College of Family Physicians of Canada

The College of Family Physicians of Canada (CFPC; French: Collège des médecins de famille du Canada, CMFC) is a professional association and the legal certifying body for the practice of family medicine in Canada. This national organization of family physicians was founded in 1954 and incorporated in 1968.[1] Although membership is not mandatory to practice medicine, it currently numbers over 38,000 members.[2] Members of the CFPC belong to the national College, as well as to their provincial or territorial chapters. The CFPC uses both English and French as official communication languages.

College of Family Physicians of Canada


AbbreviationCFPC
Formation1954
TypeProfessional society, Regulatory college
Legal statusActive
PurposeFamily medicine certification; advocacy, life-long learning
HeadquartersMississauga, Ontario, Canada
Region served
Canada
Membership
38,000 members
Official languages
English and French
Websitehttp://www.cfpc.ca

The CFPC establishes the standards for the training, certification, and lifelong education of family physicians in Canada. It accredits postgraduate family medicine training programs in Canadian medical schools, conducts the certification examination for graduating family medicine residents, and grants the certification (CCFP) and fellowship (FCFP) designations to its members.

The CFPC is a member of the World Organization of Family Doctors.[3] The CFPC is based in Mississauga, Ontario.

History

The CFPC was founded in 1954 in Vancouver, British Columbia, as the "College of General Practice of Canada" out of a need to ensure family physicians were dedicated to continuing medical education.[4] There were 400 members at inception.[5] and Victor L. Johnston, the first executive director, remained in office for ten consecutive years. The first executive committee and board of representatives consisted of 17 members.[6] In 1964, the College obtained its current name.

Governance

The CFPC is governed by members of the executive committee and the board of representatives. The current executive director and chief executive officer is Dr. Francine Lemire.

Collaboration with the Medical Council of Canada

In 2013, the CFPC collaborated with the Medical Council of Canada (MCC) to deliver a new "harmonized" certification examination in family medicine. Those who passed the new examination and met all other qualifications of both organizations were awarded both the Licentiate of the Medical Council of Canada (LMCC), the medical license to practice in Canada, and the certification in family medicine designation (CCFP).[7] Nevertheless, upon review of the harmonized examination, the CFPC determined that the Certification Examination in Family Medicine did not result in the anticipated benefits for the Certification decision. For this reason, starting in 2016, the two examinations were once again run separately, as they were prior to 2013.[8]

Continuing professional development

The CFPC has numerous opportunities for the continuing professional development of its physician members.

Mainpro+

The CFPC runs a program designed to support the continuous professional development of its members called Mainpro+ (Maintenance of Proficiency).[9] This program assesses proposed learning modules and seminars against established standards and awards various types and numbers of credits that physicians can earn by participating in these learning opportunities. Credits are recorded and physicians must meet a standard number and type of credits in order to maintain their certification (CCFP).[10]

Canadian Family Physician
Main article: Canadian Family Physician

The CFPC's official monthly journal is Canadian Family Physician.

Family physicians have the possibility of accumulating MAINPRO credits by "performing brief reflective exercises after reading eligible articles in the journal," thereby contributing to the spread of family medicine stories and experience across the country to the various readers of CFP.[11]

Family Medicine Forum

Each year, the CFPC hosts the Family Medicine Forum (FMF), a national family medicine conference. The conference offers hundreds of clinical and professional development sessions for family physicians over three days in November. The conference is held at varying host cities and provinces each year. The 2016 FMF was held in Vancouver, British Columbia.

Research and Education Foundation

The Research and Education Foundation of the CFPC was established to provide funding for honours, awards, scholarships, and grants bestowed by the organization to its members. It is a registered charity with the Government of Canada.[12]

Choosing Wisely Canada recommendations

In collaboration with the Canadian Medical Association's Forum on General and Family Practice Issues, the CFPC released a list of "Eleven Things Physicians and Patients Should Question" as part of the Choosing Wisely Canada campaign. Recommendations 1 to 5 were released on 2 April 2014 and recommendations 6 to 11 were released on 29 October 2014. Recommendations specific for Canadian family medicine include:

1. Don't image patients for lower-back pain unless the patient is presenting with red flags.[13][14]

2. Don't use antibiotics for patients who have upper respiratory infections that are likely viral in origin, such as influenza-like illness, or self-limiting, such as sinus infections that lasts less than seven days.[15][16]

