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Medical Council of Canada
Assessment Review Task Force
Recalibrating for the 21st Century
Report of the Implementation Committee
Ottawa, September 2012
Future of Medical Education in Canada
•

• Respond to societal needs and ensure diversity in admissions
• Respect the scientific basis of medicine including prevention
  and public health
• Provide diverse learning contexts and emphasize generalism
• Focus on intra and inter professional practice and encourage
  leadership
• Move to a competency-based assessment system
http://mcc.ca/en/Publications/assessment_review_report.shtml
ARTF Implementation Committee
 •   Rose Carter (Chair)
 •   Trevor Theman
 •   Oscar Casiro
 •   Anne-Marie MacLellan
 •   Nancy MacBeth
 •   Michael Marrin
 •   Jay Rosenfield
     –   Ian Bowmer
     –   Krista Breithaupt
     –   Andre De Champlain
     –   Yves Lafortune
     –   Darlene Link
     –   Andrée Fortin-Bélanger


                                  4
Recommendation 1

That the requirements for the LMCC include all
components of the Canadian registration
standard for full licence:
 • A recognized MD degree
 • MCCQE Part I and II
 • Formal postgraduate education acceptable to
   the medical regulators
 • Certification from CFPC or RCPSC

                                           ARTF
Recommendation 2

That the content of MCC examinations be
expanded by:
 • Defining the knowledge and behaviours in all the
   CanMEDS roles for independent practice.
 • Revising the examination blueprints and reporting.
 • Review content and skill coverage on the blueprints
   for all MCC examinations.
 • Determine core competencies considered essential
   and explore the development of new tools to assess
   these specific competencies.
                                                  ARTF
Recommendation 3

That the timing and frequency of MCCQE Part I and II, be revisited
by:
•   Exploring options that would allow more flexibility in the
    scheduling of all MCC examinations.
•   MCCQE Part I (the knowledge and the clinical decision-making)
    and its prerequisites to be assessed at the most appropriate times in
    the learning /assessment continuum.
•   Continuing discussions with the CFPC and the RCPSC leading to
    the development of an integrated national assessment strategy.


                                                        ARTF
Business Enterprise Developments to Promote
Flexibility

       Solution for Item Banking (all exams)


          Scoring & Results Management


           Automated Item Generation

                                               8
ARTF Recommendation #3
Harmonization
CFPC
               Four more
Simulated
               OSCE Stations
Office Orals




       Common
        OSCE

                               9
Recommendation 4
That a rigorous look at the assessment of IMGs be undertaken with a view to
developing the additional tools needed to clearly assess the competencies of
IMGs by:
 • Promoting the MCCEE for its intended purpose.
 • Developing and standardizing other tools necessary to screen and assess
   IMGs coming to Canada for the purpose of entry into postgraduate training.
 • Determining the role of the MCC in assessing IMGs for readiness to entry
   into practice in Canada (e.g., identifying appropriate tools; creating new
   tools; developing standards to audit tools; or perform the assessments).
 • With partners, creating a framework for assessment for practice readiness.
 • Facilitating the development of a Canada-wide approach to assessment of
   IMGs for preparedness for practice.

                                                             ARTF
NAC – Practice Ready Assessment


                                                 Framing our Focus:
          Experience
                        Credentials

                                                 Pan-Canadian PRA
                                                 Process
                  Screening
                 assessments
                  (Point-in-Time)




                Eligible




              Practice Ready          Point-in-Time         Over-Time        PRA              Provisional
                  Route                Assessment                                              Licensure
                                                            Assessment      Decision

Sponsorship
                                           Common toolkit                 Standard decision
                                                                          & appeals process

                                                      Trained assessors


                                                                                               11
Recommendation 5
That the MCC take the lead in creating a
collaborative framework and an integrated national
strategy for competency assessment of physicians
throughout their medical careers, by working with
the Federation of Medical Regulatory Authorities of
Canada, the Collège des médecins du Québec, the
College of Family Physicians of Canada and the
Royal College of Physicians and Surgeons of
Canada.
ARTF – Action Items

