• Lifelong learning: Why Continuing Professional Development (CPD) should matter to medical students
• Let’s talk about Boundaries
• 2014 Annual Report - available now
• Upcoming Student Events
• Open Consultations

Lifelong learning: Why Continuing Professional Development (CPD) should matter to medical students

“Do not therefore imagine, that from this time [the receipt of the MD degree] your studies are to cease; so far from it, you are to be considered as but just entering upon them; and unless your whole lives, are one continued series of application and improvement, you will fall short of your duty.” (Samuel Bard, 18^th century physician and the founder of the first public hospital in New York. Quote from an address he gave to president and governors of King's College, at the commencement, held on the 16th of May, 1769.)

Convocation day should not be the end of your studies – it should ignite the beginning of a professional life of learning. Samuel Bard reminds us that lifelong learning is a commitment you make as a medical professional. One of the most important goals of medical school is to inspire and develop lifelong learning skills.

In fact, all doctors licenced to practice medicine in Ontario are required to participate in Continuing Professional Development (CPD). In 2011, regulatory change made CPD a mandatory requirement in order to maintain your certificate of registration. We see this as a very positive change that holds physicians accountable for self-improvement and continuous learning.

We know that rapid changes in medical science require constant updating of knowledge and development of new professional skills. As you continue in your practice, technologies, laws and people’s values will change, and the standards of practice will advance. As a profession, we want to maintain high standards and raise the bar generation after generation.

Dr. Rocco Gerace, CPSO Registrar, has seen his own learning needs and CPD evolve with the changes in his career. While working as an emergency physician in London, his CPD was largely clinically focused. He attended conferences and rounds, read journals and participated in the education of learners at all levels. When he became CPSO Registrar in 2002, the nature of his CPD evolved. He began reading the Harvard Business Review and other leadership/management publications for guidance. The bottom line is, lifelong learning is a professional responsibility for all physicians regardless of where you practice medicine.

There are many positive outcomes of CPD participation: it keeps you connected with your peers, it encourages knowledge transfer, staves off bad habits, and it will help you best prepare to do well on your future CPSO assessments. 

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Let’s talk about Boundaries

In the last issue of Medical Student Update, the article Sex Abuse and You highlighted the importance of the preparation you receive in medical school on issues of professionalism and maintaining appropriate boundaries. We know that many cases of sexual abuse of patients by health professionals are preceded by boundary violations. A pattern of boundary crossings could be the first step towards troubling boundary violations.

The College developed a Boundaries Self- Assessment Tool for physicians to assess their awareness of boundaries and identify the early warning signs. The tool focuses on the area’s most vulnerable to boundary blurring – i.e. gift- giving, physician’s self- disclosure, physician contact and dual relationships. Let’s use the self-assessment tool to reflect on two fictional medical students: Chris and Jan.

Jan

Jan landed a great placement in a vibrant and welcoming community. The placement is going so well that Jan hopes to return to this community to set up a practice. During an ER rotation, Jan felt particularly connected with a patient who happened to share a mutual interest - ultimate Frisbee. The patient asks if Jan is on Facebook - Jan ‘friends’ the patient.

Assessment tool question: Do I seek social contact with certain patients outside of clinically scheduled visits? If so, why?

CPSO recommendation: Seeking social contact with patients outside of clinically scheduled visits is never a recommended activity. Refrain from establishing personal connections with patients or persons closely associated with them online, as this may not allow physicians to maintain appropriate professional boundaries and may compromise physicians’ objectivity. It is acceptable to create an online connection with patients for professional purposes only.

Chris

Since starting medical school, Chris has been bombarded with requests from family and friends to discuss their personal medical issues. On a number of occasions, Chris has been asked for a clinical opinion. As a year two medical student, Chris feels uneasy about providing medical opinions but nevertheless makes recommendations to family members and social acquaintances.

Assessment tool question: Do I find myself making diagnoses for my social acquaintances?
CPSO recommendation: It’s essential that the line between the professional and personal is not blurred – once the line is blurred, there is an increased risk of boundary crossings and violations because objectivity found in the physician-patient relationship is obscured.

The self-assessment tool and boundaries policy are useful to medical students in that it asks clear questions to help you identify, reflect, and be on alert to boundary crossings when they arise. These lessons are just as imperative as your other teachings, as the physician-patient relationship is one that requires trust and mutual respect.

If you have concerns about maintaining boundaries and are looking for confidential advice, you can contact the CPSO Advisory Services line at the 416-967-2600, X603.

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2014 Annual Report - available now

Did you know that the CPSO received over 8 million hits to our website in 2014 and 8,375 responses to our policy consultations? Our 2014 annual report is now available.

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Upcoming Student Events

Have you registered for Ontario Medical Student Weekend?  Look for us at OMSW 2015, hosted by Queen’s University (October 30^th – November 1^st). See you there!

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Open Consultations

We are inviting you to provide feedback on three open consultations: Blood Borne Viruses, Block Fees and Uninsured Services and Rights, and Responsibilities: What to Expect During Medical Encounters.

Blood Borne Viruses

This draft policy sets out expectations for doctors if they are infected with a blood borne virus. It also outlines expectations to reduce the risk of acquiring or transmitting a blood borne virus (Hepatitis B, Hepatitis C, and Human Immunodeficiency Virus). Comment now.

Rights and Responsibilities: What to Expect During Medical Encounters

This document contains information on what patients can expect from their physician during a medical encounter. It also discusses the rights of patients and how the College can help if they have questions or concerns about something their physician said or did. Comment now.

Block Fees and Uninsured Services

This policy sets out expectations for physicians who charge for uninsured services and/or offer a block fee to their patients. Comment now.

DEADLINE for feedback is November 20^th, 2015. To see all of our consultations, visit our main consultations page.

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We want to hear from you!