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
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."