azskeptic
09-24-2004, 05:46 PM
AZ SKEPTIC says: an alternative if you get turned down by canadian medical schools and US schools is to go osteopathic. read below how the licensing effort is going in Canada. az skeptic
CANADIAN OSTEOPATHIC ASSOCIATION
ANNUAL REPORT, 2004
President: Dr. Ted Findlay, D.O.
Past-President: Dr. Doug Lauder, D.O.
Secretary-Treasurer: Dr. David Fiddler, D.O.
Trustees: Dr. James Church, D.O.
Dr. W. K. Church, D.O.
Dr. Douglas Fiddler, D.O.
Dr. Ted Findlay, D.O.
Dr. Doug Lauder, D.O.
Administrative Secretary: Mr. Paul Ling
Annual Meeting: June 7, 2004
The osteopathic medical profession in Canada has made tremendous strides over the past year in terms of official recognition by relevant Canadian accrediting and registration bodies. We seem to be on the cusp of even greater strides over the next year or two, and have sensed a real “sea change” in the attitude and cooperation that is now extended by the groups we contact.
With the recent acceptance of the American DO degree by the College of Physicians and Surgeons of Ontario as well as the College of Family Physicians of Canada, there remains one significant barrier to the ability of our graduates to establish practice in Canada.
The Royal College of Physicians and Surgeons of Canada
The RCPSC has the mandate of accrediting post-graduate specialty medical training programs across Canada. Historically, this organization has taken a very narrow view of its role, with little or no interest in evaluating the graduates of foreign training programs, or facilitating the participation of IMG’s into Canadian post-graduate training programs. However, there now seems to be more pressure exerted by the provinces to encourage the Royal College to participate in initiatives that can help alleviate physician shortages.
The COA has had recent contact with the RCPSC, letter attached. This letter was encouraging in that it is the first time that we have been shown anything other than a closed door. In follow-up phone calls, I have learned that Credentials Committee meeting of Feb. 26 deferred making a decision on the acceptability of the osteopathic medical degree until the next meeting to be held in September. In part, this is to allow the committee time to collect and evaluate “Further Information.” To date, the COA offer to provide additional information has not been replied to. The contact person at RCPSC is Ms. Connie Cote (1-800-668-3740 #203).
Nonetheless, a DO has been accepted into an orthopaedic medicine fellowship at the University of Western Ontario, to begin in July, 2004. It will be difficult for the RCPSC to ignore this precedent, and the wishes of the program directors to have DO participants.
Secondary Barriers
It is now time to shift our focus to what may be called secondary barriers to osteopathic registration in Canada. These are items that in themselves do not prevent participation, but make it significantly more difficult.
1. COMLEX recognition: In Canada each province has the ability to set its own standards for examinations and certifications required of registrants. As such, there is not one body that we can lobby for COMLEX recognition on par with the Medical Council of Canada examinations. Certain provinces require eventual MCC examination completion by all registrants, others do not. Some may be open to exploring COMLEX as an alternative. Rather than try to approach 10 jurisdictions independently, it would be more cost and time effective to try to get on the agenda of the annual meeting of the Federation of Medical Regulatory Authorities of Canada. Unfortunately, we were not successful in an application for the June, 2004 meeting.
2. Recognition of AOA accredited post-graduate training. At the moment, there seems to be a comfort level on the part of the various provinces in accepting programs that are ACGME accredited or dually ACGME/AOA accredited. I don’t sense that there will be interest in looking at DO accredited programs until there are a significantly larger number of DO’s practicing in Canada. However, some provinces have indicated informally an interest in potentially looking at DO accredited graduates, on a case-by-case basis.
3. At the moment, American trained DO’s need to complete the Evaluating Examination of the Medical Council of Canada (MCCEE) before having access to the Qualifying Examination (MCCQE) that is considered the standard for licensure across Canada. This provides an additional expensive hurdle that our graduates must complete. There is a working committee of the MCC that is looking at this issue, and I have been told informally that there could be interest in removing this barrier for DO’s that have completed ACGME accredited residency programs.
