‘The motion from our members was to stop:’ CFPC prez talks next steps now that college has ceased implementation of third-year FM addition

In a dramatic turnaround, the College of Family Physicians of Canada (CFPC) has announced it’s ceasing implementation of its plan to add a third year to family medicine residency programs. “It’s not a pause. . . . The motion from our members was to stop. We’ve announced that we’ve stopped, ” Dr. Michael Green, president of the CFPC, said in an interview at the Family Medicine Forum in Montreal, referring to the feedback the college got from members at its Nov. 1 annual meeting. Now, the college's new work is to get input from residency training programs and their partners on advancing and modernizing medical education. Dr. Green pointed out that the CFPC doesn’t implement or run family medicine training itself. “We certify graduates, and we accredit the programs that train our residents. It’s departments of family medicine, through their residency training programs, that put it on the ground. They do that with support from their partners in the healthcare system, doctors in the community who teach, hospitals that are the teaching sites and financial support from the government.” But the CFPC is firm, he said, that there’s no need right now to change the accreditation standards. Read: What will the CFPC do next? Family docs pass non-binding vote asking to pause addition of third-year to FM residency The CFPC now is going to refocus its efforts on hearing more from its partners about the way ahead because people at those “programs are the ones who brought their concerns to us about needing to modernize training and many programs (had) questions (and were saying) ‘we’re running out of time in our programs to deliver everything we want.’” Those programs, he said, will need to examine how well they're achieving their goals, and how they might modernize next. “The federal government, through Service Canada, has supported a big project to look at what are our training needs for the future, not just in family medicine, but in other professions that are involved in primary care teams.” But this is not a “pause” he emphasized. “To me, a pause is we’re going to come back to this in two months or three months or four months. We have just said, ‘We’re going to stop doing this right now and we’re going to engage with our partners and look around and see what people think about the right way forward,’ and then we’ll move forward and if there’s a recommendation from those partners in an external review to go back and look at standards again, then at some point one of our boards will look at it.” Dr. Green stressed that family medicine education does need to be advanced—the real question is how. “If you look even at the motion from our members, they agree we should be looking to modernize and make our training fit for what Canadians need in the future. They just were not convinced that a solution today of an additional year of training was the only solution and they asked us to stop, look both ways.” CFPC members made it clear that this should happen with an external review, he noted, not an internal process, “and that’s what we’ll do.” Dr. Green argued the “underlying issues” that drove this haven’t changed. “We need, I think, a different approach to working together with our partners to figure out what that looks like for effective modern family medicine training in the future.” Partners have brought up many things they think should be added to family medicine training, “for example, ultrasounds becoming the stethoscope of the future. Every family doctor’s going to need to know how to use point-of-care ultrasound at some point. So we’re going to have to put that in our training. So then the question will become: Can that be accomplished inside a two-year program? Do you have to have a three-year program? Could it be an add-on course that you do afterwards? Can you build it in? There’s many different ways.” The next step for CFPC partners and members, he said, is to dig into these multiple options. “Maybe it’s that some residents could voluntarily choose a three-year program? Well, residents already can choose to apply for an extra few months in areas that they think they need extra training in. As an enhanced skills program director for eight years, we ran a lot of those programs and we had a lot of demand for those programs from our residents. The concern was making it mandatory for everybody and so we’ve agreed to stop, talk, and figure out the path forward and will take as long as it takes to get to the best answer.”

‘The motion from our members was to stop:’ CFPC prez talks next steps now that college has ceased implementation of third-year FM addition

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