Your dollars at work

February 1, 2018 | Author: Dr. Andrew Padmos

Dear colleagues,

I recently had an exchange with a Fellow about Royal College membership dues.

At issue was where membership dollars are being spent.

After several emails, a phone call and a face-to-face visit to the Fellow’s nearby office (yes, I do make house calls) I knew that what we were really discussing was the value of Royal College Fellowship.

One Fellowship, many values

The value of Fellowship does not hinge on one thing, nor is it the same for all Fellows.

  • On one end of the spectrum, there is our shared “noble purpose”: setting and sustaining high standards for Canadian postgraduate medical education and continuing professional development to ensure patients will receive the highest quality care today and in the future.
  • On the other end of the spectrum, there is the more functional aspect of membership: compliance with the Maintenance of Certification Program – a licensure requirement for specialists in practice.

How you perceive the value of your Royal College Fellowship probably falls somewhere between these two ends.

But Fellowship is more than just MOC

The Royal College works to ensure public safety by certifying residency programs, accrediting the schools that deliver postgraduate medical training and assessing residents to ensure they have met those standards.

The Royal College contributes to key discussions, and monitors and synthesizes specialist employment data to help individuals who shape our health care system connect with the information they need to make better and more informed decisions.

The Royal College promotes your Fellowship designation (FRCPC or FRCSC) as an internationally-recognized hallmark of excellence and, through its global efforts, contributes to health systems improvement.

Being part of a network of care

I have been a Fellow for more than 40 years now. I have seen this organization safeguard traditions and adapt to address modern practice realities. Beyond those achievements and the day-to-day work carried out by our dedicated volunteers and staff members, I believe that Royal College Fellowship is about being a part of something greater than myself.

It is about being part of a network of colleagues who hold each other accountable to high standards and aspire every day to give the best possible care to their patients.

It is about striving to be better than you were the day before, staying up-to-date, continuously learning and innovating.

It is about helping to shape future generations of doctors, being a role model, feeling pride at the title “Royal College Fellow” and building up and supporting each other in this diverse but unified profession.

It is about giving back and improving patient care, across Canada and around the world.

Your dollars at work

Health care keeps changing; not surprisingly, training standards must keep pace. We need to make the investment into residency training and into professional development across the learning continuum for the next generation of specialists and health care workers. Your Fellowship dues enable us to do this.

Each year, over 40,000 Fellows complete their MOC program requirements. This is both our public commitment to our peers, as well as our commitment to our patients.

What does Royal College Fellowship mean to you?

Please email me or post in the comments section.