4. For those that wish to participate in a Canadian post-graduate residency program, the Canadian Residency Match Service (CaRMS) does not allow access to the “first iteration” to anyone other than a current year graduate of a Canadian medical school. Unfortunately, this match takes place after the corresponding American match process. In order to participate in the Canadian match, a candidate needs to essentially sit out the American match, which is a professional gamble. I have learned that the limits on the first match are at the discretion of the Association of Canadian Medical Colleges, Dr. Hawkins, Executive Director.
5. At a recent CFPC function in Calgary I was approached by an executive officer of the Canadian Medical Association with a proposal that the COA consider applying for affiliate membership in that organization. The benefits to the COA would be:
a. Inclusion on the CMA mailing list, with the opportunity to review and comment on proposed policy statements and positions before release.
b. Paid-for attendance at the annual January meeting of “Affiliated Societies.”
c. Optional and non-paid attendance and vote at the annual “General Council.”
d. No cost to the COA
However, CMA guidelines suggest that unless a recognized Royal College division, the minimum membership of new affiliates should be 100 physicians, of whom 50% must have CMA membership. The current smallest affiliate is that of disabled physicians, with 40 members. It is unlikely that a smaller affiliate would be considered, but this could be a promising contact when COA membership is at a level that can support application.
A brief summary of current developments in certain provinces, from West to East:
British Columbia:
As the medical profession in B.C. moves from the Medicine Act to the Health Professions Act, it appears that title protection for the medical professions including osteopathy will shift from the College of Physicians and Surgeons to the Ministry of Health. It is uncertain that there will be the same level of interest in protecting osteopathic designations under the new legislation, an issue that the British Columbia Osteopathic Association is actively pursuing. In the past year, a candidate was successful in obtaining B.C. registration after presenting AOA credentials followed by the “Comvex” examination. Registration was granted under the limited license pathway, although an unrestricted license pathway continues to be open with completion of the MCC examinations.
Alberta:
Alberta will be making a similar move to a new Health Professions Act in 2005, and no changes in registration provisions for D.O.’s are anticipated. The MCC examinations are a requirement with unlimited licensure granted.
Ontario:
At the Sept. 19 meeting of the Council of the College of Physicians and Surgeons of Ontario, the following resolution was passed:
The Council adopts the policy that the degree, “Doctor of Osteopathy”, granted by an osteopathic medical school in the United States of America that was, at the time the degree was granted, accredited by the American Osteopathic Association, is an equivalent degree in medicine to one granted by a medical school that was, at the time the degree was granted, an accredited medical school as described for the purpose of clause a) of “degree of medicine” in Section 1 of Ontario Registration 865/93.
[Note: - This does not dispense with the clerkship requirement in the definition.]
Current registration information for American trained osteopathic information appears on the CPSO website, and has been made widely available within the American Osteopathic Association, including information posted on the AOA website.
The College of Physicians and Surgeons of Ontario has released a May 2004 Discussion Paper, “Tackling the Doctor Shortage”, which includes the following proposals:
Section III. Maximize the Use of Existing Resources and Eliminate Existing Barriers:
Recommendation #6 Recognition/equivalency of screening examinations:
a. The College should explore recognition of the United States Medical Licensing Exam (USMLE), National Board of Osteopathic Medical Examiners (NBOME), Federal Licensing Examination (FLEX), Educational Commission for Foreign Medical Graduates (ECFMG) and Comprehensive Osteopathic Medical Licensing Examination (COMLEX) immediately as equivalent to the Medical Council of Canada Qualifying Examination (MCCQE) for purposes of registration. “The College believes that the standard set by these examinations are equivalent to our own Ontario standards. Accordingly, we should recognize them as such and require no further training or assessment of applicants who hold these qualifications.”
Recommendation #8 Develop a process to recognize specialists:
a. The College should develop a process to recognize specialists who have specialty certification in their own jurisdictions and training to Accreditation Council for Graduate Medical Education (ACGME) recognized programs equivalent to Royal College requirements.
