1
Presented by :
Pathway to Medical License Certification in Canada
Dr. Gary Srebrolow LLB, DDS, BSc, FCLMChair of Health Law Group Blaney McMurtry LLP
Blaney McMurtry LLP
Please be advised that the information on these slides is not intended as legal advice. Individuals are advised to contact their own Health Law lawyer to obtain advice regarding their own circumstances and situation.
2
Health Law GroupImmigration GroupReal Estate & LeasingLabour & EmploymentCorporate & CommercialLitigation – Insurance DefenceFamily LawWills & EstatesPrivacy
Blaney McMurtry LP - Full Service Law Firm
44
SpeakersSpeakersDr. Gary SrebrolowDr. Gary Srebrolow
Chair of Health Law Group Chair of Health Law Group Insurance DefenceInsurance DefencePast DentistPast Dentist
Ian EpsteinIan EpsteinPartner Partner Past Managing PartnerPast Managing PartnerImmigration / Insurance Defence / Health Law Immigration / Insurance Defence / Health Law
Suzanne BaileySuzanne BaileyImmigrationImmigrationInsurance Insurance DefenceDefenceOn On Executive of the Citizenship and Immigration Executive of the Citizenship and Immigration Canada section of the Ontario Bar Association Canada section of the Ontario Bar Association
3
55
Seminar OverviewSeminar Overview1.1. AIPSOAIPSO2.2. IMG History & BackgroundIMG History & Background3.3. IMG Intake IMG Intake -- CEHPEACEHPEA4.4. CPSO CertificationCPSO Certification5.5. MOH ProgramsMOH Programs6.6. IMGsIMGs in Western Canadain Western Canada7.7. Immigration issuesImmigration issues8.8. Questions & AnswersQuestions & Answers
66
AIPSOAIPSONon-profit, independent professional association
Represents internationally trained physicians and surgeons Mission: Integration of internationally-trained physicians into the Canadian health care systemInformation sourceNetworkingAdvocacyFounded in 1998 with 70 membersNow more than 2000 registered physicians - 105 countries
4
77
IMG History & BackgroundIMG History & Background1998: CPSO and Ontario Medical Schools began to 1998: CPSO and Ontario Medical Schools began to look at ways of assessing and training look at ways of assessing and training IMGsIMGs2002: Development of IMG assessment program2002: Development of IMG assessment program2004: IMG Ontario2004: IMG Ontario
OneOne--stop entry point for stop entry point for IMGsIMGsAssessment and trainingAssessment and training165 165 IMGsIMGs in 2004in 2004
2007: 2007: IMG Ontario ceases operationIMG Ontario ceases operation2008: CEHPEA begins operation2008: CEHPEA begins operation
Centre for Evaluation of Health Professional Educated AbroadCentre for Evaluation of Health Professional Educated AbroadTransfer of Evaluation and Assessment Programs to CEHPEATransfer of Evaluation and Assessment Programs to CEHPEACEHPEA is now the entry point for CEHPEA is now the entry point for IMGsIMGs in Ontarioin Ontario
88
Ontario IMG Stats Ontario IMG Stats IMG Ontario CertificatesIMG Ontario Certificates
1637
2402 2511 2638 27472961
3279
481828 962 1069 1082 1247 1403
0
500
1000
1500
2000
2500
3000
3500
1997 2002 2003 2004 2005 2006 2007
Total Certificates IMG Certificates
Total Certificates include: Independent, Restricted, Short Total Certificates include: Independent, Restricted, Short Duration, Academic and Duration, Academic and PostgradPostgrad
5
99
Ontario IMG Stats Ontario IMG Stats 2007 Certificates by MD Source2007 Certificates by MD Source
2007 Total Certificates
Ontario, 35%
Other Canada, 20%
IMG, 43%
USA, 2%
Ontario Other Canada USA IMG
2007 Total Certificates: 32792007 Total Certificates: 3279
1010
Ontario IMG Stats Ontario IMG Stats
IMG Independent Practice Certificates
107 122146
169192
215 229275
050
100150200250300
2000 2001 2002 2003 2004 2005 2006 2007
IMG Independent Practice Certificates
6
1111
IMG INTAKE IMG INTAKE -- CEHPEACEHPEA
1212
CEHPEA Background InfoCEHPEA Background InfoNot for ProfitNot for ProfitFunded by MOHLTCFunded by MOHLTCWorks in conjunction with CPSO / RCPSCWorks in conjunction with CPSO / RCPSCEvaluation and Assessment functionsEvaluation and Assessment functionsResident selection by University ProgramsResident selection by University ProgramsAssumed IMGAssumed IMG--Ontario backlogOntario backlogOnOn--site written and clinical examssite written and clinical exams2 Streams:2 Streams:
