excellence innovationcredibility · 2019-09-10 · annualreport2010/11 c e h p e a 5...

EXCELLENCEINNOVATION

CREDIBILITY

A N N U A L R E P O R T 2 0 1 0 / 1 1

Annual Report 2010/11

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HealthForceOntario is the province’s strategy to ensure thatOntarians have access to the right number and mix ofqualiYed health professionals – now and in the future. As partof that strategy, the Centre for the Evaluation of HealthProfessionals Educated Abroad (CEHPEA) was established tocreate a gold standard for assessment and training ofinternationally educated health professionals.

That was four years ago. We are pleased to report that wehave created the largest International Medical Graduate(IMG) assessment and training centre in Canada. Beyond thesize and scope of our examinations and educationalprograms, it is gratifying to hear from our

stakeholders that we have earned a reputation for excellence,innovation and credibility.

We are committed to supporting the province’s efforts toincrease access to medical professionals, while ensuring thatthe highest standards are met. Whether it is creating orrunning examinations or training programs, we constantlyevaluate, Yne tune and improve our processes, products andservices based on best practices and consultations with ourpartners and clients.

Given our expertise with large-scale written and clinicalassessments, we were invited to play a leadership role in

Message fromthe Executive Director and Board Chair

“Our success has only been possiblebecause of the governanceprovided by our Board of Directors,the expertise of our partners, thetalent of our staff and the fundingprovided by the Ministry of Healthand Long-Term Care. Together we arepaving the way for internationallyeducated health professionals topractice in Ontario and improvingaccess to patient care.

Margaret NelliganBoard Chair

Anne Marie CrescenziExecutive Director and CEO

Inside this report

3 Message from the Executive Director and Board Chair

5 About CEHPEA

6 Written and Clinical Assessments: Enhancing IMG Assessments and Expanding to New Professions

14 Education Programs: Helping IMGs Make the Transition to Practice in Ontario

21 Governance: Our Board of Directors 2010/11

23 CEHPEA Executive Team


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About CEHPEAThe Centre for the Evaluation of Health Professionals EducatedAbroad (CEHPEA) is the only organization in Ontario thatprovides assessment, evaluation and training programs forinternationally educated health professionals. With state-of-the-art examination and education facilities in downtownToronto, CEHPEA is the largest assessment centre of its kindin Canada.

CEHPEA is part of the province’s HealthForceOntario strategyto address the shortage of health human resources, includingexpanding and enhancing services provided to internationallyeducated health professionals.

Our overall goal is to facilitate entry to training or practice forinternationally educated health care professionals. It plays a

dual role - assessing International Medical Graduates (IMGs)to ensure that they meet Canadian standards for training andpractice, as well as providing programs to orient candidatesto training and practice in Canada.

VISION: To facilitate access to a health care career tointernationally educated health professionals who want toreside and practice in Ontario, through the provision ofevaluation and orientation services.

MISSION: To be an integral part of the Ministry of Health andLong-Term Care’s health strategy by providing ongoingevaluation and orientation programs for InternationallyEducated Health Professionals based on the needs of Ontario’shealth care system and applicants.

Facts and Figures

13.54%11.82%12.73%

9.92%11.82%12.73%

11.33%11.82%12.73%

13.38%13.51%10.61%

6.14%4.56%5.30%

3.93%4.39%5.09%

3.14%3.04%3.60%

3.30%3.20%2.97%

Our Partners

Message fromthe Executive Director and Board Chair

As we develop our assessments and orientation programs,we have increasingly collaborated and consulted with ourpartners and stakeholders, including the provincial andfederal governments, medical schools, physicians, nursesand allied health professionals. Other key stakeholdersinclude the College of Physicians and Surgeons of Ontario,the Royal College of Physicians and Surgeons of Canada,the Council of Ontario Faculties of Medicine, the College ofNurses of Ontario, HealthForceOntario and other regulatorybodies of the various health professions.

India Iran Pakistan Egypt Iraq Bangladesh Nigeria Romania Sri Lanka Russia

2.99%3.04%2.12%

2.99%2.70%1.48%

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Top 10 countries where CEHPEA applicants received their medical undergraduate degree

2008/09

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6.14%7.43%10.82%

45.82%43.75%40.55%

35.27%37.50%38.00%

12.75%11.31%10.61%

< 29 years of age 30 - 39 years of age 40 - 49 years of age > 50 years of age

Age distributions of IMG candidates applying to CEHPEA

the National Assessment Collaboration (NAC) to create aprocess to assess IMGs’ medical knowledge and skills andprovide a nationally recognized credential. As our GeneralComprehensive Clinical Examination (CE1) was the largest inthe country, we provided a large amount of examinationcontent for the NAC Objective Structured Clinical Exam(OSCE) from our CE1 item bank. The new NAC OSCE, whichreplaces CE1, was launched in March and CEHPEA will be thebiggest test site in Canada. In 2010/11 we also offered writtenand clinical assessments for seven specialties and ran a testsite for the Pharmacy Examining Board of Canadaexamination.

In addition to ongoing reYnements of our assessments andeducational programs, we have made many improvementsto streamline processes for IMGs. This year we revamped ourwebsite to make it easier for applicants to access informationabout our services and requirements. We also improved theprocess for retrieving and validating professional credentialsby becoming a Licensed User of the Medical IdentiYcationNumber for Canada and partnering with the Medical Councilof Canada Physician Credentials Repository.

We have always responded quickly to ministry directions andthe changing needs of our stakeholders and Ontario’s healthsystem. As a result, we have often been propelled into newfrontiers and asked to come up with creative ideas.Innovation – the process of bringing ideas to life – hasbecome one of our strengths.

Our Pre-Residency Program (PRP) and Orientation to Trainingand Practice in Canada (OTPC) program were created at therequest of Program Directors from Ontario’s Faculties ofMedicine. These programs, which are unique to Ontario, havebeen extremely successful and this year, they were taken tothe next level with the launch of a new, improved hybrid(classroom and online learning) model for the OTPC program.The new program provides more Zexibility, outstanding e-learning modules, discussion forums, polls and real-timefeedback. This format has generated a high level ofengagement and satisfaction among participants.

