title: National programmes for validating physician competence and fitness for practice: a scoping review.
abstract: OBJECTIVE
  To explore and categorise the state of existing literature for national programmes designed to affirm or establish the continuing competence of physicians.
  
  
  METHODS
  Scoping review.
  
  
  METHODS
  MEDLINE, ERIC, Sociological Abstracts, web/grey literature (2000-2014).
  
  
  METHODS
  Included when a record described a (1) national-level physician validation system, (2) recognised as a system for affirming competence and (3) reported relevant data.
  
  
  METHODS
  Using bibliographic software, title and abstracts were reviewed using an assessment matrix to ensure duplicate, paired screening. Dyads included both a methodologist and content expert on each assessment, reflective of evidence-informed best practices to decrease errors.
  
  
  RESULTS
  45 reports were included. Publication dates ranged from 2002 to 2014 with the majority of publications occurring in the previous six years (n=35). Country of origin--defined as that of the primary author--included the USA (N=32), the UK (N=8), Canada (N=3), Kuwait (N=1) and Australia (N=1). Three broad themes emerged from this heterogeneous data set: contemporary national programmes, contextual factors and terminological consistency. Four national physician validation systems emerged from the data: the American Board of Medical Specialties Maintenance of Certification Program, the Federation of State Medical Boards Maintenance of Licensure Program, the Canadian Revalidation Program and the UK Revalidation Program. Three contextual factors emerged as stimuli for the implementation of national validation systems: medical regulation, quality of care and professional competence. Finally, great variation among the definitions of key terms was identified.
  
  
  CONCLUSIONS
  There is an emerging literature focusing on national physician validation systems. Four major systems have been implemented in recent years and it is anticipated that more will follow. Much of this work is descriptive, and gaps exist for the extent to which systems build on current evidence or theory. Terminology is highly variable across programmes for validating physician competence and fitness for practice.
authors.affiliation: Research Unit, Royal College of Physicians and Surgeons of Canada, Ottawa, Ontario, Canada.
authors.forename: Tanya
authors.initials: T
authors.lastname: Horsley
authors.affiliation: Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Jocelyn
authors.initials: J
authors.lastname: Lockyer
authors.affiliation: Toronto, Ontario, Canada.
authors.forename: Elise
authors.initials: E
authors.lastname: Cogo
authors.affiliation: Research Unit, Royal College of Physicians and Surgeons of Canada, Ottawa, Ontario, Canada.
authors.forename: Jeanie
authors.initials: J
authors.lastname: Zeiter
authors.affiliation: Department of Medicine, Memorial University, St. John's, Newfoundland, Canada.
authors.forename: Ford
authors.initials: F
authors.lastname: Bursey
authors.affiliation: Continuing Professional Development, Office of Specialty Education Royal College of Physicians and Surgeons of Canada, Ottawa, Ontario, Canada.
authors.forename: Craig
authors.initials: C
authors.lastname: Campbell
mesh_terms: D002170:Canada; D002568:Certification / Q000592:standards; D006801:Humans; D008004:Licensure / Q000592:standards; D010820:Physicians / Q000592:standards*; D011361:Professional Competence / Q000592:standards*; D015397:Program Evaluation / Q000379:methods*; D006113:United Kingdom; D014481:United States
keywords: EDUCATION & TRAINING (see Medical Education & Training); MEDICAL EDUCATION & TRAINING; SCOPING REVIEW; VALIDATING PHYSICIAN COMPETENCE