Accreditation FAQs and the RDoC Pre-Accreditation Questionnaire

McMaster University – May 28 – June 2, 2023

What is accreditation?

Accreditation is a peer-reviewed, continuous quality improvement process whereby information on the structure, process, and outcomes of an educational program, its educational environment, and the institution are evaluated against pre-defined educational standards by an independent organization. Accreditation is:

  • Aimed at improving the quality of postgraduate medical education
  • Permits objective evaluation of postgraduate medical education programs against minimum standards
  • Serves as a tool for program directors for planning review or evaluation of their programs and making necessary

Why is accreditation important in postgraduate medical education (PGME)?

Accreditation is integral to the future of postgraduate medical education programs, institutions, and postgraduate medical trainees. Residency programs at each university must be high quality to ensure that their trainees meet the competencies required of physicians to serve Canadians in a professional, safe, and healthy manner.

Which regulatory bodies are responsible for PGME accreditation in Canada?

In Canada, the accreditation process is carried out conjointly among the Royal College of Physicians and Surgeons of Canada (Royal College), the College of Family Physicians of Canada (CFPC), and the Collège des médecins du Québec (CMQ) for schools in Québec. 

Together, the Colleges are identified as CanRAC – the Canadian Residency Accreditation Consortium. CanRAC has led and facilitated the development of the new residency accreditation system, including developing national conjoint standards for evaluating and accreditation Canadian residency programs.

Why is accreditation important to residents?

Resident input is a cornerstone of the PGME accreditation system. Accreditation is one of the best opportunities to improve your residency program. A full accreditation review happens only once every eight years, giving a unique opportunity to shape your program and ensure that your voice is included. This will be a key opportunity to discuss your program with surveyors – celebrate the things you love about your program and discuss any concerns you may have or issues you believe need to be addressed.

Accreditation is meant to improve the quality of your residency education. It seeks to ensure that residents have all necessary resources available and utilized efficiently to meet the training requirements of their specialty, subspecialty, or area of focused competence. In summary, the conjoint accreditation process:

  • Ensures quality of training for residents in Canada
  • Evaluates residency programs and institutions to ensure compliance with requirements
  • Facilitates continuous quality improvement (CQI) of residency programs and institutions
  • Ensures residents’ training enables them to meet the needs of the population to be served upon completion of training

What are my risks?

Accreditation is a peer-reviewed process of continuous quality improvement based on standards common to all postgraduate medical training programs in Canada. Maintaining the standards means maintaining excellent programs and producing physicians who are ready for practice. Residents will not lose their ability to write exams, lose their ability to graduate, or to become employed due to a program’s accreditation status. Accreditation is not intended to:

  • Demonstrate excellence of departments or services
  • Prove excellence and reputation of program, research, teachers, and university
  • Observe residents’ performance

Why is accreditation being conducted?

The PGME accreditation process in Canada is based on a system of regular accreditation reviews that occur every eight years. McMaster University will undergo its regular accreditation review from May 28 – June 2, 2023. 

The accreditation review will provide a firsthand peer-review evaluation of the institution and all programs. This process will determine how each program and institution meets the CanRAC Standards of Accreditation.

What are the Standards of Accreditation?

The conjoint system of accreditation in Canada, known as Canadian Excellence in Residency Accreditation (CanERA), is built on Standards of Accreditation that allow for the objective assessment, accreditation, and continuous quality improvement of institutions and programs. The standards aim to ensure that residency programs adequately prepare residents to meet the healthcare needs of their patient population(s) upon completion of training. These standards comprise:

  • General Standards of Accreditation for Institutions with Residency Programs
  • General Standards of Accreditation for Residency Programs
  • Discipline-specific standards (specific to each program)
  • Specific standards for Family Medicine (Red Book)

How does RDoC prepare me for my role in the accreditation review?