In another exciting development this year, we havebroadened our focus to work on several major nursinginitiatives. We have partnered with Nipissing University as itlaunches an innovative type of Bachelor of Science in Nursingdegree program. Collaborating with the College of Nurses ofOntario (CNO) we created a Quality-Assurance PracticeAssessment OSCE for nurse practitioners as part of theircontinuing competence assessment. We are also workingwith CNO and the Nursing Secretariat to develop andimplement an assessment process for InternationallyEducated Nurses (IENs). As the number of IENs is triple thenumber of IMGs, the scale of these assessments isunprecedented in Canada.

While expanding to new professions, we never lose sight ofour core commitment to being a world-class centre forrigorous and objective assessment. Our exams areconstructed by our in-house experts working with medicaleducation experts from Ontario’s universities andprofessional colleges. Extensive training is provided forexaminers and standardized patients and their feedback,along with candidate evaluations, is solicited every step ofthe way. We take great pride to ensure that rigorousprocesses are in place to evaluate and validate the accuracyof testing procedures and the calculation of results. The resultis a reputation for unquestioned credibility.

*If you would like to obtain a copy of CEHPEA’s audited Ynancial statements for 2010/11 please send your request to [email protected]

The Ontario government, as part of its HealthForceOntariostrategy, recognized the importance of internationallyeducated health care professionals and provided funding tosupport CEHPEA in becoming the largest International MedicalGraduate (IMG) assessment centre in Canada. In a few shortyears, CEHPEA has created a world-class centre for rigorousand objective assessment. Several factors have contributed toour success.

“We have always taken great care to evaluate and validate theaccuracy of the testing processes and the calculation of results,”says Dr. Murray Urowitz, CEHPEA’s Director of HealthProfessional Affairs. “It is extremely gratifying that ourassessments have earned a reputation for unquestionablecredibility, providing medical schools with importantinformation to help them select the best candidates.”

Committed to excellence and precision in testing, we areconstantly Yne-tuning our examination content and processes

based on evaluation reports and input from candidates,examiners and participants. As well, we collaborate andconsult with our partners and stakeholders every step of theway as we develop our assessments.

In addition to our external examiners and in-houseexamination experts, our Standardized Patient Program iscritical to the success of our clinical examinations.

As well, CEHPEA’s unique facilities were designed speciYcally toaccommodate large-scale written and clinical examinations.Our state-of-the-art examination and education centreoccupies more than 50,000 square feet in downtown Toronto.

“All these factors result in a sophisticated, documentedassessment system that runs very smoothly,”says Marla Nayer,PhD, CEHPEA’s Director of Assessment Operations.

Based on our experience running large-scale clinical andwritten examinations we were able to play a leadership role in


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the development of a new, National Assessment Collaboration(NAC) Objective Structured Clinical Exam (OSCE) for IMGs andwill be the largest test site in Canada.

CEHPEA’s core business originally focused on examinations toassess International Medical Graduates’ (IMGs) readiness totrain and practice in Ontario. We have continued to reYne andgrow that part of our business, while applying our assessmentexpertise to other professions.

We have also signiYcantly expanded our focus through severalnew initiatives and partnerships, including: planning for thedevelopment of an assessment process for InternationallyEducated Nurses; creating a Quality-Assurance PracticeAssessment OSCE for nurse practitioners; partnering withNipissing University School of Nursing on an innovative newdelivery for BScN education; and, becoming a test site for thePharmacy Examining Board of Canada examination.


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Written and Clinical Assessments:Enhancing IMG Assessments

and Expanding to NewProfessions

Developing an assessment process forInternationally Educated Nurses (IENs) with the

College of Nurses (CNO) and the NursingSecretariat of the Ministry of Health and Long-

Term Care

Working with CNO to create a Quality-AssurancePractice Assessment OSCE for nurse

practitioners

Partnering with Nipissing University’s School ofNursing on a new delivery system for BScN

education

Playing a leadership role in the developmentand launch of a national clinical assessment

(NAC OSCE) for IMGs

Operating the largest test site in Canada for theNAC OSCE

Running written and clinical exams for sevenspecialties

Facilitating retrieval of IMGs’ professionalcredentials

Running a test site for the Pharmacy ExaminingBoard of Canada examination

Dr. Murray UrowitzDirector of Health Professional Affairs

Marla Nayer, PhDDirector of Assessment Operations

“ It is extremely gratifying that our assessmentshave earned a reputation for unquestionablecredibility, providing medical schools withimportant information to help them selectthe best candidates. ”

“ Many factors haveresulted in a sophisticated,documented assessmentsystem that runs verysmoothly.”

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The backgrounds of International Medical Graduates seekingresidency in Ontario are diverse and until March, 2011,CEHPEA’s General Comprehensive Clinical Examination (CE1)provided Program Directors of Ontario’s Faculties of Medicinewith important information to assist them in selectingcandidates for residency. The CE1 was an Objective StructuredClinical Exam (OSCE) that tested clinical skills with emphaseson communications, data collection, management andprofessional skills.

The CE1, which was unique to Ontario, was initially offeredonce a year but the number of exams offered by CEHPEA hasincreased over the years and in 2010/11, seven examinationswere held with a registration of 403 candidates. By comparison,most provinces offer a similar assessment once a year.

The CE1 was by far the largest and most comprehensive in thecountry. CEHPEA’s Executive Team played a leadership role in

the National Assessment Collaboration (NAC) to create anational process to accurately and efficiently assess IMGs’medical knowledge and skills and ensure more mobility forIMGs with a nationally recognized credential. As well, CEHPEAprovided a large amount of the examination content for theNAC OSCE from its CE1 item bank.

The NAC OSCE was formally launched on March 19, 2011. TheNAC OSCE assesses the readiness of an IMG for entrance intoa Canadian residency program. It is a national, standardizedexamination that tests the knowledge, skills and attitudesessential for entrance into postgraduate training in Canada.

