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The National IMG Database - CAPER

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									The National IMG Database
Tracking the Assessment, Certification
and Licensing of International Medical
Graduates in Canada

                      Steve Slade, VP Research and Analysis
                      Tamara Brown, Project Manager
                      Canadian Post-MD Education Registry
                      Association of Faculties of Medicine of Canada
 Tracking Successful Practices
        and Outcomes

The History Behind the IMG Database
Primary Drivers of FQR for Physicians

• Increased immigration of medical
  graduates to Canada
• Balancing our need for physicians with
  public safety
• Growing emphasis on foreign credential
  recognition and standardization
• Ethical recruitment and treatment of IMGs
Data in an Evolving Context
Number of IMGs in the Active Physician Workforce, Canada, 1994-2008
History of the National IMG Database


   2004      Canadian Task Force on the Licensure of
             International Medical Graduates


 2005-2009   Phase 1: Foundational Activities



 2010-2013   Phase 2: Development of an Analytical
             Agenda and Increasing Project Visibility
Phase 1: Building Partnerships


               •   Medical Council of Canada (MCC)
               •   7 IMG assessment centres
               •   17 Faculties of Medicine
               •   The College of Family Physicians of
                   Canada (CFPC)
               •   The Royal College of Physicians and
                   Surgeons of Canada (RCPSC)
               •   Collège des médecins du Québec (CMQ)
               •   9 regulatory authorities
Phase 2: Outcomes and Indicators

For Example…

Outcome: Transparent, appropriate and expeditious
pathways to practice
   • Indicator: numbers traversing various pathways
   • Indicator: average time between milestone events
Outcome: Increased standardization across jurisdictions
  • Indicator: frequency of milestone events across
     jurisdictions
  • Indicator: frequency of migration across jurisdictions
Tools and Strategies to Track IMGs
Effective Indicators for Evaluating Progress
towards Outcomes

Four critical indicators along the path to licensure:

•Success on Medical Council of Canada (MCC) Exams
        MCCQEE          MCCQEI          MCCQEII

•Entry into postgraduate training (residency)

•Certification with the CFPC, CMQ, or RCPSC

•Licensure with a Canadian Regulatory Authority
Number of IMGs who passed MCC
Examinations, 2005-2010
   Data in an Evolving Context
   Increased Number of First Year Post-MD Trainees




Source: CAPER, AFMC, 2010. Note: Excludes visa trainees.
Following a Cohort of Canadian Citizen IMGs

                    1491            MCCEE

  ASSESSEMENT
                     461       MCCQEI & MCCQEII
     114

                     322            PGME


                     144       CFPC/RCPSC/CMQ

                     41           LICENSURE
2008-2010



                 CERTIFICATION WITH
     EE           RCPSC/CFPC/CMQ              PGME

    1147              2522                    1681



          QEI                         Licensed

          1530                          829
                        QEII

                       1245
2008-2010



     EE          LICENSED           PGME

    1647          2604                  377



          QEI               Certified

          1256                633
                   QEII

                   763
Data Gaps versus Knowledge Gaps
 Data Gaps

• Country where MCCEE is written (many write the EE abroad)
• When was citizenship gained
• Pre-medical experiences/education
• MD program experiences
   Ø Clerkship component?
   Ø Clinical elective in Canada?
Knowledge Gaps – Plans for Future Analysis




                                           CROSS-
 PREDICTORS OF        PREDICTORS OF
                                       JURISDICTIONAL
    SUCCESS             RETENTION
                                          ANALYSIS




                                      ALTERNATIVES
                                           FOR
                                      UNSUCCESSFUL
                                          IMGs
             PATHWAYS AND
               PROCESSES
Thank you.

The IMGs in Canada Project Team:
Steve Slade, VP, Research and Analysis CAPER-ORIS
Tamara Brown, Project Manager, tbrown@afmc.ca
Linda Bourgeois, Research Associate, lbourgeois@afmc.ca




This project is funded by the Government
of Canada's Foreign Credential
Recognition Program.

								
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