6th RAC Summit
Key discussion & next steps
Introduction
The 6th Regional Advisory Committee (RAC)
Summit was held at the Royal College
headquarters in Ottawa on Friday, May 29,
2015.
The Summit objectives were to provide
participants with:
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an update on discussions and
decisions from the May 28
abbreviated RAC meetings
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an update on the 2014 Physician
Employment Study and a summary
of highlights from the Royal College
advocacy consultation process
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opportunity to learn about and provide feedback on the latest developments in
Competence by Design, in particular the launch of CanMEDS 2015, and the emerging
directions for CPD within a competency-based system
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information on resiliency, and tools to identify opportunities to develop and/or adapt
resiliency resources for use by Royal College Fellows
Participants included Fellowship Affairs and Regional Advisory Committee members and
Royal College staff. In total, there were 72 attendees.
Presentations from the summit are available through the Royal College Office of Operations
(kmcnulty@royalcollege.ca).
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Session 1: Feedback from RAC abbreviated Meetings (May 28)
Presenters – RAC Chairs
Douglas Hedden, MD, FRCSC (RAC 1 Chair)
BJ Hancock, MD, FRCSC, FACS (RAC 2 Chair)
Vivian McAlister, MB, FRCSC (RAC 3 Chair)
Ranjit Baboolal, MD, MRCP, FRCPC (RAC 3 member)
Robert Sabbagh, B Pharm, MD, MSc, FRCSC (FAC Chair, presenting for RAC 4 Chair)
Robert LaRoche, MD, FRCSC (RAC 5 Acting Chair)
Session description
This session followed up on work completed at
abbreviated RAC meetings the night before the
Summit. During these evening meetings two of
the key items of business discussed were: Draft
RAC 2015-16 Work Plan and RAC member
outreach – new resources.
Discussions focused on ways to implement the
work plan and identified opportunities to
highlight the value of Royal College Fellowship
to regional members. RAC Chairs reported back
highlights from their group discussion to
Summit participants.
Khalid Azzam, MBBS, FACP (RAC 3)
Report back agenda item 1: 2015-16 RAC Work Plan
Project 1 - Outreach to residents and early-career Fellows
Project 2 - Strengthening engagement with Fellows, partner organizations and associations
Project 3 - Recognizing excellence and achievement of Fellows
RAC members were asked to provide feedback on the following:
Major initiatives that should be considered for inclusion in the work plan
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Providing better and more accessible care and services to individuals (facilitate
portability across provinces)
Core competencies for practicing Fellows and granting privileges: proposed Royal
College role in remediation and professional development of skills (Need a tool to
evaluate these competencies)
Educational opportunities for Fellows in CBD, ePortfolio and MOC: personal learning
projects
Expand to consider support for distributed medical education outside traditional
academic centers, for residents (and inclusive of residents) and Fellows/faculty
Support the mission of the College vs increase the presence of the RAC (include
residents and public)
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Consider new honorific recognition at the regional level, not simply review current
offerings. Local and international contribution (eg. Dean’s list); increase public
visibility
o focus on publicizing and simplifying nomination/selection process
o logistical support for nomination, selection from the Royal College
Suggestions for project descriptions, objectives, metrics
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Enhanced presence within the various regional communities that bring value
(outreach projects)
Value of Fellowship campaign (branding)
Break down the projects into smaller components to make objective and metric
setting easier
Project 1: have metrics around “performance” in distance medical education sites
around communications, collaborations.
Project2: Clarify where visibility is lacking and identify relevant target stakeholders
(patient, society)/associations
Project 3:
o Awareness-raising for awards (increase number of nominations)
o Learn from university promotion of awardees
o Develop tool to determine best awards/grants to apply for
o Provide guidance to grant applicants
Roles RAC members can play to ensure success of the work plan
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RAC members to present and lead discussions around Royal College initiatives at a
regional level
Personal communication and outreach to Fellows beyond academia
Participation in educational opportunities with NSSs and other national/regional
forums (connecting with new members at these events)
One-pager on role and responsibility of RAC as well as the Royal College
Communications with other professionals
Work with FMSQ as a stakeholder/partner to ensure success
Support use of designation of Royal College
Expand on local communication tools (e.g., university med school newsletters)
Participate in promotion/ dissemination / engagement of awards
o Have RAC members present awards when significant peer recognition events
are taking place in the region (universities, local medical societies)
RAC members felt the proposed work plan projects aligned with the Royal College’s strategic
plan, although there was concern around the size of the projects and the resources to
support these projects. The order of priority must be taken into consideration.
