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We have recently received notification from the Canadian Residency Accreditation Consortium (CanRAC:a partnership of the Royal College, the College of Family Physicians of Canada and the Collège des Médecins du Québec) on the upcoming plans for the new conjoint system for Accreditation. These changes will affect all of our residency training programs.


A major change is that the date of the next on-site accreditation review for the University of Toronto has been changed to Fall 2020 and an element of more frequent data monitoring and reporting will be incorporated into the accreditation cycle.

10 key components of the new accreditation system are:

  1. A new framework of standards for residency programs, with an emphasis on high-yield markers and program outcomes;
  2. A new institutional review process, standard system, and status category;
  3. A renewed emphasis on the quality and safety of learning environments;
  4. Introduction of a digital Accreditation Management System that makes the accreditation process more efficient;
  5. A new eight-year cycle of regular accreditation visits, supported by continuous data monitoring;
  6. Increased emphasis on self-evaluation and continuous quality improvement;
  7. Enhanced onsite review processes, such as tracer methods;
  8. New decision categories, with thresholds to improve consistency of decision-making;
  9. A new category of “exemplary” ratings to identify programs who have developed outstanding innovations;
  10. A systematic approach to evaluation, research, and continuous improvement of the system.


We will continue to keep you updated as we receive more information and details on the new accreditation standards and process.

Accreditation Cycle Update

The new accreditation changes have highlighted the importance of our own rigorous internal review process and the emphasis that we continue to place on continuous quality improvement. Regularly scheduled internal reviews began in January 2015 and will be continuing until November 2016. Follow-up internal reviews will begin in March 2017 and will continue to November 2017. Written reports began in March 2016 and will continue into January 2018.

Internal Reviews

As per the Accreditation Guidelines outlined by the Royal College and the CFPC, it is required that all programs undergo an Internal Review as a part of the regular accreditation cycle. Internal Reviews are conducted by a team of U of T Faculty and resident reviewers. The team reviews the program’s Pre-Survey Questionnaire (PSQ) and other program/site-specific documentation prior to the review. On the day of the internal review, the team meets with program/site directors, faculty, residents/trainees, chiefs and committee members. Following the internal review, a report is completed by the review team. This Internal Review Report is then reviewed by the PGME Internal Review Committee, or the PGME Family Medicine Internal Review Subcommittee, who then vote on a decision outlining next steps for the program/site.


Mandated Internal Reviews

Mandated Internal Reviews are those that have been mandated by the Royal College or the CFPC. These reviews follow the same process as Internal Reviews but must also be submitted to the respective national Accreditation Committee following their completion. The Mandated Internal Review Reports must be submitted to the committee by the postgraduate dean, and must also include a separate resident/trainee Report.


Internal Review Committee & Family Medicine Internal Review Subcommittee



The Internal Review Committee (IRC) is a subcommittee of the Postgraduate Medical Education Advisory Committee (PGMEAC) of the University of Toronto, Faculty of Medicine and retains oversight responsibility of the internal review of residency programs according to the standards of accreditation of the RCPSC and the CFPC.


The Family Medicine Internal Review Subcommittee (FM-IRSC) is an ad hoc subcommittee of the IRC and PGMEAC.



Following an Internal Review, there is a presentation of the report to the respective committee (IRC or FM-IRSC). Two members of the committee will present the program/site’s IR Report, PSQ and other relevant documents to the larger committee. The committee will then vote on the most appropriate plan for follow-up for this program/site. All recommendations of the FM-IRSC are taken to the IRC for review and approval. The PGME office sends a formal decision letter informing the program of the IRC or FM’IRSC decision.


Possible Outcomes

Follow-up Internal Review

Your program/site is asked to participate in another Internal Review to follow up on the progress made to address the weaknesses identified in the Internal Review Report.


Written Report

Your program/site is asked to submit a Written Report to the IRC or the FM-IRSC to follow up on the progress made in addressing the weaknesses identified in the Internal Review Report.


Written Report + Resident Report

Your program/site is asked to submit a Written Report to the IRC or the FM-IRSC to follow up on the progress made in addressing the weaknesses identified in the Internal Review Report. In addition, the residents in the program are asked to submit a Resident Report, which will provide a resident perspective on progress made to address the weaknesses as well as any other issues identified in the report or by the IRC/FM-IRSC.


No Further Action

No further action is required by your program/site until the next scheduled review in the next accreditation cycle.



For all accreditation related matters and questions, please email

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