What Exactly Is the MCCEE Canadian Medical Exam?

Many medical students from around the world are eager to practice in Canada once qualified. In order for this to occur, they will need to sit for and pass the Medical Council of Canada Evaluating Examination (MCCEE). Students who apply to write this exam must be in their final 20 months of their training program when applying to write it. The student’s school must be listed in the International Medical Education Directory (IMED) as well.

An Essential Prerequisite

All medical school graduates who have studied internationally as well as all U.S. osteopathic surgeons are required to undergo and write the MCCEE medical exam prep if they would like to be able to qualify to write the Medical Council of Canada Qualifying Examinations. The MCCEE is basically a general assessment of a student’s medical knowledge when it comes to the principal disciplines of medicine, and it has been created in order to assess the knowledge and skills that are essential for medical students to have before they will be permitted to enter their first year of fully supervised postgraduate training.

A Multiple Choice Examination

Unlike many other traditional medical examinations, the MCCEE is a computer based option that consists of 180 questions that are based on a multiple choice format. Each question lists five possible answers, of which students need to ensure that they select the best or correct option for each one. The ranges of topics that are covered in this particular exam include Adult Health, Maternal Health, Child Health, Population Health and Ethics and Mental Health. Quite a few of the questions have also been formulated to focus on general practice.

Processing Applications

Students who wish to write this examination will need to provide a certified copy of their non-expired passport, a certified identity confirmation form and a student attestation if they are medical students. Medical graduates will need to submit a copy of their final medical degree or diploma as well. It’s important for students to remember that the entire application process can take a long as three weeks. Although students can apply to take this examination at any time of the year, there are specified dates throughout the year when they will actually be written.

Preparing for Exam Day

Students who are involved in their MCCEE medical exam prep should ensure that they have at least two pieces of government-issued identity documentation with them, each of which has to contain a photo and signature. The names on these documents must match the name that the student has used to register their online MCCEE exam application. Students who arrive at the exam venue without the correct identification will not be allowed to write and will therefore also forfeit the fees that they have paid in.

Once students have written their examination, they will need to sign out of the venue so they can obtain a Test Completion Notice. This serves as proof that they have indeed written the exam and all they will need to do afterwards is await their exam results.

Reassessing Worksite Wellness After All These Years: Still Medical or Blossoming Into REAL Wellness?

INTRODUCTION

One advantage of stayin alive beyond expectations (i.e., reaching a state of perennialhood) is increased wisdom and, sometimes, witnessing desired changes. That’s the hope, in any case, attributable to decades of increasingly prescient observations and greater openness to alternate experiences. What better time than later life to reexamine opinions and beliefs? Why finish with that old time religion or other fossilized attachments political, social and so on? Oftentimes, these hardened impressions are outdated or otherwise ripe for reforms. Or not.

In any case, many might benefit from periodic scrutiny of long held views. On occasions, some opinions, even biases, could be in need of amendments, or at least refinements.

A personal example is a long held claim that worksite wellness programming has been and remains overly medical, dating back to the modern restart of the wellness movement in the early 1980’s. Particularly with respect to three of the four dimensions of REAL wellness, worksite programming has ignored systematic efforts to promote positive mental skills, such as reason (critical thinking), exuberance (joy and added meaning) and liberty (expanded personal freedoms). The other dealing with exercise and nutrition (Athleticism) has received ample attention at worksites and elsewhere.)

Is there credible evidence of a turn toward REAL wellness, recognizing that such initiatives might be addressed by other terms?

Some colleagues more attuned to workplace best practices and innovations have urged a reassessment. I’m told there are REAL wellness priorities and programs underway that promise results.

Spurred on by an invitation to appear on a webinar of a leading worksite wellness organization to discuss the book Not Dead Yet (NDY). I decided, in true stayin alive fashion, to explore what’s new in corporate wellness.