Next step
Feedback will be reviewed and, where feasible and aligned within the RAC mandate,
incorporated in the next iteration of the 2015-16 RAC Work Plan (to be circulated to
committee members for review and electronic approval).
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Report back item 2: RAC member outreach – new resources (PowerPoint
presentations)
Suggestions on proposed PPT format / notes
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Less is more
Resident handover, resiliency, health human resources
Manpower, workforce and career planning
Encouraging young Fellow participation on Royal College committees
Socialization of awards and grants opportunities
Social media methods of outreach preferred: the value of PPT format is
questionable
Ensure CanMEDS logo is displayed
Include an FAQ document to accompany presentation or link to website where
they can find out more
Promote Royal College Services Centre
Ideas for presentation/dissemination of outreach PPTs:
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Making Royal College content more readily available online via TED talks
format
Peer-to-peer coaching
Local, regional and specialty society opportunities for education of Fellows
Grand rounds
Link information dissemination to accreditation-style ‘blitz’ visits (e.g., for
CanMEDS 2015 launch)
Take advantage of existing meetings to share information and promote the
role of the RAC and the Royal College
Present to incoming R1s in one go
Suggestions for future outreach resources/tactics
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Royal College centralized presence at various meetings on a national level
Face-to-face meetings within the various regional communities
Videoconferencing / video blogs (ie Dr. Padmos’ international update)
Pairing of RAC members to go out and do community outreach
RAC champions for CBD transformational change
Exploit communication avenues already being used
Better communicate who and what RAC members are (RAC member feature
each month in Royal College publication)
Develop and implement a corporate communication strategy, then align
member outreach
Emphasis on tangible benefits for residents (e.g., job opportunities)
Promotion of awards and grants (what/how)
Mentorship program / other in-development services
Promote how to accredit journal clubs / rounds
Transition into practice – CPD, what is an FTE, billing
Orientation for new Fellows
Next step
Applicable updates will be incorporated within the next iteration of the PowerPoint
presentations, and then shared with RAC members.
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Session 2: Health Policy Update (Employment Study/Advocacy)
Presenter
Danielle Fréchette, MPA, Executive Director, Office of Health Systems Innovation and
External Relations (OHSIER)
Session description
Mrs. Danielle Fréchette pre-circulated an update on the 2014 Physician Employment Study,
including data captured for 2013 survey participants regarding their employment status one
year following certification.
Mrs. Fréchette provided a summary of highlights from the Royal College advocacy
consultation process. The Royal College’s Health Policy Unit is leading an initiative to help
determine the guiding principles and framework within which the Royal College will
engage in advocacy.
The consultation process sought feedback on questions such as how advocacy can support
Royal College Fellows and their patients; criteria for determining advocacy issues the Royal
College should pursue; and opportunities for partnerships or collaborations. Discussions
from the consultation process and at the Summit informed recommendations presented to
Council in June 2015.
Discussion points
Participants asked that the following additional issues be considered for future Royal College
advocacy efforts:
Medical marijuana: This issue is evolving quickly and should not be ignored (previously the
Royal College has conferred broadly on this issue, collected evidence and shared with
government to help inform their decision).
Local health authority level: Specialists in rural
practice do not have the same benefits as large
centers.
Mental health: Management of those with mental
health issues is in need (need to improve
dissemination of tools).
Loss of physician autonomy: There is concern
around health authorities removing physician
autonomy. The use of ongoing credentialing could
encourage autonomy through demonstration of
competence. Many physicians are discouraged with
being treated as a disempowered employee.
Danielle Fréchette, MPA, Executive Director,
Health Systems Innovation and External Relations
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Health prevention: The Royal College should take a stronger role in advocating the role of
prevention, healthy lifestyles, and other determinants in influencing health (within Canada
and internationally).
Public debates: It is important for the Royal College not to undermine its role as knowledge
experts when trying to change opinions. The truth is the ultimate goal. The Royal College
should only engage in public debates in rare cases (the exception).
