Registration Pathways Evaluation

Evaluating registration pathways and policies using peer assessment

The College is conducting an evaluation of our registration policies and pathways to determine what, if any, differences exist in the performance of physicians who achieve Ontario registration through alternative and traditional pathways.

We have developed alternative registration pathways over the past several years with the intention of improving patients’ access to medical care without compromising our registration standards. This evaluation will assess whether:

  1. the alternative registration pathways and policies are achieving their intended purposes;
  2. changes are required to the alternative registration pathways and policies (i.e., is the bar set too high; too low; or appropriate);
  3. ongoing educational needs for physicians may differ depending on their route to registration, (which, if so, will enable the development of appropriate quality improvement initiatives).

The evaluation includes both a retrospective analysis (using existing data such as complaints information) and a prospective analysis (using a standardized assessment process, including a multisource feedback (MSF) component).

The traditional peer assessment is augmented by a MSF component to assess a greater number of physician roles, as outlined in the CanMEDS framework. Of the seven CanMEDS roles (medical expert; communicator; collaborator; advocate; manager; scholar; professional) the current peer assessment protocol addresses aspects of only two CanMEDS roles (medical expert; and communicator, but only in relation to record-keeping).

Incorporating MSF provides an opportunity to assess additional roles to complement the data collected on the medical expert role. Adding the MSF component to assess the communicator role is particularly desirable, for a number of reasons, including that public complaints to the College often include a concern about inadequate communication; and studies of physicians trained elsewhere demonstrate some problems with the communicator role.

In addition, MSF is widely used by other regulatory bodies and physician organizations and has been studied extensively.

Before using MSF in assessments for the project, the tools and processes were piloted and evaluated. This involved the participation of 31 volunteer peer assessors. Generally, the physicians participating in the pilot responded positively to the MSF implementation process, the structures to support the program, and the MSF report and outcomes.

We began contacting potential evaluation participants in May 2013. Several hundred physicians who were licensed via the traditional registration pathway of completing postgraduate training and examinations in Canada will be matched to physicians who were registered through an alternative pathway or policy. A number of defined variables (e.g., age, gender, years since attainment of undergraduate medical degree, medical specialty, practice structure, clinical experience) will be used to match physicians.

In-office assessments will start in the fall of 2013, and the project will run for the next several years.

An FAQ has been developed for participants, which provides more general and specific information about the pathways evaluation project, and the multisource feedback tool.

For more information about the evaluation project, please contact Wendy Yen, Research Associate at Evaluation participants will be contacted individually by a College assessment coordinator.