1. Family Medicine1. Family Medicine2. Specialist2. Specialist
Training ProgramsTraining ProgramsPrePre--Residency Program for Family Medicine Residency Program for Family Medicine Orientation to Training and Practice in CanadaOrientation to Training and Practice in Canada
7
1313
CEHPEA CEHPEA -- ProcessProcess1.1. Eligibility (Screening):Eligibility (Screening):
Must meet Must meet ““Basic RequirementsBasic Requirements”” and and ““Additional RequirementsAdditional Requirements””PostgradPostgrad training training
2.2. Examinations:Examinations:AllAll applicants Invited to participate in written and/or clinical skapplicants Invited to participate in written and/or clinical skills ills examinations if meet above requirementsexaminations if meet above requirements
3.3. Interviews:Interviews:Selected based on Application Review and Exam resultsSelected based on Application Review and Exam resultsFurther assessment of clinical skillsFurther assessment of clinical skills
4.4. File Review:File Review:Review of application, exams, skills assessment and interviewReview of application, exams, skills assessment and interviewDetermine candidates most likely to succeed Determine candidates most likely to succeed –– DiscretionaryDiscretionary
5.5. Selection:Selection:PGY1: Family Medicine or SpecialtyPGY1: Family Medicine or SpecialtyPGY2: SpecialtyPGY2: SpecialtyPRA: Practice Ready Assessment (Family Medicine or Specialty)PRA: Practice Ready Assessment (Family Medicine or Specialty)Overall: 200 + positions yearlyOverall: 200 + positions yearly
1414
CEHPEA CEHPEA –– Basic RequirementsBasic RequirementsCurriculum VitaeCurriculum VitaeCanadian Immigration StatusCanadian Immigration StatusEnglish Language ProficiencyEnglish Language ProficiencyMCCEE Exam MCCEE Exam –– Passing GradePassing GradeMCCQE1 Exam MCCQE1 Exam –– Passing GradePassing GradeMD MD -- listed in World Directory of Medical Schoolslisted in World Directory of Medical SchoolsMedical School Transcripts Medical School Transcripts –– NotarizedNotarizedCandidate Disclosure Candidate Disclosure
Signature requiredSignature requiredAgree that have made full disclosureAgree that have made full disclosurePermit CEHPEA to contact othersPermit CEHPEA to contact othersAllow CEHPEA to share your infoAllow CEHPEA to share your infoAcknowledge false application will be rejectedAcknowledge false application will be rejected
8
1515
CEHPEA CEHPEA Additional RequirementsAdditional Requirements
Postgraduate Medical EducationPostgraduate Medical EducationFor PGY2 or PRA, need at least 1 year of PG trainingFor PGY2 or PRA, need at least 1 year of PG trainingMay be known as Intern, resident or house officer May be known as Intern, resident or house officer Observer or Research Fellow does not count Observer or Research Fellow does not count Notarized copy of diploma/degree/certificate requiredNotarized copy of diploma/degree/certificate required
Independent Professional PracticeIndependent Professional PracticeFor PRAFor PRAWithin last 5 years of date of applicationWithin last 5 years of date of applicationIndependent Practice Independent Practice –– No supervisionNo supervisionObserver or Research Fellow does not countObserver or Research Fellow does not countNeed letter from University, hospital or licensing authorityNeed letter from University, hospital or licensing authority
1616
CEHPEA ExamsCEHPEA Exams
9
1717
CEHPEA ExamsCEHPEA Exams
Comprehensive Clinical Exam 1 (CE1)Comprehensive Clinical Exam 1 (CE1)
Specialty Written Exam (SWE)Specialty Written Exam (SWE)
Specialty Clinical Exam 2 (CE2)Specialty Clinical Exam 2 (CE2)
1818
CE1 EXAMCE1 EXAMBroad based comprehensive clinical examBroad based comprehensive clinical examFor PGY1 level (Family Medicine or Specialty)For PGY1 level (Family Medicine or Specialty)Also for some SpecialtiesAlso for some Specialties
