1. ECHOWhat the creation of the MCC meant for health care in Canada by : Na n c y Ma c Be t h ,Vice-President and Member at Large of the Medical Council of CanadaSir Thomas Roddicksvision over 100 years ago was borne of a desire to develop a qualification in medicine that would be accepted across the country. His eloquent and impassioned statements on the floor of the House of Commons argued that for the sake of theThe Medical peace, order and good government clause in the British North America Cou ncilAct, we must develop national standards to assess our physicians. The Medical Council of Canada, forged as an Act of Parliament in 1911,of Canadais the result of Roddicks persistence. We might pause and reflectN e w s l e tter on what that event meant for Canada as we celebrate our 100th anniversary. August 2012Firstly, it was the beginning of Canadas treasured value of universalhealth care. If Canadians were to eventually have access to healthcare regardless of ability to pay, it had to start with an acceptance ofa co-ordinated, pan-Canadian role in health care. And that is exactlyCanadians have a right to demand. Our corewhat Roddicks Bill did. It took another 70 years to find acceptance forresponsibility will always be to improve thethe five principles of the Canada Health Act but I would like to think thatassessment of physicians. We will also workit was the legislation sheparded by Roddick that first opened the doorto maintain a complete record of all physiciansto this concept.practising in Canada. We will meet the highestSecondly, federal/provincial tension is inevitable in Canada due to the of research standards in assessment and 1 0 0 y e a r s o f e xc e l l e n c e 2 division of powers giving health-care responsibility to the provinces.since evaluation tends to drive curriculumdevelopment, we will continue to influenceUp d a t e o n t h e Ap p l i c a t i o n f o r But, here again, the history of the development of the MCC hasmedical education curriculum. Me d i c a l Re g i s t r a t i o n4 proven that we can have national standards as a result of collaborationamong the provinces rather than having that standard imposed by theSome may say that a 100-year old organization Bl u e p r i n t p r o j e c t 6 Federal government. Since representatives from all the provincial andis an anachronism and therefore not relevantterritorial medical regulatory authorities and all the Canadian facultiesClinical exam harmonization 8 of medicine make up the Council, the collective provincial role isin todays changing world. In fact, the MCChas struggled, evolved and changed and Pr a c t i c e - re a d y a s s e s s m e n t 10 respected and enhanced.will continue to do so in contributing to the C a n a d i a n C o n f e re n c e o n Finally, from that first exam session in Montreal in 1913 of 71 excellence of our Canadian health-care system.Me d i c a l E d u c a t i o n 11 candidates to the point today where the MCC administers 13,000exams a year in Canada and in over 80 countries, we have come aThat is cause for celebration. Happy anniversaryto the Medical Council of Canada.Dr. Ia n B ow m e r h o n o u re d 13 long way. And we have much to do to continue to uphold the standardsNancy MacBeth was Minister of Health of theProvince of Alberta from 1988 to 1992.

2. 2ECHOMCC celebratesMedical C o u n c i l o f C a n a d a100 years of excellence 100 On b e h a l f o f Dr. H l n e B o i s j o l y, De a n o f t h e Faculty of Medicine of the Un i ve r s i t y o f Mo n t re a l , Dr. R a m s e s Wa s s e f, Chair of the MCCs Central Ex a m i n a t i o n C o m m i t t e e ( l e f t ) p re s e n t s Dr s . Michael Marrin (centre) and Ia n B ow m e r ( r i g h t ) w i t h a c e r t i f i c a t e i n re c o gnition of the MCCs 100 years o f s e r v i c e a n d d e vo t i o n t o t h e m e d i c a l p ro f e s sion and also for excellence a n d v i g i l a n c e i n t h e e va l u a t i o n o f p h y s i c i a n s .One-hundred years ago, the 32 members of the newly establishedMedical Council of Canada (MCC) met for the first time on ParliamentHill in Ottawa. A unique combination of representatives from each ofthe licensing bodies and each recognized medical school of the day,Council embodied then, as it does today, inter-provincial co-operationas well as collaboration among academic and practising physicians. This historic inaugural assembly was also a testament to the efforts of the Councils founder, Sir Thomas Roddick, who had strived for nearly two decades to introduce the legal changes needed to create the Council. A century later, the 2012 Council will convene in a special commemorative Annual Meeting that will honour his memory and continue to build on his legacy. This year s meeting, which will be held at the new Ottawa Convention 00Centre, promises to be very special. Its program includes an elegant gala dinner at the Museum of Civilization, complete with entertainment and special guests, and a centennial breakfast on Parliament Hill, the location where the first meeting was held.Executive Secretary to the Board Andre Fortin-Blanger, who hasbeen instrumental in planning this event, said she looks forward to theparliamentary breakfast and the gala dinner, where the former MCCpresidents will be honoured. Locating and contacting former MCCpresidents as far back at 1975 was a challenge, she said. But suchan interesting one! Through this process, I also learned tremendouslyabout these extraordinary individuals. 