Italy scraps all medical school qualifying exams

[islam620]

https://www.reuters.com/article/us-health-coronavirus-italy/italy-rushes-to-promote-new-doctors-to-relieve-coronavirus-crisis-idUSKBN214245

 

This means immediately releasing into the National Health System the energy of about 10,000 doctors, which is fundamental to dealing with the shortage that our country is suffering,” he said in a statement.

The graduates will be sent to work in general practitioners’ clinics and at old peoples’ homes, freeing up more experienced colleagues who will be sent to the rapidly filling hospitals.

[Intrepid86]

Italy is desperate. Proportionally, they've been hit much harder than China, and want more personnel to get things under control. The virus might be harmful to the public, but so is scrapping quality control like examinations and letting thousands of unproven people assume responsibility for delivering medical care.

[rogerroger]

On 3/17/2020 at 10:47 PM, Intrepid86 said:

Italy is desperate. Proportionally, they've been hit much harder than China, and want more personnel to get things under control. The virus might be harmful to the public, but so is scrapping quality control like examinations and letting thousands of unproven people assume responsibility for delivering medical care.

300-400 people a day are dying in Italy. The situation there is like nothing seen since WW2. Having people out there doing something is better then having no one...

Canada is entering into the same situation. Final year residents are being given temporary liscenses to practice independently without writing the exams. Exams are cancelled this spring. We need the people.  
 

The scale of what is coming is truly unlike anything we have seen in generations. 

Edited March 22, 2020 by rogerroger

[ellorie]

Just now, rogerroger said:

300-400 people a day are dying in Italy. The situation there is like nothing seen since WW2. Having people out there doing something is better then having no one...

Canada is entering into the same situation. Final year residents are being given temporary liscenses to practice independently without writing the exams. Exams are cancelled this spring. We need the people.  

To be fair, Ontario is giving us temporary licenses WITH supervision, which they have always done for people who were exam eligible but didn't write for whatever reason (e.g. illness) or failed their first try.  They haven't actually created a new pathway.

[islam620]

I think what many are advocating for is a change to the system , to make an exception in this climate, and allow residency programs to evaluate and perhaps jointly award FRCSC/CCFP without having to write exams 6+ months into 'semi supervised' practice 

[LittleDaisy]

2 hours ago, rogerroger said:

300-400 people a day are dying in Italy. The situation there is like nothing seen since WW2. Having people out there doing something is better then having no one...

Canada is entering into the same situation. Final year residents are being given temporary liscenses to practice independently without writing the exams. Exams are cancelled this spring. We need the people.  
 

The scale of what is coming is truly unlike anything we have seen in generations. 

I think that given CFPC and Royal College exams are cancelled, the majority of Canadian provinces are granting a PROVISIONAL license which requires SUPERVISION and UNDERTAKING by an experienced physician who has no conflict of interests, and who can't take any form of remuneration. 

For any surgical specialties, high acuity specialty such as emergency medicine, ICU or GIM, it will be difficult to secure a hospital position as CPSO requires the physicians to be preferably on site when the supervised new grad is working, and no hospital chief of staff prefers to hire someone with a provisional license.

It also creates problems for residents who have already secured a job position or a fellowship position which requires full certification. I think that if the provincial colleges really think ahead of the game, anticipating that frontline physicians will get infected especially given the current lack of PPE, they need temporary independently licensed new grads. 

I can't imagine how the job market will be for specialties not in demand secondary to COVID-19, i.e: surgical specialties, any specialty that is not psychiatry, emergency medicine, family medicine and pediatrics. Given that the hospital and outpatient clinics are all doing outpatient telemedicine or phone visits, it will be difficult for a new grad to set up a practice. 

[islam620]

9 minutes ago, LittleDaisy said:

I think that given CFPC and Royal College exams are cancelled, the majority of Canadian provinces are granting a PROVISIONAL license which requires SUPERVISION and UNDERTAKING by an experienced physician who has no conflict of interests, and who can't take any form of remuneration. 

For any surgical specialties, high acuity specialty such as emergency medicine, ICU or GIM, it will be difficult to secure a hospital position as CPSO requires the physicians to be preferably on site when the supervised new grad is working, and no hospital chief of staff prefers to hire someone with a provisional license.

It also creates problems for residents who have already secured a job position or a fellowship position which requires full certification. I think that if the provincial colleges really think ahead of the game, anticipating that frontline physicians will get infected especially given the current lack of PPE, they need temporary independently licensed new grads. 

I can't imagine how the job market will be for specialties not in demand secondary to COVID-19, i.e: surgical specialties, any specialty that is not psychiatry, emergency medicine, family medicine and pediatrics. Given that the hospital and outpatient clinics are all doing outpatient telemedicine or phone visits, it will be difficult for a new grad to set up a practice. 

Further to approve the >2000 new provisional licenses between GP/specialist will probably take a lot of time. Right now, provisional licenses are only approved monthly- even if they do allow everyone to get one they will probably be ++ delayed. Models are showing COVID peaking in July. It seems counterintuitive to now ask >2000 doctors to do extra work to supervise new grads in the midst of the all this. Poor use of resources. This will also greatly affect rural areas where there might not be doctors to supervise and now new grads can not go up there to work. 

[Intrepid86]

3 hours ago, rogerroger said:

Canada is entering into the same situation. Final year residents are being given temporary liscenses to practice independently without writing the exams. Exams are cancelled this spring. We need the people.  

I'm fairly certain that exams are cancelled here due to health concerns and social distancing, rather than any actual need for more doctors right now.

