Electronic exchange of information on professional or good standing

1. Electronic exchange of information on professional or good standing

2. Electronic exchange of information on professional or good standing

3. The vision • “a common passport – the creation of a new registration procedure to be used by a group of countries” – Gerald Bury - 1998 • “development of the competent authority concept based on gold standards of CGS and verification of the doctors history” – Sue Ineson - 2002 • The concept refined – a way to transfer secure information so a jurisdiction knows the doctor is bone fide, knowledge is current and is fit to be registered- IAMRA working group 2002-2004

4. The rationale • Medical migration is a reality- countries, specialties and individual benefit • Doctors travel for : • Employment • Training • Fulfil service needs • Promote innovation • Therefore there is a need to simplify and facilitate the movement of competent doctors and decrease the time and cost involved in sitting different and diverse examinations and registration requirements

5. “This concept of a medical passport , while ideal is just a bit premature… ..the reality will not easily be achieved.”

6. Fast track credentialing system • Divide the passport concept into ‘doable’ segments • Streamline the current systems and utilise modern technology • Start small and allow the concept to grow

7. Electronic exchange of CGS • As part of IAMRA fast track credentialing project the GMC and MCNZ agreed to trial and then extend bilateral agreements for certificates of good standing • In 2003 a pilot was set up between GMC and MCNZ to exchange CGS by encrypted emails

8. Electronic exchange of CGS • Basis of the system was • Memorandum of understanding which defined each Council’s CGS • Performance agreement • Encryption • A specific mail box • Had permission of the doctor • System allowed for payment

9. What was exchanged • Name • Former names if known • Unique identifier or registration number • Date of birth • Primary medical degree- year and place of qualification

10. Benefits of electronic exchange • Simplicity • Direct from the other jurisdiction • Encryption to increase security • CGS was up to date at time of actual registration • Speed of exchange • Do not have to have exactly the same standard of CGS • Built relationships to enable other developments to be forwarded • Improved service for doctor The review of the pilot was positive

11. Extension of the exchange to other jurisdictions From 2004 onwards • Other groups started to develop bilateral agreements with GMC and MCNZ and with each other • The individual basis allowed the jurisdiction to get agreement with those it had most CGS traffic By mid 2006 • 14 countries and states had cross exchanges and 11 countries in the Europe agreement

12. Developments • Heath Professionals Crossing Borders • GMC part of the European Consensus conference which developed agreement on the exchange of certificates of professional status Worldwide • Other groups continue to join the GMC and MCNZ network • The GMC and MCNZ agreed to extend the CGS information

13. Review of benefits A questionnaire was conducted in April 2006 The results: • Response from 12 jurisdictions including Ireland , South Africa, states in Australia and Canada, New Delhi and countries in Europe

14. Rationale • Increased timeliness and authenticity • Expeditious transfer • Security and speed • Decrease in paper work • Memorandum with definitions did not require common standards for CGS • Beneficial to doctors and Councils • “the most logical and timely method of securely providing certificates of professional conduct”

15. Concerns • Encryption- this continues to cause some issues in some jurisdictions • Training of staff • Time to get it under way • Not all saw memorandum necessary • Concern that there may be no paper trail

16. The way forward • Now numbers varied from very few to transfer of 1000s and as more countries join the network grows Suggestions for better development • Promote more via IAMRA • Put directory of groups participating on website • International standard and /or terminology • Encryption- this continues to cause some issues in some jurisdictions

17. GMC-MCNZ relationship • The CGS enabled the two groups to improved their relationship at a staff to staff member level • In late 2003 as young NZ doctors finished their intern year and looked to do their “OE” as many as 500 CGS a month were being sent to GMC electronically. • Now the GMC sends about 1000 per annum and NZ sends up to 100 annually • Therefore it makes sense to extend the concept

18. GMC-MCNZ Extension • Stage one: extra information to help verification • Gender • Primary qualifications • Post grad qualifications • Start date as a specialist • Passport number

19. GMC-MCNZ Extension Stage two • Verification of identity • Passport number and photograph of doctors who have passed entry examinations Stage three • Passport number and photographs of own graduates

20. GMC-MCNZ Extension Stage four • Verification of work history Stage five • Bilateral agreement on entry examinations Stage six • Access to each others data base to a certain level

21. Thanks • GMC especially Amanda Watson who helped develop the work • Medical Council of New Zealand and staff who helped with trial • All those who completed the questionnaire • IAMRA - for giving us a reason for and a way to develop new concepts

22. From Good to Great – Jim Collins • “Being an effective organisation ……being the very best what you do ………..moving from good to great………lies in the discipline to do what ever it takes to become the best at what you do….then seek continual improvement…. • It is really that simple. • And it is really that difficult!”