Our Blog

Category Archives: Credentials

Discusses Canadian credentialing issues, mainly related to changes initiated by the Royal College of Physicians and Surgeons of Canada (RCPSC) and the College of Family Physicians of Canada (CFPC).

Time to champion regionalization of Licensure

This April 15, 2016 Medical Post article by Dr. Sarah Giles once again addresses the high cost of credentialing and licensing for physicians seeking to do locum work in neighbouring health boards and provinces. CanAm has been out spoken on this issue. What the general public and government officials don’t realize is that we are talking about thousands for dollars not a few hundred. The redundancy is unreal and in no other profession is it tolerated. Why is it that the only government championing this issue is the smallest province of Canada? Prince Edward Island’s health minister appears to be the only brave government official to champion regionalization of Licensing Colleges.

See full article below:

‘Alphabet soup’ isn’t always easy to swallow

April 15, 2016 by Dr. Sarah Giles

Yet again, I’ve traveled to another province and paid a rather large sum of money to re-certify one of my alphabet courses. The “alphabet courses” is my name for those “mandatory” courses hospital administrators insist locums have up to date but look the other way when none of the physicians in their own ER department have done them in six years. I have quite a collection of these courses: BLS, ACLS, NRP, ALARM, PALS and ATLS, to name the big ones.

I think there is benefit in continuing education, reviewing changes in practice, and going through mock scenarios. I do, however, have some reservations about these courses:

1. Some of the courses are cash cows. They cost a lot of money to attend and for those of us who live outside major urban centres, they are difficult and expensive to get to. I do not believe the vast majority of courses need to be recertified in person or every two years. I think it is likely possible to read the text, write a test, and Skype into a few mock scenarios to prove one’s abilities in a given area.

2. There is an inherent bias in these American-made courses against rural and remote care provision. Basically, in these texts, if you don’t have a CT scanner, thoracic surgeon, interventional radiologist or high-level NICU within your facility, you need to drop everything and call in a plane. Now, that’s often the right thing to do but in rural and remote Canada, there are some opportunities to watch stable patients and to use clinical judgment that these U.S.-based practitioners, who face far more lawsuits than Canadian practitioners, are unwilling to consider.

3. The course faculty are almost exclusively Ivory Tower practitioners because the courses rarely come to the places I work and it’s cheaper to get to a big city than it is to travel to another small town where the courses may have local doctors running them. We need big-city specialists to help our patients but I become enraged when every story coming from the course faculty is about screw-ups in the periphery. I’ve never heard a story about a remarkable save from a resource-limited environment and I think the instructors are often disrespectful of the work remote and rural practitioners do. Of course, I’m not exactly part of the solution but in my defense, becoming a course instructor would require me to spend a lot of time in major urban centres and I would likely have to spend even more time there in order to teach the minimum number of courses needed to stay current.

4. I realize that we need to break the material down somehow, but it seems unrealistic to look at trauma and resuscitation without looking at cardiac rhythms. We need courses that allow us to bring these skills together. Courses such as the Comprehensive Approach to Rural Emergencies (CARE) are dreamy answers to this need but it doesn’t meet those alphabet soup needs, and it requires a hospital administration that is supportive and has money.

In the end, it’s probably best for me to try to recertify these courses at rural conferences, when the room is full of like-minded people. Unfortunately, it turns out that rural doctors who toil away in their small communities really need locums so they can leave to attend the big rural conferences, so I’m usually working during those events. I could try to help create a rural/remote supplement for these courses but I’m not sure I could win a conversation with the ivory tower academics when they often have big studies to back them up and I only have anecdotes.

Dr. Sarah Giles is locum family physician.

PEI making changes to rules governing College of Physicians and Surgeons

CanAm perspective: In May 2015, Dr. Victoria Dawson, a bright young Anglo Canadian, US trained Family Physician was denied a medical license in PEI – because she refused to take an English Proficiency Test.

CanAm immediately issued press releases to the Charlottetown Guardian newspaper and the Medical Post decrying PEI’s loss of a talented physician by an absurd decision of the PEI College.

In response PEI’s Minister of Health, Doug Currie announced that the government was going to review the legislation governing the role of the College.

***

Changes to the rules governing the province’s College of Physicians and Surgeons will help ensure more oversight and allow changes to rules on language tests for doctors with foreign credentials.

Amendments to the Medical Act introduced Tuesday in the legislature will give the minister the ability to appoint someone to make an inquiry into the operation of the college and to make recommendations.

This person would have all the powers and protections of a commissioner under the Public Inquiries Act.

Health Minister Doug Currie says this step will allow for increased accountability over the body that licenses and regulates all physicians in Prince Edward Island.

But Currie stressed the college will continue to be solely responsible for licensing doctors going forward.