3. 3ECHOMCC celebratesMedical C o u n c i l o f C a n a d a100 years of excellence100Dr. C l a i re To u c h i e p resenting at DalhousieUn i ve r s i t y o n Ju n e 1 4 , 2012, as par t of theM C C s c e n t e n n i a l w o rkshop seriesphoto credit | Rox y Pe lham, Administrator, Division of Medical Education, Dalhousie University A series of other special events and activities to celebrate the MCCs centennial will take place throughout 2012 and in early 2013. The Council will be sponsoring an invitational workshop and reception at each faculty of medicine in Canada. The MCC will bring together guest speakers who are experts in their respective fields to present on topics related to physician assessment. The receptions will provide university faculty and student representatives with a chance to get to know the Council members appointed by their university and provincial regulatory 00She said that she felt the centennial meeting would notonly serve as an opportunity to honour the past, butalso a chance to celebrate the organization for what it istoday. This Annual Meeting will show how far weve comeand how much was achieved in 100 years. This year stheme, Excellence through evidence: implementing therecommendations of the Assessment Review Task Force,will also encourage us to look at our plans for the future. authority. The MCC created a corporate video to mark its 100th anniversary. This video, which is available on the MCCs website and on YouTube, highlights the organizations history and its role in the Canadian medical community. As part of the centennial celebrations, the MCC had asked Members of Council and vital contributors to submit aMedical assessment is in constant evolution.brief personal account of what the Council means to them. A different article has been featured on the MCC website every weekIn addition, in conjunction with the 2012 Annual Meeting, of 2012.the MCC and the Federation of Medical RegulatoryAuthorities of Canada will host the International AssociationTo enter its second century in style, the MCC has also freshenedof Medical Regulatory Authorities (IAMRA) Internationalup its image. After undergoing a branding exercise, the MCCConference on Medical Regulation, an event that will bring launched on Feb. 9, 2012, a new look and feel complete with atogether over 250 delegates and distinguished guests fromnew logo, which has been applied to its website, applications andover thirty countries. publications. 4. 4ECHOUpdate on the Application forMedical C o u n c i l o f C a n a d aMedical Reg istration in Canada The AMRC development team regularly holds sprint revie ws to update staff on the latest progress with the project. On July 20, staff were briefed on the applications centre assignment functionality. Once all medical regulatory authorities (MRAs) sign on to useHuman Resources and Skills the new system, physicians will be able to apply through theDevelopment Canada, the Federation portal to multiple MRAs for a licence to practise medicine.of Medical Regulatory Authorities of This will help physicians, and especially international medicalCanada (FMRAC) and the Medical graduates, apply to multiple jurisdictions simultaneously.Council of Canada (MCC) arecollaborating to develop the Application The system h a s a n e w n a m e !for Medical Registration in Canada The new portal will be called PhysiciansApply.casystem. The new system, launching in (InscriptionMed.ca in French). The MCC and FMRAC wouldApril 2013, will feature an applicationlike to thank the survey participants who helped select theprocess that will allow physicians name for the portal. Your feedback has been invaluable. Yourto apply for a medical licence. Thecomments have helped ensure that the selected name isproject is funded by the Governmentappropriate to position the system as a central applicationof Canadas Foreign Credential portal for the medical community, both in Canada and on theRecognition Program. international scene. 5. 