree. To facilitate sharing of the degree, the
Pierre LemayDirector Repository and Registration Centre, MCC
Canadian graduates’ medical degree information will now be received and added to physiciansapply.ca
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physiciansapply.ca account about a month after convocation for information about the new system. Once the record of graduation is available, the diploma image can be added.
Canadian specialty credentials are the next step for physiciansapply.ca, and he said the current plan is to allow physicians to upload these in about one year’s time.
physiciansapply.ca is also home to the Application for Medical Registration (AMR). Launched in February 2014, AMR allows physicians to apply for a medical licence or practice permit to multiple MRAs using a common application process. The credentials, including the medical diploma, in physiciansapply.ca can “prepopulate” the AMR, said Mr. Lemay, saving steps for those using AMR to make their application. He said five provincial /territorial MRAs are currently using the AMR, and another five are expected to be on board by the end of 2016.
MCC is launching an uploading function that will allow Canadian graduates to easily upload images in common image formats. Once available, Canadian graduates will be encouraged to add an image of their diploma to their account in anticipation of future licensure.
Mr. Lemay said 2016 graduates should start checking the MCC website and their
Recognizing that physicians need to be more than medical experts and that assessment is more than examinations, the MCC has embarked on a national project to incorporate multisource feedback into physician quality assurance and improvement programs.
The project builds on a “360-degree” evaluation tool first developed in 1999 by the College of Physicians and Surgeons of Alberta (CPSA) with the University of Calgary. Now transferred to the MCC, it has been renamed “MCC 360” and is the cornerstone of the project. The tool uses surveys
Assessment o f “ so f te r sk i l l s ” th roughou t t ra in ing and p rac t i ce : FE
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the MCC 360 – Multisource Feedback project
to collect feedback from the physician him- or herself, coworkers (such as office staff), colleagues (such as other physicians and allied health professionals), and patients, concerning the physician’s “softer skills.”
“There are a number of competencies required to be a good physician: communication and collaboration, professionalism, advocacy on behalf of your patients, managing your practice, leadership, and scholarly skills. We need to pay attention to all of those.” said Dr. Karen Mazurek.
Following the survey process, a report is produced “to identify areas of strength and areas to improve, so physicians have some data available to them to look at how they can improve their practice,” explained Ms. Cindy Streefkerk, Project Lead with MCC’s Psychometrics and Assessment Services.
But the Multisource Feedback project will include more than the MCC 360, she said. “The project includes the tool, standards, national comparisons of scores, but it is a broader program, including survey service delivery, offering feedback supports and research to inform best use of the tools.” Multisource feedback will typically form one part of a comprehensive quality assurance/quality improvement process for physicians.
The impetus to develop multisource feedback on the national scale came from across the country.
“In Alberta, we developed the tool for doctors in our province, and then other provinces started to ask
To be a physician is so much more than being just a medical expert...
Dr. Karen MazurekChair, MCC 360 –
Multisource Feedback Committee; Deputy Registrar of the CPSA
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potential to improve physicians’ skills across the continuum, “from the minute we get into medical school until we leave the practice of medicine,” emphasized Dr. Mazurek.
Governance of the multisource feedback project is a collaborative effort, said Ms. Streefkerk, including users and non-users, certification colleges, representatives from undergraduate
and postgraduate medical education, continuing professional development, and researchers.
This is where MCC came in. “We’re looking to standardize and enhance the tool and also to improve the reporting so that the physician can start improving based on the data,” said Ms. Streefkerk. The project to reach these goals is expected to take about three years, after which multisource feedback will become a continuing MCC program.
Multisource feedback represents a move toward in-practice assessment as a valuable addition to traditional exam-based assessment, said Ms. Streefkerk. It has the
“They will bring forward that national view on the tool to help us make decisions.” Four working groups are considering research to support evidence-informed changes to standards, feedback supports, and operational survey service delivery.
“My vision is that every physician in our country will participate in this kind of 360-degree process at one or more points in their careers,” said Dr. Mazurek. “And they’ll want to do it because the feedback that they’ll get will be helpful to them in providing good care to their patients.”
For more information about the MCC 360 – MSF project:
us if they could use it. It became evident that a number of different organizations and people wanted to do the same thing,” said Dr. Mazurek. But maintaining the tool and developing it further proved challenging. “We recognized that we had a lot of areas where we needed to to improve the tool. It’s not an easy job to create a tool like this; it’s hard work!”
A fee of $195 per submission payable to the Medical Council of Canada (MCC) is now in effect forthe Application for MedicalRegistration (AMR) onphysiciansapply.ca.Candidates using the AMRwill have this MCC feecharged to their account.The MCC fee is in additionto any fees chargedby medical regulatoryauthorities (MRAs).
FEE:
$ 1
95
The MCC fee was initially waived when the AMR was launched in February 2014. At that time, only a few MRAs were using the AMR, and a MCC fee would have unduly penalized those candidates who needed to apply via the AMR.
