Abstracts
Abstract
Introduction: The College of Family Physicians of Canada (CFPC) offers the Certificate of Added Competence (CAC) program to designate a family physician with enhanced skills. In 2015, the College expanded its program to introduce enhanced certification in four new domains: Palliative Care, Care of the Elderly, Sports and Exercise Medicine, and Family Practice Anesthesia. In this study, we elicited perceptions from Canadian family physicians with and without the CAC on practice impacts associated with the program.
Methods: Active family physicians in Canada with and without CACs were surveyed between November 2019 to January 2020. Descriptive statistics were generated to describe the perceptions of family physicians regarding the CAC program and its impacts on practice.
Results: Respondents agreed with several benefits of the program including enhancing the capacity to deliver comprehensive care, alleviating the burden of patient travel by increasing the availability of care in rural and remote communities, and providing opportunities to engage in various collaborative care models and new leadership roles. All respondents perceived CAC holders to pursue the certificate to meet both professional interests and community needs.
Conclusions: There is a need for strong and continued investment in systemic practice improvements that incentivize the delivery of comprehensive family medicine practice.
Résumé
Introduction : Le certificat de compétence additionnelle (CCA) accordé par le Collège des médecins de famille du Canada (CMFC) vise à reconnaître un haut niveau de compétences chez un médecin de famille. En 2015, le Collège a élargi le titre de compétences additionnelles à quatre nouveaux domaines : soins palliatifs, soins aux personnes âgées, médecine du sport et de l'exercice, et anesthésie en médecine familiale. Dans cette étude, nous avons recueilli les perceptions de médecins de famille titulaires et non titulaires d’un CCA sur l’influence de pratiques associées au programme de certification.
Méthodes : Des médecins de famille actifs au Canada, titulaires et non titulaires du CCA, ont été interrogés entre novembre 2019 et janvier 2020. Des statistiques descriptives ont été générées pour décrire leurs perceptions concernant le Certificat et ses impacts sur la pratique.
Résultats : Les répondants s’entendaient pour reconnaître au CCA plusieurs avantages, notamment le fait d'améliorer la capacité des médecins à fournir des soins complets, de leur offrir la possibilité de s'engager dans divers modèles de soins collaboratifs et de nouveaux rôles de leadership, et d'alléger le fardeau des déplacements des patients en augmentant la disponibilité des soins dans les populations rurales et éloignées. Tous les répondants estiment que les médecins recherchent l’obtention de ce titre de compétence pour répondre à la fois à leurs intérêts professionnels et aux besoins de la collectivité.
Conclusions : Il faut investir de manière importante et continue dans des améliorations systémiques qui favoriseront une pratique holistique de la médecine familiale.
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Appendices
Bibliography
- College of Family Physicians of Canada. A new vision for Canada: family practice — the patient’s medical home 2019. Mississauga (ON): College of Family Physicians of Canada; 2019 Available from: https://patientsmedicalhome.ca/files/uploads/PMH_VISION2019_ENG_WEB_2.pdf. [Accessed on Feb 17, 2023].
- Grierson L, Vanstone M. The rich potential for education research in family medicine and general practice. Adv Health Sci Educ Theory Pract. 2021 Jun;26(2):753-763. https://doi.org/10.1007/s10459-020-10030-5.
- College of Family Physicians of Canada. Family medicine professional profile. Mississauga (ON); 2018. Available from: https://www.cfpc.ca/CFPC/media/Resources/Education/FM-Professional-Profile.pdf. [Accessed on Feb 17, 2023].
- Baldwin DC Jr. Some historical notes on interdisciplinary and interprofessional education and practice in health care in the USA. J Interprof Care. 2007 Feb;21(1):23-37. https://doi.org/10.1080/13561820600995553.
- Fowler N, Oandasan I, Wyman R, eds. Preparing our future family physicians. An educational prescription for strengthening health care in changing times. Mississauga, ON: College of Family Physicians of Canada; 2022.
- College of Family Physicians of Canada. Family medicine professional profile. Mississauga, ON: College of Family Physicians of Canada; 2018.
