Practice Readiness Assessments: Applicant Manual (Specialist) Page 1 Updated January 31st, 2013
Applicant Manual (Specialist)
1.0 Description and Purpose
3.0 Clinical Objectives for Specialists
4.0 Responsibilities of Applicants
5.0 Responsibilities of Assessors and Practice Supervisors
Schedule A: Supervised Practice Assessment Report Schedule B: Chart Review and Chart Stimulated Recall Worksheet and instructions
Provincial Physician Assessment Program Practice Readiness Assessments
Practice Readiness Assessments: Applicant Manual (Specialist) Page 2 Updated January 31st, 2013
1.0 DESCRIPTION & PURPOSE To qualify for an assessment, applicants must first apply through Registration for a practice permit. Physicians who do not meet the full requirements of the General Register must undergo and successfully pass a practice readiness assessment prior to obtaining a practice permit on the Provisional Register. There are two unique components to a practice readiness assessment, and most, but not all, physicians (see below for exceptions) must undergo and successfully pass both components:
1. Preliminary Clinical Assessment: The applicant (candidate) is placed in the practice setting of an approved assessor, who assesses the applicants clinical competence through direct observation. The duration of the preliminary clinical assessment is typically three months.
In some cases, the College may elect to waive the preliminary clinical assessment (e.g., some U.S. applicants, applicants with previous practice experience in a Canadian setting, distinguished applicants appointed to full-time academic appointments, Canadian-trained applicants who have not passed the national certification exams, etc.).
2. Supervised Practice Assessment: For a supervised practice assessment, the applicant acts as the
most responsible physician in his or her own practice and bills for services provided. An approved assessor visits on a regular basis and assesses the applicants clinical competence by reviewing charts, having case-based discussions with the applicant and providing multi-source feedback. The duration of a supervised practice assessment is typically three months.
Capacity within the two medical schools in Alberta sometimes doesnt support the performance of competency-based assessments on behalf of the College for physicians seeking a practice permit to practice independently. Consequently, community physicians, ideally with experience evaluating student physicians in a specialist practice setting, help conduct practice readiness assessments. The assessments are based on defined objectives, explicit performance standards, and clear statements as to the competence achieved. A practice readiness assessment is only part of the information the College uses to reach a decision about an applicants eligibility for registration. The mere completion of any assessment required by the College does not guarantee a practice permit will be issued. The possible outcomes of an assessment range from eligibility for registration, to registration with conditions, to denial of registration. A practice readiness assessment is not intended to be a training experience. Its purpose is to give applicants opportunities to demonstrate their core knowledge and proficiency in clinical skills, patient management and resource utilization in the specialist practice setting. The College's goal is to register only competent and effective practitioners. These and other standards set by the College help to ensure that Albertan's receive the best care that our profession can offer.
Practice Readiness Assessments: Applicant Manual (Specialist) Page 3 Updated January 31st, 2013
2.0 APPLICANTS Applicants for College-approved practice readiness assessments may be:
1. Graduates of foreign medical schools who have: successfully completed a postgraduate program of at least 48 months discipline-specific
specialty training obtained outside of Canada, specialty certification and recognition in the discipline of training by another medical regulatory authority, or
successfully completed a postgraduate program of at least 36 months specialty training obtained outside Canada, specialty certification and recognition in the discipline of training by another medical regulatory authority. (Candidate may not be eligible for specialist recognition in Alberta.)
2. Graduates of Canadian medical schools who have not successfully completed the national certification exam.
3. Specialist physicians who seek to return to practice after three or more years away from clinical or specialty practice.
4. Other physicians who are required by the College to demonstrate their fitness to practice medicine in this setting.
3.0 CLINICAL OBJECTIVES FOR A PRACTICE READINESS ASSESSMENT The clinical objectives identified in the assessment evaluation tools represent the Colleges minimum expectation for independent specialized practice. The objectives for a specific applicant may be modified after consultation between the applicant, the assessor and a College designate who is familiar with the candidate's background and intended practice location. Where specific objectives cannot be met within the assessors practice, the College may need to make other arrangements in consultation with the assessor. The applicant and the assessor/supervisor should review the objectives for the assessment at their first meeting. Assessment should be a dynamic activity, and objectives should be met and recorded throughout the assessment. The assessor/supervisor is required to submit formal evaluation reports of the applicants performance to the College at prescribed intervals (see 5.0 Responsibilities of Assessors/Supervisors). FITERs from the respective specialty discipline will be used as an evaluation report for the Preliminary Clinical Assessment. A copy of the final evaluation report for the Supervised Practice Assessment is included as Schedule A. Both the applicant and the assessor/supervisor should review and sign the evaluation reports before submitting them to the College. Signature by the applicant does not necessarily mean agreement with the findings but does mean he or she agrees the evaluation has been discussed with him or her.
Practice Readiness Assessments: Applicant Manual (Specialist) Page 4 Updated January 31st, 2013
4.0 RESPONSIBILITIES OF APPLICANTS Preliminary Clinical Assessment:
1. The primary responsibility for demonstrating proficiency in patient care rests with the applicant. The applicant must be fully aware of the objectives of the preliminary clinical assessment and take the initiative to achieve them.
2. The applicant must respect the final authority of the assessor, whose primary responsibility is to his or her patient. The degree of independence afforded the applicant is decided by the assessor after consideration of the applicant's proficiency with the consent of the patient. The applicant is not registered for independent practice and must be under the supervision of the assessor at all times.
3. The applicant must integrate into the assessor's practice and function in accordance with the custom of the practice in matters such as hours of work, on-call responsibility and relationships with office staff and consultants.
4. The applicant must provide quality patient care commensurate with his or her level of training and recent experience. Applicants must ask for supervision in novel or complex cases, and in order to be observed achieving an objective.
5. The applicant must review all clinical work with the assessor at regular intervals, and seek and attend to feedback and to any recommendations of the assessor.
6. The applicant is expected to discuss any difficulty in meeting any requirements or objectives of the preliminary clinical assessment with the assessor. In the event of disagreement between the applicant and the assessor with respect to the purpose or conduct of the preliminary clinical assessment, the applicant is expected to discuss the problem with the appropriate Assistant Registrar at the College.
7. The applicant must respect the assessor's evaluation of the applicant's performance and discuss any outstanding difference of opinion with the Assistant Registrar. The assessor's evaluation report is only part of the information used in reaching a decision about eligibility for registration.
8. The applicant must remain in good standing on the Provisional Register Physician Undergoing Assessment at the College of Physicians & Surgeons of Alberta and carry adequate professional liability insurance throughout the assessment.
Supervised Practice Assessment:
1. The primary responsibility for demonstrating proficiency in patient care rests with the applicant. The applicant must be fully aware of the objectives of the supervised practice assessment and take the initiative to achieve them.
2. The applicant is the most responsible physician whose primary responsibility is to his or her patient. The applicant must remain in good standing on the Provisional Register Conditional Practice at the College of Physicians & Surgeons of Alberta and carry adequate professional liability insurance throughout the assessment.
3. The applicant will be visited in his or her office by the practice supervisor, initially on a weekly basis, to review charts, hold case-based discussions and provide advice on issues as they arise. The case reviews should include a broad cross section of medical conditions including chronic
Practice Readiness Assessments: Applicant Manual (Specialist) Pag