The NAC OSCE is expected to replace all current OSCEexaminations (including CEHPEA’s CE1) in provinces withactive IMG assessment programs. In 2011, CEHPEA remainsthe largest test site in Canada and will be administering fourNAC OSCEs.


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Through large-scale written and clinical exams, CEHPEAassesses the skill level of internationally educated healthprofessionals and their readiness for practice in Ontario.CEHPEA’s standardized evaluations ensure that IMGs meet thestandards for Canadian training and practice, enables themto compare their clinical competencies with those ofCanadian medical graduates and improve their chances ofobtaining residency positions.

While other provinces mostly focus on assessment of fully-trained physicians, Ontario (through CEHPEA) providesassessments of IMGs across the entire spectrum of readiness,ranging from candidates with no prior experience, to thosewith partial training and practice experience, to physiciansthat have years of medical practice experience in anothercountry.

CEHPEA assesses IMGs to determine their preparedness forthe following levels of postgraduate medical education:

1) Entry-Level Training (PGY1 – Yrst year of postgraduatetraining in Family Medicine or Specialty ResidencyProgram)

2) Advanced Specialty Training (PGY2 – second year ofpostgraduate training in a Specialty Residency Program)

3) Practice Ready Assessment – six month assessment in asupervised clinical setting

ReYning and IncreasingAssessments for IMGs

Ontario absorbs more International Medical Graduates (IMGs) than all otherprovinces combined. Even so, the process is extremely competitive.

Fast Facts

Examinations Conducted by CEHPEA in 2010/11

In total, 522 IMGs participated in examinations offered byCEHPEA from April 1, 2010 to March 31, 2011. CEHPEAconducted:

• 7 Clinical Exams (CE1) in the Family Medicine Stream

• 1 Clinical Exam (NAC OSCE) in the Family MedicineStream

• Specialty Written Exams (SWE) for Anesthesia, GeneralSurgery, Internal Medicine, Obstetrics/Gynecology,Orthopedic Surgery and Pediatrics

• Specialty Clinical Exams (CE2) for Anesthesia, GeneralSurgery, Internal Medicine, Obstetrics/Gynecology,Ophthalmology, Orthopedic Surgery and Pediatrics

• Surgical Skills Exams for General Surgery,Obstetrics/Gynecology and Orthopedic Surgery

Assessing Readiness forEntry-Level Training

The National Assessment Collaboration’s (NAC) ObjectiveStructured Clinical Exam (OSCE) is a “hands-on” examinationthat simulates typical clinical scenarios where standardizepatients are trained to portray patients with speciYc problems.Candidates are assessed for language usage and proYciency,clinical skills as well as basic knowledge of therapeuticmanagement of common complaints.

The examination includes problems in medicine, pediatrics,obstetrics and gynecology, preventive medicine andcommunity health, psychiatry and surgery. At each station, aphysician examiner observes and assesses performance whilethe candidate interacts with the standardized patient.

The NAC OSCE is intended to help rank IMGs who apply toindividual Canadian medical school postgraduate programs.

Passing this examination does not guarantee a trainingposition in Canada, but rather provides feedback to theprogram directors who are selecting trainees on the strengthsand weaknesses of the individuals who take this examination.

All candidates are, at a minimum, required to have passed theMedical Council of Canada Evaluating Examination (MCCEE)before being eligible to take the NAC OSCE. The CanadianResident Matching Service (CaRMS) is accepting NAC OSCEresults as part of match application packages.

The NAC OSCE is not a prerequisite to obtain the Licentiate ofthe Medical Council of Canada. However, depending on theprovincial IMG assessment program, a pass result on the NACOSCE may be a prerequisite for eligibility for residencytraining programs.

What is a NAC OSCE?


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International Medical Graduates (IMGs) who have experienceas physicians in other countries may be able to apply forAdvanced Specialty Training and Practice Ready Assessment(PRA).

Advanced Specialty Training (PGY2) refers to the second yearor more advanced years of postgraduate training in aspecialty residency program. IMGs entering at an advancedlevel have been assessed as requiring between one and fouryears of training in order to meet the registrationrequirements to practice in Ontario.

Practice Ready Assessment (PRA) allows physicians, withprevious practice experience in another country, to undergoa six-month assessment in a supervised clinical setting todetermine whether or not they need further training or areready to enter directly into practice. Upon successfulcompletion of the PRA, they are considered practice readyand can apply for registration to practice medicine in Ontario.This assessment yields huge beneYts by fast-tracking theprocess, saving time and money and increasing the numberof qualiYed specialists in the province.

CEHPEA provides the following assessments to testcandidates’appropriateness for the PGY2 or PRA levels in thespecialty stream:

• Specialty Clinical Examinations (CE2)

• Specialty Written Examinations (SWE)

• Surgical Skills Assessment at the University of Toronto’sSurgical Skills Centre at Mount Sinai Hospital

Assessing Readiness for Advanced-Level Training

The National Assessment Collaboration was established tocreate a national assessment process to accurately andefficiently assess IMGs’ medical knowledge and clinical skillswhich would be acceptable to all jurisdictions in Canada andwould ensure more mobility for IMGs with a nationallyrecognized credential.

The National Assessment Collaboration is comprised of HealthCanada, the Medical Council of Canada, the provincial andterritorial governments, the seven regional IMG assessmentprograms (including CEHPEA for Ontario), the provincial andterritorial medical colleges, the Federation of MedicalRegulatory Authorities of Canada, the Association of Facultiesof Medicine of Canada, the Royal College of Physicians andSurgeons of Canada and the College of Family Physicians ofCanada.

The Collaboration was Yrst focused on creating a nationalclinical OSCE examination (Objective Structured ClinicalExamination) and struck an OSCE test committee to lead thisinitiative. Arthur Rothman, EdD, psychometrician consultant

for CEHPEA was chosen as the Yrst chairman of thiscommittee. The Medical Council of Canada serves as thecentral coordinating and administrative body to standardizethe development, measurement and administration of theOSCE assessment process. However, the examination is beingadministered locally by the provincial test centres. In Ontariothe assessment is delivered by CEHPEA.