A WEBINAR

On October 30, I participated in a hour-long webinar with Dr. Paul Terry, senior fellow and editor of the Health Enhancement Research Organization (HERO). The theme was Thriving & Flourishing (At Any Age)! The initial focus was the 56 tips for successful aging described in the book. Sharing the webcast podium with me was Susan Bradley Cox, one of the eighteen world triathlon champions over age 75 profiled in NDY.

A CAUTIONARY NOTE ON PERSPECTIVE

Under the best of conditions, the impact of worksite wellness will necessarily be incidental relative to the larger issues employees face. Social determinants such as deficient educational levels, poor housing conditions, dysfunctional cultural influences, economic pressures, crime, mental and physical disabilities and much more are more consequential but not malleable by worksite wellness. While important, it’s helpful to realize that macro changes in society and the environment should be a priority, not to be overlooked while promoting worker wellbeing. A few health promotion classes and other initiatives to encourage good health skills and practices during the few hours per week available for worksite programming should not distract from the larger issues that most affect quality of life.

This point was made by economist Thierry Malleret at the 2019 Global Wellness Summit in Singapore October 15-17:

Skyrocketing costs of healthcare, housing and education are decimating the US middle class and causing rising inequality and anxiety-and the phenomenon is not limited to the US. But when it comes to social and environmental progress, the US appears as a significant, underperforming outlier. According to the Social Progress Index, the US is the only developed country that is backsliding, both in absolute and relative terms, compared to its peers. It now ranks 26th in social progress, while Norway comes first.

Many (e.g., Benjamin Libet, Dan Wegner, Thalia Wheatley, Sam Harris and a majority of contemporary scientists) marshal evidence to support the view that free will is a myth, that determinism prevails. If so, this takes the zing out of oft ballyhooed enthusiasm for self-responsibility, and witticisms such as P.J. O’Rourke’s crack that no drug, not even alcohol, causes the fundamental ills of society. If we’re looking for the source of our troubles, we shouldn’t test people for drugs, we should test them for stupidity, ignorance, greed and love of power.

THE HEALTH ENHANCEMENT RESEARCH ORGANIZATION (HERO)

HERO is a national think tank whose mission is to advance best practices in employee health promotion. HERO provides leadership in research and education on the impact of worksite wellness, on best practices for positive health outcomes and on the role and nature of healthy cultures for successful employee performance.

Over the course of several years, Paul Terry has extended polite and always collegial invitations to consider more charitable assessments about worksite wellness. In the weeks leading to the webinar, while seeking to better appreciate positive (i.e., REAL wellness-like) programming, I reviewed HERO’s archived interviews with worksite leaders, as well as the organization’s annual forum proceedings, research studies, think tank meetings, scorecard initiatives, briefs, blogs and news releases. All impressive, to be sure.

After receiving an advance partial draft of this article, Paul offered the following:

It’s a tall order to summarize all the ways that workplace health is aligned with REAL Wellness as it’s been occurring for a long time and has already apparently eluded your observant proclivities. I’ve pasted an editorial below that will be published in January. I think the ‘Pillars’ exemplify the liberty and reasoning aspects of your philosophy. My editorials are open access. In the past years I’ve written about voluntariness and autonomy (liberty), about parsing between facts, truth and empirical evidence (reason and liberty) happiness and meaning and life purpose in an interview with Richard Lieder and Vic Strecher (reason and exuberance). In each editorial I feature cases and examples of how the private and public sector are increasingly collaborating to achieve these REAL approaches.

All that strikes me as encouraging and welcome news. The theme of the recently concluded HERO forum was Thriving Organizations Achieving Well-Being Through Collaboration. Much attention was focused on the Federal government’s Healthy People 2030 initiative, a science-based rendering of 10-year national objectives. The goal of Healthy People continues to be improving the health of all Americans.

Based upon short (under six minute) expert interviews conducted at the last HERO conference with national figures in worksite wellness, a further glimpse into REAL wellness-related initiatives in corporate programming can be sensed.

EXCERPTS FROM EXPERT INTERVIEWS

Krystal Sexton, head of Human Performance and Care at Shell, identified psychological characteristics of employees who most impact organizational performance. Such Individual qualities include hope, optimism, resilience and self-confidence; team dynamic factors that matter most are those that tend to lift people up, provide role clarity and find common ground.