5ECHOUpdate on the Application forMedical C o u n c i l o f C a n a d aMedical Reg istration in CanadaPro j e c t p ro g ressThe business requirements for the projectsystem. This means that candidates will use begin an application process through thehave almost all been collected. The system PhysiciansApply.ca instead of MCC-Onlinenew system. The application will alreadyis in the midst of its development and testing and PCRC-Online to apply for MCC exams, be pre-populated with existing data inphase. Fifty per cent of the development ofview examination results, submit source the candidates account. For example,the new system is complete.verification requests, etc. information that was contained in his or her PCRC-Online and/or MCC-Online accounts,The project team has been collaboratingIn addition to this functionality, the system in addition to the new information andwith stakeholders, including the faculties will be designed to allow qualified physiciansdocuments in the PhysiciansApply.caof medicine and the certifying colleges, toto apply for a medical licence. However,account, will appear as part of theestablish processes for the exchange of data MRAs will adopt the new system gradually, application. This will ensure a moreand documents to the new system. meaning that most MRAs will start directing seamless process to share information and their applicants to use the system over timedocuments with the MRAs.The new system has undergone a privacy and not necessarily at the time of the systemimpact assessment. As a result, the MCCslaunch in April 2013. Applicants will just need to answer somePrivacy Officer is working on updating privacy additional questions. The types and numberpolicies and procedures prior to the launch of To learn about the requirements and the of questions will vary depending on thethe new system.process to apply for a medical licence in a MRAs selected by the candidate. Once particular jurisdiction, physicians will continue submitted, the application will be directed W h a t t o e x p ect when the system to be encouraged to first visit the MRAs electronically to the MRA itself to process launcheswebsite. Links to these sites are available the application. from the FMRAC website.The new system will launch in April 2013.Stay tuned for more information on theAt that time, candidates with MCC andHowever, once a candidate is directed by thePhysiciansApply.ca portal, including a sneakPhysician Credentials Registry of Canada MRA to use the PhysiciansApply.ca portal to peek in the coming months of what the new(PCRC) accounts will be migrated to the newapply for a medical licence, the candidate will system will look like. 6. 6ECHOMedical C o u n c i l o f C a n a d aBlueprint projectThe MCC is launching this project to provide assurancethat MCC assessments fulfill all the requirements andstandards for credentialing examinations. It will also providea clearly documented and deliberate process to update examspecifications while responding to ongoing developments inthe profession.The MCC has struck a Board of Governance to oversee theBlueprint project process. Board of Governance membersinclude: As the Medical Council of Canada (MCC) begins to implement Dr. Ramses Wassef, the recommendations of theChair of the Blueprint project Board of Governance Assessment Review Task Force, one and the Central Examination Committee of the first priorities is to undertake Dr. Trevor Theman, an examination blueprint project. This representing the MCCs Executive Board and the project will ensure that the critical core Assessment Review Task Force competencies, knowledge, skills and behaviours of a physician entering Dr. Florin Padeanu, supervised and unsupervised practicerepresenting the MCCs Clinical Decision Making are being appropriately assessed. Test Committee 7. 7ECHOMedical C o u n c i l o f C a n a d aBlueprint project Dr. Nancy Brager,The full project will consist of three The project is currently in the first phase, which representing the MCCs Central phases that will take place over a includes collecting data from external sources, Examination Committeeperiod of three to five years. piloting some key survey instruments and conducting analyses. The first phase also includes Dr. Ken Harris, launching a national survey in early 2013 to obtain representing the Royal College of feedback on areas that require assessment. Physicians and Surgeons of CanadaPhase 1 data collection research and analysis Dr. Tim Allen, of possible skills and The MCC has approached a group of experts in representing the College of Family competencies requiredthe medical community to take part in a Delphi Physicians of Canada for the MCCQE Part I questionnaire process. The questionnaire wasand Part IIlaunched in July and will take place over the Dr. Anne-Marie MacLellan, summer. The outcome of the questionnaire will be representing the Collge des mdecinsPhase 2 development andconsensus on overarching competency statements. du Qubectransition to newThese statements, in turn, will be used to guide theexamination blueprintdevelopment of the national survey. Dr. Karen Mann, representing the MCCs Objectives As a result of the research and consultation CommitteePhase 3 construction andadministration of newundertaken throughout the first phase of the Dr. Sarkis