Medical residents ask for oral certification exam to be cancelled during pandemic third wave

·3 min read
Medical residents are completing training in specialized areas, such as internal medicine and general surgery. (Shutterstock - image credit)
Medical residents are completing training in specialized areas, such as internal medicine and general surgery. (Shutterstock - image credit)

Jack Pang, who is completing the fifth year of his public health residency, says he's fortunate compared to other resident doctors.

His Calgary bosses at Alberta Health Services are making sure he has a reasonable workload and schedule, giving him time to study for his oral certification exam on May 28.

The high-stakes specialty certification exams, offered through the Royal College of Physicians and Surgeons of Canada, must be passed by residents before they can seek a licence from provincial regulators to practise without supervision.

But Pang wants the exams to be cancelled, saying studying is taking him away from work he could be doing to help other health-care professionals deal with the third wave of the pandemic.

"For the next two weeks, instead of taking my time off to study, I could be working full-time and supporting my jurisdiction," he said.

Jack Pang, a fifth-year public health resident with the University of Calgary, is scheduled to take his oral certification exam on May 28.
Jack Pang, a fifth-year public health resident with the University of Calgary, is scheduled to take his oral certification exam on May 28.(CBC News via Google Meet)

Despite concerns raised by advocacy organizations and staff physicians across the country, the college has decided to go ahead with oral exams for its final-year residents. The exams, taking place in May and June, "will be virtual in 2021, not in-person and face-to-face," states the college's website.

Pang is one of almost 1,100 residents and staff physicians from across the country who signed a letter asking the Royal College to cancel the oral exam.

Exams scheduled for 2020 were cancelled by the college due to the pandemic, noted the letter. "One year later, we are seeing the highest yet new case counts and intensive care admissions.

"We believe the same leadership and flexibility are required to protect the public and preserve health-care capacity during this pandemic."

Licensing process

The Royal College currently certifies residents in more than 60 specialties and sub-specialties, including internal medicine and general surgery.

Residents seeking certification take both a written and oral — also known as an applied — exam before they can seek a licence to practise. The written exams for this year's crop of residents were completed in March and April.

Oral exams have been cancelled for internal medicine residents due to a shortage of examiners, according to an online update from the Resident Doctors of Canada (RDoC).

Residents can either go ahead with the oral exam this spring or defer until 2022.

Franco Rizzuti, president of the Professional Association of Resident Physicians of Alberta, says he's heard from residents that they're stressed and tired from working during the pandemic and studying for the certification exam.
Franco Rizzuti, president of the Professional Association of Resident Physicians of Alberta, says he's heard from residents that they're stressed and tired from working during the pandemic and studying for the certification exam. (CBC News via Google Meet)

Resident representatives say those aren't great options.

"The vast majority are incredibly frustrated at the fact that the option provided was do the exam now, when more and more is being asked of residents and staff … or delay for a year when that potentially means ... a whole bunch of other challenges," said Franco Rizzuti, fourth-year public health resident at the University of Calgary and president of the Professional Association of Resident Physicians of Alberta (PARA).

Pang and Rizzuti said if residents opt to defer, they are given a provisional licence but worry that could hinder their job opportunities. Other physicians across the country have echoed similar comments throughout the pandemic.

The College of Family Physicians of Canada decided that family medicine residents seeking certification will only do the written exam this year, with special oral exams offered to those who fail.

'Careful consultation'

In an emailed statement, the college said listened to concerns but made the decision to move ahead after "careful consultation." It said the virtual oral exam would follow public health guidelines and that there will be enough examiners available.

Rizzuti said the pandemic has really changed what health care looks like and that residents are dealing with a lot right now.

"They just feel their voice hasn't been heard in this conversation."

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