 • Develop a map of all current MCC projects
   and align them with the ARTF
   recommendations




                                           13
ARTF Implementation Map
  Application for Medical Registration in Canada & sub-projects    • Delivery date: March 2013


                                                                  • Delivery date: March 2013
                   CFPC-MCC Harmonization
                                                                  • Refined Model: December 2015


                 Scoring & Results Management                     • Proposed delivery date: mid 2013


         Solution for Item Banking (Phase III, all exams)         • Delivery date: to link with Blueprint


                        Blueprint Project                         • Three phases - 2013 -2014 - 2016


        NAC Practice Ready Assessment (Phase I Design)            • Delivery date: December 2013


                         Space Planning                           • Proposed delivery date: January 2015

     Flexibility - Increased Frequency of MCCQE Part I and        • Proposed delivery date: July 2016
harmonization of one or more Royal College Specialty with Part II

            International Delivery of MCC QE Part I               • Proposed delivery date: dependent on business plan



                                                                                                                         14
ARTF Implementation Committee
ARTF – Action Items
 Review the FMEC PG
  recommendations and ensure that the
  Blueprint project is aligned with the
  significant recommendations.




                                          15
Postgraduate education
1. Ensure the Right Mix, Distribution, and Number
   of Physicians to Meet Societal Needs
2. Cultivate Social Accountability through Experience
   in Diverse Learning and Work Environments
3. Create Positive and Supportive Learning and Work
   Environments
4. Integrate Competency-Based Curricula into
   Postgraduate Programs
5. Ensure Effective Integration and Transitions along the
   Educational Continuum
Postgraduate education
 6. Implement Effective Assessment Systems
 7. Develop, Support, and Recognize Clinical Teachers
 8. Foster Leadership Development
 9. Establish Effective Collaborative Governance in
    PGME
10. Align Accreditation Standards
ARTF – Action Items
 • Approach the RCPSC re: flexibility of exams.
   Possible harmonization of other specialty
   examinations

  Develop a White Paper describing a model for
   an integrated national assessment strategy

 • Include consultation with the Royal College and
   CFPC


                                                     18
ARTF – Action Items
 FMRAC Working Group on Assessment
  and Supervision to Steer
  Recommendation #5 - Practice Ready
  Assessment

 Begin to develop a communication
  strategy based on the work already started
  with the Blueprinting Project