Session 1: Feedback from RAC Meetings (pm May 28)
Session 3: Competence by Design (CBD)
CBD Topics & Presenters
CanMEDS 2015 update & CBD overview
Ken Harris, MD, FRCSC, Deputy CEO & Executive Director, Office of Specialty Education
Competency-based CPD Summit outcomes
Craig Campbell, MD, FRCPC, Director, Continuing Professional Development, Office of
Specialty Education
William Code, MD, FRCPC, RAC 1 member
CPD Educators: Exploring their role in a competency-based system
Jennifer Gordon, MEd, CAE, Associate Director, Continuing Professional Development, Office
of Specialty Education
Context/Session description
Members of the Royal College’s Office of Specialty Education lead participants in an
interactive session that:
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Informed participants about plans to update the CanMEDS diagram, and provided an
overview of the latest development in the CBD initiative;
Shared outcomes and key policy directions identified at the April 15/16, 2015
Competency-based CPD Summit; and
Asked for feedback on the role of the Royal College’s CPD Educators and on how
their roles might evolve to support Fellows within a competency-based CPD system.
Discussion points
CanMEDS diagram
Participants were invited to provide their
preference on three potential concepts of the
CanMEDS diagram. The draft concepts had been
circulated to various groups for feedback. The
final recommendation was taken to Council in
June 2015, with the new diagram revealed at the
International Conference of Residency Education
(ICRE) in October 2015.
Michel Sauvé, MD, FRCPC (RAC 1)
&
David Ross, MD, FRCSC (RAC 1)
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CanMEDS 2015 in practice / Competency-based practices / Importance of assessment
Participants were asked to provide feedback (via a live electronic poll) on the following three
questions:
Question 1: What does it mean to you to apply CanMEDS 2015 to your practice?
Majority said
o It “covers good, safe practice” & “all aspects of my practice”
o It articulates what is required to meet patient needs
Major
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themes
Why change from Manager to Leader? (lots on this)
“Relevance”?
“Anxious” about administrative burden & implementation
Minor theme
o Will it force people out of practice? Do EPAs= liability issues?
Question 2: What are you already doing that aligns with competency-based practices?
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Peer review and feedback from residents
Multi-source feedback including patients
Practice performance evaluations
Recertification courses
Competency-based CME using evaluation & simulation
Link lectures to CanMEDS roles
Lifelong learning
Practice-based CPD
Younger Fellows mentor older colleagues
Interprofessional education
Learning plans
Question 3: Why does assessment matter?
Response
Count
Assessment drives learning in practice
Self-assessment is inaccurate
Assessment is part of lifelong learning in practice
All of the above
None of the above
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CPD Educators: Exploring their role in a competency-based system
Participants were asked to provide feedback (via a live electronic poll) on the following four
questions:
Question 1: How can CPD Educators and RAC members collaborate to support the CPD
mandate of the RC?
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Major theme
• Have CPD Educators hold “training sessions” at each RAC meeting so that RAC
members in turn can make presentations at their home hospitals and specialty
societies, and provide support to their colleagues. RAC members could be CPD
champions.
Minor
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themes
Have CPD Educators provide regular information updates to RACs
Have a shared resource center for presentation slides, FAQs, etc.
Use RAC members for small pilot training programs
Provide a link to CPD Educators and RAC members on MAINPORT ePortfolio home
page
Question 2: How do you see CPD Educator and RAC member roles evolving in a
competency-based CPD World?
Major themes
• Team work between CPD Educators and RAC
members to reach Fellows/MOC participants
• Using collegial relationships to spread the
news of coming changes (culture change)
• Better communications with rural practicing
physicians
• Educate RAC members/CPD Educators about
CBD approach
• RAC evolving into educator role
• Mentorship roles for senior Fellows
Steve Simpson, MD, FRCPC (RAC 2)
Minor
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Specialty-specific CPD educators
Education around CanMEDS roles
Working with NSSs to develop tools
How can roles evolve when we don’t know the direction yet?
Promotion of effective LLL with resources (how-to videos)
RAC members/CPD Educators can be notified if Fellows in their region have been
inactive on MAINPORT ePortfolio for 6 months in order to offer support
• Use RAC members as MAINPORT ePortfolio testers
Question 3: How can we work together to support the cultural shift required for CBD and
CBD/CPD?