About the National Assessment Collaboration

Arthur Rothman, EdDChair, OSCE TestCommittee About the

Surgical Skills Assessment

Working in partnership with the University of TorontoSurgical Skills Centre at Mount Sinai Hospital, CEHPEA runspractical assessments for general surgery, obstetrics/gynecology and orthopedic surgery specialties. The Centreprovides a laboratory setting where basic and complexsurgical procedures can be learned, practiced and assessed.CEHPEA chooses stations from the Centre’s bank thenrevises the stations, checklists and rating scales to suit theevaluation requirements of the speciYc specialty as well asCEHPEA assessment processes and rating scales, which areconsistent across the examinations. The Surgical SkillsAssessment provides an opportunity for IMGs todemonstrate their technical skills and examiners to assesstheir level of practice as compared to Canadian standards.

“We have a great relationship with CEHPEA and workingwith Marla Nayer and her assessment team is fantastic,”saysSurgical Skills Centre Manager Lisa Satterthwaite.

SWE � � � � � � �

CE2 � � � � � � �

SSA � � �

Advanced Specialty Assessments Offered by CEHPEA

Anesthesia General Surgery Internal Medicine Obstetrics/Gynecology Ophthalmology Orthopedic Surgery Pediatrics

Partnership with PCRC Streamlines Application ProcessIn order to facilitate the 2011 application process forcandidates, CEHPEA has partnered with the Medical Councilof Canada Physician Credentials Repository (PCRC) for theveriYcation of international medical credential documents.This service is designed to reduce duplication of effort bygathering, verifying and permanently storing credentials in acentralized repository so that IMGs don’t have to constantlyreproduce credentials wherever they go.

PCRC provides a national standardized approach toveriYcation of IMGs’ credentials. PCRC also serves as apermanent electronic repository for physicians’ credentialssuch as Medical Degrees, Medical Degree Transcripts,postgraduate training certiYcates, specialty certiYcates, andmedical licensure/registration certiYcates. Supportingdocuments such as translations, proof of name changedocuments, identity documents, etc., and MCC examination

results documents may also be stored in the repository. Oncemedical credentials and supporting documents are registeredwith PCRC, candidates can choose to share these documentswith any of the organizations registered with PCRC, includingCEHPEA.

CEHPEA Becomes a Licensed User of MINCIn another new development this year, CEHPEA became aLicensed User of the Medical IdentiYcation Number forCanada (MINC). MINC is a nationally-recognized uniquelifetime identiYer system, developed to identify everyindividual in the Canadian medical education and practicesystems. MINCs are issued by a federally-incorporated not-for-proYt organization owned by the Federation of MedicalRegulatory Authorities of Canada and the Medical Council ofCanada. Once assigned, a MINC remains unchangedthroughout the individual’s entire medical career.

Facilitating Retrieval of IMGs’ Professional Credentials

(SWE): Specialty Written Examinations (CE2): Specialty Clinical Examinations (SSA): Surgical Skills Assessment


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We have been collaborating with the College of Nurses ofOntario (CNO) to develop an ongoing Quality AssurancePractice Assessment OSCE for nurse practitioners in theprovince. The pilot was completed on June 1, 2011 and thelaunch is planned for early 2012. The OSCE is one part of CNO’scontinuing competency assessment for nurse practitioners,which also includes an Objective Test, a Chart Review andInterview Assessment.

“We selected CEHPEA to partner in this project because it hasthe experience and infrastructure to conduct this evidence-based, standardized assessment process,” says JanetAnderson, RN, CNO’s Manager of Quality Assurance in thedepartment of Practice and Regulatory Policy.

CEHPEA worked with CNO experts to identify thecompetencies they wanted to assess, developed the blueprint

and helped them to develop OSCE stations. The stations haveall been put through a very strong development process. Twostandardized patients were trained and a nurse practitionerwas brought in to go through the stations. These Yeld testsinvolved the newly appointed Chief Examiner, a nursepractitioner, observing participants going through thestations. After making further reYnements, another group ofnurse practitioners went through the stations in a groupformat, providing feedback on content as well as ensuringthat the scoring tool worked as required.

“This has been a very exciting initiative as together, wedeveloped the OSCE from scratch,” says Marla Nayer, PhD,CEHPEA’s Director of Assessment Operations. “I am veryimpressed that the College is doing a clinical assessment of aclinical role. It has created a particularly rigorous process. “

Creating an OSCE-Style Assessment forNurse Practitioners

Janet Anderson, RN, Manager of Quality Assurance, CNO

“We selected CEHPEA to partner in this project because it has the experience and infrastructureto conduct this evidence-based, standardized assessment process. ”

Leeann Whitney, BScN, MAEd, Program Manager, Nipissing University

“CEHPEA provides a professional environment for learning and testing with itsexamination rooms and Standardized Patient Program. ”

Partnering with Nipissing University ona New Delivery for BScN Education

We are pleased to announce that we have partnered withNipissing University as it launches a new type of Bachelor ofScience in Nursing degree program (BScN) in September2011. It is an accelerated, two-year, second degree program,based on an apprenticeship model with clinical placementsat Yve Toronto teaching hospitals and Toronto Public Health.CEHPEA will be providing classroom and examination space.

“CEHPEA provides a professional environment for learningand testing with its examination rooms and Standardized

Patient Program,” says Leeann Whitney, BScN, MAEd, andProgram Manager for New and Emerging Nursing Programs atNipissing University in North Bay.“They have been excellent atcommunicating with us and understanding our needs andhave been extremely open to this innovative apprenticeshipprogram, which is the Yrst of its kind in Ontario.”

Graduates of the program will be able to apply to sit for theCanadian Registered Nurse Examination.


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In an exciting new direction, CEHPEA has been asked todevelop and implement an assessment process forInternationally Educated Nurses. “With the numbers ofInternationally Educated Nurses roughly triple the number ofInternational Medical Graduates, the scale of theseassessments is unprecedented in Canada,” says Anne MarieCrescenzi, CEHPEA’s Executive Director and CEO.

