The Canadian Association of Emergency Physicians (CAEP) responds with concern to the College of Physicians and Surgeons of Ontario (CPSO) policy on Expectations Physicians not Certified in Emergency Medicine Intending to Include Emergency Medicine as a Part of their Rural Practice
The Canadian Association of Emergency Physicians (CAEP), while supporting the need for high standards of emergency medicine practice, is very concerned that the implementation of this CPSO policy does not reflect the reality of limited medical resources in rural settings.
"We understand and support the College's effort to establish competency-based standards for physicians practicing emergency medicine in rural settings. The complexity of emergency medicine has increased exponentially over the years, and patients have a right to expect high-quality care in any emergency department. However, CAEP does not believe that the College's policy is achievable over a short time frame and could worsen access to care in rural areas. To realistically achieve competency-based standards, there is a critical need for more residency training positions in Emergency Medicine and increased exposure to emergency medicine in family medicine training programs. Lastly, mentorship does not come without costs, and the CPSO must ensure that reasonable resources are available to support this initiative." states Dr. Alecs Chochinov, CAEP President.
Full CAEP statement:
The Canadian Association of Emergency Physicians' (CAEP) response to the College of Physicians and Surgeons of Ontario (CPSO) policy on EXPECTATIONS OF PHYSICIANS NOT CERTIFIED IN EMERGENCY MEDICINE INTENDING TO INCLUDE EMERGENCY MEDICINE AS PART OF THEIR RURAL PRACTICE CHANGING SCOPE OF PRACTICE PROCESS
CAEP acknowledges the College's effort to establish standards for the delivery of safe and competent emergency care, which is consistent with the aim of CAEP's Mission and Vision.
CAEP is concerned about the short time frame for implementing this change, due to its potential negative impact on the provision of rural emergency care. Invoking these changes immediately could result in a crisis in staffing of rural Emergency Departments with accompanying Emergency Department closures. We therefore recommend the implementation of this policy be delayed.
It is CAEP's position that standards for all physicians providing emergency care should be competency-based, not location-based. We believe that all physicians who deliver emergency care should be shown to have achieved the required competencies, not just those working in rural settings.
CAEP wishes to reiterate the urgent need for more training positions in Emergency Medicine (both Royal College of Physicians and Surgeons of Canada and College of Family Physicians of Canada streams) and increased exposure of Family Medicine residents to Emergency Medicine during their core training, in order to produce a sufficient number of emergency providers and ensure that those providers have the requisite competencies to function safely in the emergency department environment.
CAEP supports the concept of mentoring new graduates in Emergency Medicine but recognises the burden that this places on a limited number of rural mentors. Appropriate infrastructure and educational resources must be put in place to facilitate education, and compensation made available for all mentorship activities.
Celebrating 40 years as the national voice of emergency medicine, the Canadian Association of Emergency Physicians (CAEP) advocates on behalf of emergency physicians and their patients, provides continuing medical education, supports research and strengthens the emergency medicine community. In cooperation with other medical specialties and committees, CAEP also plays a vital role in the development of national standards and clinical guidelines.
CAEP keeps Canadian emergency physicians informed of developments in the clinical practice of emergency medicine and addresses political and societal changes that affect the delivery of emergency health care to Canadians. Visit our website at caep.ca.