AnesthesiaAnesthesiaGeneral SurgeryGeneral SurgeryOrthopedic SurgeryOrthopedic SurgeryOtolaryngology Otolaryngology –– Head and Neck SurgeryHead and Neck SurgeryPathologyPathologyPsychiatryPsychiatry
12 stations with clinical problems12 stations with clinical problemsScores valid for 3 yearsScores valid for 3 yearsMaximum of 3 attemptsMaximum of 3 attemptsFeedback Report availableFeedback Report availableStudy GroupStudy GroupConsider mentor and tutoring by Ontario physician Consider mentor and tutoring by Ontario physician
10
1919
SWE EXAMSWE EXAM
For PGY2 or PRA (Specialty)For PGY2 or PRA (Specialty)Specialty Specific written examsSpecialty Specific written examsMultiple choiceMultiple choiceScores valid for 3 yearsScores valid for 3 yearsCan repeat exam to better scoreCan repeat exam to better scoreMost recent score counts (even if fail)Most recent score counts (even if fail)
2020
CE2 EXAMCE2 EXAMFor PGY2 or PRA (Specialty)For PGY2 or PRA (Specialty)Specialty Specific clinical examsSpecialty Specific clinical examsPatient stations and interactionsPatient stations and interactionsScores valid for 3 yearsScores valid for 3 yearsCan repeat exam to better scoreCan repeat exam to better scoreMost recent score counts (even if fail)Most recent score counts (even if fail)
Need to pass both SWE and CE2 (and CE1) Need to pass both SWE and CE2 (and CE1) for Specialty programsfor Specialty programs
11
2121
CEHPEA CEHPEA -- InterviewInterviewSpeak to past applicantsSpeak to past applicantsPrepare for interview but do not overPrepare for interview but do not over--prepareprepareOpportunity to assess your personalityOpportunity to assess your personalityOpportunity to screen Opportunity to screen ““Red FlagsRed Flags””::
English (Language) problemsEnglish (Language) problemsCommunication problemsCommunication problemsPersonality problems Personality problems –– i.e. accept criticismi.e. accept criticismAttitude Attitude –– can you work with otherscan you work with othersLikeabilityLikeabilityClinical SkillsClinical Skills
Have a career plan in placeHave a career plan in placeHave a backHave a back--up planup planDonDon’’t oversell yourselft oversell yourself
2222
CEHPEA CEHPEA –– File ReviewFile ReviewSuccess Factors:Success Factors:
Background and trainingBackground and trainingPractice ExperiencePractice ExperiencePerformance on examsPerformance on examsPersonality and interpersonal skillsPersonality and interpersonal skillsAre you committed?Are you committed?Are you desperate and does it show?Are you desperate and does it show?Will you work well with supervisors who may be Will you work well with supervisors who may be younger and less experienced than you?younger and less experienced than you?Will you be a Will you be a ““know it allknow it all””Do they see you as a Do they see you as a ““riskrisk”” to leave to leave Do you have good command of EnglishDo you have good command of English
12
2323
CEHPEA SELECTIONCEHPEA SELECTION
2424
CEHPEA CEHPEA –– PGY1PGY1First Year of PG or residency trainingFirst Year of PG or residency trainingFamily Medicine or SpecialtyFamily Medicine or SpecialtyFamily Medicine: 2 yearsFamily Medicine: 2 yearsSpecialty: 4 Specialty: 4 –– 5 years5 yearsFinal placement/selection by programFinal placement/selection by programNeed a Certificate of PG Training from CPSONeed a Certificate of PG Training from CPSOExpected to obtain CFPC CertificationExpected to obtain CFPC CertificationCan also apply to Can also apply to CaRMSCaRMS (Matching Program)(Matching Program)
IMG streamIMG streamResidency statusResidency statusMDMDMCCEEMCCEEEnglishEnglishPreference given to CEHPEA applicantsPreference given to CEHPEA applicants
13
2525