This project was initiated by the College of Nurses of Ontarioand approved by the Ministry of Health and Long-Term Carethis year. We are working collaboratively with our nursingpartners to develop the written and clinical (OSCE)assessments for nurses educated abroad.

Currently, if nurses abroad graduated from accredited andrecognized nursing schools, they could be given the go-ahead by the College to write the Canadian NursingRegistration Examination. If this route is not an option, nursesmay be required to go to bridging programs before earningthe right to take the national licensing exams.

In the future Internationally Educated Nurses will be able toattend CEHPEA directly for assessment and then on to thelicensing exam.

“It is a very positive move,” says Anne Marie Crescenzi. “Oncethe assessments are up and running, candidates will knowmuch sooner if they can access the exams.”

Expanding Our Scope:A New Focus On Nursing

This has been a year of major expansion as we have broadened our focus to work onseveral major nursing initiatives in partnership with the Nursing Secretariat of the

Ministry of Health and Long-Term Care, the College of Nurses and NipissingUniversity’s School of Nursing.

Developing a New Assessment Process forInternationally Educated Nurses

Anne Marie Crescenzi, Executive Director and CEO, CEHPEA

“With the numbers of Internationally Educated Nurses roughly triple the numberof International Medical Graduates, the scale of these assessments is

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“For example, there are individuals we treat, individuals whoare members of the team and then there is the intricatecomplexity of interactions with the various parts of thehospital system, the community in general, other agenciesand allied health professionals. So for a person who is new tothe system, being able to pick up on these subtleties andsometimes minimal cues, CEHPEA’s education programs helpyou navigate the system and get the most out of the learningenvironment.”

A Student-Centred Approach to TrainingWhile CEHPEA’s education programs are committed to apatient-centred approach, our education experts are alsocommitted to a student-centred approach.

“It is our intention that our programs are both enriching toeach individual’s unique education, knowledge, skills, trainingand in some cases, previous practice,” says Marie Rocchi,BScPhm, MDEd, CEHPEA’s Director of Educational Programs.“We are very responsive and adaptive and are continuallytrying to improve – even while the programs are in session. Itis very important that each participant’s experience berelevant and meaningful.”


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Integrating qualiYed and competent International MedicalGraduates (IMGs) into Ontario’s medical system helps toimprove access to health care for Ontarians. Recognizing thatthey are a great resource, for the past 20 years Ontario hasactively committed to increasing the number ofinternationally educated health professionals and absorbsmore IMGs than all other provinces combined. CEHPEAprovides education programs to help IMGs make thetransition to practice in Ontario through our Pre-ResidencyProgram (PRP) for Family Medicine Residents and theOrientation to Training and Practice in Canada Program(OTPC) for specialty residents.

Orienting IMGs to Canada’s Patient-Centred Medical Culture“Until recently, the traditionalhealth care delivery system aroundthe world has been very doctorcentred,” says Dr. Murray Urowitz,CEHPEA’s Director of HealthProfessional Affairs. In other words,the doctor has the knowledge tomake a diagnosis, prescribestreatment and conveys thatinformation to the patient and thepatient does what the doctor says.The Canadian medical culture isvery different. For the last two

decades or more it has been very patient centred. “This is amajor paradigm shift for many International MedicalGraduates and our orientation programs help them tounderstand that patients want doctors to communicatefrequently and clearly and expect them to collaborate withother components of the health system.“

Building on the CanMEDS FrameworkBoth the PRP and OTPC programs are Yrmly grounded in theCanMEDS Framework (2005) which was developed by theRoyal College of Physicians and Surgeons of Canada. Eachsession in our education programs is linked to one or more ofthe corresponding roles or competencies.

“Our orientation programs stress the non-medicalcompetencies,” says Dr. Urowitz. “We assume the medicalexpertise is already there as candidates have alreadygraduated from medical school. The CanMEDs Frameworkoutlines the competencies for a physician in addition to themedical expert role. The other competencies are often called“softer” skills. But soft should not imply not important.”

According to Dr. Salvatore Spadafora, Vice Dean, PostgraduateMedical Education, Faculty of Medicine at the University ofToronto, physicians face quite a complex matrix of interaction.

Education Programs:Helping IMGs Make the

Transition to Practicein Ontario

© 2005 The Royal College of Physicians and Surgeons of Canada

New Director of Educational Programs appointed

Curriculum renewed for PRP and OTPC

Designed innovative new ways to delivereducation programs

Launched new hybrid (classroom online)OTPC program

Educ

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A Year of Innovation and Renewal

Dr. Murray Urowitz

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Pre-Residency Program Orientation to Training and Practice in Canada Physician Assistant Integration Program

Participation in CEHPEA’s Education Programs


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Participants are a very diverse group representing manydifferent specialties and a variety of backgrounds. Some havelived and trained in other countries, while others areCanadians educated abroad. Some are fresh out of school,while others may have had years of practice in their countries.

“Subjectively I believe that since we have had the orientationprogram, IMGs have come to training with an ‘edge’,” says Dr.Salvatore Spadafora, Vice Dean, Postgraduate MedicalEducation, Faculty of Medicine at the University of Toronto.“They have more knowledge of the system than those thatcame before the program was in place. They can adapt to thecomplexity of the training environment just a little bit fasterand the quicker you can adapt to a new and complexenvironment, the quicker you can get on with very intenselearning.”

Designing Innovative Ways to Deliver OTPCIn an exciting new development this year, CEHPEA introducedonline learning to the OTPC program. This was in response toProgram Directors and previous participants that asked thatthe program be more Zexible, given major time constraintsand logistical challenges facing residents as they prepared fortheir residency programs. As a result, the curriculum wasrevamped and a number of classroom sessions weretransferred to the online environment.