Unfortunately, this and the other interviews did not identify specific company wellness programs that addresses these drivers of company success. I’ll look on the bright side and assume there must be training for all that promotes specific agendas.

A video of and follow-up telephone and e-mail communications with Jessica Grossmeier, HERO’s Vice-President of Research, revealed the nature of the HERO scorecard. The instrument is designed to help organizations discover best practices for promoting workplace wellbeing. It identifies opportunities to improve and measure progress.

However, Ms. Grossmeier noted that the current version of the tool only addresses the Athleticism element, but invited suggestions about future iterations of the Scorecard. One resource was cited as an effort to help industry professionals develop more critical thinking skills. HERO has since provided more detailed examples of how to apply these critical thinking tips to findings in a number of research studies.

The Expert Interview Series on HERO’s YouTube Channel features additional short videos of national leaders who spoke at the recent HEROForum19′ gathering on the Achieving Well-being through Collaboration theme.

• Nico Pronk, Dushanka Kleinman and Mary Pittman on Healthy People 2030: Objectives for the Nation and the Role of Business.

• Sara Singer, Stanford professor on four pillars of a culture of health and the role of internal and external collaboration.

• Brian Castrucci, President and CEO of the deBeaumont Foundation on the business case for private sector and community partnerships and collaboration.

• Andrea Walsh, JD, President and CEO HealthPartners on the benefits to business of community health, on reducing stigma of mental illness and the imperative of partnerships.

• Matt Steifel, Kaiser Permanente on the relationship between social determinants of health and the role of these factors in workplace health and well-being initiatives.

• Karen Moseley, President, HERO on the role of collaborations and measurement development on what’s next and mission critical for HERO.

• Paul Terry, Senior Fellow, HERO, on new study findings released for the first time at HEROForum19′.

WHAT TO MAKE OF WORKSITE WELLNESS AFTER CONDUCTING THIS CURSORY, SKETCHY AND YES, PERFUNCTORY REASSESSMENT?

Before going any further, let me express gratitude to Paul Terry for extraordinary assistance that made possible this quick tour of contemporary developments and meaningful advances in the art and science of worksite health promotion. The links alone should be of value to many who might not otherwise have discovered these informative resources.

What’s amazing is that Paul provided this guidance while hiking down and out of the Grand Canyon, communicating only by carrier pigeons and mirrors to relay data to HERO headquarters in Minneapolis. (The part about hiking in the Grand Canyon is true.)

So, did I benefit from this periodic review of my notion that worksite wellness has done too little to promote wellbeing while focusing too much on identifying and modifying risky habits? It seems so. As all study authors note at the conclusion of their research reports, further studies (and generous grants to fund same) are imperative.

It was certainly beneficial to learn more about the work the HERO organization is doing in this field. HERO is to worksite wellness what the National Wellness Institute once was to the promotion of the wellness concept and the Global Wellness Institute is for the concept today — a worldwide promoter of research, initiatives, roundtables, annual summits, discussions, gatherer of wellness evidence and sponsor of bold initiatives, such as The Wellness MoonshotTM: A World Free of Preventable Disease. In their own words, the GWI informs and connects key stakeholders capable of impacting the overall wellbeing of our planet and its citizens. Not incidentally, GWI makes all of its valuable information and resources available at no cost, which allows anyone, anywhere, access.

In conclusion (at last), this review has made me more informed and much more interested in learning more about new developments in worksite wellness relative to REAL wellness. Again, thanks to all who contributed, directly and otherwise.

A REFRESHER ON THE CONCEPT OF WELLNESS

Wellness initially took root as a lifestyle, a way that individuals make informed choices to establish and sustain positive levels of mental and physical health beyond the absence of illness and disease. The lifestyle is founded on personal responsibility, disciplined habits and skills related to effective decision-making, enjoyment of life, exercise, nutrition, stable emotions, personal freedoms of mind and body, ample meaning and purpose, a supportive culture and environmental awareness, among other life-enriching qualities. In a work setting, safety might also be promoted, in the form of freedom to speak freely without fear of retribution.