CEHPEA CEHPEA –– PGY2+PGY2+22ndnd (or higher) Year of PG residency training(or higher) Year of PG residency trainingSpecialties: 1 Specialties: 1 –– 4 years of training4 years of trainingAmount of training depends on candidateAmount of training depends on candidateAssigned to Ontario residency program Assigned to Ontario residency program Selection of candidates is responsibility of the Selection of candidates is responsibility of the program directors of the respective residency program directors of the respective residency programsprogramsCEHPEA is not involved in selection processCEHPEA is not involved in selection processNeed a Certificate of PG TrainingNeed a Certificate of PG TrainingExpected to obtain RCPSC CertificationExpected to obtain RCPSC Certification
2626
CEHPEA CEHPEA –– PRAPRAPractice Ready AssessmentPractice Ready Assessment6 month assessment in a 6 month assessment in a supervised clinical setting in an supervised clinical setting in an Ontario medical schoolOntario medical schoolNeed a PG Certificate from CPSO Need a PG Certificate from CPSO After assessment After assessment –– 3 outcomes:3 outcomes:
1. Ready for Certificate1. Ready for Certificate2. Need more PG training (up to 2 yrs)2. Need more PG training (up to 2 yrs)3. Unsuitable 3. Unsuitable –– DismissedDismissed
If successful If successful –– 5 year monitored 5 year monitored specialty practice in under serviced specialty practice in under serviced Ontario communityOntario communityReturn of Service Agreement (ROS)Return of Service Agreement (ROS)Restricted Certificate to Practice for 5 yearsRestricted Certificate to Practice for 5 years
14
2727
CPSO CERTIFICATIONCPSO CERTIFICATION
2828
1.1. Submit ApplicationSubmit Application –– Credentialing and Credentialing and AssessmentAssessment
2.2. Registration Staff Review Registration Staff Review –– Anything missing Anything missing or any Red Flags will result in denial and or any Red Flags will result in denial and referral to Registration Committee (RC) for referral to Registration Committee (RC) for further reviewfurther review
3.3. Notice of review sent outNotice of review sent out4.4. Additional Materials can be submitted to RCAdditional Materials can be submitted to RC5.5. RC reviews file and additional submissionsRC reviews file and additional submissions6.6. Lawyer can assist/clarify Registration issuesLawyer can assist/clarify Registration issues6.6. Decision releasedDecision released
CPSO CPSO Application ProcessApplication Process
15
2929
Carefully complete all formsCarefully complete all formsLegibleLegibleSpellingSpellingGood command of EnglishGood command of EnglishGet help if requiredGet help if required
Include all information Include all information –– lack of lack of information will put you at bottom of information will put you at bottom of pilepileDo not make false or misleading Do not make false or misleading statementsstatementsHandle Handle ““Red FlagRed Flag”” questions you questions you answer answer ““YesYes”” to very carefully to very carefully Get legal help if have something to hideGet legal help if have something to hideBe polite to CPSO staff as they can Be polite to CPSO staff as they can bury your Applicationbury your ApplicationObtain good Reference LettersObtain good Reference Letters
CPSO CPSO –– Application TipsApplication Tips
3030
““Red FlagRed Flag”” IssuesIssues
16
3131
8 Members8 Members6 Physicians6 Physicians2 Public members2 Public members
Meet 10 times per yearMeet 10 times per yearReview stacks of ApplicationsReview stacks of ApplicationsTime from Application to Time from Application to Decision can be 6 Decision can be 6 –– 8 months8 months
CPSO CPSO Registration CommitteeRegistration Committee
3232
Health Professions Appeal & Review BoardHealth Professions Appeal & Review BoardHPARBHPARBTribunal, but court likeTribunal, but court likeCPSO will have counselCPSO will have counselApplicant can have counselApplicant can have counselPaper Review or HearingPaper Review or HearingRecommend HearingRecommend HearingAfter HPARB After HPARB –– can appeal to Divisional Courtcan appeal to Divisional Court
CPSO CPSO –– AppealsAppeals
17
3333
CPSO Certification OptionsCPSO Certification OptionsComplete PG Training or PRAComplete PG Training or PRA
WhatWhat’’s Next?s Next?