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A few years ago, Program Directors from Ontario’s Faculties ofMedicine realized that a signiYcant number of InternationalMedical Graduates (IMGs) seemed to be experiencingdifficulty with the transition into training. Responding to thatneed, CEHPEA developed the Family Medicine Pre-ResidencyProgram (PRP) and it is now a mandatory orientation for allIMGs who are accepted in an Ontario Family Medicineresidency program.

Phase 1 consists of six weeks of educational sessions andpatient simulations. A variety of committed and experiencedmedical educators work closely with standardized patients to

provide participants with an experiential learning experiencewith simulation. A strong foundation in Phase 1 is critical forthe success of IMGs in Phase 2, which involves seven weeksof on-site clinical rotations at the sites where they beenassigned for their two-year residency program. They arepaired up with mentors (residents that are already in theprogram) to observe the life of a resident and are given anorientation to all areas in which they will work. In the comingyear we will be meeting with Program Directors to undertakea curriculum review in the light of the changingdemographics of our student body.

Family MedicinePre-Residency Program (PRP)

Given the success of the Pre-Residency Program for FamilyMedicine, University Program Directors asked CEHPEA tocreate a similar program for IMGs accepted into residencypositions for other specialties.

The Orientation to Training and Practice in Canada wascreated in February 2009 as an intensive preparatory programfor IMGs who are accepted into the Yrst year of postgraduatetraining in specialty residency positions at Ontario medicalschools. The program addresses key competency areas whilegiving candidates a safe environment to hone their skillsbefore residency.

“The OTPC program provides so many opportunities on somany levels whether it be scholar or medical expert orcollaborator or any of those competencies that we now thinkare really important as part of residency training,” says Dr.Shobhan Vachhrajani, an OTPC instructor who is a 7th yearneurosurgery resident and PhD candidate in clinicalepidemiology at the University of Toronto.

Orientation to Trainingand Practice in Canada (OTPC)

Dr. Shobhan VachhrajaniOTPC Instructor

“Cohort 11A”, the inaugural classof the hybrid OTPC online/

classroom session.

In developing the online modules, CEHPEA chose sessionsthat were delivered in the classroom and produced high-quality video lectures. Each module begins with a link to theCanMEDS framework followed by the module’s learningobjective. Viewers can then watch a video lecture, replaying orpausing if interrupted. Each module has a post-testassessment so that participants can measure their mastery ofthe material. There are also additional resources to enrich thecontent such as article, papers and links to websites.

Launching the “New and Improved” OTPC ProgramThe Yrst session of the new, compressed three-week hybridmodel (classroom and online) was launched in June 2011 with“Cohort 11A.” It was designed to deliver the programeffectively and efficiently, while creating more opportunitiesfor engagement. Many lectures are interactive in nature andsome include experiential learning with standardizedpatients.

The Yrst week focuses on Professional Identity andOrganizations including patient- centered practice and theIMG’s relationship with various organizations. Week 2 exploresthe Healthcare Team and Training Environment, with anemphasis on interprofessional collaboration, conZictresolution, ethical and legal situations, and boundary issues.The last week focuses on Communities and Society, includingtopics such as family violence, elder abuse, mental health andFirst Nations.

“The program is a true immersion in Canadian practiceexpectations,” says Marie Rocchi, CEHPEA’s Director ofEducational Programs. “It is our intention that the program isboth enriching to each individual’s unique education,knowledge, skills, training and in some cases, previouspractice, as well as enlightening – highlighting areas whereperhaps some development is needed.”

The new model offers many beneYts for the learners. For onething, it is more convenient. IMGs now have a choice of fourdifferent starting dates, rather than the customary twopreviously offered. As well, they receive their Yrst or secondchoice of session, allowing them to attend their medicalschool activities and take care of personal tasks such asrelocating to a new city. The online modules, which areintegrated with weekly classroom sessions, can be completedat times that are convenient for their schedules.


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The online component also stimulates a high degree ofengagement and satisfaction. Although the online learningis intended to be completed by an individual, it includesforums within each module so that students can discuss thecontent with their peers and in some cases, with the facilitatoror expert in the area. It also includes polls on various topicsand an opportunity to provide real-time feedback on eachmodule.

“This inaugural group was inspiring to me as an educator,”saysMarie Rocchi, Director of Educational Programs.“It was a bit ofa boot camp as we were tweaking, adapting and building aswe went along. This was an ideal cohort to go through thiswith us. They were very active, full of innovative ideas anddidn’t complain even though we were developing andreYning the program while it was running.”

Participants in “Cohort 11A” enjoyed being part of this“incubator in education” and readily engaged in onlinediscussion groups, polls and evaluations and provided inputevery step of the way.

At the completion of the Yrst blended program, Dr. SanjayVashishtha who is starting a residency in pediatrics, spoke onbehalf of the class: “We feel gratitude for the respect andhospitality of the CEHPEA staff and admiration for theirpassion and dedication. We were given lots of opportunitiesto give feedback and help shape the program and it waswonderful to be involved in the process. All of us have learneda lot and fostered bonds that will last a long time. It has beenan interesting journey.”


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Dr. Sogbein, who is originally from North Bay, completedhis undergraduate degree at the University of WesternOntario, his PhD at McMaster University and his medicaltraining at the University of Sydney in Australia. Hecompleted the inaugural, blended OTPC program and isstarting a residency in Nuclear Medicine at the University ofOttawa in July.

“This program provides an excellent opportunity fornetworking with future colleagues. It was exceptionallywell organized and relevant with respect to understandingour new role within the CanMEDS framework, andattempted to address the unique needs and learningperspectives of specialist trainees. OTPC gave us theopportunity to gauge our current strengths andweaknesses - effective communication for example - whileproviding opportunities for self-reZection and constructivecriticism/evaluation by our colleagues in a collegial andnon-threatening environment. Additionally, for IMGslacking familiarity with the Canadian system of medicaleducation and practice, the OTPC program provides thenecessary tools to supplement core medical knowledgewith the softer skills necessary to maintain a patient-centered approach.”