                                           19

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Artf presentation

  • 1. Medical Council of Canada Assessment Review Task Force Recalibrating for the 21st Century Report of the Implementation Committee Ottawa, September 2012
  • 2. Future of Medical Education in Canada • • Respond to societal needs and ensure diversity in admissions • Respect the scientific basis of medicine including prevention and public health • Provide diverse learning contexts and emphasize generalism • Focus on intra and inter professional practice and encourage leadership • Move to a competency-based assessment system
  • 4. ARTF Implementation Committee • Rose Carter (Chair) • Trevor Theman • Oscar Casiro • Anne-Marie MacLellan • Nancy MacBeth • Michael Marrin • Jay Rosenfield – Ian Bowmer – Krista Breithaupt – Andre De Champlain – Yves Lafortune – Darlene Link – Andrée Fortin-Bélanger 4
  • 5. Recommendation 1 That the requirements for the LMCC include all components of the Canadian registration standard for full licence: • A recognized MD degree • MCCQE Part I and II • Formal postgraduate education acceptable to the medical regulators • Certification from CFPC or RCPSC ARTF
  • 6. Recommendation 2 That the content of MCC examinations be expanded by: • Defining the knowledge and behaviours in all the CanMEDS roles for independent practice. • Revising the examination blueprints and reporting. • Review content and skill coverage on the blueprints for all MCC examinations. • Determine core competencies considered essential and explore the development of new tools to assess these specific competencies. ARTF
  • 7. Recommendation 3 That the timing and frequency of MCCQE Part I and II, be revisited by: • Exploring options that would allow more flexibility in the scheduling of all MCC examinations. • MCCQE Part I (the knowledge and the clinical decision-making) and its prerequisites to be assessed at the most appropriate times in the learning /assessment continuum. • Continuing discussions with the CFPC and the RCPSC leading to the development of an integrated national assessment strategy. ARTF
  • 8. Business Enterprise Developments to Promote Flexibility Solution for Item Banking (all exams) Scoring & Results Management Automated Item Generation 8 ARTF Recommendation #3
  • 9. Harmonization CFPC Four more Simulated OSCE Stations Office Orals Common OSCE 9
  • 10. Recommendation 4 That a rigorous look at the assessment of IMGs be undertaken with a view to developing the additional tools needed to clearly assess the competencies of IMGs by: • Promoting the MCCEE for its intended purpose. • Developing and standardizing other tools necessary to screen and assess IMGs coming to Canada for the purpose of entry into postgraduate training. • Determining the role of the MCC in assessing IMGs for readiness to entry into practice in Canada (e.g., identifying appropriate tools; creating new tools; developing standards to audit tools; or perform the assessments). • With partners, creating a framework for assessment for practice readiness. • Facilitating the development of a Canada-wide approach to assessment of IMGs for preparedness for practice. ARTF
  • 11. NAC – Practice Ready Assessment Framing our Focus: Experience Credentials Pan-Canadian PRA Process Screening assessments (Point-in-Time) Eligible Practice Ready Point-in-Time Over-Time PRA Provisional Route Assessment Licensure Assessment Decision Sponsorship Common toolkit Standard decision & appeals process Trained assessors 11
  • 12. Recommendation 5 That the MCC take the lead in creating a collaborative framework and an integrated national strategy for competency assessment of physicians throughout their medical careers, by working with the Federation of Medical Regulatory Authorities of Canada, the Collège des médecins du Québec, the College of Family Physicians of Canada and the Royal College of Physicians and Surgeons of Canada.
  • 13. ARTF – Action Items • Develop a map of all current MCC projects and align them with the ARTF recommendations 13
  • 14. ARTF Implementation Map Application for Medical Registration in Canada & sub-projects • Delivery date: March 2013 • Delivery date: March 2013 CFPC-MCC Harmonization • Refined Model: December 2015 Scoring & Results Management • Proposed delivery date: mid 2013 Solution for Item Banking (Phase III, all exams) • Delivery date: to link with Blueprint Blueprint Project • Three phases - 2013 -2014 - 2016 NAC Practice Ready Assessment (Phase I Design) • Delivery date: December 2013 Space Planning • Proposed delivery date: January 2015 Flexibility - Increased Frequency of MCCQE Part I and • Proposed delivery date: July 2016 harmonization of one or more Royal College Specialty with Part II International Delivery of MCC QE Part I • Proposed delivery date: dependent on business plan 14 ARTF Implementation Committee
  • 15. ARTF – Action Items Review the FMEC PG recommendations and ensure that the Blueprint project is aligned with the significant recommendations. 15
  • 16. Postgraduate education 1. Ensure the Right Mix, Distribution, and Number of Physicians to Meet Societal Needs 2. Cultivate Social Accountability through Experience in Diverse Learning and Work Environments 3. Create Positive and Supportive Learning and Work Environments 4. Integrate Competency-Based Curricula into Postgraduate Programs 5. Ensure Effective Integration and Transitions along the Educational Continuum
  • 17. Postgraduate education 6. Implement Effective Assessment Systems 7. Develop, Support, and Recognize Clinical Teachers 8. Foster Leadership Development 9. Establish Effective Collaborative Governance in PGME 10. Align Accreditation Standards
  • 18. ARTF – Action Items • Approach the RCPSC re: flexibility of exams. Possible harmonization of other specialty examinations  Develop a White Paper describing a model for an integrated national assessment strategy • Include consultation with the Royal College and CFPC 18
  • 19. ARTF – Action Items FMRAC Working Group on Assessment and Supervision to Steer Recommendation #5 - Practice Ready Assessment Begin to develop a communication strategy based on the work already started with the Blueprinting Project 19