“This is not about the politicians taking over licensing for physicians in Prince Edward Island, this is about giving the college the ability to address some of their issues.”

Another change will allow the college to waive English proficiency tests for English-speaking doctors who may have studied in a foreign country and want to practice in P.E.I.

Continue reading the full story in The Guardian … 

English Language Policy

CanAm’s perspective:

All provinces with the exception of Ontario now strictly adhere to ELP (English Language Policy) set out by FMRAC (Federation of Medical Regulatory Authorities of Canada).

Prior to August 5, 2015, colleges of CPSNS and CPSNL were allowing exceptions to the rule by applying some common sense to the guidelines. Unlike the College of PEI, where guidelines were judged as strict rules, both CPSNL and CPSNS would exempt physicians whose post-graduate training and scope of practice were primarily completed in English countries — such was the case for Dr. Victoria Dawson.

However, on August 5, 2015, both CPSNL and CPSNS decided to adhere to FMRAC’s policy strictly. The reason given was to maintain a unified position on this matter across the country. CPSNS and CPSNL’s “flexibility” had put some of their MRA partners across the country in some jeopardy. An example in point was CPSPEI. So the common sense approach is no more.

Interestingly enough, CPSO — which is the largest jurisdiction in Canada — has NOT introduced an ELP. So while the smaller provinces strictly adhere to FMRAC’s policies, Big Brother ignores and reaps the benefit of having less complex licencing requirements.

So all of those Canadian citizens who are training abroad and desire to return to Canada, such as Dr. Victoria Dawson, can take comfort in CPSO common sense policy!

CSI Inc. helps physicians cut through red tape

A job in a new licensing board is within your grasp, and the only thing standing in your way is a few pieces of paper.

Trish Dehmel, Director of CSI Inc. in Halifax, says her job is to help physicians cut through the red tape — allowing them to obtain those documents quickly and easily.

“It can be hard for individuals to contact the right people in some countries — or even to know who to contact — and how to get them to take you seriously,” says Dehmel. “Providing criminal checks is not a priority in some foreign countries, and so they may not attach as much importance to providing the results as we do in North America.”

In some instances, records are centralized to the region in which they lived, searches cannot be conducted nationally, and data may only be obtainable for the past seven years.

A former federal police office, Dehmel knows the industry inside out and has been helping healthcare professionals navigate the system for the last decade.

CSI employees work with healthcare professionals, hospitals, private clinics, and licensing colleges in order to simplify the process of obtaining police clearance checks and certificates of conduct.

The requirements are different for each licensing board. In Nova Scotia, for example, a new physician needs a criminal records search to satisfy the requirements of the College of Physicians and surgeons. If they plan on working for Capital Health or the IWK Health Centre, they will also need a search of the pardoned sex offender database, which requires a set of fingerprints and takes about two weeks.

But it’s not always as easy as it sounds.

“We often work with physicians who are in Canada and apply for a job within a new board, and the board says ‘Well, you worked in Saudi Arabia, so you need to provide a criminal record check from Saudi Arabia,’ or ‘You worked in four different U.S. states. We need checks from all of them,’” explains Dehmel. “That’s where we can help.”

In many cases, a criminal record search can be ordered on CSI’s website using a system called e-Consent. You’ll be asked five “out of wallet” questions about things that only you would know, and answering correctly allows the system to verify your identity without a passport or fingerprints.

While many people still refer to the “vulnerable sector check” that was in place prior to 2009, Dehmel says it’s now a search of the pardoned sex offender database. It involves using fingerprints to ensure a person is not listed in the sexual assault database under any name, in any province. CSI has a portal service with the College of Physicians and Surgeons so the results are reported directly to them.

Dehmel says healthcare professionals are welcome to call CSI with questions about the process, and they have resources and contacts in most countries around the world.

“We provide fast, efficient service, and make the process easier for professionals who need these documents,” says Dehmel. “We’re here to help.”

New project will speed up credential recognition for international medical graduates

Moving to Canada and securing work as a physician can be extremely challenging, according to Canada’s minister of employment and social development, Pierre Poilievre.

Based on a new report by the Panel on Employment Challenges of New Canadians, Poilievre says many new Canadians have trouble getting their qualifications recognized. Other problems include lacking relevant Canadian work experience, or having inadequate pre-arrival information.

The minister recently announced funding for two new projects that will help international medical graduates have their credentials recognized more quickly.

The panel’s report recommended that each occupation develop a single national standard — as well as a point of contact — for skilled immigrants, so it’s easier for them to transition into meaningful employment. It also discussed the importance of producing better, more coordinated labour market information for newcomers. Poilievre has promised to review the panel’s recommendations.

H/T Advisor.ca