Andrew Padmos, BA, MD, FRCPC, FACP
Chief Executive Officer


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Dr. Andrew Padmos | March 26, 2018
Thank you for your candid views. I read your comments and have been thoughtfully considering each one. There are no easy answers. One of the greatest challenges I face as CEO of the Royal College is how to communicate the value of membership dues, beyond our MOC Program and highly-regarded Fellowship designation. The important investment you make in the future of the profession, in maintaining standards and improving training methods – at all stages of one’s career – cannot be overstated. This is the future of specialist care, by you and by others, for you and for loved ones. We had our Council meeting last month and I shared with them some of the opinions you have voiced here. At each meeting, we set aside time for a round table discussion where Council members report on issues impacting specialists in their various regions. This is a time to orient ourselves in the practice realities of all of our members; it sets the context for the business before us. We know there are areas for improvement. Changes will come over the next several years. Our next strategic plan, set for release this June, has been crafted with your input. Our new Practice, Performance and Membership Office is also striving to increase the value of our member offerings. Please keep your ideas and thoughts coming. My goal is for all Fellows to see this as their Royal College, to find support and pride in their Fellowship. I know it will take time to establish those links. -Andrew
Mohamed Shaikh Najeeb | February 8, 2018
As an underemployed specialist I find that the royal college has not put the appropriate amount of effort in communicating the value of fellowship. In my past work, in a remote location that i have since left, some hospital departments, namely the diagnostic departments like pathology and radiology, and some in surgery and gynecology, were staffed by foreign doctors who were not eligible for royal college fellowship. the standard of practice was reduced by their presence as they often practiced outdated or incorrect medicine. my concerns fell upon deaf ears when communicated to administration. it would appear that the hospital administration prefers to get any warm body to practice rather than provide incentives for appropriately trained individuals to take these positions. at its essence this is a patient care safety issue and the royal college has not done its duty in ensuring that the public is protected by ill trained doctors. if the royal college cannot communicate the value of fellowship, and we are competing in a worldwide market where certification is optional, then i wonder what the purpose of the royal college is. it does not hold the monopoly on canadian practice certification, as it should, yet it costs us significant money and time. and for what?
Dr. Andrew Padmos | March 26, 2018
Dear Dr. Najeeb, I’m sorry to hear about your employment challenges. I agree with your views on the importance of Royal College certification as the national standard. In fact, I think that all regulatory colleges accept the certification of the Royal College as “the gold standard” for independent practice. We do know that provinces and territories have challenges in filling rural openings where some Canadian-trained specialists do not wish to practice, and because they have to meet patient needs, they do register physicians and surgeons from outside Canada. These decisions are the responsibility of each province, not the Royal College. We do provide alternative routes to certification so that all specialists practising in Canada can find a pathway to meet the national standard. We work closely with the provincial and territorial colleges to make them aware of these alternative routes, but I am sure that we can do more to better communicate the value of Royal College certification and Fellowship to the public and the profession. In regards to physician employment challenges, we continue to investigate the multiple factors underlying physician unemployment and under-employment. A new report is expected later this year. Sincerely, Andrew
Alistair | February 9, 2018
Well put.. as a foreign medical graduate who did full residency here in Canada I feel shortchanged when these others may practice without certification
D.B.Sanders | February 3, 2018
I agree with most of the above. The MOC program is simply self serving nonsense to support yet another layer of bureaucracy. The recent insistence that all educational credits be from within Canada assumes that acquiring medical information from out of country is less valuable. This is arrogant self serving stupidity on behalf of the college. The notion that the College must approve all programs beforehand is offensive. We do not need the College to decide what content is of medical value or what is relevant to our own practice. Many hours of daily reading, journal and internet searches that are needed to practice are completely unacknowledged and far more valuable than much of the tripe that has been certified. College dues should be raised or lowered according to the rise or lowering of fee schedules rather than at the whim of those that provide apparent governance. The leadership of both the College and CPSO demonstrate only self interest for their personal fiefdoms rather than making any meaningful contribution to the practice of medicine. If the College believes it should continue in the roll of hall monitor for MOC ,it should demand that physicians be compensated for their time and coverage of the expenses that continue while they attend meetings. This is fair. The current status is unacceptable.
Dr. Andrew Padmos | March 26, 2018
Hi Dr. Sanders, for clarification on what educational activities count for credits, I invite you to email or call our Royal College Services Centre directly. We accredit a variety of activities and journal reading and scanning do have a credit value. I can also share with you that our CPD Unit is looking into accrediting more international activities. Hopefully you will see your options expanded in the coming year or two. In the meantime, if you would like to have a chat with me about how best the Royal College can support you in your commitment to MOC and continuing professional development, please let me know. We can set up a call. -Andrew
Alistair | February 5, 2018
Well put! We are tired of this gouging by all the colleges and perhaps we should tell all of them to go to H.... if none of us joined ala strike mode, who would pay for their ivory towers of wisdom Make them powerless and useless as they almost are!
SK | February 3, 2018
