CAAM-HP 10 TH ANNIVERSARY CONFERENCE- JULY 28-30, 2014. PROFESSOR HOWARD SPENCER REGISTRAR, MCJ &CAMC
History of CAMC Registration/Licensing Registration/Licensing in CARICOM The Challenges The way forward
History of CAMC First proposed as the Caribbean Medical Council Cost implications of a Secretariat ruled out such an organization Caribbean Association of Medical Councils agreed upon by Meeting of Chief Medical Officers. Proposal accepted by COHSOD in 1998
New Institution s Tasks An acceptable examination for admission into medical practice Accreditation of medical schools- CAAM-HP Code of practice- database of medical practitioners- consultation on matters of discipline Establishment of a specialist register
The fundamental purpose of the Caribbean Association of Medical Councils shall be to contribute to the attainment of the highest quality of health care to the people of the Caribbean Region by ensuring the health professionals meet the highest standards of practice and the protection of public health.1998
1)To protect the health of the public through: Maintenance of the highest standards of medical education and practice Promotion of regional perspective on physician registration on issues relating to the licensing of physicians Development and maintenance of a regional perspective on issues relating to the regulation of medical practice 2)To create a sustainable mechanism for collaboration and the exchange of information
MEMBER STATES ANTIGUA AND BARBUDAhttp://antiguabarbudamedicalcouncil.com/ 89,000 THE BAHAMAShttp://bahamasmedicalcouncil.org/about-us/ 317,000 BARBADOS- BELIZE - http://health.gov.bz/www/ http://health.gov.bb/ 290,000 327,000
MEMBER STATES DOMINICA- 73,000 GRENADA- 109,000 GUYANA- 740,000 HAITI- 9.8M
JAMAICA -http://jamaicamedicalcouncil.org/ 2.9M MONTSERRAT- 5,000 ST. LUCIA-http://www.slmdc.org/ 162,000 ST. KITTS AND NEVIS-http://gov.kn/ 50,000
ST. VINCENT AND THE GRENADINEShttp://www.health.gov.vc/ 103,000 SURINAME- 560,000 TRINIDAD AND TOBAGOhttp://www.mbtt.org/ 1.2M
CARICOM ASSOCIATE MEMBERS CAYMAN ISLANDShttp://www.gov.ky/portal/page?_pageid=114 2,1594768&_dad=porta 56,000 TURKS AND CAICOS ISLANDS- 36,600
CARICOM ASSOCIATE MEMBERS ANGUILLA- 13,000 BERMUDA- http://www.bhec.bm/ 67,000 BRITISH VIRGIN ISLANDShttp://bvimdc.com/BVI_Medical_%26_Dental_ Council/Welcome.html 24,000
Establishing the CARICOM Single Market and Economy (CSME) The decision in 1989 to establish the CARICOM Single Market and Economy (CSME) was a move to deepen the integration movement and to better respond to the challenges and opportunities presented by globalisation.
Establishing the CARICOM Single Market and Economy (CSME) While a primary focus of the Common Market was on liberalising trade in goods among the Members, the Single Market and Economy not only expands this process to include services, but also provides for the free movement of capital (money), skilled labour, and the freedom to establish business enterprises anywhere in the Community. It also deepens economic cooperation among the Member States participating in the Single Market and Economy.
The functions of the Council shall be- (a) to register medical practitioners; (b) to appoint examiners to conduct examinations in respect of persons applying for registration as medical practitioners as may from time to time be necessary under the provisions of this Act; and (c) to ensure the maintenance of proper standards of professional conduct by registered medical practitioners
TYPES OF REGISTRATION 1)Full 2) Provisional 3)Locum provisional 4) Special
Provisional Registration available to graduates of recognised medical universities/colleges who wish to pursue internship. Note requirements vary based on the educational institution that the medical degree was obtained.
Temporary Registration available to graduates of recognised medical universities who have completed internship but are not eligible for Full registration. Sub-categories include Temporary Academic, Temporary Conditional and Special Temporary Registration Full Registration available to graduates of recognised medical insitutions and U.S. or U.K. specialists. Fully registered Members of GMC or the Irish Medical Board are eligible to apply for this category. Doctors with Full Registration with MBTT can register postgraduate qualifications
The functions of the Council shall be- (a) to register medical practitioners; (b) to appoint examiners to conduct examinations in respect of persons applying for registration as medical practitioners as may from time to time be necessary under the provisions of this Act; and (c) to ensure the maintenance of proper standards of professional conduct by registered medical practitioners
Why should there be an examination? How many Councils had a Registration examination? Who should do the examination?
Number of Operating Medical Schools (Source: IMED) As of February 6, 2014, there were 2,372 recognized and operating medical schools in 179 countries or territories listed in the International Medical Education Directory (IMED).