- Grierson L, Allice I, Baker A, et al. Impacts of the Certificates of Added Competence credentialling program: a qualitative case study of enhanced-skill family medicine practice across Canada. CMAJ Open. 2021 Oct 4;9(4):E966-E972. https://doi.org/10.9778/cmajo.20210013.
- Fowler N, Wyman R, editors. Residency Training Profile for Family Medicine and Enhanced Skills Programs Leading to Certificates of Added Competence. Mississauga, ON: College of Family Physicians of Canada; 2021.
- Goldman J, Meuser J, Rogers J, et al. Interprofessional collaboration in family health teams: an Ontario-based study. Can Fam Physician. 2010 Oct;56(10):e368-74.
- Meuser J, Bean T, Goldman J, et al. Family health teams: a new Canadian interprofessional initiative. J Interprof Care. 2006 Nov;20(6):436-8. https://doi.org/10.1080/13561820600874726
- Lavergne MR, Goldsmith LJ, Grudniewicz A, et al. Practice patterns among early-career primary care (ECPC) physicians and workforce planning implications: protocol for a mixed methods study. BMJ Open. 2019 Sep 10;9(9):e030477. https://doi.org/10.1136/bmjopen-2019-030477.
- Glazier J. Specialization in family medicine education: abandoning our generalist roots. Fam Pract Manag. 2007 Mar;14(3):13-5. PMID: 17388627.
- Coutinho AJ, Cochrane A, Stelter K, Phillips RL, Peterson LE. Comparison of intended scope of practice for family medicine residents with reported scope of practice among practicing family physicians. JAMA. 2015 Dec 8;314(22):2364-2372. https://doi.org/10.1001/jama.2015.13734
- Dhillon P. Shifting into third GEAR: current options and controversies in third-year postgraduate family medicine programs in Canada. Can Fam Physician. 2013 Jul;59(7):e406-12.
- Shepherd LG, Burden JK. A survey of one CCFP-EM program's graduates: their background, intended type of practice and actual practice. Can J Emerg Med. 2005;7: 315-320. https://doi.org/10.1017/S1481803500014500
- Grierson L, Allice I, Tong XC, et al. Motivations for pursuing enhanced skill credentials in family medicine: a study of the Certificates of Added Competence in Canada. Fam Med. 2022;54(6):431-7. https://doi.org/10.22454/FamMed.2022.213612
- Thornton JS, Grierson L, Vanstone M, et al. A win-win for sport and exercise medicine and primary care: a qualitative case study of the added competence model in Canada. J Sports Med. 2022:1-7. https://doi.org/10.1007/s40279-022-01663-6
- Tong XC, Hanel E, Mahmud M, Allice I, Vanstone M, Grierson L. The CFPC certificate of added competence (CAC) in emergency medicine: reflections from current research on the CAC program. CJEM. 2022:1-3. https://doi.org/10.1007/s43678-022-00302-3
- Howard M, Fikree S, Allice I, et al. Family physicians with certificates of added competence in palliative care contribute to comprehensive care in their communities: a qualitative descriptive study, Pall Med Rep. 2023;4:1, 28–35, https://doi.org/10.1089/pmr.2022.0057.
- Correia RH, Grierson L, Allice I, et al. The impact of care of the elderly certificates of added competence on family physician practice: results from a pan-Canadian multiple case study. BMC Geriatr. 2022;22:840. https://doi.org/10.1186/s12877-022-03523-4
- Artino AR Jr, La Rochelle JS, Dezee KJ, Gehlbach H. Developing questionnaires for educational research: AMEE Guide No. 87. Med Teach. 2014 Jun;36(6):463-74. https://doi.org/10.3109/0142159X.2014.889814
- Grierson L, Vanstone M, Allice I. Understanding the Impact of the CFPC Certificates of Added Competence. College of Family Physicians of Canada. 2020. Available from: https://www.cfpc.ca/CFPC/media/PDF/2020-04-CAC-Impact-Study-Report.pdf. [Accessed on Jun 28, 2023].
- Orser BA, Chen R, Wang J, et al. Improving access to safe anesthetic care in rural and remote communities in affluent countries. Toronto (ON): University of Toronto; 2019. https://doi.org/10.1097/01.aoa.0000603632.75640.94