RDoC Update on MCCQE2

October 7, 2020

Dear Colleague,

If you are scheduled to write the MCCQE Part II exam, then this message is for you.

We have heard from thousands of residents over the past few years about numerous concerns with the MCCQEII exam. It will come as no surprise, that many of you feel the exam is redundant and wonder how it is relevant to your long-term practice goals. We understand those concerns and pre-pandemic, the RDoC Board began a process to spearhead an evaluation of how residents’ knowledge and skills should best be evaluated. Not surprisingly, in March of this year, circumstances required us to turn our focus to COVID-19 and the myriad of issues facing our education and our clinical work, including advocating to the CFPC, RCPSC and licensing authorities on behalf of our graduating members.

During the pandemic, RDoC has held fast to two guiding principles related to all examinations. First – we believe that the safety of the candidate is paramount. Second – we believe that no one’s ability to enter practice should be impeded due to the pandemic. We achieved universal agreement with these principles and in the spring of 2020, all examining bodies agreed to postpone written exams until they could be delivered safely. Similarly, all of the medical licensing authorities agreed that they would provide a provisional license to any practice-eligible candidate who was exam ready but who had not been able to sit their exam.

A number of weeks ago, we asked you to share your concerns with us about the QEII exams through an online survey. More than 800 of you provided us with raw and unfettered responses that have served as the backbone to the advocacy work that we have been engaged in. Armed with all of this information, we reached out to the leadership of the Fédération des Médecins Résidents du Québec, the Canadian Federation of Medical Students and the Fédération médicale étudiante du Québec and asked them to join with us in advocating on behalf of our collective membership. This resulted in a series of meetings with the leadership of the Medical Council of Canada. We discussed our concerns about the QEI exams as well as concerns related to the QEII exams. We were able to get assurances from the MCC that they would deliver the QEII exams in accordance with local public health guidelines and that resident safety would be paramount. We also obtained their agreement to provide exams for residents that require an accommodated exam format in every province rather than only offering it in Toronto.

In our meeting with the MCC last week, we raised the issue that many current family medicine residents were not offered the opportunity to sit the October 2020 or February 2021 exam. We were told that the priority for exam spots was being given to the cohort that are currently in practice with provisional licenses. While this priority setting may be understandable, we remain concerned that there might not be sufficient capacity for everyone to sit the exam prior to graduation and so we obtained a commitment from the MCC that they would work with us to advocate that the provincial licensing authorities once again issue provisional licenses, if necessary.

In the past week, our concerns about the safety of sitting the exam in some jurisdictions has increased. We have become aware that some candidates are being required to travel outside of their home jurisdiction to sit the exam and that in some situations, they are required to travel to an area that is now identified as a COVID hotspot. We understand how anxiety provoking this is and am reminded that our first principle is to ensure that everyone is safe. The MCC have assured us that, “They are in close touch with public health on a regular basis and that they can and will offer a safe exam experience for all participants, respecting and exceeding all public health guidelines. All sites have a multi-page document of location requirements that they have to adhere to”. The MCC states that it is a resident’s choice to evaluate what level of risk they are comfortable with, and while we acknowledge this, we have worked hard to ensure that you have viable options.

In the past week, we have spoken with many key stakeholders across the country to express our concerns and to galvanize support. We want to thank those Post-graduate Deans who have added their voices and who are intent on ensuring that the safety of their residents is paramount. We also want to thank the Association of Faculties of Medicine for their support in raising our concerns with the Federation of Medical Regulatory Authorities of Canada (FMRAC).

Yesterday, candidates scheduled to sit the exam in Kingston were notified that the exam site was being cancelled due to ‘recent developments and changes to public health guidelines’. Earlier in the planning phases, Hamilton had indicated that they would not make their facilities available. It is entirely possible that as the second wave worsens, similar test sites will arrive at the same conclusion. Yesterday, we reached out directly to the CEO of the MCC who reiterated their commitment to provide a safe exam experience and who provided the assurance that, during COVID-19, the MCC has a liberal refund policy in place that candidates may request at their discretion.

We have been in constant contact with the Federation of Medical Licensing Authorities, advocating on your behalf and on behalf of our former members who are currently working with a provisional license. We are pleased to be able to report to you that we have confirmation that all of the medical licensing authorities will extend the duration of any currently issued COVID-19 provisional license for anyone who is unable to sit the MCCQE Part II exam this fall.

We have also had confirmation that FMRAC is asking the licensing authorities two other important questions in response to our advocacy on behalf of the 2021 graduating cohort:

  1. If members of the 2021 graduating cohort are unable to take the MCCQE Part II because it is not being offered or because it is over-subscribed, will you provide them with the same kind of license as you did for the 2020 cohort?
  2. If any candidate feels it would be unsafe or unwise to take the exam that is taking place, would your licensing authority either extend the COVID-19 license for the 2020 cohort or offer a new provisional COVID-19 provisional license to the 2021 cohort?

FMRAC agreed to discuss these questions at their scheduled meeting at the end of the month but we are pleased to tell you that in response to our request, they distributed these questions to the licensing authorities yesterday and will keep us informed regarding the responses.

We are optimistic that the provincial licensing authorities will provide a positive response to both of the questions that FMRAC sent to them, thereby supporting our guiding principles. We know that there are regional differences related to the pandemic. We also know that some members want the exams done and over with, while others feel the personal risk of attending the exam is too high and want to be able to defer the exam until it is safe. We are working hard to ensure that there is flexibility in the system and that everyone has viable options.

Making sure candidates are safe and that you are able to transition into practice are our top priorities. I, as well as the team at RDoC, hear you and we will continue to advocate effectively on your behalf to ensure these priorities are met. We will continue to elevate your voices and concerns at every opportunity. Do not hesitate to reach out to us to share your concerns at covid19@residentdoctors.ca.

I will be sure to update you with more information as it becomes available.

Warm regards,

Esther Kim MD

RDoC President