Certificates of Added Competence in Family Medicine

New! In-Practice Certification Route for four CACs

Now accepting applications for Addiction Medicine, Care of the Elderly, Palliative Care, and Sport and Exercise Medicine.
 

Apply for a CAC

  • 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 those family physicians who have achieved a defined level of competence and commitment to maintenance. Members who hold CACs are valued resources to other family physicians and to our patients. The use of a CAC Special Designation denotes the achievement of a defined level of competence in the domain of the CAC and a commitment to its ongoing maintenance.
     

  • Approved CAC domains of care in family medicine

    • Addiction Medicine
    • Care of the Elderly
    • Emergency Medicine
    • Enhanced Surgical Skills
    • Family Practice Anesthesia
    • Obstetrical Surgical Skills
    • Palliative Care
    • Sport and Exercise Medicine

  • Residency Training Profile

    The College of Family Physicians of Canada (CFPC) is pleased to share with you the Residency Training Profile for Family Medicine and Enhanced Skills Programs Leading to Certificates of Added Competence (Residency Training Profile). This document defines the broad scope of training required to prepare family physicians to meet the evolving health care needs of patients and communities in Canada.

    The Residency Training Profile is based on the Family Medicine Professional Profile, which the CFPC published in 2018 to describe family physicians’ collective commitment to providing accessible, continuous, and comprehensive patient-centred care.  
     
    The Residency Training Profile clarifies that a principle aim of enhanced skills residency training leading to Certificates of Added Competence (CACs) is to enable advanced practice and health systems leadership. CAC holders are local and systems-level care champions, functioning as resources to their colleagues and communities. They support continuity and extend the role of the comprehensive family physician by providing backup and consultation to colleagues treating patients with challenging conditions, ideally integrated in a Patient ‘s Medical Home practice environment.

  • How is competence in a CAC domain of care assessed?

    The priority topics and key features for the assessment of competence were developed by the CFPC Working Groups on the Assessment of Competence in Addiction Medicine, Care of the Elderly, Enhanced Surgical Skills, Family Practice Anesthesia, Obstetrical Surgical Skills, 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 CACs, and to inform the curriculum and training development.

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

  • How do I acquire a CAC?

    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 Emergency Medicine.

    All candidates who successfully complete the Examination of Added Competence in Emergency Medicine will automatically receive a CAC in Emergency Medicine.

    Addiction Medicine | Care of the Elderly | Enhanced Surgical Skills | Family Practice Anesthesia | Obstetrical Surgical Skills | Palliative Care | Sport and Exercise Medicine

    1. Canadian Residency Certification Route (CRCR)
    How do I acquire my CAC now that I have completed a Canadian residency program?
    Graduates of accredited Category 1 programs who hold Certification in the College of Family Physicians of Canada (CCFP) are eligible for CACs and consequently will be granted the right to use their designations as long as they maintain their status as a CFPC member and ongoing Mainpro+® requirements.
     
    Eligibility Criteria   
    Membership
    The applicant must be a member in good standing with the College of Family Physicians of Canada at the time of the application, holding the Certification in the College of Family Physicians of Canada (CCFP) designation.
     
    Postgraduate training in the domain of care
    Successful completion of an accredited enhanced skills residency program at a Canadian university, as confirmed by the program.
     
    Formal invitation from the College of Family Physicians of Canada to apply for a CAC in the domain of care
    Upon receipt of a Confirmation of Completion of Training from the program, all eligible candidates will be directly contacted and offered an opportunity to apply for a CAC. CFPC is in direct communication with universities and candidates are not required to personally request the Confirmation of Completion of Training from the program.
     
    A non-refundable fee of $330 will be charged at the time of application. We wish to note that CACs are a revenue-neutral program for the CFPC and this nominal fee is calculated annually to cover the cost of the application and review processes.

    2. In-Practice Certification Route (IPCR)
    We are now accepting applications through the In-Practice Certification Route (IPCR) for CACs in Addiction Medicine (AM), Care of the Elderly (COE), Palliative Care (PC), and Sport and Exercise Medicine (SEM).
     
    Domain-specific eligibility requirements: Detailed instructions for application are published on the application platform.
     
    Applicants: Family physicians who are members of the College in good standing, and who hold the CCFP designation and a valid and unrestricted license to practise in Canada may access the application platform and start building their application portfolio. Once an applicant determines that they meet the domain specific eligibility requirements, they will be able to complete the application and submit it for the review.
    An access fee of $364 will be charged for access to the application portfolio, and the IPCR assessment fee of $3,973 will be charged at the time of submission.
     
    Reviewers: Applications from each domain of care will be reviewed by a panel of five CFPC members with a CAC in the relevant domain of care. The panel will be supported by a senior staff member from the College’s CAC department. The panel will review the presented evidence for each applicant, weigh and consider it appropriately, and arrive at a recommendation whether to award a CAC. Each recommendation will be forwarded to the CFPC’s Board of Examinations and Certification for final review and decision, and it will be communicated to the applicant.
     
    Timelines: Applications are available year-round. Physicians have continuous access to the platform as they are building their application portfolio. Reviews are conducted once a year and recommendations are then submitted to the Board of Examinations and Certification for approval. The IPCR cut-off date for the 2025 review group is September 30, 2025. Applications that are submitted by September 30, 2025, will be reviewed by the Peer Review Committee in spring 2026. The IPCR cut-off date for the 2026 review group is September 30, 2026.


    The CFPC is considering the In-Practice Certification Route (IPCR) for CACs in Enhanced Surgical Skills (ESS), Obstetrical Surgical Skills (OSS), and Family Practice Anesthesia (FPA). Following an extensive consultation process, a proposal for the IPCR for ESS, OSS, and FPA was produced and it is currently being evaluated by the internal project team. Please revisit this web page for future updates.

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

    A CAC credential is conferred by the CFPC in the form of 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 continuing professional development (CPD).

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

    CAC credential

    Designation

    Addiction Medicine

    CCFP (AM) / MCFP (AM)

    Care of the Elderly

    CCFP (COE) / MCFP (COE)

    Emergency Medicine

    CCFP (EM) / MCFP (EM)

    Enhanced Surgical Skills

    		 CCFP (ESS) / MCFP (ESS)

    Family Practice Anesthesia

    CCFP (FPA) / MCFP (FPA)

    Obstetrical Surgical Skills

    		 CCFP (OSS) / MCFP (OSS)

    Palliative Care

    CCFP (PC) / MCFP (PC)

    Sport and Exercise Medicine

    CCFP (SEM) / MCFP (SEM)
    Please note: MCFP holders are eligible for CACs only through the one-time leader route (available only for a limited time when a new domain of care is approved for a CAC).
     

  • Will I need to maintain my CAC?

    The CFPC is currently updating the Mainpro+ platform to allow for the tracking of CPD activities that relate to a CAC domain of care.

    To maintain a CAC and the privilege of using this Special Designation, CAC holders will soon be required to earn and report at least 75 certified Mainpro+ credits related to each CAC domain of care in their five-year Mainpro+ cycle.

    This credit requirement forms part of, and is not additional to, the standard Mainpro+ requirements of 250 Mainpro+ credits, including at least 125 certified credits. Holders of more than one CAC will need to earn and report 75 certified Mainpro+ credits for each CAC they have.  CAC holders will be provided ample notice before these new CAC maintenance requirements are introduced.

    If you have any questions about credit requirements, please contact CPD staff at [email protected] or 1-800-387-6197 ext. 560.

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