Meterissian,examinations Blueprint project, the MCC will produce draft test representing postgraduate deans specifications for the Medical Council of Canada Qualifying Examination Part I and Part II. The Dr. Bruce Wright, public will be invited to provide feedback on the representing the MCCs Research draft test specifications in fall 2013. The MCCs and Development Committee and Central Examination Committee will approve the undergraduate deans final test specifications at the end of 2013. Dr. Dipinder Keer, representing the Canadian Association of Internes and Residents Dr. Fleur-Ange Lefebvre, representing the Federation of MedicalFo r m o r e i n f o r m a t i o n o n t h e Regulatory Authorities of Canada M C C s Bl u e p r i n t p r o j e c t , p l e a s e v i s i tw w w. m c c . c a / e n / e x a m s / b l u e p r i n t Ms. Gwen Haliburton, public member 8. 8ECHOMedical C o u n c i l o f C a n a d aClinical exam harmonization by theMedical Council of Canada and the College of FamilyPhysicians of CanadaThe harmonization p ro j e ct t e a m d u r i n g a r u n - t h ro u g hof the specialaccommodationp ro c e s s e s i n p re p a r a t i o n f o rthe launch oft h e h a r m o n i ze d examinationThe Medical Councilof Canada (MCC) and the Collegeexpertise and know-how to develop All candidates will be required toof Family Physicians of Canada (CFPC) are harmonizing the a harmonized exam that will meet the eligibility requirementsCertification Examination in Family Medicine with the Medical streamline the assessment process of both the CFPC and theCouncil of Canada Qualifying Examination (MCCQE) Part II. for family medicine candidatesMCC. As a result, the eligibilityThe resulting new Certification Examination in Family Medicinewhile maintaining exam validity and requirements for the new(incorporating SAMPs, SOOs and OSCEs) will be launched in reliability. Certification Examination in Familyspring 2013.Medicine include a pass standingFamily medicine candidates whoon the MCCQE Part I and sourceWhen meeting all other requirements of both organizations,are eligible to take the MCCQEverification of required medicalcandidates who challenge and pass this exam will be granted Part II are encouraged to forgo thiscredentials. For more informationCertification in Family Medicine (CCFP) from the CFPC and the exam and instead take the newand a complete list of eligibilityLicentiate of the Medical Council of Canada (LMCC). Certification Examination in Familyrequirements, visit:Medicine starting in spring 2013.This project has been an excellent collaboration between www.cfpc.ca/2013_CCFPthe MCC and CFPC, said Dr. Ian Bowmer, Executive DirectorSeveral new policy decisions haveof the MCC. Both organizations have contributed theirrecently been announced: 9. 9ECHOMedical C o u n c i l o f C a n a d aClinical exam harmonization by theMedical Council of Canada and the College of FamilyPhysicians of Canada Those residency or practice- Candidates must successfully eligible candidates who passedcomplete both the written the MCCQE Part II on or beforecomponent (SAMPs) and spring 2011 will have the the enhanced clinical skillsAn initial list of examination sites has been opportunity to sit the traditionalcomponent (SOOs and OSCEs)published. This list will be expanded to include Certification exam (current to be awarded their CCFP. Ifadditional sites as they become confirmed. format of SAMPs and SOOscandidates are unsuccessful on Both organizations are meeting regularly only) in the spring and fall of both components, they will be to finalize examination processes including 2013. The CFPC will offer the required to re-sit the full exam. candidate registration, site administration, traditional exam to these groupsIf candidates are unsuccessful examiner recruitment and scoring. Operational only in 2013. on one of the two exam processes have been documented and the components, they may retake Both organizations hadproject team is running exam simulations to that component of the exam at a committed that the fee for thehelp prepare for the launch of the harmonized reduced fee. Decoupling of the harmonized exam would not examination. exam components only applies to be higher than the combinationrepeat attempts to pass the new of the two separate 2013 fees Certification exam. for the traditional Certification exam and the MCCQE Part II. If a candidate is unsuccessful The new exam fee for 2013 has in meeting the standard for Fo r m o r e i n f o r m a t i o n o n t h e n e w been set at $4,600, the agreed- Certification, the MCCs Central upon threshold. Key elementsExamination Committee (CEC) Certification Examination in contributing to the exam feewill review the candidates Fa m i l y Me d i c i n e , p l e a s e v i s i t include opening new examperformance on the clinical www.mcc.ca/en/news/Enhanced_examination.shtml sites and offering the exam skills component of the new or as geographically close to theCertification exam. The CEC will candidates as possible. determine if the performancewww.cfpc.ca/2013_CCFP meets a pass standard comparable to the one for the MCCQE Part II, and therefore whether to award the LMCC. 10. 