3. Don't order screening chest X-rays and electrocardiograms (ECGs) for patients who are asymptomatic or low risk.[17]

4. Don't screen women with Pap smears if they are under 21 years of age or over 69 years of age.[18]

  • Don't do screening Pap smears annually in women with previously normal results
  • Don't do Pap smears in women who have had a hysterectomy for non-malignant disease

5. Don't do annual screening blood tests for patients unless they are directly indicated by the risk patient's risk profile.[19]

6. Don't routinely measure Vitamin D in adults who are low risk.[20]

7. Don't do screening mammography for low-risk women aged 40–49.[21][22]

8. Don't do annual physical exams on asymptomatic adults who have no significant risk factors.[23][24]

9. Don't order DEXA (Dual-Energy X-ray Absorptiometry) screening for osteoporosis on patients who are low-risk.[25][26]

10. Don't advise patients with diabetes who do not require insulin to routinely self-monitor blood sugars between office visits.[27][28]

11. Don't order thyroid function tests in patients who are asymptomatic.[29][30]

Enhanced skills programs

The CFPC recognizes several enhanced skills programs that generally last between three and twelve months. These advanced programs are accessible to practicing family physicians as well as Canadian medical residents who are completing their second year of residency in family medicine. In some cases, the enhanced skills program counts as a third year of residency. The following are some existing enhanced skills programs, which are recognized by the College of Family Physicians of Canada (CFPC) and lead to the obtention of a Certificate of Added Competence (CAC) in a specialized domain of family and community medicine:[31]

Some other enhanced skills programs which do not necessarily lead to a certificate of added competence with the CFPC but are nonetheless accessible for graduating or practicing family physicians include the following:[38]

Physician members of the Canadian Forces can benefit from supplementary training and obtain the Certificate of Added Competence in Emergency Medicine via subsidized education from the Department of National Defence of Canada.[39]

Student interest groups in family medicine

Several medical schools in Canada have student interest groups in family medicine, as well as other medical specialties. These student interest groups often organize activities that allow fellow medical students to explore some facets of the medical specialty. In September 2014, for example, the family medicine student interest group at McGill University hosted the sixth family medicine student symposium, gathering over 600 students from the four Quebec faculties of medicine (McGill University, Université de Montréal, Université Laval, and Université de Sherbrooke), as well as the University of Ottawa.[40] While the conferences took place in the McIntyre Medical Sciences Building, the workshops led by practicing physicians and family medicine residents took place in McGill's medical simulation center near the downtown campus.