Major themes
• Keep it simple
• NSSs as partners and ambassadors. Specialty-specific champions, the sooner the
better
• Local multi-specialty meetings - ‘we’re all doing this together’
• Stress the benefits and advantages of change and that it is what good doctors are
already doing
• Educate volunteers about new system and change management, provide tools
• Involve local peers
• Needs to be relevant to all physician types - how they can perform CPD in their
respective roles and type of practice
• Privacy issues with recording CBD
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Minor
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themes
Encourage regular reporting of CPD activities throughout the year
Royal College can lead conferences that fulfill CPD
Lobby for point of care assessment tools
Communications that speak about global skills that make a difference
Effective use of social media
Teach the relevance of CBD to one’s natural career progression
Advance teaching and promotion
Set out desired behaviours all RAC members/CPD Educators can practice and model
Investing in leadership
RAC members disseminate info with their colleagues, specialty society, regional
hospital
Preparation of responses to naysayers
RAC summit
Clear measurable objectives
Fellows must see they can still influence the process
Change is necessary – burning platform
Focus on relationships and support not ‘judgment’
Question 4: What are the top five priorities for CPD Educators and RAC members related
to CPD Timelines?
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Training/education to be able to support Fellows and network
Relevance to practice, MOC Program, self-regulation
Collaborations with NSSs and university chairs
Accessibility
Avoiding duplication
Communications – benefits, need for change, encouraging regular MAINPORT
ePortfolio entries, importance of CPD, awareness, large 2015 cohort
Tools – creation of tools and sharing them, App/MAINPORT ePortfolio upgrades
Assessment – importance of assessment, creation of Section 3 activities with content
experts
Ensuring availability of support, tools
Concern was expressed around pushback and disassociation with the Competence by Design
initiative: there is a need for more communication regarding CBD’s purpose and
philosophy.
Next step
The Office of Specialty Education aims to provide RAC members with templates and
examples of assessment tools at their fall 2015 (or spring 2016) meetings. Discussions of
and RAC involvement in CBD developments will be ongoing.Session 3: Competence by Design
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Session 4: Plenary – Building Resiliency Skills
Presenters
LCol Suzanne M Bailey, MSM, CD, MSW, SSO Social Work & MH Trg, CF Health Services
Group HQ, Department of National Defence
Breanna Balaton, MD, Co-Chair, RDoC Wellness Committee
Annie Trépanier, MD, Chair of the FMSQ Resident Wellness Committee
Douglas Hedden, MD, FRCSC, Walter Stirling Anderson Professor and Chair, Department of
Surgery, Faculty of Medicine & Dentistry, University of Alberta, (Edmonton) Zone Clinical
Department Head, Alberta Health Services , Chair of RAC 1
Session description
Representatives from Canada’s Department of National Defence, Resident Doctors of
Canada, the Fédération des médecins résidents du Québec, and Dr. Hedden lead the plenary
by sharing their experiences in developing resiliency curricula and resource materials for
their constituents.
Discussion focused on:
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the definition of resiliency, and identification of the
warning signs when resiliency weakens
factors that lead to the identification of resiliency as a
necessary competency for military and medical
personnel
lessons learned related to getting buy-in and
participation from end-users for whom the materials
were developed
the impact that the resiliency programs have had for the
Annie Trépanier, MD
constituent groups and
the links between resiliency and positive, productive work environments
Discussion points
Data: There would be value in presenting data around resiliency issues to the Fellows.
Maybe it’s not a new problem – it’s simply that indicators did not previously exist.
Resources: A summary of source material and resources should be collated and made
available to Fellows.
Accredited self-assessment program: Royal College could consider developing an online
accredited self-assessment program on resiliency (related issues) and promote to
Fellows.
Emphasis: The Royal College should promote the fact that although one is still functioning –
one still may need help.
Next Step
The Royal College’s Office of Specialty Education has gathered a working group on physician
wellness and is looking to develop a curriculum (partnering with various associations
including the Canadian Psychiatric Association).
