Your dollars at work

Andrew Padmos
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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Avatar 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
Avatar 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?
Avatar 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
Avatar 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
Avatar 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.
Avatar 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
Avatar 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!
Avatar 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.
Avatar 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
Avatar 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.
Avatar 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
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