How do you get a Certificate of How do you get a Certificate of Independent Practice from CPSO?Independent Practice from CPSO?
3434
CPSO CertificationCPSO CertificationAfter Ontario PG TrainingAfter Ontario PG Training
CPSO Independent Practice CertificateCPSO Independent Practice CertificateRequirements:Requirements:
MD MD –– Recognized by World Directory of Medical Recognized by World Directory of Medical SchoolsSchoolsMCCQE1 and MCCQE2MCCQE1 and MCCQE2RCPSC or CFPC Certification (By Examination)RCPSC or CFPC Certification (By Examination)Completion of 1 yr of PG training or active Completion of 1 yr of PG training or active medical practice or clinical clerkshipmedical practice or clinical clerkshipImmigration StatusImmigration Status
Must meet all requirementsMust meet all requirements
18
3535
CPSO CertificationCPSO CertificationAfter Ontario PRAAfter Ontario PRA
After Practice Ready Assessment:After Practice Ready Assessment:Restricted Certificate granted by CPSORestricted Certificate granted by CPSOTerms, Conditions & LimitationsTerms, Conditions & LimitationsExpires in 1 year Expires in 1 year –– can renew annually can renew annually –– for 5 yearsfor 5 yearsGeographical restriction Geographical restriction –– LocationLocationSupervision, monitoring and reporting termsSupervision, monitoring and reporting termsConditional on Exam completion in set time periodConditional on Exam completion in set time period
MCCQE2MCCQE2RCPSCRCPSCCFPCCFPC
In conjunction with Return of Service Agreement (ROS)In conjunction with Return of Service Agreement (ROS)
After fulfill all terms, can convert to Independent After fulfill all terms, can convert to Independent CertificateCertificate
3636
CPSO CertificationCPSO CertificationAlternative PathwaysAlternative Pathways
What if you did not qualify via CEHPEAWhat if you did not qualify via CEHPEAAre there other Are there other ““PathwaysPathways”” to Certification to Certification available for available for IMGsIMGs in Ontario?in Ontario?December 1, 2008 December 1, 2008 –– 4 New CPSO Pathways4 New CPSO PathwaysFast Track to CertificationFast Track to CertificationAre they helpful?Are they helpful?Do they solve the IMG backlog problem?Do they solve the IMG backlog problem?
