Overview of the PACE Assessment Program
PACE Assessment Program
The Physician Assessment Centre of Excellence (PACE) offers work-place based assessments for internationally trained physicians (ITPs) who are seeking medical licensure in Nova Scotia to practise in office-based primary care or hospitalist medicine.
PACE serves as a pathway to licensure in Nova Scotia by ensuring Candidates demonstrate the knowledge, skills, and judgment required to practise safely and ethically in Canada.
There are two separate assessment programs — one in office-based primary care and one in hospitalist medicine. Applicants must only apply for the program for which they are eligible. There are separate application forms for each program. It is possible to apply for both programs.
Learn more at frequently asked questions
Office-Based Primary Care Assessment Program
The office-based primary care program has two dedicated assessment centres that also serve as medical clinics designed to evaluate internationally trained physicians (ITPs) in office-based primary care. At the PACE Clinic, the Candidates provide primary care to the patients of PACE while overseen by the well-trained family physician Assessors.
The office-based primary care PACE Clinics are located at the Halifax Shopping Centre and 117 Kearney Lake Road. If you are selected for the office-based primary care assessment program, the PACE team will advise you of the location where your assessment will take place.
Hospitalist Assessment Program
PACE has partnered with Nova Scotia Health to establish two hospital sites offering assessments in hospitalist medicine. Candidates offered a position in the hospitalist medicine assessment program will provide care to inpatients while overseen by well-trained hospitalist assessors.
PACE has partnered with two Nova Scotia Health hospitals — Dartmouth General Hospital and Colchester East Hants Health Centre. If you are selected for the hospitalist assessment program, the PACE team will advise you of the location where your assessment will take place.
Unique Aspects of PACE
The Assessment Program was developed in partnership with the Medical Council of Canada (MCC).
PACE is a pathway to licensure for internationally trained physicians.
The PACE Assessment Program occurs in an authentic professional environment using a workplace-based assessment (WBA) model — a method for evaluating what physicians do in daily practice.
PACE is not a point-in-time examination, and Candidates are never required to complete a point in time examination. Candidates are assessed while providing care to patients under the supervision of licensed family physician Assessors.
Key Features of PACE
- Centralized assessment with dedicated clinics and partner hospitals
- Trained Assessors working collaboratively
- Candidates provide direct patient care while being assessed
- Use of audiovisual equipment for assessment of ITPs in the office-based primary care PACE Clinics
- A community of practice for both Candidates and Assessors
- Immediate impact on patient care by serving new patients
PACE Assessment Programs Eligibility Criteria
The College of Physicians and Surgeons of Nova Scotia (the ‘College’) sets the eligibility criteria for participation in the PACE Assessment Program. For detailed eligibility requirements, please refer to the College’s website for:
- Pathway to Conditional Licensure for Internationally Trained Physicians via a Practice Ready Assessment — Office-Based Primary Care
- Pathway to Conditional Licensure for Internationally Trained Physicians via a Practice Ready Assessment: Hospitalist Medicine
PACE Selection and Review for PACE Assessment Programs
Please refer to the PACE Selection and Review for PACE Assessment Programs.
Program Expectations
PACE Candidates are expected to have the required training, knowledge, skills and currency to practice as a primary care physician or hospitalist in Canada. The Assessment Program provides the opportunity for them to demonstrate their competence in a safe, supportive environment.
PACE is not a training centre; it is expected that Candidates have the medical knowledge, skills and experience to see patients on their own, while under the supervision of an Assessor who also serves as the most responsible physician.
The assessment is designed to replicate what a Candidate’s practice would look like in the real world; they will have access to the tools and resources that they would use in practice and the expectation is that they will deepen their understanding of the Nova Scotia healthcare system throughout the assessment period.
Pre-Arrival Resources
Candidates will receive a digital pre-arrival resource package to help them prepare for the assessment and begin familiarizing themselves with the context for healthcare in Nova Scotia.
Welcome Collaborative
Prior to beginning the Assessment Program, Candidates must attend the Welcome Collaborative; an orientation program offered by The College of Physicians and Surgeons Nova Scotia.
The Welcome Collaborative helps new-to-practice-in-Canada physicians understand the healthcare system in Nova Scotia and set them up for success in long-term practice. During the Welcome Collaborative, several partner organizations share insights related to the practice of medicine in Nova Scotia. This allows Candidates to learn about the Canadian and Nova Scotia healthcare system prior to beginning their assessment.
PACE Candidates will participate in the in-person or virtual Welcome Collaborative prior to starting their assessment.
Onboarding for Assessment Program and Clinic
Prior to providing patient care, Candidates are onboarded to the Assessment Program and PACE Clinic or partner hospital through an introduction to staff, policies, and procedures. Onboarding includes training on the electronic medical record MedAccess utilized at PACE Clinic or relevant medical record at the partner hospital. Candidates are also trained to use the assessment tools and platform (Risr Advance).
The onboarding phase is designed to set PACE Candidates up for success so that they can focus on practising medicine and providing excellent care to patients.
