In October 2017, two Clinical Neurological Sciences (CNS) Department members, Dr. Michael Nicolle, Chief of Neurology and Dr. David Steven, Co-Chair of the Epilepsy Program, traveled to Kuwait with a delegation from the Royal College of Physicians and Surgeons of Canada (RCPSC) to assist the Kuwait Institute for Medical Specializations (KIMS) administer specialty training exams to their neurology and neurosurgery residents, the first time that this type of examination has been administered in Kuwait.
Drs. Nicolle and Steven were selected by the RCPSC due to their respective roles as Chair and Vice Chair of the Neurology and Neurosurgery Examination Committees with the RCPSC. These committees are responsible for developing and scoring the Royal College examinations in neurology and neurosurgery. In 2017, over 80 neurology residents and 33 neurosurgery residents participated in the Canadian RCPSC exams. Four residents in each specialty took the KIMS exam.
Despite the substantial difference in the number of candidates being assessed, the work involved in preparing for the exams remained the same. Dr. Nicolle worked alongside four Canadian neurologists who were past examiners for the RCPSC. The Canadian team worked with nine Kuwaiti physicians to determine which questions would be used on the written exam as well as to oversee the OSCE examination for the Kuwaiti candidates.
Dr. Steven worked with three Canadian examiners to administer the neurosurgery exam noting that the local Kuwaiti neurosurgeons did not participate in order to avoid a conflict of interest of examining their own residents. Given his small team, Dr. Steven had reached out to neurosurgeons across Canada, including CNS’s Dr. Mel Boulton, to submit written questions for use in the Kuwait exam.
“We had to come up with 100 questions and the Kuwaiti neurologists came up with 100 questions” says Dr. Nicolle. Out of those 200 questions, the neurology examiners selected the 100 best short answer questions to use on the exam.
“The majority of questions chosen for the exam were submitted by the Canadian team because we have more experience formulating written assessment questions,” said Dr. Nicolle.
The short answer questions made up only half of the examination, which was administered over two days. The other half of the exam was comprised of practical Objective Structured Clinical Examination (OSCE) stations where candidates were tested on their knowledge of clinical tasks.
The trip to Kuwait provided Dr. Nicolle and Dr. Steven greater insight on the examination process in Canada. “I learned that having a small program can be an impediment,” said Dr. Steven.
“We take for granted that we [training programs in Canada] can call on any number of physicians from any city or specialty to participate in the assessment of a resident. Most examiners have never met the candidate so they can provide an impartial assessment. When you only have six neurosurgeons, evaluating residents objectively becomes more of a challenge”
The trainees who were examined in 2017 were KIMS’ first class of neurology and neurosurgery residents to undergo this examination. In the past, many Kuwaiti physicians wishing to subspecialize would pursue residency or fellowship training in other countries, returning home when their training was complete. In fact, The Department has a long-standing relationship with physicians and training programs in Kuwait and the Middle East with approximately 20% of former CNS neurology and neurosurgery trainees are from Gulf States.
Although the RCPSC administered KIMS exam does not imply certification in Canada, Dr. Nicolle and Dr. Steven are confident that residents who passed the KIMS exam could also pass the exam in Canada.
The RCPSC and KIMS have signed a three year contract for specialty exams so Dr. Nicolle and Dr. Steven will be traveling to Kuwait on an annual basis until 2020.
Neurology Exam Team.
Back row left to right: Dr Maher Orabi (KIMS), Ms. Yasmin Al-Nifisi (KIMS), Dr. Raed Alroughani (KIMS), Dr. Michael Nicolle (CNS), Dr Andaleeb Arshad (KIMS)
Front row left to right: Mr. Abdulateef Bin Eissa (KIMS), Dr Anil Thussu (KIMS), Dr Kefaya Abdulmalek (KIMS), Dr. Colin Chalk (Montreal), Dr. Christine De Meulemeester (Ottawa), Dr. Fiona Costello (Calgary), Dr. Chris White (Calgary)