19
3737
CPSO Pathway # 1 CPSO Pathway # 1 Canadian MD and PG TrainingCanadian MD and PG Training
No RCPSC or CFPC certificationNo RCPSC or CFPC certificationMCCQE 1 and 2 (or Equivalent)MCCQE 1 and 2 (or Equivalent)>> 5 years of independent practice in Canada or U.S.5 years of independent practice in Canada or U.S.Assessment after first yearAssessment after first yearCan then apply for Independent CertificateCan then apply for Independent CertificateNot for Not for IMGsIMGs
3838
IMG MD with Canadian PG TrainingIMG MD with Canadian PG TrainingNo RCPSC or CFPC certificationNo RCPSC or CFPC certificationMCCQE 1 and 2 (or Equivalent)MCCQE 1 and 2 (or Equivalent)5 or more years of independent practice in Canada 5 or more years of independent practice in Canada Assessment after first yearAssessment after first yearCan then apply for Independent CertificateCan then apply for Independent CertificateFor For IMGsIMGs with Canadian practice experiencewith Canadian practice experienceAvoids CEHPEA processAvoids CEHPEA process
CPSO Pathway # 2CPSO Pathway # 2
20
3939
Canadian or US MD with US PG TrainingCanadian or US MD with US PG TrainingCompletion of Residency Program Completion of Residency Program US Specialty Board certificationUS Specialty Board certificationUSMLE completedUSMLE completedIndependent certificate to practice in Canada or USIndependent certificate to practice in Canada or USPractice with mentor or supervisor until AssessmentPractice with mentor or supervisor until AssessmentAssessment after 1 yearAssessment after 1 yearCertificate expires in 18 monthsCertificate expires in 18 monthsRenewableRenewableNot for Not for IMGsIMGs
CPSO Pathway # 3CPSO Pathway # 3
4040
IMG with US PG TrainingIMG with US PG TrainingCompletion of Residency ProgramCompletion of Residency ProgramNo RCPSC or CFPC certificationNo RCPSC or CFPC certificationUS Specialty Board CertificationUS Specialty Board CertificationUS Independent CertificateUS Independent CertificateUSMLEUSMLEPractice with mentor or supervisor until AssessmentPractice with mentor or supervisor until AssessmentAssessment after 1 yearAssessment after 1 yearCertificate expires in 18 months Certificate expires in 18 months –– can be renewedcan be renewed
CPSO Pathway # 4CPSO Pathway # 4
21
4141
More Certification PathwaysMore Certification Pathways
4242
CPSO Restricted CertificateCPSO Restricted CertificateDeficient in MCCQE1 or MCCQE2Deficient in MCCQE1 or MCCQE2Deficient in RCPSC or CFPC Deficient in RCPSC or CFPC CertificationCertificationOtherwise eligible to take examsOtherwise eligible to take examsTimeTime--limited Restricted Certificatelimited Restricted CertificateMust commit to take examMust commit to take examPractice under SupervisionPractice under SupervisionReport to registration CommitteeReport to registration CommitteeCertificate expires when exam Certificate expires when exam eligibility endseligibility ends
22
4343
CPSO CPSO –– RPA ProgramRPA ProgramRegistration through Practice AssessmentRegistration through Practice AssessmentMust be in FT practice in Canada or USMust be in FT practice in Canada or USIndependent (without supervision)Independent (without supervision)5 + years5 + yearsPresent location for at least 1 yearPresent location for at least 1 yearIf selected: 3 Day on site AssessmentIf selected: 3 Day on site AssessmentReview charts, etc.Review charts, etc.1 year Restricted Practice1 year Restricted PracticeRequires 5 year Return of Service Agreement Requires 5 year Return of Service Agreement in an underin an under--serviced area of Ontarioserviced area of Ontario
4444
MOHLTC MOHLTC Repatriation ProgramRepatriation Program
Open to Open to IMGsIMGsHave completed PG residency trainingHave completed PG residency trainingRequire up to 2 years to be eligible for Require up to 2 years to be eligible for RCPSC examsRCPSC examsPG training will be funded by MOHLTCPG training will be funded by MOHLTCMust have an offer for PG placementMust have an offer for PG placementApply to med schoolApply to med schoolWill have to enter into a ROS Agreement for Will have to enter into a ROS Agreement for under serviced areaunder serviced area
