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Executive Summary of the September 17 & 18, 2009 Council Meeting

The Council of the College of Physicians & Surgeons of Saskatchewan operates under an explicit set of governance policies. It strives to make its' work as transparent as possible to the medical profession and the general public.

Those portions of the Council's deliberations that are not confidential are open to observation by any person subject to space availability in the meeting room.

At the conclusion of each Council meeting an Executive Summary of the meeting is widely distributed to the District Medical Associations, related organizations and the public media. This Executive Summary provides a brief overview of issues discussed, decisions made, and/or actions taken by the Council. If any person wishes more detailed information about any of the issues which are not subject to confidentiality constraints, these can be obtained by contacting Ms. Tracy Hastings, the College's Regulatory Services Coordinator, at 500 - 321A 21st Street East, Saskatoon SK S7K 0C1; Phone (306) 244-7355; Fax (306) 244-0090; Email tracy.hastings@cps.sk.ca.

Future Medical Licensure Policy

At its meeting in April, 2009 the Council had unanimously approved a set of principles developed by the Federation of Medical Regulatory Agencies of Canada (FMRAC) to guide the development of common medical licensure policies to be used by all provincial-territorial Colleges of Physicians and Surgeons. The Registrar provided an update report to the Council from a meeting convened in Ottawa on September 14, 2009 to translate those principles into a draft agreement that will be presented to all of the College Registrars for signature at a meeting that will be convened in Ottawa on October 16, 2009.

In respect to future medical licensure policy in Saskatchewan, the Council also considered a report from the inaugural meeting on September 9th , 2009 of a Ministry of Health Advisory Committee which is charged with the design of a Saskatchewan based assessment program for International Medical Graduates (IMGs). This is a multi-stakeholder committee which includes representation from the Ministry of Health, the Ministry of Advanced Education and Employment, the College of Physicians and Surgeons, the Saskatchewan Medical Association, the College of Medicine, and the Regional Health Authorities.

Finally, the Council considered recent correspondence from the Deputy Minister of Health on this issue as well as feedback from a meeting on September 16th between the Minister of Health, the President of the Council, and the Registrar. The Minister of Health explicitly asked the Council to defer adoption of any bylaw amendments which will affect future medical licensure policy until there is greater clarity in respect to the evolving national policies on IMG assessment and licensure and IMG assessment capacity in Saskatchewan.

The Council agreed to accommodate the Minister's request in respect to a bylaw pertaining to the Medical Council of Canada Evaluating Examination (MCCEE). It agreed to not adopt that bylaw at its September meeting. However it also directed the President of the Council and the Registrar to reinforce to the Ministry of Health the fact that it is committed to aligning future medical licensure standards in Saskatchewan with the national standards being defined by consensus through the leadership of FMRAC. The use of the MCCEE as a basic screen of medical knowledge has long been a part of the IMG assessment procedure in all other Canadian provinces and territories and it will almost certainly be an essential element of the new national standards.

The Registrar also advised Council that there is a high probability that future national medical licensure policy will contain an IMG assessment strategy which will enable both IMG family physicians and specialists to ultimately acquire full registration in any Canadian province or territory without being obligated to acquire either the LMCC or certification from the Royal College of Physicians and Surgeons of Canada or The College of Family Physicians of Canada. The Registrar pointed out that Saskatchewan's compliance with this future policy will require amendment of all current College bylaws which require IMGs to acquire either the LMCC or Royal College certification within a defined period of time.

The Registrar sought direction and guidance from the Council in respect to how he should manage all situations in which current IMG registrants will be at risk of losing their registration status in Saskatchewan because of failure to acquire the LMCC or loss of Royal College certification eligibility. The Registrar was directed to manage these situations in accordance with the current bylaws and the executive discretion accorded to the Registrar under the current bylaws.

The Council determined that it will consider a comprehensive series of bylaws amendments pertaining to medical licensure policy once:

  1. The government of Saskatchewan has clearly articulated its position on alignment of medical licensure policy in Saskatchewan with the FMRAC approved national standards, and

  2. There is in place an acceptable IMG assessment process in Saskatchewan with sufficient capacity to accommodate all IMG licensure applicants

The Council noted that it is highly preferable, if not essential, to provide significant lead time between a decision to modify medical licensure policy and the implementation date for any modified policies. At present the development of acceptable Saskatchewan based IMG assessment capacity is the "rate limiting step" to reform of medical licensure policy. However if acceptable IMG assessment capacity should be developed quite expeditiously, amendment of the College's bylaws pertaining to medical licensure could become the "rate limiting step" to some very positive policy reform. It is therefore essential that the bylaw amendment process be well coordinated with the IMG assessment development process.

Penalty Setting

The Council convened a hearing to set penalty for Dr. Evan Franko of Saskatoon after Dr. Franko pleaded guilty to a charge of unprofessional conduct. His admitted unprofessional conduct involved the prescribing of narcotic medication to an individual who was not his patient with the intention of having that individual share the narcotic with him. The penalty imposed by the Council was that jointly recommended by the College's legal counsel and legal counsel for Dr. Franko. It included six months practice suspension, loss of narcotic prescribing authority, prohibition against practicing medicine in a clinic in which narcotics are kept on site, and other practice restrictions.

Meeting with the Auditor

The Council met with Mr. Gordon Stewart of KPMG who had been appointed by the Council as the auditor for the 2008 fiscal year. Mr. Stewart reviewed with the Council the audited financial statements for the 2008 fiscal year and reported a clean audit.