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Fee now in effect for Application for Medical
Registration
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Currently, 5 MRAs are using the AMR, with poised to come on board in 2016. MCC is therefore introducing the fee in order to maintain and improve the application process for all physicians and jurisdictions.
another 5 MRAsby end of 2016
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All involved are excited to call home the new building at 1021 Thomas Spratt Place starting in fall 2016.
During its meeting on April 9, 2016, the Executive Board completed a site visit of the new MCC building. The entire project, from construction to communications, to change management, is entitled Chrysalis to represent the transformation that will arise from moving to this new and brighter space. Project Chrysalis continues to involve broad participation of staff, including representatives from across the organization forming the Change Champions Team. Most recently, the MCC involved its staff and the Executive Board in a boardroom naming contest, with the final winning submissions to be revealed over the summer months.
Photo on over page
During its meeting on April 9, 2016, the Executive Board completed a site visit of the new MCC building. The entire project, from construction to communications, to change management, is entitled Chrysalis to represent the transformation that will arise from moving to this new and brighter space. Project Chrysalis continues to involve broad participation of staff, including representatives from across the organization forming the Change Champions Team. Most recently, the MCC involved its staff and the Executive Board in a boardroom naming contest, with the final winning submissions to be revealed over the summer months.
The annual Canadian Conference on Medical Education (CCME), held April 16 to 19, 2016, in Montreal, gave the Medical Council of Canada (MCC) an unparalleled opportunity to meet with stakeholders, let them know what MCC is doing, and get their feedback. The conference theme Accountability: From Self to Society was reflected in two pre-conference workshops, a business session, and a wide range of presentations involving MCC staff.
Presenta t ions on the fu ture o f the MCCQE Part I & Part II a t the CCME
Dr. Marguerite Roy said that MCC’s work cannot be independent. “Making sure everything is aligned and integrated” is a big part of why it is important to discuss issues with faculty and students from Canada’s medical schools.
MCC staff said that the conference also allows them to learn about the research going on at Canada’s medical schools, often far in advance of its publication. “We’re really lucky in Canada,” said Dr. Roy. “A lot of the big names in medical education are Canadian, and at the conference you get one-on-one time with them.”
In addition to representing MCC formally and informally at the conference, MCC staff found that what they learn influences where MCC is headed. Dr. Roy found that
several presentations at previous conferences led to important publications that have influenced the use of qualitative data in assessment and conceptions of validity, as just two examples.
“One session I attended has made me think about how we could reframe both our rating scales and the orientation we give the physicians who score our objective structured clinical exams,” Dr. Smee mentioned as another example. The influence works in the other direction as well, she said. “There are real synergies.” Medical schools can quickly conduct studies on interesting issues in medical education. “Sometimes you tell a school about something, and they go ahead and do it!”
Crystal ball gazing was the title of MCC’s business session on what the future holds for the new MCCQE Part I and Part II. The session highlighted the direction of the MCC’s Blueprint project, which is reviewing how well the examinations reflect the reality of medical practice
Understanding the context for our stakeholders is all part of doing our jobs.
Dr. Sydney Smee Assessment Advisor, MCC
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MCC’s Ilona Bartman made a presentation on Canadians studying abroad, looking at where they study and what specialties, with MCC’s Sirius Quin. They also joined with MCC staff Dr. Marguerite Roy, Josée Wojcik and Dr. Sydney Smee for a presentation on including the standardized patient perspective in OSCEs. The same group with MCC’s Mathieu Levesque (excluding Sydney Smee) presented on training standardized patients as assessors for multi-site OSCEs. Finally, Ilona Bartman made a presentation on assessment of electronic health record competency with colleague Saad Chahine from Western University.
As well, MCC’s Jocelyne Boyer-Richer presented a poster of her study on whether medical experts can accurately predict the difficulty of qualifying exam questions:
MCC’s Dr. André De Champlain led a pre-conference workshop on psychometrics for the medical educator and, with MCC colleagues Dr. Fang Tian and Dr. Marguerite Roy as well as Dr. Marilyn Singer of the University of Manitoba, made a presentation on Manitoba’s experience with standardized measures in predicting success in practice-ready assessment (PRA).
Dr. Claire Touchie co-led a workshop on the art and science of writing good examination questions for clinical decision-making, with MCC staff member Tanya Rivard and MCC Central Examination Committee Vice-Chair Dr. Debra Pugh. Dr. Touchie was also one of eight authors of a presentation on whether objective structured clinical examination (OSCE) scores predict performance on a national exam. A third presentation, with Dr. Teresa Cavette of the University of Manitoba, was on balancing self and professional responsibilities.
and the health-care needs of society today. The session highlighted candidate orientation tools — both those currently available and additional preparatory materials being planned. Speakers were Executive Director Dr. Ian Bowmer, Chief Medical Education Advisor Dr. Claire Touchie, and Assessment Advisor Dr. Sydney Smee. The slide presentation at the business session has been made available after the conference.
Prediction of MCQ question difficulty: an exercise in futility