10ECHOMedical C o u n c i l o f C a n a d a Coming soon: a national process for practice-ready assessment The first phase of the project involved cataloguing the various program elements already in place across jurisdictions in Canada. Cindy Streefkerk, a consultantPartners from across the country will develop aworking with the Medical Council of Canada, spearheadedpan-Canadian practice-ready assessment process for the development of this environmental scan.international medical graduates (IMGs). It was a great experience and quite informative, sheOf the new IMGs who are registered for practice everysaid. The regional programs understand the valueyear, approximately 50 per cent of them have pursued in what they each do day-to-day and how it fits in thepostgraduate training in Canada. The other half went broader context. There are regional variations in programthrough a practice-ready route.processes but theres also a willingness to participate and share across jurisdictions.The National Assessment Collaboration (NAC) wasestablished to streamline the evaluation process for Now that the environmental scan is complete, theIMGs. The NACs ultimate goal is to offer an integratedproject will turn to designing and developing the pan-assessment continuum.Canadian PRA. The pan-Canadian process will build on the strengths and best practices of the provincialThe NACs initial focus was developing a clinicalassessments.examination to help determine IMGs readiness forentry into residency. This exam, the NAC OSCE, isIm looking forward to the design and implementation of anow offered in five different provinces. Last year, over pan-Canadian practice-ready assessment, Ms. Streefkerk680 IMGs took the NAC OSCE.said. Well have to look at areas including standards development, quality assurance processes and ensuringGiven the successful operational launch of the that a solution is comparable across jurisdictions.In t e re s t e d i n m o reNAC OSCE, the NAC will now focus its attention information on on developing the pathway for practice-ready The project will be led by the NAC PRA Steeringassessment. This route would be available to IMGsCommittee, and will report to the governing body of the the pan-CanadianNAC, the National Assessment Central Coordinating p r a c t i c e - re a d y seeking a provisional licence to enter independentpractice.Committee. An integral part of the project includes assessment project? consultation and participation of the provincial PRAL e t u s k n ow , a n d w eSeveral provinces already offer a practice-ready programs. will add you to theassessment (PRA) locally. To enhance transferability PRA design sessions will be held in September, Octoberacross provincial boundaries and to reducedistribution list forand November. Research activities and a communicationsduplication, the NAC will now work with its partners toproject updates. plan are being developed to support the project.create a pan-Canadian PRA that will be consistent andcomparable across Canadian jurisdictions. The projectThe Medical Council of Canada will make thehas received funding from Health Canada for design environmental scan available on its website over theand development activities.summer months. 11. 11ECHOMedical C o u n c i l o f C a n a d aCanadian Conference on Medical Educationa successful and productive experiencefor MCC staff M C C s t a f f t o o k t u r n s a d d re s s i n g q u e s t i o n s f ro m p a r t i c i p a n t s a n d p rov i d i n g i n f o r m a t i o n o n t h e M C C and its services at the corporateThe 2012 CCME was held b o o t h . Sh ow n h e re a re Il o n a in Banff, Alta., from April 14 Ba r t m a n a n d Dr. Ma r g u e r i t e Roy. to 18, 2012 and centred onthe theme Global Health andMedical Education: BeyondBoundaries. The MCCs Manager A delegation of world-classin Assessment, Dr. Sydney researchers and experts in assessmentSmee, represented the Medical ensured the Medical Council of CanadaCouncil on the CCME Program (MCC) was well represented again Committee, helping to develop this year at the Canadian Conference the conference theme and on Medical Education (CCME). The plenary sessions as well as conference is the largest of its kind in reviewing abstract submissions. Canada, attracting on an annual basis over 1,300 participants from acrossDr. Smee had the honour of the medical education and assessment chairing a plenary session on communities. global health featuring medicaldoctor and founder of the This event provided MCC staff with the international humanitarian opportunity not only to showcase their organization War Child, own research projects but, as well, to Dr.Samantha Nutt. I was draw on the knowledge of some of the very pleased to introduce sharpest minds in the country and bring[Dr.] Samantha Nutt, said Dr. back best practices and new research Smee. I admire her activism ideas. The conference was also a great and I enjoyed reading her networking event, allowing MCC staff book Damned Nations. Her to connect with Medical Council alumni,suggestions have changed how colleagues from sister organizations,I am managing my personal peers and committee members. donations. 