Meeting with the Chair of the Finance Committee

The Council met with Dr. Mark Sheridan, the Chair of the Council's Finance Committee. The membership of the Finance Committee currently includes three members of Council and three members of the College who are not on Council. Dr. Sheridan reviewed with the Council the College budget for 2010 which was approved by the Finance Committee. The budget was based upon an assumption that the annual College fee for 2010 will be $1350. The Council approved the budget and subsequently adopted bylaw amendments to set the 2010 Annual College fee at $1350 and the monthly locum fee at $300.

Dr. Sheridan also advised the Council that the Finance Committee will be meeting in the near future to draft an investment policy that will be presented to Council for review, revision, and adoption.

Finally, Dr. Sheridan recommended that the Finance committee be authorized and directed by the Council to explore both the potential advantages and disadvantages of the College purchasing or constructing a building to house the College's operation after the current lease expires in 2012. The Council appointed a committee consisting of the Finance Committee and two members of Council to conduct this review.

Meeting with the Chair of the ECG Committee

The Council met with Dr. Roy Chernoff in his capacity as Chair of the College's ECG Committee with sets and administers an examination for family physicians seeking eligibility to bill MSB for interpreting ECGs.

Acting on a recommendation from this committee, five years ago the Council had adopted a policy which would make continuing eligibility to bill for ECG interpretation contingent upon:

  1. Performing a minimum of 500 ECG's over the previous five years, or

  2. Completion of an approved ECG course, or

  3. Successful repeat challenge of the College's ECG examination

Since the membership of Council had undergone significant change over the previous five years, the Council wished to review with Dr. Chernoff the current view of the ECG Committee with respect to this policy.

At the completion of its dialogue with Dr. Chernoff the Council determined that it will revisit this issue at its November meeting. At that meeting it will consider:

  1. Information from the MSB regarding the number of physicians impacted by the policy, and

  2. Information from a meeting on October 28 with the Ministry of Health and the SMA to discuss the future role of the College as an arbiter of physician eligibility for MSB payment for designated service codes

Other Business

The Council also:

  1. Received and discussed a report from Dr. Grant Stoneham, the Acting Chair of the Council's Registration Committee. The Council also appointed Dr. Stoneham as the Chair of this committee.

  2. Discussed a request from the Five Hills Health Region to move Dr. J. A. V. Kruger from temporary registration status to special registration status. While the Council declined the request for this change in registration status for Dr. J. A. V. Kruger, it did extend his temporary registration status pending comprehensive reform of the College's IMG assessment and licensure policies.

  3. Discussed a request from Dr. M. Kramer for exemption of the requirement that he obtain the LMCC. The Council declined to grant him the exemption but extended his time to obtain the LMCC to July 1, 2010.

  4. Appointed the members of the Nominating Committee which is a new Committee defined under the revised bylaws. It is charged with the responsibility of nominating individuals for potential appointment to standing committees defined under the Medical Profession Act, 1981 and the bylaws.

  5. Appointed Dr. Randy Friesen of Prince Albert to fill a vacancy for a physician member on the Complaints Investigation and Resolution Advisory Committee.

  6. Appointed Dr. Karen Shaw as the College second member on the Quality Improvement Advisory Group.

  7. Confirmed six members of the College as being eligible to receive Senior Life Membership status with the College.

  8. Set the Council meeting dates for 2010.

  9. Approved the written reasons for its penalty decision pertaining to Dr. T. Chambers.

  10. Approved the written reasons for its penalty decision pertaining to Dr. L. Steenberg.

  11. Reviewed the Registrars monitoring report in respect to his advancement of the Council End entitled "Physicians Prepared for the Future"

  12. Reviewed the Registrar's monitoring reports in respect to all of the Executive Limitation policies designated for review at this meeting.

  13. Expressed its support for a plan proposed by the Canadian Association of Pathology to introduce a national certification process for Class II immunohistochemistry tests.

  14. Adopted some minor housekeeping amendments to the College's regulatory bylaws.

  15. Clarified its preferences to the College staff in respect to labelling and distribution of confidential Council documents.

  16. Gave direction to Mr. Salte in respect to publication of disciplinary actions on the College's web site.

  17. Directed the staff to prepare a draft College policy on non-medical use of ultrasound technology for consideration at the November meeting.

  18. Discussed the draft Saskatchewan legislation to implement the Agreement on Internal Trade.

  19. Discussed proposed amendments to the Prescription Drug Plan Act to create a new statutory platform for the Prescription Review Program (PRP).

  20. Reviewed the current status of investigations and disciplinary actions.

  21. Reviewed the outcome from the two most recent CAPE evaluations.

The Council adjourned its proceeding at 1:20 p.m. on Friday, September 18th to enable all councillors to participate in an interdisciplinary conference focused on Patient Safety. The Conference was co-sponsored by the College of Physicians & Surgeons, the College of Pharmacists, and the Saskatchewan Registered Nurses Association.

Over the lunch hour at the interdisciplinary conference on Saturday, September 19th the Annual Meeting of the College was convened. Verbal reports about the College's work were presented by Dr. Gerry Fernandes (College President) and Dr. Dennis Kendel (College Registrar). They responded to a number of questions from persons in attendance at the meeting.

The Council will next meet on November 20th and 21st , 2009.