OTPC Candidate Experience:Dr. Bola Sogbein

Marie Rocchi, BScPhm, MDEd has been a faculty member atthe Leslie Dan Faculty of Pharmacy at the University ofToronto since 1999. She was initially hired to develop abridging program for pharmacists educated outside NorthAmerica. This has now become the acclaimed InternationalPharmacy Graduate (IPG) Program. During her tenure in theIPG Program until 2007, she oversaw the expansion tosatellite campuses at the University of British Columbia andthe University of Ottawa. In addition, the program providedacademic leadership to a committed team of program staff,lecturers and coordinators. Over 600 IPGs have completed theprogram and successfully achieved licensure in Ontario.Relationships with key stakeholders (associations, regulators,government and employers) were fostered, resulting in asustainable, credible and singular program.

Marie has been teaching undergraduate pharmacy studentssince 2008, and has been responsible for a range of subjects,including health systems, informatics, and professional

Introducing CEHPEA’s NewDirector of Educational Programs

Marie Rocchi, BScPhm, MDEdDirector Of Educational Programs, CEHPEA

practice in a variety of settings (lecture, laboratory,experiential and online).

She has been voted Teacher of the Year on three separateoccasions. Continuing her work in the access sector, she wasresponsible for the development and delivery of aninterprofessional pan-Canadian course for internationallyeducated healthcare professionals (Orientation to theCanadian Healthcare System, Culture and Context) that hasbeen widely disseminated in many provinces and professions,and continues to be offered in Ontario online and onsitethrough the Faculty of Pharmacy’s Continuous ProfessionalDevelopment Office.

Recently, Marie has developed interprofessional and inter-institutional online courses in Development Disabilities for

health sciences students, and on Surge Capacity forhealthcare professionals at Yve Toronto-area hospitals. Withan undergraduate pharmacy degree and a Master’s degree ineducation and instructional design, Marie is committed toeffective and engaging learning environments no matter thedelivery method or audience, and does so with expertise andunbridled enthusiasm. She espouses a model of originality,collegiality and collaboration in design based research, andhas undertaken innovation in the area of serious games andelectronic portfolios in her educational practice.

Marie practices pharmacy in both community and hospitalsettings, and volunteers as a pharmacy preceptor for theIMAGINE Clinic, a student-run clinic for the homeless indowntown Toronto.

CEHPEA’s NewDirector of Educational Programs


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Margaret Nelligan, ChairMargaret Nelligan has been a partner with Aird & Berlis LLPsince 1989. She is a former practice group leader of the Yrm’sCorporate Finance Group, as well as a member of the Energy,Mergers and Acquisitions and Private Equity and VentureCapital Teams. She practises in the areas of corporate andsecurities law, including investments for Ynancial institutionsand pension plans, mergers and acquisitions, restructurings,public Ynancings, acquisition Ynancings, private placements,proxy solicitations, corporate reorganizations and generalcorporate work.

Margaret is a former member of the Securities AdvisoryCouncil of the Ontario Securities Commission and is anAdjunct Professor at Osgoode Hall Law School. Margaret hasalso been selected for the Women in the Lead directory,featuring women whose professional expertise andexperience recommend them as candidates for corporateboard appointments. Recently, she was recognized as a"Woman of InZuence" by Women of InZuence Inc., a Canadianorganization dedicated to the advancement of women.

Margaret has acted as counsel to one of Canada's largest gasdistribution utilities, one of Canada's largest pension plans, aswell as numerous public and private industrial companies.She regularly advises the boards of directors of publiccompanies on corporate governance and other matters.Margaret is a director of Horizon Utilities Corporation,Ontario's third largest electricity distributor. She is also adirector of Alpine Ontario Alpin, the provincial governingbody for the sport of alpine ski racing in Ontario.

Anne CoghlanAnne Coghlan is the Executive Director and CEO of theCollege of Nurses of Ontario. The College is the regulatorybody for Registered Nurses and Registered Practical Nurses inthe province.

Anne has over 25 years of leadership experience in variedprofessional practice, management, regulatory andeducational roles.

Having obtained both her Baccalaureate and Master ofScience in Nursing from the University of Toronto’s Faculty ofNursing, Anne currently holds an appointment as AdjunctProfessor in the Lawrence S. Bloomberg Faculty of Nursing.

She is past President of the Board of Directors of theFederation of Health Regulatory Colleges of Ontario, memberof the Board of Directors of the Centre for the Evaluation ofHealth Professionals Educated Abroad, the InternationalRelations Committee of the Council for Licensure,Enforcement and Regulation, and the Editorial Advisory Boardof the Journal of Nursing Regulation.

Dr. Rocco GeraceRocco Gerace was appointed Registrar of the College ofPhysicians and Surgeons of Ontario in May 2002. Dr. Geracecarries out the Registrar’s statutory duties and oversees theCollege’s statutory obligations designated in the RegulatedHealth Professions Act. He also directs the administrative andYnancial operations of the College, and the implementationand monitoring of policies set by the Council.

Dr. Gerace graduated from the University of Western Ontarioin 1972. He is a fellow of the Royal College of Physicians andSurgeons of Canada in Emergency Medicine.

Prior to his appointment as Registrar, Dr. Gerace was anattending staff physician in the Department of EmergencyMedicine at the London Health Sciences Centre and aProfessor in the Department of Medicine, Division ofEmergency Medicine at the University of Western Ontario. Hewas also a consulting staff member at the Poison InformationCentre at the Hospital for Sick Children in Toronto.

Dr. Gerace is also a Past-President of the Medical Council ofCanada.

Governance:Our Board of Directors

2010/11

New Website Makes it Easier toAccess Information about CEHPEAThis year we undertook a major revamp of ourwebsite, which was launched in the spring of 2011.The new site provides easy access tocomprehensive information about our trainingprograms and assessments, including theapplication process, eligibility requirements, feesand schedules. It also includes important updatesfor candidates, along with links to an array ofhelpful resources.

Visit www.cehpea.ca to And out more.