See also

References
  1. "Bylaws: About CFPC: The College of Family Physicians of Canada". College of Family Physicians of Canada. College of Family Physicians of Canada. 2015. Retrieved 22 February 2015.
  2. "Missions and Goals: About CFPC: The College of Family Physicians Canada". College of Family Physicians of Canada. College of Family Physicians of Canada. 2015. Retrieved 22 February 2015.
  3. "Regions and Member Organizations". World Organization of Family Doctors. Retrieved 7 March 2014.
  4. "College History: About CFPC: College of Family Physicians of Canada". College of Family Physicians of Canada. College of Family Physicians of Canada. Retrieved 22 February 2015.
  5. Woods, David (1979). Strength in Study. Toronto: The College of Family Physicians of Canada. ISBN 0-921413-00-9.
  6. Solomon, Stan (2004). Patients First: The Story of Family Medicine in Canada. Toronto: Key Porter Books. ISBN 1-55263-605-4.
  7. "Certification in Family Medicine". Medical Council of Canada. Retrieved 7 March 2014.
  8. "Deharmonization FAQs | Certification Examination in Family Medicine | Education | The College of Family Physicians Canada". www.cfpc.ca. Retrieved 2016-07-29.
  9. "Introduction to MAINPRO: Continuing Professional Development: College of Family Physicians of Canada". College of Family Physicians of Canada. College of Family Physicians of Canada. 2015. Retrieved 22 February 2015.
  10. "Earning Mainpro Credits". Queen's University. Archived from the original on 7 March 2014. Retrieved 7 March 2014.
  11. "Canadian Family Physician MAINPRO: Continuing Professional Development: College of Family Physicians of Canada". College of Family Physicians of Canada. College of Family Physicians of Canada. 2015. Retrieved 22 February 2015.
  12. "RESEARCH AND EDUCATION FOUNDATION OF THE COLLEGE OF FAMILY PHYSICIANS OF CANADA/RECHERCHE MEDECINS DE FAMILLE DU CANADA". Canada Revenue Agency. Retrieved 7 March 2014.
  13. Chou, Roger; Fu, Rongwei; Carrino, John A; Deyo, Richard A (February 2009). "Imaging strategies for low-back pain: systematic review and meta-analysis". The Lancet. 373 (9662): 463–472. doi:10.1016/S0140-6736(09)60172-0. PMID 19200918.
  14. Williams, Christopher M. (8 February 2010). "Low Back Pain and Best Practice Care". Archives of Internal Medicine. 170 (3): 271. doi:10.1001/archinternmed.2009.507.
  15. Desrosiers, Martin; Evans, Gerald A; Keith, Paul K; Wright, Erin D; Kaplan, Alan; Bouchard, Jacques; Ciavarella, Anthony; Doyle, Patrick W; Javer, Amin R; Leith, Eric S; Mukherji, Atreyi; Schellenberg, R Robert; Small, Peter; Witterick, Ian J (2011). "Canadian clinical practice guidelines for acute and chronic rhinosinusitis". Allergy, Asthma & Clinical Immunology. 7 (1): 2. doi:10.1186/1710-1492-7-2. PMC 3055847. PMID 21310056.
  16. Smith, Stephen R. (26 March 2012). "Treatment of Mild to Moderate Sinusitis". Archives of Internal Medicine. 172 (6): 510–3. doi:10.1001/archinternmed.2012.253. PMID 22450938.
  17. Tigges, S; Roberts, DL; Vydareny, KH; Schulman, DA (November 2004). "Routine chest radiography in a primary care setting". Radiology. 233 (2): 575–8. doi:10.1148/radiol.2332031796. PMID 15516621.
  18. Canadian Task Force on Preventive Health, Care; Dickinson, J; Tsakonas, E; Conner Gorber, S; Lewin, G; Shaw, E; Singh, H; Joffres, M; Birtwhistle, R; Tonelli, M; Mai, V; McLachlin, M (8 January 2013). "Recommendations on screening for cervical cancer". CMAJ : Canadian Medical Association Journal. 185 (1): 35–45. doi:10.1503/cmaj.121505. PMC 3537778. PMID 23297138.
  19. Boland, BJ; Wollan, PC; Silverstein, MD (August 1996). "Yield of laboratory tests for case-finding in the ambulatory general medical examination". The American Journal of Medicine. 101 (2): 142–52. doi:10.1016/s0002-9343(96)80068-4. PMID 8757353.
  20. Hanley, DA; Cranney, A; Jones, G; Whiting, SJ; Leslie, WD; Cole, DE; Atkinson, SA; Josse, RG; Feldman, S; Kline, GA; Rosen, C; Guidelines Committee of the Scientific Advisory Council of Osteoporosis, Canada (7 September 2010). "Vitamin D in adult health and disease: a review and guideline statement from Osteoporosis Canada". CMAJ : Canadian Medical Association Journal. 182 (12): E610-8. doi:10.1503/cmaj.080663. PMC 2934850. PMID 20624868.
  21. Ringash, J; Canadian Task Force on Preventive Health, Care (20 February 2001). "Preventive health care, 2001 update: screening mammography among women aged 40-49 years at average risk of breast cancer". CMAJ : Canadian Medical Association Journal. 164 (4): 469–76. PMC 80774. PMID 11233866.