23
4545
2 New Pathways 2 New Pathways under Consideration by CPSOunder Consideration by CPSO
Pathway # 5 Pathway # 5 -- Specialist IMG with PG trainingSpecialist IMG with PG trainingNonNon--Canadian PG program completed Canadian PG program completed RCPSC approvedRCPSC approvedLicense to practice in Canada or approved jurisdictionLicense to practice in Canada or approved jurisdictionMCCQE1MCCQE1Supervised until assessedSupervised until assessedMust complete MCCQE2 during termMust complete MCCQE2 during termAssessment after 1 yearAssessment after 1 yearBenefit: No RCPSC Certification requiredBenefit: No RCPSC Certification required
4646
2 New Pathways 2 New Pathways under Consideration by CPSOunder Consideration by CPSO
Pathway # 6 Pathway # 6 -- IMG with Unapproved PG trainingIMG with Unapproved PG trainingMD from unapproved jurisdictionMD from unapproved jurisdictionPG not recognized by RCPSCPG not recognized by RCPSCMCCQE 1 and MCCQE2 passedMCCQE 1 and MCCQE2 passedIndependent practice for 5 + years in CanadaIndependent practice for 5 + years in CanadaSupervised practice until AssessmentSupervised practice until AssessmentAssessment after 1 yearAssessment after 1 yearBenefit: No RCPSC or CFPC Certification requiredBenefit: No RCPSC or CFPC Certification requiredGood for IMG practising in Canada who wants to come Good for IMG practising in Canada who wants to come to Ontarioto Ontario
24
4747
Future Changes to IMG Process?Future Changes to IMG Process?MOHLTC wants to increase IMG accessMOHLTC wants to increase IMG accessMOH realized that decrease in med students MOH realized that decrease in med students resulted in physician shortageresulted in physician shortageMinister George Minister George SmithermanSmitherman (June 16, 2008) (June 16, 2008) re Bill 197:re Bill 197:
We know that there are many qualified, competent We know that there are many qualified, competent and safe international medical doctors who have and safe international medical doctors who have chosen to come to Ontario and others who will follow. chosen to come to Ontario and others who will follow. We know we need them. This legislation, if passed, We know we need them. This legislation, if passed, will help us, it will help them and more importantly, it will help us, it will help them and more importantly, it will help Ontariowill help Ontario’’s patients.s patients.
4848
Removing Barriers Report Removing Barriers Report (March 2008)(March 2008)
MOHLTC 5 Point Action Plan for MOHLTC 5 Point Action Plan for IMGsIMGs::1. Fast1. Fast--Track Canadian or US physiciansTrack Canadian or US physicians2. Transitional License 2. Transitional License –– Practice under supervision Practice under supervision
while complete education or gain experiencewhile complete education or gain experience3. Bridging Programs for 3. Bridging Programs for IMGsIMGs –– to get them ready for to get them ready for
Ontario practiceOntario practice4. Improved Support and Increased Assessments4. Improved Support and Increased Assessments5. Coordinated assistance: For alternative medical 5. Coordinated assistance: For alternative medical
careers (i.e. Physician Assistants)careers (i.e. Physician Assistants)
25
4949
Roadblocks to ChangeRoadblocks to ChangeNo changes will occur without CPSO collaborationNo changes will occur without CPSO collaboration
CPSO (October 27, 2008):CPSO (October 27, 2008):……CollegeCollege’’s mandate is not to train or supply s mandate is not to train or supply doctors for the province, but to ensure that doctors for the province, but to ensure that those who practice medicine in Ontario are those who practice medicine in Ontario are competent.competent.
