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Dear Premed101,

As another round of the LMCCII exam passes, I propose we independently and systematically collect data to evaluate the importance, satisfaction and impact of this exam. If you have taken this exam, you are an important stakeholder and I invite you to answer the following survey.

This survey will take approximately 5 minutes. I have collected questions from the literature and crafted some of my own (unfortunately unvalidated) that have been used to evaluate other OSCE exams.

All answers will remain anonymous, confidential and reported in aggregate form. Answers may be left blank, and you may withdraw consent at any time via private message of your Survey ID. There is no compensation for taking this survey. This survey was not approved by any ethics board, and is not associated with any institution. I declare no conflicts of interest. If you have any further questions (or questions that you would like to see included!), feel free to comment or send me a private message.

Thank you and I hope we can get some interesting data! Please click here to take the survey: http://lmcc2survey.ga/

Sincerely,
/u/PublicWifiHotspot

PS ublock and other adblockers may block Qualtrics, the data platform used for this survey. There are no advertisements included.

TLDR; voice your opinion at http://lmcc2survey.ga/

 

FAQ:

1. What do you intend to do with this data?

Publish it in aggregate form for all to see and to get the dialogue going.

2. What is your goal number of responses?

The maximum we can get, the stronger a case we can make! I think two hundred fifty would make a compelling case, but let's top that!

 

Update 1: We are at 50 responses! Thanks everyone who has contributed so far!

Update 2: 99 responses! Keep the data coming!

Update 3: 160! Thank you everyone and feel free to keep sharing!

Update 4 (Nov 2): 200!!

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On 10/28/2018 at 6:36 PM, PublicWifiHotspot said:

Dear Premed101,

As another round of the LMCCII exam passes, I propose we independently and systematically collect data to evaluate the importance, satisfaction and impact of this exam. If you have taken this exam, you are an important stakeholder and I invite you to answer the following survey.

This survey will take approximately 5 minutes. I have collected questions from the literature and crafted some of my own (unfortunately unvalidated) that have been used to evaluate other OSCE exams.

All answers will remain anonymous, confidential and reported in aggregate form. Answers may be left blank, and you may withdraw consent at any time via private message of your Survey ID. There is no compensation for taking this survey. This survey was not approved by any ethics board, and is not associated with any institution. I declare no conflicts of interest. If you have any further questions (or questions that you would like to see included!), feel free to comment or send me a private message.

Thank you and I hope we can get some interesting data! Please click here to take the survey: http://lmcc2survey.ga/

Sincerely,
/u/PublicWifiHotspot

PS ublock and other adblockers may block Qualtrics, the data platform used for this survey. There are no advertisements included.

Great initiative. Too bad that the physician apply doesn't do automatic surveys!

I personally find LMCC 2 to be out of scope of practice for residents not in general practice, when will a internist see a kid or deal with antepartum hemorrhage? When will a pediatrician ever treat an adult ? I don't understand why it is required for every CMG or IMG to gain their independent license. It's relevant for family medicine, but CFPC has its own licensing exam which is very stressful and more demanding in itself. 

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3 minutes ago, LittleDaisy said:

Great initiative. Too bad that the physician apply doesn't do automatic surveys!

I personally find LMCC 2 to be out of scope of practice for residents not in general practice, when will a internist see a kid or treat pregnant women? When will a pediatrician ever treat an adult ? I don't understand why it is required for every CMG or IMG to gain their independent license. It's relevant for family medicine, but CFPC has its own licensing exam which is very stressful and more demanding in itself. 

Thanks for your valuable and insightful input! Please feel free to share this post if you feel strongly about collecting data and independently evaluating the LMCCII. Thanks!

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I think that LMCC II was initially created for every resident to get their general practice license after 12 months of postgraduate training, so you could moon light as a staff or locum here and there as a general practitioner. 

CFPC has its own licensing exam for FM grads,  also, other subspecialty residents can't practice general medicine with 1 year of postgraduate training.  I don't see a point of still keeping LMCC 2?! I don't think that it's fair for non FM residents to write LMCC II, given that it won't be relevant to your future scope of practice. 

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6 hours ago, LittleDaisy said:

I think that LMCC II was initially created for every resident to get their general practice license after 12 months of postgraduate training, so you could moon light as a staff or locum here and there as a general practitioner. 

CFPC has its own licensing exam for FM grads,  also, other subspecialty residents can't practice general medicine with 1 year of postgraduate training.  I don't see a point of still keeping LMCC 2?! I don't think that it's fair for non FM residents to write LMCC II, given that it won't be relevant to your future scope of practice. 

its the $$$. why close down a profitable business 

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11 minutes ago, LittleDaisy said:

Lol makes sense. The physician examiners nor the LMCC II facilitators are not paid, and doing it as volunteering. 