  22. Canadian Task Force on Preventive Health, Care; Tonelli, M; Connor Gorber, S; Joffres, M; Dickinson, J; Singh, H; Lewin, G; Birtwhistle, R; Fitzpatrick-Lewis, D; Hodgson, N; Ciliska, D; Gauld, M; Liu, YY (22 November 2011). "Recommendations on screening for breast cancer in average-risk women aged 40-74 years". CMAJ : Canadian Medical Association Journal. 183 (17): 1991–2001. doi:10.1503/cmaj.110334. PMC 3225421. PMID 22106103.
  23. Boulware, LE; Marinopoulos, S; Phillips, KA; Hwang, CW; Maynor, K; Merenstein, D; Wilson, RF; Barnes, GJ; Bass, EB; Powe, NR; Daumit, GL (20 February 2007). "Systematic review: the value of the periodic health evaluation". Annals of Internal Medicine. 146 (4): 289–300. doi:10.7326/0003-4819-146-4-200702200-00008. PMID 17310053.
  24. Krogsbøll, LT; Jørgensen, KJ; Grønhøj Larsen, C; Gøtzsche, PC (20 November 2012). "General health checks in adults for reducing morbidity and mortality from disease: Cochrane systematic review and meta-analysis". BMJ (Clinical research ed.). 345: e7191. doi:10.1136/bmj.e7191. PMC 3502745. PMID 23169868.
  25. Lim, LS; Hoeksema, LJ; Sherin, K; ACPM Prevention Practice, Committee (April 2009). "Screening for osteoporosis in the adult U.S. population: ACPM position statement on preventive practice". American Journal of Preventive Medicine. 36 (4): 366–75. doi:10.1016/j.amepre.2009.01.013. PMID 19285200.
  26. Papaioannou, A; Morin, S; Cheung, AM; Atkinson, S; Brown, JP; Feldman, S; Hanley, DA; Hodsman, A; Jamal, SA; Kaiser, SM; Kvern, B; Siminoski, K; Leslie, WD; Scientific Advisory Council of Osteoporosis, Canada (23 November 2010). "2010 clinical practice guidelines for the diagnosis and management of osteoporosis in Canada: summary". CMAJ : Canadian Medical Association Journal. 182 (17): 1864–73. doi:10.1503/cmaj.100771. PMC 2988535. PMID 20940232.
  27. Cameron, C; Coyle, D; Ur, E; Klarenbach, S (12 January 2010). "Cost-effectiveness of self-monitoring of blood glucose in patients with type 2 diabetes mellitus managed without insulin". CMAJ : Canadian Medical Association Journal. 182 (1): 28–34. doi:10.1503/cmaj.090765. PMC 2802601. PMID 20026626.
  28. Gomes, T; Juurlink, DN; Shah, BR; Paterson, JM; Mamdani, MM (12 January 2010). "Blood glucose test strips: options to reduce usage". CMAJ : Canadian Medical Association Journal. 182 (1): 35–8. doi:10.1503/cmaj.091017. PMC 2802602. PMID 20026624.
  29. U.S. Preventive Services Task, Force (20 January 2004). "Screening for thyroid disease: recommendation statement". Annals of Internal Medicine. 140 (2): 125–7. doi:10.7326/0003-4819-140-2-200401200-00006. PMID 14734336.
  30. Surks, MI; Ortiz, E; Daniels, GH; Sawin, CT; Col, NF; Cobin, RH; Franklyn, JA; Hershman, JM; Burman, KD; Denke, MA; Gorman, C; Cooper, RS; Weissman, NJ (14 January 2004). "Subclinical thyroid disease: scientific review and guidelines for diagnosis and management". JAMA. 291 (2): 228–38. doi:10.1001/jama.291.2.228. PMID 14722150.
  31. "Certificates of Added Competence in Family Medicine". College of Family Physicians of Canada. College of Family Physicians of Canada. 2015. Retrieved 21 January 2019.
  32. "Certificates of Added Competence in Family Medicine: Emergency medicine" (PDF). College of Family Physicians of Canada. College of Family Physicians of Canada. 2015. Retrieved 21 January 2019.
  33. "Certificates of Added Competence in Family Medicine: Palliative care" (PDF). College of Family Physicians of Canada. College of Family Physicians of Canada. 2015. Retrieved 21 January 2019.
  34. "Certificates of Added Competence in Family Medicine: Care of the Elderly" (PDF). College of Family Physicians of Canada. College of Family Physicians of Canada. 2015. Retrieved 21 January 2019.
  35. "Certificates of Added Competence in Family Medicine: Sport and exercise medicine" (PDF). College of Family Physicians of Canada. College of Family Physicians of Canada. 2015. Retrieved 21 January 2019.
  36. "Certificates of Added Competence in Family Medicine: Family Practice Anesthesia" (PDF). College of Family Physicians of Canada. College of Family Physicians of Canada. 2015. Retrieved 21 January 2019.
  37. "Certificates of Added Competence in Family Medicine: Addiction Medicine" (PDF). College of Family Physicians of Canada. College of Family Physicians of Canada. 2015. Retrieved 21 January 2019.
  38. "Enhanced Skills Programs in Family Medicine". University of Toronto, Faculty of Medicine, Department of Family & Community Medicine. University of Toronto. 2015. Retrieved 21 January 2019.
  39. "Medical Officer: Training". Government of Canada. Government of Canada. 2015. Retrieved 21 January 2019.
  40. "6th Annual Family Medicine Student Symposium - I am Family Medicine". McGill University. McGill University. 2015. Retrieved 22 February 2015.
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