The Clinical Skills Assessment and Training Program is designed to assess core knowledge, skills and competencies of physicians in a general / family practice setting. It provides specific, individualized training, as prescribed by the assessment process, and evaluated the effectiveness of the training through in-training evaluation and re-assessment.

The Program was established in December 1997 within the Professional Development Department, Faculty of Medicine, Memorial University of Newfoundland. It operates from Western Memorial Regional Hospital in Corner Brook, Newfoundland. Administration of the program is provided by a faculty appointed Director, and a Coordinator. A Medical Advisory Board with representation from the Faculty of Medicine, Newfoundland Medical Board, Newfoundland and Labrador Medical Association, and Newfoundland and Labrador Health Care Association provides ongoing policy guidance to the program. An Academic Advisory Committee provides advice on academic matters within the program. Clinical disciplines within the Faculty of Medicine, Professional Development, and rural medicine are represented on this committee. The Program is further supported by a network of faculty assessors and preceptors from every discipline, who provide assessment and supervision for clinical traineeships, depending upon the participants' individualized need

Eligibility Criteria

Physicians considered candidates for the CSAT Program include:

  1. Physicians seeking licensure who are judged by the Newfoundland Medical Board are eligible for assessment. They will have obtained a passing score on MCC Evaluating Exam, demonstrated English language proficiency with a satisfactory score in TOEFL and TSE, and will not have been out of practice for more than three years.
  2. Candidates who have been out of practice for longer than 3 years may be considered for assessment and training if the candidate has sponsorship and financial support from a hospital board and if:
    - They have been assessed at the undergraduate level and recommended for the CSAT program, or
    - They have successfully completed LMCC Part I and Part II and is recommended for the CSAT Program by the Newfoundland Medical Board.
  3. Physicians referred by the licensing authority for assessment.
  4. Physicians who hold a license and want to do the assessment as part of their continuing medical education.
  5. This program is prepared to accept candidates referred by licensing authorities from other Atlantic Provinces for the assessment / re-assessment.


a. Assessment:

Assessment instruments are standardized and in the form of multiple choice examination, therapeutic assessment, structured oral interview, and standardized patient encounters. Actual assessment tools and performance standards have been adapted from the Clinicians Assessment and Enhancement Program (CAEP), University of Manitoba. Assessors do not know the reason for referral, to ensure fairness of the program. Confidentiality is assured. Based upon the assessment, a comprehensive report is compiled outlining strengths and weaknesses and, if appropriate, recommendations for training.

The assessment results are discussed with the academic advisory committee who determined the training requirements of the candidates based upon the assessment. If the physician is judged to require 6 months or less of training from an academic point of view, eligibility for the training component of the program is established and the training arranged.

b. Training

The training process is a collaborative effort, between the physician participant, the Director and the faculty preceptors to implement training as prescribed by the assessment process. The program is designed to facilitate a style of ongoing change in the participant's practice. The process includes monitoring and evaluating the participant's progress in meeting the educational goals, re-assessment upon completion of the program and scheduled follow up over a pre-determined period of time.

Educational interventions, in addition to clinical practice, could include courses, workshops, communications skills training, self study / reading programs, etc. The physician, during training, is placed on the education registry with the Newfoundland Medical Board and functions as family practice resident at the PGY 1 level.

Throughout the training process, communication with the participant takes place regularly to discuss activities and progress. In addition, progress is continually monitored by maintaining contact with the various faculty preceptors.

c. Re-assessment:

Upon completion of the training, the participant may undergo a summative, focused re-assessment. A comprehensive report is prepared outlining the participant's progress identifying achieved and /or needed improvements. The report may also identify a schedule for follow up. There may be situations where a re-assessment is not recommended. This decision is dependent on how well the participant did in the initial assessment, the amount of training prescribed, and in-training evaluations. If the physician meets the requirements satisfactorily, he/she is then eligible for provisional licensure.

d. Program Status:

The Clinical Skills Assessment and Training Program has been operating for one year. As of September 2000, 43 candidates have completed the assessment. Training was offered to 28 candidates. Fifteen candidates required more than six months training and therefore did not meet the criteria. The final candidate withdrew from the program but was eligible for training. Currently, there are eight physicians provisionally licensed within the province of Newfoundland and Labrador since the beginning of the CSAT Program, and another six pending when training and re-assessment is completed in the next few months.

For further information please contact:

P.O. Box 2005
Corner Brook, NL
A2H 6J7
Tel: 709-639-2728
Fax: 709-634-9175