The response of the Ministry of Health to these proposals is as yet unknown but the implications are tremendous. Graduates of accredited American Osteopathic colleges could be eligible for registration in Ontario with no further examinations necessary, requiring only completion of recognized post-graduate training. Besides Canadian programs, these would be ACGME or dually accredited residency positions. Given the weight that Ontario carries within organizations such as the Federation of Medical Regulatory Authorities of Canada, this would be an extremely important precedent for the other provinces to emulate. However, significant opposition from the Medical Council of Canada can be anticipated.
Quebec:
As previously noted, there is no title protection for the osteopathic profession in Quebec including D.O., osteopathic physician or osteopathic medicine. This is in spite of the fact that American trained D.O.’s may register with the Quebec equivalent of the College of Physicians and Surgeons. There have been several media stories lately about a multi-million dollar lawsuit that has been launched against a non-accredited osteopath/naturopath following an alleged harmful result from neck manipulation. A non-accredited association of osteopaths is seeking governmental recognition with the associated ability to respond to public complaints and presumably also title protection. It will be interesting to see how the numerous groups of self-designated osteopaths within that province respond to this type of initiative. The COA’s concerns regarding the dangers to the public of non-qualified osteopathic practitioners has been communicated to the Quebec government and College on numerous occasions.
Other Provinces:
For a brief summary of the current status of the osteopathic medical profession in the other provinces, please refer to the 2003 COA Annual Report.
International Activities:
Dr. Findlay has attended the October 16, 2003 and April 17, 2004 meetings of the Council on International Osteopathic Medical Education and Affairs of the American Osteopathic Association, as well as the annual convention and scientific assembly. Additionally, he attended the October 13, 2003 Steering Committee meeting of the Osteopathic International Allicance held in conjunction with the AOA annual convention.
Finally, the Canadian Osteopathic Association is hosting the second Invitational Conference of the Osteopathic International Alliance, which will be held in Toronto immediately following the Annual General Meeting of the COA. We continue to play an important role in discussions regarding the further global advancement of the osteopathic philosophy and affiliated organizations. It is our pleasure and honour to host the first meeting of this body held outside of the United States.
Respectfully submitted,
Ted Findlay, DO
President
Canadian Osteopathic Association
(###NOTE: You can contact Dr. Finlay at tfindlay@telus.net
CANADIAN OSTEOPATHIC ASSOCIATION
ANNUAL REPORT, 2004
President: Dr. Ted Findlay, D.O.
Past-President: Dr. Doug Lauder, D.O.
Secretary-Treasurer: Dr. David Fiddler, D.O.
Trustees: Dr. James Church, D.O.
Dr. W. K. Church, D.O.
Dr. Douglas Fiddler, D.O.
Dr. Ted Findlay, D.O.
Dr. Doug Lauder, D.O.
Administrative Secretary: Mr. Paul Ling
Annual Meeting: June 7, 2004
The osteopathic medical profession in Canada has made tremendous strides over the past year in terms of official recognition by relevant Canadian accrediting and registration bodies. We seem to be on the cusp of even greater strides over the next year or two, and have sensed a real “sea change” in the attitude and cooperation that is now extended by the groups we contact.
With the recent acceptance of the American DO degree by the College of Physicians and Surgeons of Ontario as well as the College of Family Physicians of Canada, there remains one significant barrier to the ability of our graduates to establish practice in Canada.
The Royal College of Physicians and Surgeons of Canada
The RCPSC has the mandate of accrediting post-graduate specialty medical training programs across Canada. Historically, this organization has taken a very narrow view of its role, with little or no interest in evaluating the graduates of foreign training programs, or facilitating the participation of IMG’s into Canadian post-graduate training programs. However, there now seems to be more pressure exerted by the provinces to encourage the Royal College to participate in initiatives that can help alleviate physician shortages.
The COA has had recent contact with the RCPSC, letter attached. This letter was encouraging in that it is the first time that we have been shown anything other than a closed door. In follow-up phone calls, I have learned that Credentials Committee meeting of Feb. 26 deferred making a decision on the acceptability of the osteopathic medical degree until the next meeting to be held in September. In part, this is to allow the committee time to collect and evaluate “Further Information.” To date, the COA offer to provide additional information has not been replied to. The contact person at RCPSC is Ms. Connie Cote (1-800-668-3740 #203).
