Foreign specialists need not apply
Online posting: August 14, 1997
Published in print: Oct. 1, 1997 (CMAJ 1997;157:869)
Re: Storm of protest greets motion to restrict specialty
exams, by David Square, CMAJ 1997;157:1188-9 [full text / résumé]
David Square has raised some interesting issues. The motion that
was recently considered by the Royal College of Physicians and
Surgeons of Canada (RCPSC) is quite challenging, but makes me
curious. Is the accreditation process applied by the RCPSC very
different from that applied in most other countries? Are there
any formal studies looking at competency or performance of
trainees from different specialty-training programs around the
world?
Although the motion may affect small numbers of physicians,
this is not the issue: this should be an issue of principle. Do
we have good reasons to deny foreign-trained specialists the
right to challenge our examinations? Even though only a handful
of specialists might be affected, this would translate into
thousands of Canadians who might be denied quality care,
especially in remote areas. Even though foreign specialists will
not provide the ultimate solution to Canada's maldistribution
problems, they are and will likely continue to be an important
element of any solution.
I realize the act of accreditation involves tremendous
responsibility and that authorities must ensure that only
competent and capable specialists are allowed to practise.
However, can we really exclude, carte blanche, entire groups of
trainees from some countries? It seems arrogant to suggest that
our training programs are of higher calibre than similar programs
in Germany, France or Japan. It would be fascinating to see the
data supporting this notion.
Shabbir M.H. Alibhai
Richmond Hill, Ont.
s.alibhai@utoronto.ca
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