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The Royal College Program Directors Handbook: a Practical Guide for Leading an Exceptional Program Preface

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The Royal College Program Directors Handbook: a Practical Guide for Leading an Exceptional Program Preface The Royal College program directors handbook: A practical guide for leading an exceptional program Preface Consider the following tale, which will be familiar to many new program directors (PDs) in Canada: When I became a PD in 2000, I thought I knew what I was getting into. I was expecting a rewarding, challenging leadership position in education that would allow me to set a direction and provide support for a future generation of doctors. It turned out to be all of this and more; I’m thankful that the rewards far exceeded my expectations and the challenges were mitigated by a strong support network and resident cohort. But I admit that my initial experiences in the job were largely a trial by fire. I had a brief handover from my predecessor and was given a new book on the “newest thing” in residency education — CanMEDS 2000 — but other than that I was set adrift to run the residency program and seek help when needed. One resource that proved very helpful was the Royal College of Physicians and Surgeons of Canada’s annual workshop for new PDs and accreditation surveyors. I was assigned to the surveyor workshop by mistake; it turned out to be very useful, as our accreditation visit was scheduled to take place in 8 short months’ time, and I had still received no instruction on the nuts and bolts of running a program. PDs come to their positions in a variety of ways. way from peers, support staff and residents. Our own Some PDs seek out the role; others are invited to take experiences, then, prompted our desire to help others the job and either embrace the opportunity or accept prepare for their PD roles. the position reluctantly. Some step into the job after receiving training and resource materials; others do Over the years we have delivered the Royal College’s so with no preparation at all. Some PDs run large workshop for new PDs numerous times (both together programs and some run small ones. A few PDs start new and with various other “partners in crime”) and surveyed programs, but most of them run established programs. many programs. We have come to realize that many PDs Some are charged with the task of stepping in to are in the same (leaky) boat we were in when we started. reverse the downward course of a program in difficulty. They need a practical resource on running a program. Regardless of how they get their start, PDs work The Royal College’s workshop for new PDs, although constantly to keep their programs alive, well and kicking. valuable, is offered only once per year, is limited in scope They will be faced with unique situations from time to by the single-day format and provides no enduring time, but many of the challenges they encounter will be support beyond the workshop. Furthermore, many new similar to ones successfully faced by other PDs in the PDs simply cannot attend. past and can be overcome with techniques and processes To supplement the informal feedback we received over (and some duct tape) borrowed from them. the years at the new PD workshop, we sought to formally The vignette that opened this Preface describes the explore the needs of PDs across Canada. In 2010 experience of one of us (GB). When the other one we conducted a survey of 214 residency PDs, which (DD) was appointed to his PD position, he thought he produced a 93% response rate and generated valuable was simply a place holder until someone else showed up. insight about what a new PD would find helpful in a No one showed up. Without training, DD stumbled and manual. From this, potential topics emerged for a PD toiled, designing solutions to problems that others had manual. We identified a wide range of suitable experts already solved and grateful to be able to learn along the across the country and approached them about writing chapters for the manual. The authors have focused on practicality and useful advice (rather than theory), Being a PD is a drawing on their experiences and the literature. rewarding experience We believe that this manual will be instrumental in helping new PDs become comfortable and effective in We hope that the Royal College Program their role, providing a basic reference about the day-to- Directors Handbook is a useful resource day operation of a residency program. In addition, it will for you. We invite you to share your provide an enduring reference should challenges arise. thoughts and experiences with us We also anticipate that it will be valuable to more ([email protected]), and we would experienced PDs and other education leaders both particularly appreciate any feedback you within and outside Canada. The manual is meant to might be able to give us about the manual, complement other Royal College publications and the annual PD workshop. Two companion publications including ideas about additional topics for new PDs are the CanMEDS Assessment Tools the manual should cover, to improve Handbook and Educational Design: A CanMEDS subsequent