Currently consist of Part 1 Multiple Choice Examination (online administration), and Part 2 Clinical (Practice-based) Examination Only candidates who are successful in the Part 1 Examination will qualify to proceed to the Part 2 Examination CAMC Dec 2012 24
The multiple choice examination (MCQ) is a test of the principles and practice of medicine in the disciplines of internal medicine, family medicine, emergency medicine, paediatrics, surgery, obstetrics, gynaecology, community health and psychiatry The MCQ is in two parts (morning and afternoon sessions), each of three hours duration; each part contains 100 questions The MCQ examination is held over one day, simultaneously at approved centres within the Caribbean, and has been administered electronically since October 2008 CAMC Dec 2012 25
The clinical examination evaluates clinical competence in terms of medical knowledge, clinical skills, problem solving and clinical decisionmaking and professional attitudes for the safe and effective clinical practice of medicine in the Caribbean region The clinical examination consists of a multi-station structured assessment of clinical skills Disciplines covered include: medicine and surgery, obstetrics and gynaecology, paediatrics, family medicine, emergency medicine, community health and psychiatry CAMC Dec 2012 26
The clinical examination evaluates clinical competence in terms of medical knowledge, clinical skills, problem solving and clinical decisionmaking and professional attitudes for the safe and effective clinical practice of medicine in the Caribbean region The clinical examination consists of a multi-station structured assessment of clinical skills Disciplines covered include: medicine and surgery, obstetrics and gynaecology, paediatrics, family medicine, emergency medicine, community health and psychiatry CAMC Dec 2012 27
The examinations are currently conducted biannually (April/May and October/November) Candidates wishing to participate in the examinations must register at least one month prior to the written examination date CAMC Dec 2012 28
Full launch of regional computer-based MCQ examination on 24 th October 2008 Sites now include: Guyana, Trinidad, Barbados, Jamaica, Bahamas, St. Lucia, Belize, St. Vincent & Grenadines, Antigua Aim to increase number of sites according to candidate requests and availability of locations with technical capacity CAMC Dec 2012 29
Yearly Outcome of MCQ Examination 2007-1 2007-2 2008-1 2008-2 2009-1 2009-2 2010-1 2010-2 2011-1 2011-2 2012-1 2012-2 2013-1 80.00% 70.00% 60.00% Average Pass Rate: 53% 50.00% 40.00% 30.00% MCQ participants PASS FAIL 20.00% 10.00% 0.00% Examination date all yrs CAMC Jul 2013 30
Yearly Outcome of OSCE Examination 2007-1 2007-2 2008-1 2008-2 2009-1 2009-2 2010-1 201-2 2011-1 2011-2 2012-1 2012-2 2013-1 90.00% 80.00% 70.00% Average Pass Rate: 64% 60.00% 50.00% 40.00% 30.00% OSCE participants PASS FAIL 20.00% 10.00% 0.00% Examination date all yrs CAMC Jul 2013 31
The functions of the Council shall be- (a) to register medical practitioners; (b) to appoint examiners to conduct examinations in respect of persons applying for registration as medical practitioners as may from time to time be necessary under the provisions of this Act; and (c) to ensure the maintenance of proper standards of professional conduct by registered medical practitioners
Authority of Medical Boards/Councils: In those parts of the Medical Act which determines registration status of medical doctors Which ensure the maintenance of proper standards of professional conduct by registered medical practitioners. Differed significantly from one country to the other
IGA (Intergovernmental Agreement) This would ensure signatories were in agreement with decisions- draft by legal body of CARICOM little progress over the years. Constitution. Needs to be finalized following several decisions but awaits the IGA for completion. CAMC Exam Part2. Clinical Exams currently only in Jamaica. Will require expansion to accommodate increase in number of candidates
CAUCUS OF HEALTH MINISTERS IN 2010 REQUESTED The Accreditation of hospitals for internship, to create uniformity in the internship experience. Create a database for vacancies in the medical profession which can be taken up by CARICOM national. The registration of specialists.
Champion support for the accreditation of hospitals in the Region for internship to allow for standardisation of the experience of interns and provisionally registered doctors Lobby CARICOM Governments to provide the budgetary support for the accreditation of hospitals to establish/increase internship posts. Lobby support for the creation of a database of medical posts in all hospitals in the CARICOM countries to allow for greater access by qualified CARICOM Nationals to these posts.
WAY FORWARD Ensure Governments recognise the budgetary implications for making the CAMC examination the regional examination for licensing/registration of new doctors in CARICOM countries Ensure that the Inter-governmental Agreement to allow for proper functioning of the CAMC is finalised
THE WAY FORWARD Establish the relationship with graduates from recognised programmes worldwide Establish the relationships with other medical registration bodies worldwide Establish requirements for continuing medical education Establish registration of specialists.
QUESTIONS