Assessment Verification Period

For International Medical Graduates entering Postgraduate Medical Education in Ontario

Purpose

To obtain a Postgraduate Education Certificate from the College of Physicians and Surgeons of Ontario (CPSO), international medical graduates entering from CaRMS or the Advanced Level Postgraduate Training Program, are required to undergo an Assessment Verification Period (AVP). Successful completion of the AVP is required before learners can obtain a Postgraduate Education Certificate from the CPSO prior to full acceptance into an Ontario residency program.

Process

The AVP is an assessment process that evaluates IMGs to determine if they can function at their reported level of training. It is 12 weeks in duration. Learners will be evaluated in terms of their clinical skills in the program to which they are seeking entry, as well as their basic skills in internal medicine, obstetrics and gynaecology, paediatrics, psychiatry and general surgery, appropriate for practice in the chosen discipline.

The AVP assesses learners in a supervised clinical, multidisciplinary environment where there is patient input on an ongoing basis. Assessment also ensures that learners are: mentally competent to practice medicine; able to practice with decency, integrity and honesty and in accordance with the law; possess sufficient knowledge, skill and judgment to engage in postgraduate medical training as authorized by the Postgraduate Education Certificate; can communicate effectively and display an appropriate professional attitude.

After a training program accepts an IMG learner, the PGME Office sends a letter of Appointment to the CPSO. The CPSO will then send an application package to the learner. When the application is complete the CPSO will issue a Postgraduate Education Certificate to the learner for the AVP.

The prospective IMG resident is to be assessed by the department at the end of the 4 weeks and 8 weeks using the detailed assessment form. At the end of the AVP period, the department/program will complete the AVP final assessment form and forward it to the PGME Office at pgme.registration@utoronto.ca for the Associate Dean’s signature.

Once signed, the PGME Office will submit the AVP final assessment form to the CPSO. Postgraduate Medical Education (PGME) Registration may then be completed.

Supervision

The AVP assessment must take place within appropriate, supervised clinical activity in a multidisciplinary environment with patient input on an ongoing basis.

AVP learners may sign their own orders; however, the clinical supervisor may choose to have orders co-signed initially, or for the duration of the assessment period. The Postgraduate Education certificate granted for the AVP states that the learner may practice medicine “under a level of supervision that is determined to be appropriate for the holder and the program of medical education and assessment, by a member of the College of Physicians and Surgeons of Ontario designated by the director of the program.” It is up to the supervising physician to determine whether or not the learner may write orders. In addition, there may be hospital policies which require AVP learners to have their orders co-signed throughout the AVP.

Assessment/Evaluation Format

Program Directors must ensure that learners are evaluated and given written feedback on a regular basis during the AVP. Evaluations and meetings should be well documented and should take place at the end of the 4 weeks and 8 weeks. The final AVP assessment should be informed by the detailed AVP assessments as well as other assessment metrics used during the AVP (e.g., EPA assessments, ITARs, field notes). The final AVP assessment form is to be completed at the end of the 12-week AVP period. 

If the learner has been assigned to one or more rotations, the evaluation form completed by the supervisor should be forwarded to the Program Director for compilation in the final AVP assessment form.

Licensure Extension

• Application for a 6 week extension of the AVP can be made to CPSO if remediation is required (without Registration Committee referral) to allow for adequate assessment of the learner, but not for remediation.  A letter from the Program Director is required confirming the reasons for the extension and how the extension and weaknesses will be addressed. The Postgraduate Associate Dean must support the request to CPSO.
• An additional 6 week period can be requested.  This must be approved by the CPSO Registration Committee.