General Membership Minutes

GENERAL MEMBERSHIP MEETING 14 September 1999, 6:00 pm - Friends House, Toronto MINUTES

1. Welcome / Call to Order

Uzma Shakir, Executive Director of the Council of Agencies Serving South Asians, sponsor of the FTDA, opened the meeting with a welcome and a brief background to the FTDA and the objectives of the association. 2. Project Coordinator Update Elizabeth McIsaac, Project Coordinator for the FTDA, provided an update on the work of the association. An outline of the structure of the association, including Ontario FTDAs, general membership, steering committee and focus group consultations was provided, as well as information about registration.

An update of the FTDA website was provided, including an outline of the information to be provided: notice board (upcoming meetings, minutes from general meetings and steering committee meetings, other relevant announcements); Press releases / Submissions / Briefs; Licensing information (requirements for each province and the United States generally are provided); Employment (community programmes, job postings, internet links); Registration on-line; Other links (licensing bodies, professional associations, medical schools, etc.)

3. Report on the McKendry Task Force Lillian Lockyer, spokesperson for the FTDA, reported on the submission made on behalf of the FTDA to Dr McKendry who was appointed to commission a task force on the doctor shortage by the Ontario Ministry of Health. A summary of the positions submitted and recommendations made was outlined. 4. Membership Consultation Based on the recommendations the FTDA was asked to submit to the McKendry Task Force, the membership was asked to consider two questions; i) In order to successfully complete the MCCQE Part 1, what do foreign trained physicians need? and ii) In order to successfully obtain and complete residencies as specialists, what do foreign trained specialists need? The meeting was broken into 2 group, general practitioners and specialists, to discuss each question. The general practitioners further divided into two groups to facilitate discussion. The following highlights the points raised in these discussions. FTD Needs to Successfully Complete the MCCQE

FTDs cannot expect guarantees, but want a fair chance to work as physicians
Transcript Evaluation Transcripts to be evaluated on their face. Establish a meaningful credential evaluation system
MCCEE The exam fee ($1000) is excessive and needs to be reduced. Financial assistance similar to OSAP, which includes support for living expenses is needed. There is also a need to have institutions like Kaplan approved for OSAP funding. Successful completion of the exam is only valid for 5 years. The recommendation to allow limited licensure and hospital employment upon completion was also made. This recommendation also addresses the requirement for Canadian experience. Develop the MCCEE and MCCQE Part 1 as a unified exam. There is a refresher course offered at the University of Toronto to help prepare for exams, however the issue of foreign student fee structures remains a problem
IMG Complete elimination
One year of Canadian Experience Rotation in all departments is very important. Where physicians are less than 5 years out of practice, perhaps only a mentorship should be required, whereas for physicians who are more than 5 years out of practice, a rotation (this would include specialists). The required 1 year experience in the Canadian system (internship, not observer status) should be paid. This internship would include taking histories of patients and physical examination. FTDs coming to Canada with years of experience should be considered to complete the MCCQE Part 2 immediately with no internship requirement. A case by case evaluation system of requirements would be helpful, although this might be difficult to implement.
Professional Gatekeeping There is a need to devise a fair process which is flexible and tailored to current needs.
Special Needs of FTDs These include professional and cultural orientation, and eligibility for financial assistance. There is a need for an immersion / adaptation program.
Relocation to Underserviced Areas FTDs are willing to relocate to underserviced areas however, relocation should be under a limited placement, e.g. 3-5 years
National Standardization There is a need to standardize the licensing processes nationally, with equal acceptance by all provinces.

FTD Needs to Successfully Fulfill Residency Requirements

Credential Assessment Residency programs outside Canada must be recognized/ evaluated. Experience assessment should be reviewed by a central review board.
Qualifying Examinations Need for review of contents of evaluating exams, and consideration of evaluating exam only in the area of specialization
Conditional / Temporary License (restricted) There should be immediate acceptance into the system after passing the MCCQE, with supervision at the level of senior registrar.
Residency After receiving a license, residency should be the same for local and foreign trained physicians, with discretionary power at the level of programme director (i.e. recommend licensure after 1 year). There is also a need to devise system/process comparable in requirements to foreign funded residencies.
Integration of Specialists Process should include completion of MCCEE and MCCQE, one year of residency in specialty, followed by board/fellowship exams - also suggested that there be one standard exam (like the USMLE) which permits entrance into the system (i.e. residency).

5. Next Steps and Wrap Up Each group briefly presented its recommendations. Ongoing consultation based on these identified needs will take the form of focus groups in the upcoming months. Members interested in participating were asked to sign up. The next general membership meeting will be held in December 1999.