Certified specialists in good standing are encouraged to apply for admission to fellowship and gain the privilege of using the designation FRCPC or FRCSC. Fellowship, unlike certification, depends on maintaining a process of continued learning as an integral part of the social contract that underpins professional status. This concept has led the college to establish the Maintenance of Certification Program and to require completion of the program for renewal of fellowship after 2005. Thus, the designation FRCPC and FRCSC would ensure that a specialist has not only received quality training and passed a certifying examination but is also achieving national standards of continuing professional development throughout his or her career.

Fellowship in the college is not a requirement for licensure. It is, however, a reality that an increasing number of hospitals, licensing bodies and courts require physicians to document their participation in continuing medical education. The Maintenance of Certification Program provides fellows with a standardized method of documentation and ensures that benchmarks for continuing medical education are fair and consistent from one jurisdiction to another.

The allegation that the Royal College did not consult its fellows before deciding to institute maintenance of certification or during the development of the program is untrue. There was consensus among the presidents of the national specialty societies in 1997 that maintenance of certification should be introduced. A broadly conducted survey of fellows during the external review of the college revealed a similarly strong level of support. An Angus Reid poll conducted for the Medical Post in October 1999 indicated that two-thirds of fellows accept the Maintenance of Certification Program.

The reputation of the Royal College in Canada and abroad depends on setting and maintaining standards for postgraduate education. Specialists stress the importance of continuing professional development to themselves and the profession as a whole. Yet, until now the specialist community had not formally expressed the same commitment to continuing medical education and continuing professional development as it had to postgraduate medical education.

Critics of the new program appear to think that no standards, no accreditation and no monitoring should be applied to their continuing professional development. We believe this is a minority view.