I'm not sure if you're being serious or sarcastic so...

This is factually incorrect. The MCC provides honorarium (ie money) to all physician examiners as stated on their website: https://mcc.ca/examinations/nac-overview/become-a-physician-examiner/

26 million dollars of their 38 million dollar revenue goes directly to compensation. A further 6 million goes to "management and administration", which is almost certainly compensation as well. Source: https://apps.cra-arc.gc.ca/ebci/haip/srch/t3010form23sched6-eng.action?b=107687220RR0001&fpe=2017-03-31

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1 hour ago, DogDays said:

I'm not sure if you're being serious or sarcastic so...

This is factually incorrect. The MCC provides honorarium (ie money) to all physician examiners as stated on their website: https://mcc.ca/examinations/nac-overview/become-a-physician-examiner/

26 million dollars of their 38 million dollar revenue goes directly to compensation. A further 6 million goes to "management and administration", which is almost certainly compensation as well. Source: https://apps.cra-arc.gc.ca/ebci/haip/srch/t3010form23sched6-eng.action?b=107687220RR0001&fpe=2017-03-31

On their website, it states that  Earn CPD credits and an honorarium (including a certificate indicating the educational activities accomplished throughout the examination process)

I thought that honorarium means a small amount of money or just the certificate itself . Sorry for the confusion

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5 minutes ago, deathvvv said:

that still leaves a hefty 4 million dollar profit

I still think that the exam is not that relevant given that after we passed LMCC 2, we still need to pass our royal college or CFPC licensing exam, what's the point? 

 

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one small weird point - the LMCC is also required still because we are under the same accreditation system as the US - a system which still has internship years. They have step exams taken at that time and our LMCC exams are the equivalent. We obviously don't have control over that system - but if we ever dropped the exam we basically are also leaving that system as well. For some potentially that is a big deal as we lose a relatively unique advantage with respect to the US market. 

 

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10 hours ago, rmorelan said:

one small weird point - the LMCC is also required still because we are under the same accreditation system as the US - a system which still has internship years. They have step exams taken at that time and our LMCC exams are the equivalent. We obviously don't have control over that system - but if we ever dropped the exam we basically are also leaving that system as well. For some potentially that is a big deal as we lose a relatively unique advantage with respect to the US market. 

 

just to add - I am not sure that advantage is worth it ha - I really am surprised we haven't just created a completely Canadian system here. I mean if you want control that is how you do it. Still since I am actually using that property of the LMCC right now I suppose I had to mention it. 

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13 hours ago, LittleDaisy said:

I still think that the exam is not that relevant given that after we passed LMCC 2, we still need to pass our royal college or CFPC licensing exam, what's the point? 

 

Actually, I do think there is a point to the lmcc2 exam. I think that there should be a standardized exam to test minimum levels of competence in physical exam maneuvers and clinical reasoning and patient interactions. But I do agree with you it should not be tested during residency since every specialty have their own graduating exams. I think that it is a remnant of the old system and basically free money for them. I do think that the LMCC 2 should be combined with LMCC 1. Basically like the step 2 CK/CS component and administered during clerkship (3rd/fourth year) to show that you have the basics down.

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Just now, deathvvv said:

Actually, I do think there is a point to the lmcc2 exam. I think that there should be a standardized exam to test minimum levels of competence in physical exam maneuvers and clinical reasoning and patient interactions. But I do agree with you it should not be tested during residency since every specialty have their own graduating exams. I think that it is a remnant of the old system and basically free money for them. I do think that the LMCC 2 should be combined with LMCC 1. Basically like the step 2 CK/CS component and administered during clerkship (3rd/fourth year) to show that you have the basics down.

move the LMCC part 1 to end of 3rd year, and the part two exam at the end of med school? 

It would be an extremely long exam I think to combine both parts to the same day. 

There was talk about us splitting off from the US system in Canada about 5 years ago. If we ever did we could entertain this options. The current system doesn't really serve our needs particularly well overall. At least they moved back a bit the part 2 for many of us - the farther it is from med school the more of the basics you will never end up using anyway you will forget. 

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3 minutes ago, rmorelan said:

move the LMCC part 1 to end of 3rd year, and the part two exam at the end of med school? 

It would be an extremely long exam I think to combine both parts to the same day. 

There was talk about us splitting off from the US system in Canada about 5 years ago. If we ever did we could entertain this options. The current system doesn't really serve our needs particularly well overall. At least they moved back a bit the part 2 for many of us - the farther it is from med school the more of the basics you will never end up using anyway you will forget. 