Thank you for your editorial. I have been trying to get a straight forward answer to a question. Is Royal College Fellowship mandatory? Are there other avenues for physicians for MOC documentation. Its great that there are institutional goals, however for my day to day practice I do not see the benefit of those achievements.
Dr. Andrew Padmos | March 26, 2018
Hello SK, no, Royal College membership is not mandatory, but only paid-up members are entitled to refer to themselves as “Fellows” or use the post-nominals: FRCPC or FRCSC. Our Membership Services Team can help you with alternative pathways to complete your required MOC documentation. However, I’d like to speak to you about “membership value” if we could set up a call at your convenience. -Andrew
Etela Neumann | February 1, 2018
I totally lost my written comment, because I needed to change my password each time I enter any page requiring a password. Yet I have been able to enter my MOC credits 2 weeks ago. And I am willing to repeat it if Dr. Padmos would care to hear it. I was comparing the dues physicians pay in BC and the fact that our College gets over 16 million dollars + in fees, and the only value we get is being registrants.
Dr. Andrew Padmos | March 26, 2018
Hi Dr. Neumann, I would be interested in hearing your ideas. Please let me know if you would like to arrange a call to discuss. -Andrew
Alistair Duncan | February 1, 2018
The "value" for money that we receive for enforced "membership" is small at best.....the huge increases that were imposed a few years back, despite assurances that CME monitoring would not increase fees, far outstripped the cost of living and the increases that various provinces imposed upon us. I see the RCPSC as another money grabbing organization that supports MDs who could not have survived in the real world of actually practising medicine! Similar in nature each provincial college........we need one body to licence us all, after all we have to do our LMCC as a national exam. Take the fees back to the days of the mid 80s, and apply a cost of living only or what the average specialist increase was and get back to me.
Dr. Andrew Padmos | March 26, 2018
Hi Dr. Duncan, I would be interested in hearing your ideas. Please let me know if you would like to arrange a call to discuss. -Andrew
Robert Krusehl | February 1, 2018
While I agree with and continue to support the stated intentions and functions of the Royal College I am not convinced that members are receiving good value for their membership dues. I believe that there is room for substantial reductions in Roayl College operating costs. Sincerely
Dr. Andrew Padmos | March 26, 2018
Hi Dr. Krusehl, I would be interested in hearing your ideas. Please let me know if you would like to arrange a call to discuss. -Andrew
Dr Anthony Petrasek | February 1, 2018
Royal College dues continue to rise despite the fact that Ontario specialists have worked without a contract now for 4 years and despite the fact that we have endured a unilateral 7% cut to our fees. We are now waiting until May 25th to start binding arbitration that may last well into Oct, 2018. None of my CME cost or lost work time is compensated by the Ontario Ministry of Health. CME may be a professional obligation but it is hard to feel like you are a professional when your payor treats you so poorly. As you mentioned the Royal College does vital work certifying new grads and residency programmes but why do the fellows have to carry that cost? What about government providing some support? So much money is currently wasted in managing the healthcare system basically to reduce cost and decrease utilization at a time when need for care is continuing to rise. Fellows want a reduction in their dues because our renumeration has dropped. Doesn't it seem fair that the College should reduce fees by cutting its own costs? Also why does the College not speak out against the Ontario gov't and its decision to withdraw CME funding for specialists? Apparently CME funding for Family MDs was partially re-instated when they protested. Healthcare in Ontario has really suffered until Wynne. It would be nice to hear our College speak out in support our Fellows who struggle everyday to deliver best care in a clearly broken, underfunded, poorly managed system. Also why not hold the Feds accountable for their declining healthcare transfer contributions?
Dr. Andrew Padmos | March 26, 2018
Dear Dr. Petrasek, these are indeed trying times for physicians in Canada and especially in Ontario, where barriers to good patient care remain and physicians have been treated very poorly. I would be pleased to speak to you directly about Royal College work, value and dues and have asked my assistant to arrange a call soon. - Andrew
Dr. Jonathan Doe | February 1, 2018
RCPSC dues are much too expensive and physicians are being gouged. To see how one's dollars are being spent, one need only visit the College's beautiful stained-glass-and-marble palace atop Echo Drive in Ottawa, and count the number of catering staff. To say that the funds are spent on quality control for Canadian physicians is risible; trainees spend thousands of dollars for these exams, and yet the MDs actually creating the exams are unpaid. Physicians administer their own MOC through a website, and pay thousands annually for the privilege. The college is no more or no less than another unaccountable authority in Canada's medical regulatory-industrial complex. For shame.
Dr. Andrew Padmos | March 26, 2018
Dear Dr., I gather from your comments that you have visited the College building on Echo Drive and it is beautiful, historic and well-maintained to standards that our Fellows would expect. Perhaps you are unaware of the 1,200+ meetings each year, hosted by the College to manage and support the work of over 90 specialty committees and an equal number of examination boards, in addition to regular College business in curriculum, accreditation, policy and membership support. Catering staff do provide lunch service to our visiting volunteer Fellows and guests who attend these meetings and work in behalf of all members. I would be happy to discuss our expenses and revenues in a telephone conversation at your convenience. - Andrew
Brian Clapson | February 1, 2018
Andrew, nicely stated. The issue of value can be cloudy at best when so many of our fellows are busy with the practice of medicine, family and involvement with other medical organizations. It is easy to not be up to date with everything in the world of our college, so your discourse is an excellent reminder that our member fellows are well served and the money / resources of the RC thoughtfully applied to the many areas that require attention. Keep up the great work!