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Appendix A:
6th RAC Summit Attendees
RAC 1
Vincent Arockiasamy, MRCPI, FRCPC
Marian Berry, MD, FRCPC
Ravinder Bhui, MD, FRCSC
Earl Campbell, MD, FRCSC
William Code, MD, FRCPC (Faculty)
William Dafoe, MD, FRCPC
Douglas Hedden, MD, FRCSC (Chair, Faculty)
Joanna Lazier, MD
David Ross, MD, FRCSC
Michel Sauvé, MD, FRCPC (Gastroenterology),
FRCPC (Internal Medicine), FRCPC (Critical Care
Medicine), FACP, FCCP, Master Clinical Epidemiology
and Biostatistics
Steve Simpson, MD, FRCPC
Vishal Varshney, MD
RAC 2
Hussam M. Azzam, MD, FRCSC, MRCOG, FACOG, PGDAES, CCPE
Breanna Balaton, MD (Faculty)
George Carson, MD, FRCSC, CSPQ, FSOGC
Annie Ducas, MD
BJ Hancock, MD, FRCSC, FACS (Chair)
Sarah Mueller, MD, FRCSC
F. Gigi Osler, BScMed, MD, FRCSC
Richard (Sam) Rowe, MBBS, MAEd, FRCPC
Eric Sigurdson, MD, FRCPC
Robert Weiler, MD, FRCPC
MJ Willard, MD, FRCPC
RAC 3
Jacques Abourbih, MDCM, FRCSC
Shabbir Amanullah, MBBS, DPM, MD, MRCPsych,
CCT(Geriatric Psychiatry), FRCPC
Khalid Azzam, MBBS, FACP
Ranjit Baboolal, MD, MRCP, FRCPC
Vinita Bindlish, MD, FRCPC
Vick Chahal, MD, FRCSC
Vlad Diaconita, MD
Roy Kirkpatrick, MD, FRSCS
Angus Maciver, MD FRCSC, FACS
Vivian McAlister, MB, FRCSC (Chair)
Anna Rozenberg, MD, FRCPC
Suzan Schneeweiss, MD, FRCPC
RAC 4
Frédéric Bernier, MD, MHA, FRCPC
Françoise Chagnon, MDCM, FRCSC, FACS, CHE, ADM.A, C.Dir
Chair)
Sam Daniel, MD, FRCSC
Fréderick D’Aragon, BSc(N), MD, FRCPC
Eleanor Elstein, MD, FRCPC
Marie-Andrée Girard, MD, FRCPC
Christopher Lemieux, MD
Robert Sabbagh, B Pharm, MD, MSc, FRCSC (Chair of Fellowship
Affairs Committee, Faculty)
Renée Soucy, MD, FRCSC
RAC 5
Bruce Cameron, MD, FRCPC
Laurette Geldenhuys, MD, FRCPC
Erica Holloway, MD, FRCSC
Heather Keizer, BA,BSc, MD, FRCPC(Psychiatry),
HPRT (Trauma)
JP King, MD
Christopher Kovacs, MD, FRCPC, FACP, FACE
Robert LaRoche, MD, FRCSC (Acting Chair)
Jo-Ann Talbot, MD, FRCPC
Sandra Wajstaub, MD, FRCPC
Ward Yuzda, MD, FRCPC
Royal College
Andrew Padmos, BA, MD, FRCPC, FACP, Chief Executive Officer
Ken Harris, MD, FRCSC, Deputy CEO & Executive Director, Office
of Specialty Education (Faculty)
Michel Cavallin, MBA, Chief Operating Officer
Danielle Fréchette, MPA, Executive Director, Office of Health
Systems Innovation and External Relations (Faculty)
Craig Campbell, MD, FRCPC, Director, Continuing Professional
Development, Office of Specialty Education (Faculty)
Steve Slade, Director, Health Systems and Policy
Christine James, MA, CAE, Associate Director, Membership
Services & Programs
Jennifer Gordon, MEd, CAE , Associate Director, Continuing
Professional Development, Office of Specialty Education (Faculty)
Paul Tomascik, Senior Analyst, Health System and Policies
Rhonda St. Croix, Change Initiative Advisor
Allison Fitzgerald, Manager, Royal College Services Centre
Asha Jhamandas, Senior Communications Specialist
Ines Martin, Regional Education Coordinator
Kora McNulty, Administrative Coordinator, Membership Services
Jocelyne Carrier, Staff representative, Fédération des médecins
résidents du Québec
Additional Faculty
Lieutenant Colonel Suzanne Bailey, MSM, CD, MSW,
SSO Social Work & MH Trg
Annie Trépanier, MD
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