I think it is reasonable to make it a 2 day exam. MCQ exam of lmcc part 1, then lmcc part 2 on the second day. Or alternatively, have lmcc1 at end of third year and lmcc 2 during fourth year after carms. I find the CDM section of lmcc 1 pretty useless and could be removed. The lmcc 2 covers that clinical decision part anyway.

Also please elaborate, in what way would you propose to split the US vs Canada system? 

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20 minutes ago, deathvvv said:

I think it is reasonable to make it a 2 day exam. MCQ exam of lmcc part 1, then lmcc part 2 on the second day. Or alternatively, have lmcc1 at end of third year and lmcc 2 during fourth year after carms. I find the CDM section of lmcc 1 pretty useless and could be removed. The lmcc 2 covers that clinical decision part anyway.

Also please elaborate, in what way would you propose to split the US vs Canada system? 

well I mean right now we cannot change the LMCC - if what i have been told by them anyway. We are a bit of a slave to the US accreditation system. They won't let us drop a comprehensive LMCC exam and they won't let you just shorten things either. You would have to create a new Canadian only accreditation system to do it, and kick them out completely. That is just one part of the  inertia as to way things just keep staying the same - even though for literally 2 decades people have been saying this should change.  

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36 minutes ago, rmorelan said:

well I mean right now we cannot change the LMCC - if what i have been told by them anyway. We are a bit of a slave to the US accreditation system. They won't let us drop a comprehensive LMCC exam and they won't let you just shorten things either. You would have to create a new Canadian only accreditation system to do it, and kick them out completely. That is just one part of the  inertia as to way things just keep staying the same - even though for literally 2 decades people have been saying this should change.  

Fair enough. To be honest I feel like there is nothing wrong with the current accreditation system. Now carms spots for cmgs that's another matter (but that's more resource availability rather than accreditation). I don't think they need to shorten the lmcc. But be more like the USMLE where they move lmcc2 to fourth year after carms (which is basically like vacation anyway). This way the basics are still fresh for all med students and they are not so far removed into their specialties that they don't know how to work up a vaginal bleeding during pregnancy lets say. 

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1 hour ago, deathvvv said:

Fair enough. To be honest I feel like there is nothing wrong with the current accreditation system. Now carms spots for cmgs that's another matter (but that's more resource availability rather than accreditation). I don't think they need to shorten the lmcc. But be more like the USMLE where they move lmcc2 to fourth year after carms (which is basically like vacation anyway). This way the basics are still fresh for all med students and they are not so far removed into their specialties that they don't know how to work up a vaginal bleeding during pregnancy lets say. 

true! I am glad though they didn't go the full range of steps the USMLE has. Ha also glad we don't tie extreme importance to the final score of the exam (say for residency spots....)

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I don't see the need to change it. I think we should have our equivalent to the US's USMLEs, I also think that it is still important to have general physician capabilities even as a specialist. I also don't know if that idea of doing the lmcc 1 after 3rd and 2 after 4th is going to work in 3 yr schools. 

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On 10/31/2018 at 5:27 PM, rmorelan said:

true! I am glad though they didn't go the full range of steps the USMLE has. Ha also glad we don't tie extreme importance to the final score of the exam (say for residency spots....)

I wish it were like this in Canada. At least the USA has a standardized measurement of medical knowledge that can be used to stratify applicants which makes it more difficult for programs to be corrupt

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I see the utility of testing...but what is the justification for the cost? Can we not demand some transparency? We pay them million(s?)/year in testing fees...we should be able to say or do something.

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49 minutes ago, GrouchoMarx said:

I wish it were like this in Canada. At least the USA has a standardized measurement of medical knowledge that can be used to stratify applicants which makes it more difficult for programs to be corrupt

there is validity to that - but I don't think the LMCC is good enough to do it first off. You would have to redesign that entire test. Like the US it would then immediately force all the medical schools to train for that test as well to a much higher degree. Not really terrible things there but would take time and a pile of money. 

I am just not sure I like the idea of a single point of failure in the system. One bad test day can wipe out everything you worked for. There is also some not completely incorrect concern that your ability on a multiple choice exam shouldn't stratify you as much as the US does (it is easier to get into a US medical school than a Canadian one to  start with - and ability on that test beyond a point is probably a less useful indicator of ability as a resident). Doesn't mean that I don't think though some absolute measure of medical knowledge wouldn't be a welcome addition to the assessment of candidates - right now we do have the other problem, no clear idea at all of the knowledge of candidates. 

 

 

 

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