Specific Standards of Accreditation for Residency Programs in Clinical Pharmacology and Toxicology 2013 VERSION 2.0 INTRODUCTION A university wishing to have an accredited program in Clinical Pharmacology and Toxicology must also sponsor accredited programs in Anesthesiology, Emergency Medicine, Internal Medicine, Pediatrics, and Psychiatry. The purpose of this document is to provide program directors, surveyors and residents with an interpretation of the general standards of accreditation as they relate to the accreditation of programs in Clinical Pharmacology and Toxicology. This document should be read in conjunction with the General Standards of Accreditation, the Objectives of Training and the Specialty Training Requirements in Clinical Pharmacology and Toxicology. STANDARD B1: ADMINISTRATIVE STRUCTURE There must be an appropriate administrative structure for each residency program. The program director must be certified by the Royal College in one of the five primary disciplines: Anesthesiology, Emergency Medicine, Internal Medicine, Pediatrics and Psychiatry. Please refer to Standard B1 in the General Standards of Accreditation for the interpretation of this standard. STANDARD B2: GOALS AND OBJECTIVES There must be a clearly worded statement outlining the goals of the residency program and the educational objectives of the residents. The general goals and objectives for Clinical Pharmacology and Toxicology are outlined in the documents Objectives of Training and the Subspecialty Training Requirements in Clinical Pharmacology and Toxicology. Based upon these general objectives each program is expected to develop rotation specific objectives suitable for that particular program, as noted in Standard B2 of the General Standards of Accreditation. STANDARD B3: STRUCTURE AND ORGANIZATION OF THE PROGRAM There must be an organized program of rotations and other educational experiences, both mandatory and elective, designed to provide each resident with the opportunity to fulfil the educational requirements and achieve competence in the specialty or subspecialty. This document may be reproduced for educational purposes only provided that the following phrase is included in all related materials: Copyright 2013 The Royal College of Physicians and Surgeons of Canada. Referenced and produced with permission. Please forward a copy of the final product to the Office of Education, attn: Associate Director. Written permission from the Royal College is required for all other uses. For further information regarding intellectual property, please contact: documents@royalcollege.ca. For questions regarding the use of this document, please contact: accred@royalcollege.ca. Page 1 of 6
The structure and organization of each accredited program in Clinical Pharmacology and Toxicology must be consistent with the specialty training requirements as outlined in the Specialty Training Requirements in Clinical Pharmacology and Toxicology. The program must be organized such that residents are given individual professional responsibility, under appropriate supervision, according to their level of training, ability, and experience. STANDARD B4: RESOURCES There must be sufficient resources including teaching faculty, the number and variety of patients, physical and technical resources, as well as the supporting facilities and services necessary to provide the opportunity for all residents in the program to achieve the educational objectives and receive full training as defined by the Royal College specialty training requirements. In those cases where a university has sufficient resources to provide most of the training in Clinical Pharmacology and Toxicology but lacks one or more essential elements, the program may still be accredited provided that formal arrangements have been made to send residents to another accredited residency program for periods of appropriate prescribed training. Learning environments must include experiences that facilitate the acquisition of knowledge, skills, and attitudes relating to aspects of age, gender, culture, and ethnicity appropriate to Clinical Pharmacology and Toxicology. 1. Teaching Faculty There must be a sufficient number of qualified teaching faculty to supervise the residents and provide teaching in the basic and clinical sciences related to Clinical Pharmacology and Toxicology. 2. Number and Variety of Patients The number and variety of patients available for teaching must be sufficient to allow residents to attain the objectives outlined in the Objectives of Training. It is essential that there be adequate numbers of patients available for teaching, in whose management the resident actively participates to provide adequate consultation experience in the following areas:, acute and chronic pharmacotherapy; toxicology; adverse drug reactions; application of individualized therapeutics as outlined in the Objectives of Training. Where certain clinical conditions occur so infrequently that clinical material is not always available, the program must ensure that those conditions are covered by other educational means. Page 2 of 6
