Certificates of Added Competence in Family Medicine

Online application for a CAC in Addiction Medicine is now open.

Priority topics and key features for the assessment of competence in five Category 1 enhanced skills programs

What are Certificates of Added Competence, and why should I apply?

The College of Family Physicians of Canada (CFPC) is the professional home for family physicians who provide comprehensive, continuing care to their patients as well as family physicians who focus some or all of their practices in certain domains of care that help meet the needs of their patients and communities. While maintaining our pride as family physicians and the generalists that we are trained to be, we acknowledge that the delivery of family medicine services is evolving. Certificates of Added Competence (CACs) provide a means of recognizing enhanced areas of expertise achieved and maintained by some family physicians. Members who hold CACs are a valued resource to other family physicians and to our patients.

Approved CAC domains of care in family medicine:

  • Care of the Elderly (COE)
  • Emergency Medicine (EM)
  • Family Practice Anesthesia (FPA)
  • Palliative Care (PC)
  • Sport and Exercise Medicine (SEM)

Newly approved domains of care:

  • Addiction Medicine
  • Enhanced Surgical Skills

What is assessed to determine competence?

The priority topics and key features for the assessment of competence were developed by the CFPC Working Groups on the Assessment of Competence in Care of the Elderly, Family Practice Anesthesia, Palliative Care, Sport and Exercise Medicine, and the Committee on Examinations – Emergency Medicine.

The goal of the priority topics and key features is to guide the in-training and summative assessment of domain-specific competencies required for awarding Certificates of Added Competence (CAC), and to inform the curriculum and training development.

How do I acquire a CAC?

Care of the Elderly, Family Practice Anesthesia, Palliative Care, and Sport and Exercise Medicine

The credentialing phase for the first four approved domains of care outside of EM (COE, FPA, PC, and SEM), in which we recognized those members who had obtained added competence prior to 2015, was a one-time opportunity that closed in November 2015.

A new, time-limited added competence verification (ACV) route has been approved and will open early in 2018.

This route is intended for those candidates who are currently practising in a CAC-approved domain of care but who did not apply or were not eligible through the leadership route in 2015. After the ACV, the only route to a CAC will be through residency or the practice eligible route discussed below.

Emergency Medicine

The only way to obtain the CCFP (EM) designation is through the Examination of Added Competence in Emergency Medicine. There are two eligibility routes for the exam: through accredited residency training programs or through practice (please click here for more information). There will be no other route to obtain a CAC in EM.

All candidates who successfully complete the Examination of Added Competence in Emergency Medicine will automatically receive a CAC in EM. These candidates do not need to apply for a CAC.

What is the Practice Eligible Route?

The College is currently working on outlining the requirements and application and assessment processes for the practice eligible route for CACs. The new practice eligible route (PER) is intended for those in practice—not presently working in the area of competence—who would like to acquire the skill set required to achieve a CAC without completing a residency program.

CACs awarded through the practice eligible route will be awarded based of a satisfactory demonstration of the competencies that have been defined as required for certification of this level of competence in family medicine. These competencies have been defined for each domain and they have been published. The exact means by which these competencies can be assessed have not yet been developed but they will vary as they are adapted to physicians in practice. We expect to have more concrete details about this new route available in 2018. All updates will be posted on the CFPC website as they become available.

How do I acquire my CAC now that I have completed a residency program?

Graduates of accredited Category 1 programs who hold Certification in the College of Family Physicians (CCFP) are eligible for a CAC and consequently will be granted the right to use their designation, as long as they maintain their status as a CFPC member and ongoing Mainpro+® requirements.

All eligible candidates will be contacted via email and given an opportunity to apply for a CAC. A nominal application fee will be required at the time of application.

What will be the credentialing process for Addiction Medicine and Enhanced Surgical Skills?

The College is currently working on priorities for the assessment of competence and the awarding of two new CACs in Addiction Medicine and Enhanced Surgical Skills. The initial CACs (credentialing phase) will be awarded to family physicians who have previously acquired competencies deemed worthy of recognition in the approved domains through practice experience, successful completion of a residency training program and/or continuing professional development, and demonstrated leadership in the domain of the CAC. CACs will be awarded based on the credentials and documented evidence of added competence, as judged by a peer review committee process.