Candidate Community of Practice
Candidates are co-located in the primary care PACE clinics and partner hospitals, allowing for a community of peers who collaborate and share their experiences transitioning to the Nova Scotia health care context. Candidates will start at various points throughout the year (PACE assessment is competency-based rather than time-based); connecting and collaborating with various peers throughout the Assessment Program.
Patient Expectations in the Primary Care PACE Clinic
PACE Clinic patients are aware of the dual purpose of the program: to provide medical care and to assess ITPs. Patients are aware that all care is provided by the ITPs, and that audiovisual equipment is utilized for assessment purposes.
Patient Expectations in the Partner Hospitals
Inpatients at the partner hospitals are aware of the dual purpose of the program: to provide medical care and to assess ITPs. Patients are aware that all care is provided by the ITPs, and that fully licensed Assessors oversee all of their medical work.
The Assessment Process
PACE employs a competency-based approach to assessment, allowing for rolling entry into the program and individualized assessment durations. The assessment typically takes approximately 12 weeks on average, with a maximum duration of 20 weeks.
While all patient care is overseen by Assessors, it is expected that Candidates can see patients independently and do not require constant real-time supervision. Only a small portion of patient encounters are directly observed each day, while all care is reviewed in the patient record by the Assessor. If a Candidate requires constant real-time supervision, this is not the appropriate Assessment Program for them.
The Assessors do not provide training, though they will direct Candidates to relevant resources in Nova Scotia and answer any care or resource questions. Candidates are expected to create and manage a personal learning plan for addressing knowledge or skill gaps identified in assessment.
Physician Assessors have two roles in the Clinic:
- Assessor: To observe and rate care provided for patient encounters and provide feedback.
- Most Responsible Physician: To ensure safe patient care.
In the primary care PACE Clinic, the Assessors typically observe patient encounters via audiovisual equipment installed in each treatment room; allowing the Candidate to establish a rapport with patients that more authentically replicates practice (rather than the Assessor being physically present in the treatment room during care). However, Assessors may be present in the treatment room.
In the hospital setting for the Hospitalist assessment program, assessors directly observe in the patient’s hospital room as it is not possible to utilize audiovisual equipment.
Multiple assessors provide oversight and assessment for each candidate which lessens bias and strengthens the Assessment Program.
Each day, at least one Assessor will directly observe some of the Candidates’ patient encounters, documenting their observations and providing ratings on various aspects of the care provided. The assessment reviews several domains of competence and key clinical tasks, which Candidates receive in real-time assessment reports throughout the day in the assessment portal.
In the role of the Most Responsible Physician, Assessors will review the medical records for patients whose encounters were not directly observed to ensure safe patient care. The Assessor must be comfortable with the care provided while they are the Most Responsible Physician.
While Assessors do not view one another’s assessment reports, the Candidate and Program have full visibility on the Candidate’s progress and the feedback Candidates have offered in response.
Assessment reports are reviewed regularly to determine the duration of an assessment. When PACE determines sufficient assessment has taken place to make a decision regarding readiness to practise independently, Candidates will be referred to the Competence Committee (additional details included below).
In support of excellent patient care, PACE Candidates begin their assessment with longer patient encounters, increasing their daily volume and reducing encounter times throughout the duration of the assessment.
Assessment Outcomes
The CEO reviews assessment data on a weekly basis with the medical consultant.
Upon the CEO of PACE being satisfied that there is sufficient assessment evidence to make a recommendation to PACE’s Competence Committee on a Candidate’s practice readiness, the CEO shall make one of the following recommendations, and provide such recommendation to the Competence Committee, together with the reasons for the recommendation:
- the Candidate is ready to practise as the Most Responsible Physician without supervision
- the Candidate is ready to practise as the Most Responsible Physician with supervision
- the Candidate is ready to practise but not as the most Responsible Physician, and requires supervision
- the Candidate is not ready to practise
Following review of all information received by the Committee, for each candidate for whom a decision on practice readiness is being advanced to the College, the Committee may make one of the following decisions:
- the Candidate is ready to practise as the Most Responsible Physician without supervision
- the Candidate is ready to practise as the Most Responsible Physician with supervision
- the Candidate is ready to practise but not as the most Responsible Physician, and requires supervision
- the Candidate is not ready to practise
- the Candidate has the opportunity to return to the Program for further participation in the Assessment
Post-Assessment Process
The Competence Committee provides the recommendation and all relevant documentation to the College, which makes the licensing decision. The recommendations of PACE are not binding on the College.
Nova Scotia Health determines where successful Candidates will practise in Nova Scotia once granted a licence. A three-year return of service agreement is required for Candidates practising in Nova Scotia.
For clarity, decisions on registration, licensing and placement in a primary care practice are not made by PACE. PACE makes recommendations on readiness for practice; the College makes decisions on licensure; and Nova Scotia Health makes decisions on placement in a primary care practice or hospitalist position.
Impact and Future Vision
PACE is an innovative initiative designed to enhance patient care and address physician shortages in Nova Scotia. By providing a structured, competency-based pathway to licensure, PACE ensures that internationally trained physicians who successfully complete the assessment are well-equipped to integrate into the healthcare system and provide high-quality care to Nova Scotians.
Resources
Eligibility criteria for office-based primary care assessment program
Eligibility criteria for hospitalist medicine assessment program