[LittleDaisy]

29 minutes ago, Intrepid86 said:

I'm fairly certain that exams are cancelled here due to health concerns and social distancing, rather than any actual need for more doctors right now.

Yeah the exams are cancelled due to health concerns of COVID-19, which I totally understand!

It seems counter-intuitive to give provisional licenses as residents in previous years who failed certification exam will get the same provisional license with supervision. I am worried about rural physicians recruitment, as rural places don't have the luxury to have back-up supervisors and an experienced physician who can sign on to multiple new grads. 

[blah1234]

30 minutes ago, Intrepid86 said:

I'm fairly certain that exams are cancelled here due to health concerns and social distancing, rather than any actual need for more doctors right now.

Yea, I thought the rationale was that they couldn't get examiners all together in one place and they shouldn't gather the residents either.

[rmorelan]

24 minutes ago, Intrepid86 said:

I'm fairly certain that exams are cancelled due to health concerns and social distancing, rather than any actual need for more doctors right now.

True - we cannot afford to have all the examiners in one field for instance is the same place each meeting dozens of candidates a day who are also from all over the country. Candidates who also are from a health centre and so at higher risk of exposure. It is exactly the worst scenario. 

Having all these new trainees available July first would be useful - although you could argue that in many cases whoever they were going to replace very likely could defer leaving reducing the impact (at least until health care workers get sick of course). 

I still thing we should have figured out a way to give the written and multiple choice parts of the exam now - at the existing hospitals for at least the Canadian grades (even if that means a new exam is needed for any international people later on). At least that way a big part of what people are studying will be over with. That would make it easier to do oral exams later and get people out there. 

At some point the "only essential travel" you would think would kick in - getting 2000 doctors out there sounds in the relative short term pretty critical. Maybe send for some fields at least a few examiners to each school rather than meeting everyone in the same place, and use local support staff to help. Everyone is busy making sure they take care of things but of course I am sure there are retired examiners that aren't working anymore that would be willing to help give the actual exam. This is a problem like any other - there is always a solution. 

 

[islam620]

5 minutes ago, rmorelan said:

True - we cannot afford to have all the examiners in one field for instance is the same place each meeting dozens of candidates a day who are also from all over the country. Candidates who also are from a health centre and so at higher risk of exposure. It is exactly the worst scenario. 

Having all these new trainees available July first would be useful - although you could argue that in many cases whoever they were going to replace very likely could defer leaving reducing the impact (at least until health care workers get sick of course). 

I still thing we should have figured out a way to give the written and multiple choice parts of the exam now - at the existing hospitals for at least the Canadian grades (even if that means a new exam is needed for any international people later on). At least that way a big part of what people are studying will be over with. That would make it easier to do oral exams later and get people out there. 

At some point the "only essential travel" you would think would kick in - getting 2000 doctors out there sounds in the relative short term pretty critical. Maybe send for some fields at least a few examiners to each school rather than meeting everyone in the same place, and use local support staff to help. Everyone is busy making sure they take care of things but of course I am sure there are retired examiners that aren't working anymore that would be willing to help give the actual exam. This is a problem like any other - there is always a solution. 

 

 

Absolutely agree, I think there is always a solution, I just find that it has been very frustrating because it seems that both the RC and the CCFP haven't been too open to a negotiation surrounding exam plans or alternate methods of obtaining certification. As of now, it still appears that their plan is both written and oral exams are in October and some sort of possible provisional license but no definite updates .

I understand the complexities of planning big licensing exams but I would have appreciated to have felt like resident feedback was heard 

[rmorelan]

Just now, islam620 said:

 

Absolutely agree, I think there is always a solution, I just find that it has been very frustrating because it seems that both the RC and the CCFP haven't been too open to a negotiation surrounding exam plans or alternate methods of obtaining certification. As of now, it still appears that their plan is both written and oral exams are in October and some sort of possible provisional license but no definite updates .

I understand the complexities of planning big licensing exams but I would have appreciated to have felt like resident feedback was heard 

they are very old world, very rigid type of organizations. The entire things is seeped in this hierarchical tradition set. This isn't a group that changes quickly - or really quite often at all. What residents want never really seems to matter much in the process beyond a point (we are collectively a bit to blame for that as well - once the exam is done as horrible as it is then until recently you got the results in 2 days - almost everyone passes and interest in actually changing anything immediately evaporates it seems). 

They don't personally have much downside to delaying, and if anyone they let practise otherwise screws up then they would be in trouble. Plus they would have to create a duplicate exam for all fields - which sounds like a lot of work. 

 

[islam620]

Posted this in another group but might be of interest here

https://docs.google.com/forms/d/e/1FAIpQLSfC63jV31Ptd5iMuktc98Av9G_a5vmtHDTEuvWEEGO8C8s71g/viewform?fbclid=IwAR0thDfzGotNM0uC9z_UBEOMmdILUiTMzVaVFr3UDRS72e8cz5if2vAheIo

 

Really great to see a PD advocating on resident's behalf, hopefully will see some creative solutions from this 

[rogerroger]

On 3/22/2020 at 3:10 PM, Intrepid86 said:

I'm fairly certain that exams are cancelled here due to health concerns and social distancing, rather than any actual need for more doctors right now.

Of course the exams where cancelled for this reason...

Why were provisional licenses granted over just having them sit it out? A human resource rational plays a role there.  

[Intrepid86]

1 hour ago, rogerroger said:

Of course the exams where cancelled for this reason...

Why were provisional licenses granted over just having them sit it out? A human resource rational plays a role there.  

They don't necessarily want people sitting idle either, hence the provisional licenses. That doesn't mean people are needed urgently though.