While the College is committed to ensuring While the College is committed to ensuring there are no unnecessary barriers to registration there are no unnecessary barriers to registration for those seeking to practice medicine, our first for those seeking to practice medicine, our first and foremost priority is to protect the public and foremost priority is to protect the public interest and ensure patient safetyinterest and ensure patient safety
MOHLTC spending will be maintained, MOHLTC spending will be maintained, but unlikely to increasebut unlikely to increase
Limited inventory of PG positionsLimited inventory of PG positions
5050
““PossiblePossible”” ChangesChanges
26
5151
Steady increase in IMG placementsSteady increase in IMG placementsIncrease in Assessment CapacityIncrease in Assessment CapacityMove towards more Transitional Licenses Move towards more Transitional Licenses with supervisionwith supervisionBalance of Patient Safety Balance of Patient Safety vsvs Patient AccessPatient AccessEnd Game: Less expensive to certify End Game: Less expensive to certify IMGsIMGs than than to train Ontario MDsto train Ontario MDsChange takes time Change takes time -- IMG 10 years oldIMG 10 years old
““PossiblePossible”” ChangesChanges
5252
IMG TipsIMG TipsMeticulous ApplicationMeticulous ApplicationKnow how to handle Know how to handle ““Red FlagRed Flag”” issuesissues
Can hold you backCan hold you backIf conceal, could lose CertificateIf conceal, could lose CertificateGet legal assistanceGet legal assistance
Accurate, comprehensive and concise CVAccurate, comprehensive and concise CVGood and current Reference LettersGood and current Reference LettersPreparation for Clinical ExamsPreparation for Clinical Exams
MentorshipMentorshipTutoringTutoringStudy GroupsStudy Groups
Interview preparationInterview preparationProfessional Presentation Professional Presentation -- Start to FinishStart to Finish
27
5353
IMG Opportunities Across IMG Opportunities Across CanadaCanada
5454
ManitobaManitobaConditional RegistrationConditional Registration
MDMDMCCEEMCCEE, MCCQE1 or MCCQE2, MCCQE1 or MCCQE22 years of 2 years of ““acceptableacceptable”” PG trainingPG trainingComplete Assessment processComplete Assessment processInterviewInterviewGeographical limitationGeographical limitationDo not need Offer of Employment to applyDo not need Offer of Employment to applyNo time limit on licenseNo time limit on licenseAgree to monitoringAgree to monitoring
28
5555
SaskatchewanSaskatchewanProvisional License:Provisional License:
MDMDFamily MedicineFamily Medicine::24 months of 24 months of ““approvedapproved”” PG training; orPG training; orLicensed in home jurisdiction; orLicensed in home jurisdiction; orPass on MCCEEPass on MCCEERequired to commit for 3 years to a communityRequired to commit for 3 years to a communityPass MCCEE, MCCQE1 and MCCQE2Pass MCCEE, MCCQE1 and MCCQE2SpecialistsSpecialists: RCPSC eligible: RCPSC eligible
Special License:Special License:Not RCPSC eligible, but meet other criteriaNot RCPSC eligible, but meet other criteriaUnmet need for servicesUnmet need for servicesAssessmentAssessmentCommit to Commit to SaskSask for 3 yearsfor 3 years
5656
AlbertaAlbertaConditional Restricted Conditional Restricted –– Special Register:Special Register:
Part 1 Part 1 –– Family Medicine Family Medicine –– 24 months PG24 months PGPart 2 Part 2 –– Specialist Specialist –– Equivalent trainingEquivalent trainingAcceptable MDAcceptable MDLMCC (MCCQE1 and MCCQE2)LMCC (MCCQE1 and MCCQE2)Letter of Support re services requiredLetter of Support re services requiredGeographical restrictionGeographical restrictionSupervised integrationSupervised integrationNo time restriction on licenseNo time restriction on licenseConditional Restricted Conditional Restricted
Provisional RestrictedProvisional RestrictedNo LMCCNo LMCCEmergency need areaEmergency need areaLimited to 30 monthsLimited to 30 months
29
5757
British ColumbiaBritish ColumbiaTemporary Certificate:Temporary Certificate:
Approved MDApproved MD““AppropriateAppropriate”” PG trainingPG trainingPreliminary AssessmentPreliminary AssessmentMCCEE within 1 yearMCCEE within 1 yearIf specialistIf specialist-- RCPSC eligibleRCPSC eligibleUnder serviced areaUnder serviced areaApproved jurisdictionApproved jurisdiction
Dr. Gary Srebrolow Chair of Health Law Group
Blaney McMurtry LLPBarristers & Solicitors
2 Queen St. East, Suite 1500Toronto, Ontario M5C 3G5
Tel: 416-597-4875E-mail: [email protected]