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Dr. Ken HarrisKen Harris is currently the Director, Office of Education at theRoyal College of Physicians and Surgeons of Canada andProfessor Emeritus, Schulich School of Medicine & Dentistry atthe University of Western Ontario. Prior to his move to Ottawahe had served as Associate Dean, Postgraduate MedicalEducation at the University of Western Ontario as well asbeing the Director of the Education Research and ResourceUnit. He also served as Chair, Postgraduate ManagementCommittee of the Council of Ontario Faculties of Medicine.

Prior to his appointment as Associate Dean, Dr. Harris wasChair of the Division of Vascular Surgery, London HealthSciences Centre, and Richard Ivey Professor and Chair of theDepartment of Surgery, UWO. He has also held positions ofChief of the Department of Surgery at the London HealthSciences Centre and with St. Joseph’s Health Care London.

From 2006 until 2009, Dr. Harris has served as Chair of thePostgraduate Education Committee of the Council of OntarioFaculties of Medicine. He was also a member of theAccreditation Committee of the Royal College of Physiciansand Surgeons of Canada, on the Board of Directors of theFowler-Kennedy Sports Medicine Clinic and a member of theInterprofessional Education Working Group of the Ministry ofHealth and Long-Term Care.

Dr. Harris graduated from Queen’s University in 1977. He is afellow of the Royal College of Physicians and Surgeons ofCanada in General Surgery and Vascular Surgery. In 2007 hewas awarded the Vicky Blair Vascular Surgery Fellowship andis the recipient of the James IV Association of SurgeonsTravelling Fellowship, BCOE Teaching Award and USCTeaching Honour Role.

Dr. Elena SourovtsevaElena Sourovtseva is a hospitalist with the Niagara HealthSystem, a position that she has held since 2006. For the pastseveral years, she has volunteered her services to helpCanadian families to adopt children abroad. Dr. Sourovtsevais an active member of the Canadian Foundation for Plasticand Reconstructive Surgery, organizing and leadinghumanitarian missions to Russia to help children and orphanswith congenital and traumatic facial deformities to have hopefor the future.

Prior to joining the Niagara Health System, she completed allCanadian and American medical license exams while workingas a Physician Leadership consultant at Sunnybrook &Women’s hospital in Toronto. In 2004, Dr. Sourovtseva entereda full Family Medicine residency program at the University ofWestern Ontario, which she completed in 2006. At the sametime, she was actively involved with many volunteerorganizations and activities and was an Executive Member ofProfessional Associations of Interns and Residents of Ontario(PAIRO), advocating on behalf of residents and speciYcally,International Medical Graduates (IMGs). As a member of theBoard of Directors of CEHPEA, Dr. Sourovtseva hopes tocontinue to advocate for IMGs and other immigrated healthprofessionals.

Dr. Sourovtseva has an Honours Bachelor of Commerce and aMasters of Business Administration from the University ofWindsor. Prior to immigrating to Canada in 1999, shepracticed as a pediatrician in Russia and completed her PhD.Her PhD research explored the pathogenesis of hemolytic-uremic syndrome and the role of coagulation abnormalities inits pathogenesis. The work led to 23 publications andtherapeutic changes that contributed to a dramatic reductionin mortality rates for this disease in Russia.

Our Board of Directors2010/11

Dr. Mark WaltonMark Walton is the Assistant Dean, Postgraduate MedicalEducation at McMaster University and was appointed to thisposition in August 2004. He is currently the Chair,Postgraduate Management Committee of the Council ofOntario Faculties of Medicine (PGM:COFM) as well as thenational Chair of the Standing Committee on PostgraduateMedical Education for the Association of the Faculties ofMedicine of Canada (AFMC). From 2004 to 2010 Dr. Waltonwas a member of the Royal College Accreditation Committee.He is a member of the Royal College Committee onSpecialties. Prior to his appointment as Assistant Dean, Dr.Walton was the General Surgery Program Director for theDepartment of Surgery at McMaster University.

Since November 2005 Dr. Walton has been a member of theJoint working group on PG Medical Education which involvesmany of the Postgraduate Deans in Canada and the ProvincialMinistries of Health. His research is mainly clinically basedhowever his main focus is one of Undergraduate andPostgraduate Medical Education and clinical innovation.

Dr. Walton graduated from the University of Alberta in 1985.He is a Fellow of the Royal College of Physicians and Surgeonsof Canada in General and Pediatric Surgery.

Steven C. WattsSteven Watts is a partner in KPMG LLP. He specializes inserving clients in the Ynancial services industry. His clientsinclude Canadian Schedule I and II banks, and leasing andYnance companies. Prior to immigrating to Canada in 1998,Steven worked in KPMG’s offices in Amsterdam and Dubai.

Steven obtained his Canadian CA and American CertiYedPublic Accountant designations after moving to Canada. Heobtained his Bachelor of Commerce designation in Mumbai(Bombay) and Indian CA designation while training with a Big4 CA Yrm.

Steven served on the Applications Committee of the Instituteof Chartered Accountants of Ontario for eight years. In thatrole, he helped evaluate the credentials of foreign-trainedaccounting professionals who were interested in pursuingtheir Canadian CA designation. Being originally a foreign-trained accountant himself, he was able to bring a uniqueperspective to the Committee’s deliberations as it assessedthe relevant work experience and academic qualiYcations ofthe applicants. Steven hopes to share the experience hegained while on the Applications Committee with otherBoard members of CEHPEA.

He is the co-chair of the Islamic Finance Working Group of theToronto Financial Services Alliance. Steven is also a pastmentor under the Toronto Region Immigrant EmploymentCouncil’s Mentorship Program, a former member of theFinance Committee of Tafelmusik Baroque Orchestra, and pastVice-Chair of the Toronto Chapter of the Institute of CharteredAccountants of India.

Our Board of Directors2010/11

CEHPEA Executive Team

Anne Marie Crescenzi Arin De Fazio Marla Nayer Marie Rocchi Dr. Murray UrowitzExecutive Director Director of Finance PhD, BScPhm, MDEd, MD, FACP, FRCP (C),and CEO and Administration Director of Assessment Director of Educational Director of Health

Operations Programs Professional Affairs


CREDIBILITY

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