When can I apply for a CAC in Addiction Medicine or Enhanced Surgical Skills? How much will it cost to apply?

The online application for Addiction Medicine is now open, and will remain open until September 30, 2018.

The application for Enhanced Surgical Skills will open in 2018. All new information and updates will be posted on the CFPC website and shared with our members via email.

The application fee for CACs through the leader route is $1500.The CAC program is a revenue-neutral program, so fees are being set to recover costs only. The application fee is non-refundable and will be required and applied upon submission of the online application. Applications without payment will not be reviewed.

When will I know if my application for a CAC is successful?

Deliberations on applications will start in the second half of 2018, however, final decisions may not be confirmed or communicated until early 2019. Certified members will be recognized formally during the CFPC’s Convocation Ceremony in conjunction with Family Medicine Forum.

How will the application review process work?

Applications from each domain of care will be reviewed by five-person Peer Review Committees composed of a panel of CFPC members with direct experience in the domain of care of the application, a member from another CAC domain of care, and a member from a broad-based practice background. The panel will be supported in its work by a Clinician Educator and a senior staff member from the Certification and Assessment Department at the College. The panel will review the presented evidence for each candidate, weigh and consider it appropriately, and arrive at a recommendation to award a CAC or not. Each recommendation will be forwarded to the CFPC’s Board of Examiners for final review and decision.

Confirmed decisions will be communicated to the candidate. If a candidate wishes to appeal a decision, they will be able to do so following the same procedures outlined for appeals regarding the Certification Examination in Family Medicine.

How will the successful awarding of a CAC affect my credentials and designation?

A CAC credential is conferred by the CFPC in the form a diploma that will be mailed to you. Upon receiving this credential, family physicians are authorized to use the CAC designation as long as they maintain their competence through continuous professional development.

The CAC designation represents a recognition of those family physicians who have achieved and maintain enhanced skills in certain domains of care. The designation is not intended to limit physicians’ comprehensive practice and it is not related to practice privileges or billing.

CAC Credential in  Designation
Addiction Medicine CCFP (AM) / MCFP (AM)
Care of the Elderly CCFP (COE) / MCFP (COE)
Emergency Medicine CCFP (EM) / MCFP (EM)
Family Practice Anesthesia CCFP (FPA) / MCFP (FPA)
Palliative Care CCFP (PC) / MCFP (PC)
Sport and Exercise Medicine CCFP (SEM) / MCFP (SEM)

Please note: MCFP holders are eligible for a CAC only through the one-time leader route.

A formal designation has not been determined at this time for Enhanced Surgical Skills.

Will I need to maintain my CAC?

After the initial acquisition of a CAC credential, the ongoing use of the CAC designation will require that a candidate be an active CFPC member, in good standing, who maintains their competence in the domain of care as a new, specifically identified part of their 5-year Mainpro+ reporting cycle. If these requirements are not met, candidates will forfeit the right to use the CAC designation as part of their credentials.

To maintain a CAC and the privilege of using the associated special designation, CAC holders will be required to earn and report at least 75 certified credits related to their CAC domain of care in a 5-year cycle. This credit requirement is encompassed within the standard Mainpro+ requirements of 250 continuing professional development (CPD) credits, including at least 125 certified credits, which is a component of maintaining CCFP certification. An additional fee for Maintenance of Competence will be required for CAC holders and will be added to the annual membership fees. This fee will not be included in the initial CAC application fee.

The CFPC is currently updating the Mainpro+ platform to allow for the tracking of CAC CPD and is updating the Membership database to allow for the processing of the CAC fee. CAC holders will be provided ample notice before the formal CAC CPD maintenance requirements and associated annual fee are introduced.

When will other domains of care in family medicine be eligible for a CAC?

Interest has been expressed in developing new CACs in additional domains of care within family medicine. Before committing to further development, the CFPC will take the opportunity to analyze the impact of CACs on the College, its members, and on related jurisdictions. The CFPC is initiating this process and expects that the outcomes will be available in 2019 or 2020.

For questions or additional information, please write to [email protected].


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