Nonetheless, a DO has been accepted into an orthopaedic medicine fellowship at the University of Western Ontario, to begin in July, 2004. It will be difficult for the RCPSC to ignore this precedent, and the wishes of the program directors to have DO participants.
Secondary Barriers
It is now time to shift our focus to what may be called secondary barriers to osteopathic registration in Canada. These are items that in themselves do not prevent participation, but make it significantly more difficult.
1. COMLEX recognition: In Canada each province has the ability to set its own standards for examinations and certifications required of registrants. As such, there is not one body that we can lobby for COMLEX recognition on par with the Medical Council of Canada examinations. Certain provinces require eventual MCC examination completion by all registrants, others do not. Some may be open to exploring COMLEX as an alternative. Rather than try to approach 10 jurisdictions independently, it would be more cost and time effective to try to get on the agenda of the annual meeting of the Federation of Medical Regulatory Authorities of Canada. Unfortunately, we were not successful in an application for the June, 2004 meeting.
2. Recognition of AOA accredited post-graduate training. At the moment, there seems to be a comfort level on the part of the various provinces in accepting programs that are ACGME accredited or dually ACGME/AOA accredited. I don’t sense that there will be interest in looking at DO accredited programs until there are a significantly larger number of DO’s practicing in Canada. However, some provinces have indicated informally an interest in potentially looking at DO accredited graduates, on a case-by-case basis.
3. At the moment, American trained DO’s need to complete the Evaluating Examination of the Medical Council of Canada (MCCEE) before having access to the Qualifying Examination (MCCQE) that is considered the standard for licensure across Canada. This provides an additional expensive hurdle that our graduates must complete. There is a working committee of the MCC that is looking at this issue, and I have been told informally that there could be interest in removing this barrier for DO’s that have completed ACGME accredited residency programs.
4. For those that wish to participate in a Canadian post-graduate residency program, the Canadian Residency Match Service (CaRMS) does not allow access to the “first iteration” to anyone other than a current year graduate of a Canadian medical school. Unfortunately, this match takes place after the corresponding American match process. In order to participate in the Canadian match, a candidate needs to essentially sit out the American match, which is a professional gamble. I have learned that the limits on the first match are at the discretion of the Association of Canadian Medical Colleges, Dr. Hawkins, Executive Director.
5. At a recent CFPC function in Calgary I was approached by an executive officer of the Canadian Medical Association with a proposal that the COA consider applying for affiliate membership in that organization. The benefits to the COA would be:
a. Inclusion on the CMA mailing list, with the opportunity to review and comment on proposed policy statements and positions before release.
b. Paid-for attendance at the annual January meeting of “Affiliated Societies.”
c. Optional and non-paid attendance and vote at the annual “General Council.”
d. No cost to the COA
However, CMA guidelines suggest that unless a recognized Royal College division, the minimum membership of new affiliates should be 100 physicians, of whom 50% must have CMA membership. The current smallest affiliate is that of disabled physicians, with 40 members. It is unlikely that a smaller affiliate would be considered, but this could be a promising contact when COA membership is at a level that can support application.
A brief summary of current developments in certain provinces, from West to East:
British Columbia:
As the medical profession in B.C. moves from the Medicine Act to the Health Professions Act, it appears that title protection for the medical professions including osteopathy will shift from the College of Physicians and Surgeons to the Ministry of Health. It is uncertain that there will be the same level of interest in protecting osteopathic designations under the new legislation, an issue that the British Columbia Osteopathic Association is actively pursuing. In the past year, a candidate was successful in obtaining B.C. registration after presenting AOA credentials followed by the “Comvex” examination. Registration was granted under the limited license pathway, although an unrestricted license pathway continues to be open with completion of the MCC examinations.
Alberta:
Alberta will be making a similar move to a new Health Professions Act in 2005, and no changes in registration provisions for D.O.’s are anticipated. The MCC examinations are a requirement with unlimited licensure granted.
