May 19, 2013

Current Professional Issues

In addition to advocacy on public policy issues, CPA provides guidance and leadership on professional matters that affect psychiatric practice, training and research. Much of this guidance is published as clinical practice guidelines, position papers or statements, or as discussion papers developed through CPA Committees, Sections and Councils. Emergent professional issues are most often addressed through ad hoc working groups or task forces. Currently these include:

Core Competencies of the General Psychiatrist

A working group of the CPA Standing Committee on Education lead the development of a consensus within the profession on the core competencies required of the general psychiatrist. The group undertook a comprehensive survey of psychiatrists in 2005 from which it developed a framework that was submitted to the Specialty Committee of the Royal College of Physicians and Surgeons of Canada in May 2005. The working group further developed the specific core competencies required for general psychiatric practice across the lifespan which were submitted to and accepted by the RCPSC and form the basis of the new Objectives of Training (OTR) and Specialty Training Requirements (STR) that came into effect for those who began training on or after July 1st, 2009.

In 2009 CPA published, Approaches to Postgraduate Education in Psychiatry in Canada: What Educators and Residents Need to Know. This book is intended to enhance understanding of the OTR and STR and breathe life into them by presenting a toolbox approach to training paradigms. The tools exemplify strategies to realize the RCPSC training objectives while recognizing the variable resources available to Canadian departments of psychiatry.

Objectives of Training in Psychiatry
Specialty Training Requirements in Psychiatry
Approaches to Postgraduate Education in Psychiatry in Canada: What Educators and Residents Need to Know
Content of General Psychiatry Training 2004 Questionnaire: Results

Subspecialization

The subspecialties of child and adolescent, geriatric and forensic psychiatry were formally approved by the RCPSC on Sept. 29, 2009. Each new subspecialty has formed a Royal College Working Group to develop required documents, including Objectives of Training, Standards of Accreditation and a FITER for each subspecialty. Certification in each subspecialty will be by examination once the program director has completed a FITER attesting that all training requirements and competencies necessary for practice have been met. Each subspecialty will form an examination board to develop an appropriate written certification examination. All candidates must be certified in their primary specialty in order to write the RCPSC subspecialty examinations. Given the many steps required by the RCPSC for document approval and exam development, it is anticipated that the first subspecialty training programs may not be ready to accept residents until July 1, 2012 or later.

Psychiatric subspecialty OTRs and STRs

The Royal College does not mandate or organize funding for residency positions. This is a provincial ministry of health and local matter for each medical school. The CPA is collaborating with the Academies to obtain funding for the one to two years of additional training required.

Letter to Provincial Ministers of Health

Shared Care/Collaborative Care

The CPA has been collaborating with the College of Family Physicians of Canada (CFPC) to improve the practice of shared mental health care between family physicians and psychiatry. A joint 1997 position paper on Shared Care formed the basis for this collaboration. The CPA-CFPC collaborative working group produced a report on its first three years of activities in December 2000, and, in April 2002, it published a bibliography and overview on shared mental health care in Canada.
In 2003, the CPA-CFPC Shared Care Working Group gave rise to the Collaborative Mental Health Consortium to start a dialogue on improving links between the many professions involved in mental health care delivery and to work towards improving the bridge between mental health and primary care. The Consortium received a significant grant from Health Canada to undertake a collaborative mental health care initiative, which concluded in May 2006. The initiative left behind a legacy that includes a charter, baseline research papers, and a series of toolkits.

In 2011, the joint CPA-CFPC working group published a new position paper, The Evolution of Collaborative Mental Health Care in Canada: A Shared Vision for the Future. This new paper recommends steps that will enable mental health and addiction (MH&A) service providers and primary care physicians to work together to advance a shared agenda, better meet the needs of populations and communities that may traditionally have had difficulty gaining access to the care they require, prepare future practitioners for a more responsive and person-centred style of practice and influence the evolution of health care delivery in Canada.

The joint CFPC-CPA working group organizes an annual conference to support networking and knowledge exchange among clinicians involved in shared care initiatives across the country. Its other activities include promotion of collaborative care practices and principles in residency training, collaborative partnerships at the provincial level, dissemination of best practice information, and fostering international relationships on shared mental health care. The joint working group continues to meet biannually, with a mandate that includes not only coordinating the annual national shared-care conference, but working with medical schools to adapt training to meet a changing shared-care environment, and maintaining a resource website www.shared-care.ca.

Current Joint CFPC-CPA Working Group Mandate

Working Group Documents

The Evolution of Collaborative Mental Health Care in Canada: A Shared Vision for the Future (2011)
Shared Mental Health Care in Canada (1997)
Shared Mental Health Care: A Bibliography and Overview
Current Status, Commentary and Recommendations: A Report of the Collaborative Working Group on Shared Mental Health Care
Shared/Collaborative Care Website: www.shared-care.ca

Other Collaborative Care Resources

CCMHI Products
Better Practices in Collaborative Mental Health Care: An Analysis of the Evidence Base
Collaborative Care Supplement, Canadian Pharmacists Association
CCMHI Website: www.ccmhi.ca

International Medical Graduates

A 2009 survey of International Medical Graduates (IMGs) in PGY2 to PGY5 at five psychiatry residency programs identified several perceived gaps in IMG training in Canadian psychiatry residency programs. Nearly 70 per cent of survey respondents indicated that they would use IMG-specific resources if available. In response, a group of educators and IMG trainees developed a resource that would assist IMGs adjust to their first few years of residency. This orientation manual was later endorsed by the CPA Board of Directors and copyrighted by the CPA. Click here to view Orienting International Medical Graduates to Psychiatry Residency Training in Canada: A Canadian Psychiatric Association Manual.

For more information on current CPA advocacy priorities in the public policy area see the current advocacy activities page.