1. 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

3. Tracking Successful Practices and Outcomes The History Behind the IMG Database

4. 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

5. Data in an Evolving Context Number of IMGs in the Active Physician Workforce, Canada, 1994-2008

6. 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

7. 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

8. 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

9. Tools and Strategies to Track IMGs

10. Effective Indicators for Evaluating Progress towards Outcomes Four critical indicators along the path to licensure: Success on Medical Council of Canada (MCC) Exams Entry into postgraduate training (residency) Certification with the CFPC, CMQ, or RCPSC Licensure with a Canadian Regulatory Authority MCCQEEMCCQEIMCCQEII

11. Number of IMGs who passed MCC Examinations, 2005-2010

12. Data in an Evolving Context Increased Number of First Year Post-MD Trainees Source: CAPER, AFMC, 2010. Note: Excludes visa trainees.

13. MCCEE MCCQEI & MCCQEII PGME CFPC/RCPSC/CMQ LICENSURE Following a Cohort of Canadian Citizen IMGs ASSESSEMENT 114 1491 461 322 144 41

14. CERTIFICATION WITH RCPSC/CFPC/CMQ 2522 EE 1147 QEI 1530 QEII 1245 Licensed 829 PGME 1681 2008-2010

15. LICENSED 2604 EE 1647 QEI 1256 QEII 763 Certified 633 PGME 377 2008-2010

16. Data Gaps versus Knowledge Gaps

17. Data Gaps Country where MCCEE is written (many write the EE abroad) When was citizenship gained Pre-medical experiences/education MD program experiences  Clerkship component?  Clinical elective in Canada?

18. PREDICTORS OF SUCCESS PREDICTORS OF RETENTION CROSS- JURISDICTIONAL ANALYSIS PATHWAYS AND PROCESSES Knowledge Gaps – Plans for Future Analysis ALTERNATIVES FOR UNSUCCESSFUL IMGs

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