This meaning of the word is consistent with REAL wellness, the difference being that the modifier REAL introduces four specific categories or dimensions in which vital skills and positive outcomes are organized. These four dimensions can encompass all venues in which we function, such as the social, occupational and other life areas commonly put forth as wellness dimensions. (As if different skills were required for optimal functioning in varied spheres of life.) The four REAL wellness dimensions are reason, exuberance, athleticism (exercise and nutrition) and liberty.

REAL wellness should encourage and guide people to think and function rationally, to live exuberantly, to maintain physical fitness, to dine wisely consistent with factual nutritional knowledge and to live as freely as possible. The latter means becoming liberated from cultural or circumstantial elements such as superstitions, irrational dogmas and other mental and social limitations that add constraints on personal liberties.

And that’s about it, folks.

The end.

Medical Education in Russia

Medical education in Russia usually lasts 6 years for an undergraduate MD or MBBS. The curriculum for the first two years is the same at all Faculties. It includes preclinical and fundamental medical sciences that are the essential basis for any medical specialty. Medical specialization starts at the third year of studies; the curriculum includes propedeutics, biochemistry and pathology (pathological anatomy and pathological physiology) clinical and special subjects, depending on the orientation.

The principal feature of medical education in Russia for both the Faculties of curative medicine and pediatrics is the introduction of a new approach to the training of internists and pediatricians that implies a two-year continuing primary specialization, one year while at the institution and the other year after graduation. The nature of medical education in russia and its curriculum at these Faculties is designed to cover all the general medical education within five years.

During the third, fourth, and fifth years, students perform clinical work as nurses, feldshers, and clinical assistants. In the sixth year, medical students take their primary specialization in one of the following clinical subjects: Faculty of Curative Medicine (surgery, obstetrics, and gynecology) of Faculty of Pediatrics (pediatrics, including child infectious diseases, and pediatric surgery, including orthopedics). Sub specialization in clinical areas is not an option during the undergraduate program, as profound knowledge of the main clinical subjects is believed to be fundamental for adequate training of doctors.

After 6 years of medical education in Russia, students pass a state examination according to the curriculum, obtain a Doctor’s Diploma, and complete a one year internship in medical units under the supervision of specialists. Instruction in ophthalmology, otolaryngology, dietology, climatotherapy, endocrinology, clinical biochemistry, physiotherapy, and such aspects of surgery as oncology and neurosurgery is provided by the appropriate departments.

The instructional methodology in Russian medical schools includes lectures by the leading specialists and regular practical classes throughout the course of studies.

Training programs at medical schools in Russia are adjusted to the needs of population in accordance with health priorities. Thus, when in the 1950s the non-communicable diseases became a real health problem; these subjects were strengthened and introduced more widely into curricula. When the role of primary health care became more evident in the 1970s, medical education in Russia became adapted to this target-problem.

In Russian medical schools following the annual examinations at the end of the fourth and fifth years, senior students of all Faculties usually spend the breaks between semesters in professional training. Students are taught to use their knowledge, develop their professional skills, master up-to-date methods of diagnostics and treatment, and become familiar with all other work they will do in the future. It should be emphasized that at least 25 percent of the time within the training program of all specialties is devoted to practice at the primary health care level.

Finally after completion of medical education in Russia, students must pass state examinations in general and special medical subjects (depending on the orientation of a particular Faculty) to receive a diploma as physician of general medicine at the Faculty of Curative Medicine (VRAC), as pediatrician at the Faculty of Pediatrics, as sanitary officer at the Faculty of Hygiene, as stomatologist at the Faculty of Stomatology, or as pharmacist at the pharmaceutical institution or faculty.

Annually, about 60,000 students graduate from Russian medical schools. – Professor Felix Vartanian, MD Vice-rector of Russian Academy for Advanced Medical Studies December 2008