JANUARY 15, 2008


Older MDs get break on CCFP
written exam

CPD to replace test. No apology for 14-year
reform wait: College

Succumbing to 14 years of pressure from angry doctors, the College of Family Physicians of Canada (CFPC) has finally agreed to exempt older family physicians from the written portion of the exam required to become a certificant of the College (CCFP). These docs can instead opt to do six to eight weeks of part-time continuing professional development (CPD).

NRM learned of the change through an anonymous tip. The CFPC confirmed the changes ahead of its planned announcement later this month.

CFPC head Dr Calvin Gutkin refuses to apologize for the long wait.

"Maybe I feel a little bad," he told NRM, "but the context has changed. We need to do everything we can to promote family medicine now."

The new exemption applies only to practice-eligible doctors who entered practice before 1994, when the CCFP designation became necessary for a licence that is "fully portable" from province to province.

From now until the end of 2012, practice-eligible doctors can skip the written exam (but not the oral simulated-patient exam) in favour of CPD composed of a practice audit; a personalized set of "reflective exercises" to study peer-reviewed literature under the guidance of a CFPC-provided tutor; and a patient survey to examine communications skills.

"One of the things we didn't want to do always was disenfranchise those in practice," says Dr Gutkin, "so we wanted to be more aggressive to offer an opportunity to those who have been out there for a while to get certification through an alternate route."

The new program is expected to cost approximately the same amount as the traditional test, says Dr Gutkin: about $1,500.

Results from several pilot studies of the new program conducted last year have been "quite positive," says Dr Gutkin, though the data have not all been assessed yet.

The CFPC's new program, hints of which were first reported here in August, mirrors changes adopted by the Royal Australian College of General Practitioners in 2000.

"We've been looking at different ways of doing this for a number of years," says Dr Gutkin. "We were looking for different strategies from different countries. We were opposed to just handing people certifications if they are experienced — we wanted to find something else that has credibility but does not require the [written] exam, but that respects they have been a physician in good standing for a long time."

Dr Barbara Watts, an Orangeville, ON, family physician who's been very vocal in her criticism of the CFPC's treatment of older doctors, says her initial reaction to the changes is one of "cautious optimism." Having failed the CFPC once, she says she'll probably give it another shot now.

But for Dr Watts, the written portion of the CCFP exam wasn't the problem — it was the simulated patient exam. "I failed because I have a 'bad attitude,'" she says. "I cannot believe that a certain attitude is required to certify as a doctor, but the new grads all tell me you have to play the game. Everyone knows it's a crock but you need the piece of paper."



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