The information pamphlet on the Medical Council of Canada (MCC) evaluating examination states that “Without exception, for eligibility to sit the MCC Qualifying Examination Part I, an IMG [international medical graduate] must have a valid pass on the MCC Evaluating Examination.”1
Given that the qualifying examination is designed and promoted as representing a minimal standard of the knowledge and problem-solving skills needed for general practice in Canada,2 I do not understand the need for the evaluating examination. The IMGs who must take the evaluating examination include physicians who have completed residencies and fellowships in the United States with specialty and subspecialty certifications. Having these fellowship-trained and board-certified physicians go through the evaluating examination as a prerequisite for the qualifying examination seems redundant and unnecessary.
I am one such IMG. Originally from Pakistan, I have a total of 7 years of postgraduate training (including a US residency and a 2-year fellowship at Yale University). After earning neurology and clinical neurophysiology certifications in the United States, I worked as an assistant professor at the University of Manitoba for over 2 years. I successfully wrote my Royal College of Physicians and Surgeons of Canada examination in neurology in 2001 and was granted an unrestricted licence in Manitoba. However, when I filed a written request to write the MCC qualifying examination part I with a waiver of the evaluating examination, my request was turned down. I eventually wrote all of the required MCC examinations for the sake of obtaining a permanent Canadian licence, but at the cost of having to cancel clinics and make some patients wait even longer for care.
What is the MCC's objective in having such physicians complete the evaluating examination? Is this really a way of standardizing the delivery of health care, or is it a way of deterring qualified medical practitioners from entering into practice in Canada?
I suggest that the MCC seriously reconsider the objectives of the evaluating examination and define circumstances in which qualified physicians would be exempted.
S. Nizam Ahmed University of Alberta Edmonton, Alta.