RDoC provides you with the information you need to understand the accreditation process by:

  • Giving all residents a summary of that process and access to this webpage.
  • Posting responses to frequently asked questions.
  • Hosting two for-resident-by-resident pre-accreditation workshops where we walk you through the process, and you have the opportunity to engage with residents like yourself who have already been through the process. 
  • Obtaining early insight into your program through the RDoC Pre-Accreditation Questionnaire that we ask all residents to complete. This helps resident surveyors prepare for their job by interviewing residents at the onsite review. 

What is the RDoC Pre-Accreditation Questionnaire (RPQ)?

The RDoC Pre-Accreditation Questionnaire (RPQ) is specifically designed to obtain your perspective on your training. The RPQ was developed in 1983 and updated in 2018 to align with the new residency accreditation standards. 

We ask that every Royal College or CFPC program resident at McMaster University complete the RPQ.

How is the RDoC Pre-Accreditation Questionnaire unique?

The RPQ has been developed by residents for residents. We ask questions that gather quantitative and qualitative information on your overall residency experience. It is a unique opportunity for you to provide your perspective on your training confidentially.

How is the information from the RDoC Pre-Accreditation Questionnaire used?

RDoC will collate the results and prepare the RPQ Report of the feedback received.
The information you provide will not be shared with your program, program director, faculty, institution, or Residency Program Committee. Only the resident surveyors on the Royal College and CFPC Survey Teams will receive these reports to prepare them for the on-site visit.

RDoC will also prepare high-level RPQ Synthesis Reports. These reports will contain very general collated information synthesized from the questionnaire results.
The RPQ Synthesis Reports will be shared with the Royal College and CFPC Accreditation Survey Teams. All information provided will remain confidential, and no individual responses will be shared in any component of the shared materials.

Why is residents’ input important?

The role of residents in accreditation cannot be overemphasized. The accreditation visit is an invaluable opportunity to improve residency education. Your input allows the CFPC and Royal College to work together with the University to improve postgraduate medical education. The feedback you provide will help programs continue to promote areas of strength and simultaneously focus on areas that need improvement. Maintaining standards means maintaining excellent programs and producing physicians who are ready for practice.

What is a resident surveyor?

RDoC appoints the CanRAC resident surveyors to ensure that standards for residency education are being maintained and that the resident voice is being utilized. They are full members of the Royal College and CFPC Survey Teams. 

There will be approximately five resident surveyors appointed to the Royal College Survey Team, two resident surveyors to the CFPC Survey Team, and one resident surveyor to the PGME Institutional Survey Team. Resident surveyors will be present at some program reviews during your accreditation review.

What is the CanRAC survey?

CanRAC will be surveying residents and faculty annually via a 13-question survey. The information collected will be made available to schools to ensure continuous quality improvement. The questions are quantitative in nature, whereas the RDoC Pre-Accreditation Questionnaire will collect both quantitative and qualitative information.

My program is being reviewed during the on-site accreditation visit. How can I best prepare?

  • Attend an RDoC Pre-Accreditation Workshop
  • Complete the RDoC Pre-Accreditation Questionnaire before the CanRAC accreditation review.
  • Members of the survey team will meet with residents during the accreditation review. Before this, residents in a program should meet as a group amongst themselves to discuss what they feel are the strengths and areas of improvement for their program and what they would like to share with the surveyors.
  • Residents should identify concerns about a training program before the on-site survey visit (for example, at the Residency Program Committee, University-led Internal Review)
  • Be prepared to answer key questions during the survey team. Your feedback will help your program continue to promote (work on) the areas of strength while also focusing on areas that need improvement. For example:
  • What program strengths do you wish to highlight? 
    • What are the areas that need improvement?
    • What can accreditation do to improve your residency program?
    • What resources do you need?
    • How would you describe your residency program’s learning environment?
    • How and how often do you receive feedback on your performance?
    • How is safety/wellness promoted throughout the learning environment?

If you wish to read more information about accreditation from a resident’s perspective, please visit RDoC’s accreditation webpage.