Internal Medicine Residency Accreditation (AC) Task Force

In May 2021, the Department of Medicine received the Preliminary Accreditation Outcome for the Internal Medicine Training Program from the Royal College of Physicians and Surgeons of Canada (RCPSC). In this report, the Royal College Accreditation Committee (AC) informed the department of their decision to confer status of “accredited Program on Notice of Intent to Withdraw Accreditation.”

The RCPSC issues such a notice when it finds “Major and/or continuing non-compliance with one or more standards, which calls into question the educational environment and/or integrity of the program.” As a result of this decision, the program will undergo an external review in November 2023.

The review report highlighted numerous strengths of the program, but also identified the following areas for improvement:

1. There is an ongoing issue with resident supervision in the clinical environment, and perceived lack of support, particularly of junior learners on subspecialty services and on the Clinical Teaching Units, CTUs, during weekends. This is felt by the residents to be impacting patient safety.
2. Residents are afraid to raise substantial questions or issues with the program, for fear of repercussions, both within their training program and related to future employment in Toronto. This perception arises from observation of the treatment of residents who have spoken out.

To address these weaknesses, the Department has established the Internal Medicine Residency Program Accreditation Task Force (AC Task Force), co-chaired by Internal Medicine resident Dr. Michael Elfassy and Department of Medicine faculty member Dr. Kevin Imrie. The AC Task Force has been struck to ensure a safe, arms-length process to collect information on residents’ experiences in the program and their advice on ways to address the perception of lack of support within components of the program and the potential of repercussions for speaking out.

The Task Force is responsible for establishing and implementing a work plan to:

• Gather information on residents’ experiences in the program and their advice on ways to address the perceived lack of support and potential for repercussions for speaking out, ensuring strict confidentiality of individual resident input;
• Communicating the Task Force’s work progress and findings, with particular attention to communication with the residents in the program, the RPC, departmental leadership and PGME; and
• Providing a written report to the DoM Executive Committee, summarizing findings and recommendations.