editions. Guide for the Health Professions. The former addresses the complex problem of matching assessment tools Above all, we wish you a most to the CanMEDS Roles in an integrated and evidence- enjoyable and enriching experience informed manner. The latter focuses on the theory as a PD. and practicalities of being an educator, embedding educational best practices into a residency program, Co-Editors, Royal College Program and creating the best learning experience for residents. Directors Handbook This manual will not duplicate the content of these other publications. Rather, it focuses on the leadership, administrative and procedural aspects of running a » Glen Bandiera [email protected] program as well as several specific challenges that were identified as being particularly problematic for new PDs. » Deepak Dath [email protected] Most chapters start with a case scenario to create some context and follow through with a literature review, best » Project leader Nancy Meyers practices summary, lists of tips and pitfalls, and case Royal College of Physicians resolution. With this format, we hope that the material and Surgeons of Canada covered will be accessible and easy to identify on first » Copy editor Jennifer Thomas and subsequent readings. Freelance medical editor and writer Copyright © 2013 The Royal College of Physicians and Surgeons of Canada. All rights reserved. This material may be reproduced in whole or in part for educational, personal or public non-commercial purposes only. Written permission from the Royal College is required for all other uses. Printed September 2013. The Royal College program directors handbook: A practical guide for leading an exceptional program Preface An overview of the postgraduate medical education environment » Chapter 1: Postgraduate medical education in Canada: evolution || By: John Parboosingh inspires innovation » Chapter 2: Creating the future for your program: sage advice about || By: Kenneth A. Harris your first steps as a new program director Essential skills for program directors » Chapter 3: Collaborating for success: an essential skill for a medical educator || Deepak Dath/Renée Roy » Chapter 4: Becoming an effective postgraduate medical education leader || Susan Lieff/Ari Zaretsky » Chapter 5: Change management solutions for program directors || Deepak Dath Running your residency program » Chapter 6: Resources || Parveen Wasi » Chapter 7: Setting up a committee || Kevin Imrie » Chapter 8: Running your residency program committee (RPC) meetings || Eric M. Webber /J. Mark Walton » Chapter 9: Working with the “A” team: an effective partnership with the || Deepak Dath/Glen Bandiera/ program administrator Jennifer Thomas » Chapter 10: Selecting residents for your program || Glen Bandiera / David Chan » Chapter 11: Developing a meaningful curriculum map || Moyez B. Ladhani / Hilary Writer » Chapter 12: Designing and selecting assessment instruments: focusing on || Stanley J. Hamstra competencies » Chapter 13: International medical graduates: working with a diversity of learners || David Tannenbaum/Allyn Walsh » Chapter 14: A resident in difficulty, or a difficult resident? || Constance LeBlanc / Lorri Beatty » Chapter 15: Resident remediation || Susan Glover Takahashi » Chapter 16: Challenges for large programs || Thomas Maniatis /Glen Bandiera » Chapter 17: Accreditation || Glen Bandiera/Paul Dagg CHAPTER 1 Postgraduate medical education in Canada: evolution inspires innovation John Parboosingh, BSc, MBChB, FRCSC, FRCOG Dr. Parboosingh is professor emeritus, medical education and Obstetrics and Gynecology, University of Calgary. He is former director of professional development, Royal College of Physicians and Surgeons of Canada, and R.S. McLaughlin professor of medical education, University of Ottawa. He is a consultant in knowledge management and community learning. Objectives Case scenario After reading this chapter You are an assistant professor in the Department of you should be able to: General Internal Medicine. You have just been appointed as the department’s new residency program director. The department’s faculty of 36 full-time and part-time » describe how major developments at specialists at the university hospital hosts a reception the Royal College have contributed to to celebrate the recent accreditation of the residency the evolution of postgraduate medical program, to thank the retiring program director, Dr. education (PGME) Richard Smith, for his significant contribution over the past five years, and to welcome you. » describe how partnership with the universities has helped residency You arrange a meeting with Dr. Smith to learn about your new role and responsibilities as program director. programs to raise standards of practice At this meeting Dr. Smith summarizes the history of and prepare residents to respond to postgraduate medical education (PGME) in Canada changes in the health system over the past 80 years, as he feels that knowledge of its evolution helped him to better understand PGME » give your faculty and residents insights and explain it to residents and teachers. This knowledge into how the accreditation system inspired Dr.
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