3. Clinical Services Specific to Clinical Pharmacology and Toxicology a. In-patient Clinical Pharmacology and Toxicology programs must ensure access to an adequate number of in-patient consultations for clinical care, teaching and education, and research under the supervision of qualified specialists. b. Ambulatory Clinical Pharmacology and Toxicology programs must ensure access to an adequate number of out-patients for clinical care, teaching and education, and research under the supervision of qualified specialists. c. Consultation An active supervised consultation service is essential for the resident to gain experience in providing consultations to referring physicians. Facilities should be adequate to provide both in-patient and out-patient consultation for a range of ages and conditions in a variety of patients and disciplines as outlined in the Objectives of Training. 4. Supporting Services - Clinical, Diagnostic, Technical a. Drug Analysis Laboratory There should be supervised access to laboratories in which residents learn about routine clinical and research drug analyses and their interpretation. b. Pharmacy It is essential that there be association with pharmacists skilled in areas of drug information, medication safety and other aspects of pharmacy practice related to Clinical Pharmacology and Toxicology. c. Information Technology (IT) The resident should have access to IT necessary for data management, statistical analysis, teaching and learning applications. d. Research Facilities The Clinical Pharmacology and Toxicology program must have sufficient access to facilities for the appropriate conduct of studies relevant to Clinical Pharmacology and Toxicology. Page 3 of 6
e. Infrastructure and support The Clinical Pharmacology and Toxicology training program should ensure the resident has access to adequate infrastructure essential to training, which may include: work space, computer access, telephone and photocopying services. STANDARD B5: CLINICAL, ACADEMIC AND SCHOLARLY CONTENT OF THE PROGRAM The clinical, academic and scholarly content of the program must be appropriate for university postgraduate education and adequately prepare residents to fulfill all of the CanMEDS Roles of the specialist. The quality of scholarship in the program will, in part, be demonstrated by a spirit of enquiry during clinical discussions, at the bedside, in clinics or in the community, and in seminars, rounds, and conferences. Scholarship implies an in-depth understanding of basic mechanisms of normal and abnormal states and the application of current knowledge to practice. Please refer to Standard B5 in the General Standards of Accreditation, the Objectives of Training, the Specialty Training Requirements in Clinical Pharmacology and Toxicology, and the CanMEDS Framework for the interpretation of this standard. Each program is expected to develop a curriculum for each of the CanMEDS Roles, which reflects the uniqueness of the program and its particular environment. Specific additional requirements are listed below. 1. Medical Expert - The educational program should include lectures, seminars and self-directed learning. All programs must provide instruction including but not limited to the elements of pharmacological concepts, pharmacokinetics, pharmacodynamics, clinical toxicology, substance abuse, medication safety, laboratory methodologies, clinical trial design and other aspects of evaluative sciences, pharmacogenetics, critical appraisal, therapeutic drug monitoring, applied statistics, and drug regulation. 2. Communicator 3. Collaborator Page 4 of 6
4. Manager - Programs must provide residents with the opportunity to undertake managerial work in a collaborative environment, for example: Pharmacy and Therapeutics Committees, REB (Research Ethics Board), and participation in national and international professional societies. 5. Health Advocate 6. Scholar - The program must provide the residents the opportunity to plan and complete at least one research project within the realm of Clinical Pharmacology and Toxicology during their program. - The program must provide the residents the opportunity to learn the essential methodology to develop the foundation of an independent research career or to critically evaluate the research of others. 7. Professional STANDARD B6: EVALUATION OF RESIDENT PERFORMANCE There must be mechanisms in place to ensure the systematic collection and interpretation of evaluation data on each resident enrolled in the program. Please refer to Standard B6 in the General Standards of Accreditation for the interpretation of this standard. Page 5 of 6
The in-training evaluation process must include evaluation of research protocols and clinical reports generated as part of the training. Satisfactory completion of the program will be dependent on the basis of the composite of the above and a final global assessment arrived at by the Residency Program Committee. APPROVED BY COUNCIL April 1997 REVISED March 1999 REVISED June 2005 REVISED Specialty Standards Review Committee February 2008 REVISED Specialty Standards Review Committee February 2013 Page 6 of 6