Ontario:
At the Sept. 19 meeting of the Council of the College of Physicians and Surgeons of Ontario, the following resolution was passed:
The Council adopts the policy that the degree, “Doctor of Osteopathy”, granted by an osteopathic medical school in the United States of America that was, at the time the degree was granted, accredited by the American Osteopathic Association, is an equivalent degree in medicine to one granted by a medical school that was, at the time the degree was granted, an accredited medical school as described for the purpose of clause a) of “degree of medicine” in Section 1 of Ontario Registration 865/93.
[Note: - This does not dispense with the clerkship requirement in the definition.]
Current registration information for American trained osteopathic information appears on the CPSO website, and has been made widely available within the American Osteopathic Association, including information posted on the AOA website.
The College of Physicians and Surgeons of Ontario has released a May 2004 Discussion Paper, “Tackling the Doctor Shortage”, which includes the following proposals:
Section III. Maximize the Use of Existing Resources and Eliminate Existing Barriers:
Recommendation #6 Recognition/equivalency of screening examinations:
a. The College should explore recognition of the United States Medical Licensing Exam (USMLE), National Board of Osteopathic Medical Examiners (NBOME), Federal Licensing Examination (FLEX), Educational Commission for Foreign Medical Graduates (ECFMG) and Comprehensive Osteopathic Medical Licensing Examination (COMLEX) immediately as equivalent to the Medical Council of Canada Qualifying Examination (MCCQE) for purposes of registration. “The College believes that the standard set by these examinations are equivalent to our own Ontario standards. Accordingly, we should recognize them as such and require no further training or assessment of applicants who hold these qualifications.”
Recommendation #8 Develop a process to recognize specialists:
a. The College should develop a process to recognize specialists who have specialty certification in their own jurisdictions and training to Accreditation Council for Graduate Medical Education (ACGME) recognized programs equivalent to Royal College requirements.
The response of the Ministry of Health to these proposals is as yet unknown but the implications are tremendous. Graduates of accredited American Osteopathic colleges could be eligible for registration in Ontario with no further examinations necessary, requiring only completion of recognized post-graduate training. Besides Canadian programs, these would be ACGME or dually accredited residency positions. Given the weight that Ontario carries within organizations such as the Federation of Medical Regulatory Authorities of Canada, this would be an extremely important precedent for the other provinces to emulate. However, significant opposition from the Medical Council of Canada can be anticipated.
Quebec:
As previously noted, there is no title protection for the osteopathic profession in Quebec including D.O., osteopathic physician or osteopathic medicine. This is in spite of the fact that American trained D.O.’s may register with the Quebec equivalent of the College of Physicians and Surgeons. There have been several media stories lately about a multi-million dollar lawsuit that has been launched against a non-accredited osteopath/naturopath following an alleged harmful result from neck manipulation. A non-accredited association of osteopaths is seeking governmental recognition with the associated ability to respond to public complaints and presumably also title protection. It will be interesting to see how the numerous groups of self-designated osteopaths within that province respond to this type of initiative. The COA’s concerns regarding the dangers to the public of non-qualified osteopathic practitioners has been communicated to the Quebec government and College on numerous occasions.
Other Provinces:
For a brief summary of the current status of the osteopathic medical profession in the other provinces, please refer to the 2003 COA Annual Report.
International Activities:
Dr. Findlay has attended the October 16, 2003 and April 17, 2004 meetings of the Council on International Osteopathic Medical Education and Affairs of the American Osteopathic Association, as well as the annual convention and scientific assembly. Additionally, he attended the October 13, 2003 Steering Committee meeting of the Osteopathic International Allicance held in conjunction with the AOA annual convention.
Finally, the Canadian Osteopathic Association is hosting the second Invitational Conference of the Osteopathic International Alliance, which will be held in Toronto immediately following the Annual General Meeting of the COA. We continue to play an important role in discussions regarding the further global advancement of the osteopathic philosophy and affiliated organizations. It is our pleasure and honour to host the first meeting of this body held outside of the United States.
Respectfully submitted,
Ted Findlay, DO
President
Canadian Osteopathic Association
(###NOTE: You can contact Dr. Finlay at tfindlay@telus.net