12. 12ECHOMedical C o u n c i l o f C a n a d aCanadian Conference on Medical Educationa successful and productive experiencefor MCC staff Dr. Syd n ey Smee introducing a p l e n a r y s ession on global health Her presentation, Analytic Methods to Evaluate Item and Test Fairness: A Case study of the Medical Council of Canada Evaluating Examination (MCCEE), was co-authored by MCC Research-psychometrician Dr. Andrea Gotzmann with research conducted in partnership with Dr. Mark Gierl and Hollis Lai at the University of Alberta, a collaboration Dr. Roy qualified as fabulous! Although DIF analyses are not new to pencil-and-paper examinations, performing one on a computer-based examination was innovative. To contend with the several forms or versions of the exam, the researchers had to develop new procedures for a practical application of complex statistical models. The analysis found that almost none of the questions in the MCCEE bank were potentially biased based on the variablesDr. Smee also co-presented a workshop Dr. Marguerite Roy, Research examined. Youd always expect to find flagged items andwith Bruce Holmes of Dalhousie University,Analyst, presented cutting-I was surprised to find how few there were, said Dr. Roy.Dr. Robert Maudsley of the College of edge research on applying aThis is good news that speaks to the quality of our items.Physicians and Surgeons of Nova Scotia anddifferential item functioning As for the questions that were flagged by the study, theyAlexa Fotheringham, the MCCs Associate (DIF) analysis to the MCCs have been sent for review and revision by the expert testManager, National Assessment CollaborationEvaluating Examination to committees.(NAC). The workshop, entitled Fostering flag potentially biased itemsBetter OSCE Examiners: Participate in (questions). A DIF study As a next step, Dr. Roy said that she would like to see thisExaminer Orientation Development, was evaluates exam questions type of analysis continue to be performed as part of thedesigned to help participants improve the to verify that candidates, atMCCs regular exam validity quality assurance processes.scoring consistency of physician examinersthe same ability level, fare She would also like to explore whether this method could be(PEs) by learning to prepare effectivecomparably on the item,adapted to assess other types of examinations such as thePE orientation presentations and scoringregardless of gender, language,objective structured clinical examinations (OSCEs) and otherguidelines. country of birth or citizenship. performance-based tests. 13. 13ECHOMedical C o u n c i l o f C a n a d aDr. Ian Bow mer honoured by the Royal College ofPhysicians and Surgeons of Canada In recognition of his important HIV research and his role in shaping medical education in Canada, Dr. M. Ian Bowmer, Executive Director and CEO of the Medical Council of Canada (MCC) and Professor Emeritus at Memorial University, has been named 2012 laureate of the James H. Graham Award of Merit. The award is presented each year by the Royal College of Physicians and Surgeons of Canada (RCPSC) to a person whose outstanding achievements reflect the aims and objectives of the RCPSC. Dr. Bowmer is a true leaderin Canadian health care, said Dr. Andrew Padmos, CEO of the RCPSC. He has worked diligently to advance patient care, improve training and bring medical institutions together to create lasting change. Dr. Bowmer is recognized worldwide as a leader in medical education. He has already received several prestigious awards, including the Dr. Louis Levasseur Distinguished Service Award and the Canadian Professors of Medicine Christie Award, for his contributions in this field. In addition to his leadership role with the MCC, he has directed pivotal projects in Canadian medicine, including the Physician Credentials Registry of Canada. Dr. Bowmers thoughtful approach to assessment issues, his enthusiasm, and his spirit of collaboration have contributed substantially to the development of comprehensive strategies for the assessment of physicians entering practice, said MCC President Dr. Michael Marrin. More broadly, his vision Dr. M . Ia n B ow m e r, and leadership throughout his career have contributed toExe c u t i ve Di re c t o r a n dC E O o f t h e Me d i c a l improved medical care in Canada and internationally. Council of Canada Dr. Bowmer will receive the award this October at the 2012 Royal College Convocation ceremony in Ottawa.