Filling Out the Application ‑ General Information

Standard Application Form

Below you can find additional details/examples to help complete the Standard Application Form correctly.

NOTE: The latest application form is from December 2024. If you don't have the latest form, please either download it from our Accreditation Packages page, or email our office to request a copy of the latest package.

Part 1: Program Information

Physician Organization Details

Q1-4 - Organization Name(s) and Address(es): To be eligible for certification/accreditation, an activity must be developed or co-developed by a physician organization. (Please see the definition of a physician organization.)

For programs seeking certification for CFPC Mainpro+ credits only, some additional organizations are also considered eligible providers. These include:

• Disease-oriented patient advocacy organizations
• Government departments/agencies with an interest in and responsibility for health care
• Organizations and professional associations with an interest in and responsibility for health care that do not meet the definition of a health care/pharmaceutical industry (HPI) commercial interest (may include physician clinics)
• Medical education companies (including online educators, publishing companies, and simulation companies) that are not subsidiaries of or in the employ of an HPI commercial interest and are not developing an activity on behalf or under the direction of an HPI commercial interest

Please contact us if you’re unsure if your organization meets the requirements.

NOTE: We do not mail any documents to the organizations. All communications and documents will be sent via email.

Program Details

Q5 - Program Title:  Please enter the official program/event title, exactly as you’d like it to appear on all official documents (e.g. the letter of accreditation, invoice, and attendance certificates). Acronyms or shortened titles can be used elsewhere in the application and/or included in your email when submitting the application.

Q6 - Program Start/End Dates:  If your program starts and ends on the same day, please enter the same date. If your program has multiple sessions, please enter the dates for the first and last anticipated sessions. We cannot backdate accreditations and late fees are partially calculated based on the start date of the program.

NOTE: The accreditation period for Level 1/Section 1 Group Learning programs is 1 year.

Q7 - Credit Type: These are the types of credits you’re seeking for the program. (Most programs require Certified Activity and/or Section 1: Group Learning credits.) A program may seek multiple types of credits, though separate/additional application forms may be required. Links are included in the application form, if you require additional details around the different types of credits and the standards associated with each.

Q8 - Province of Delivery: For in-person activities, this is where the program/event will take place. For online activities, this is where the program is being delivered from. If the program will be delivered in multiple provinces/territories throughout the year, select/state each one.

NOTE: We usually cannot approve programs being delivered outside the Maritimes. If you have questions, please contact our office for details.

Q9-10 - Delivery and Program Format: The method of delivery for the program (online/in-person/both, and live/asynchronous).

Q11 - Program Type: Please choose the type that best describes your program.

• Hospital or clinical rounds: These scheduled education sessions are developed by hospital or academic departments and delivered from or within a hospital, clinical, or academic setting. The scientific planning committee must be accountable to a clinical or academic department head or equivalent.
• Journal clubs: These involve groups of physicians and other health professionals who meet on a regular schedule to review and critically evaluate recent articles in academic literature, such as scientific, medical, or philosophy literature.
• Small group learning activities: These activities are planned by an organized group of physicians and other health care professionals (approximately 12 or less) to review and discuss practice related issues. Members of the small group act as the scientific planning committee for the group.
• Faculty development: A broad range of activities used to renew or assist faculty, supervisors, preceptors, field instructors, and clinical educators in their roles. These activities are designed to improve an individual’s knowledge, skills, attitudes, and behaviours related to teaching, educational administration and leadership, and scholarship.
• Regularly scheduled series: These live (online or in-person) activities are planned as series with regular schedules. They can be offered outside a clinical or hospital setting and there is no restriction on the number of participants.

Q12 - Faculty Development Domain: If your program is not a faculty development activity, skip this question. Otherwise, choose the domain(s) that apply to your program, as per the provided definitions.

Q13 - Target audience:  We need specific details for the target audience of the program. This includes the scope of the audience (e.g. provincial, national, or otherwise), the specific specialities (e.g. family physicians, psychiatrists, anesthesiologists, etc.), and any other audience groups (e.g. residents, researchers, or other interprofessional health care groups).

NOTE:  Each target audience group should be represented on the planning committee.

Q14 - Previously Accredited: If our office has accredited/certified the program in the past, we will need to ensure that the previous application file is wrapped up before we can approve the new one. If applicable, please provide the details from the last time the program/event was approved (either by our office or by another). This typically includes yearly conferences, ongoing rounds/journal clubs, etc.

Session Details

Q15-16 - Anticipated Sessions: We need to know how many times the program will occur during one calendar year, and the location(s) and date(s) for each occurrence/session. For programs with multiple sessions throughout the year, if the number of sessions/locations has not yet been determined, please provide a best estimate. (If applicable, it’s often useful to include a (tentative) calendar of events/schedule with the application.)

NOTE: For programs with multiple sessions, we will need the details for at least the first session (title, date, location, format, learning objectives, speaker name and COI, etc.) before we can approve the program as a whole. For the rest of the sessions, we will require the details 4 weeks before the session occurs.

Q17-18 – Social Events: If there are social activities associated with the program, we need to ensure that they do not interfere/compete with educational activities. (Social activities don’t include meals/breaks.) Please indicate what the social activities are and when/where they will occur.

Q19 – Total Education Time: Indicate the number of educational hours and/or minutes it takes participants to complete the program. (This time does not include meals, breaks, social events, opening/closing remarks, awards, etc. If appropriate, this time can include pre-reading, pre-briefs, debriefs, reflections, and post-tests.) An agenda must be provided to confirm these hours, and this agenda must also indicate the time allocated for interactive learning.

NOTE:

• For online, asynchronous activities, the planning committee/program developers must estimate how long it will take participants to complete the program.
• For programs with multiple sessions (like rounds and journal clubs), please indicate the time per session.
• If the program is requesting multiple tpyes of credits (e.g. Certified Activity and Certified Assessment Activity credits), please state the time for each type.

Part 2: Administrative Information

Advertising Details

Q20-22 – Posting the Program Online: As a form of advertising and/or as a reminder, programs and sessions can be posted on various websites/calendars. (Not all options are available for all programs—it depends on the target audience and program.) Please indicate whether or not you’d like your program to appear on the listed websites, and we will add them if possible once the program has been approved.

Contact Details

Q23-25 – Contact Information: Please provide the name(s) and contact details for:

• The Chair(s) of the planning committee
• The individual(s) we should communicate with about the submitted application (if we have questions, revision requests, or require follow-up). This is usually an administrative staff member.
• The main contact for (potential) participants if they have questions. (Their information will be included in the above noted ads.)

Q26 – Website: If there is a website for the program (registration or otherwise), please provide the URL.

Scientific Planning Committee (SPC)

Q27-28 – SPC Members: List all members of the SPC (except for those who only had an administrative role and did not contribute to the content of the program) and the part of the target audience they represent. The Dalhousie Faculty of Medicine representative will also need to be identified.

Q29 - SPC Selection Explanation: The SPC must be representative of the target audience, and EDIA ought to be considered as well. Describe the process for the planning committee selection and provide any additional details that were considered for representation of the target audience.

NOTE: The SPC must include at least one member from each certifying College (the CFPC and/or RCPSC). It must also include a physician faculty member of the Dalhousie Faculty of Medicine.

Q30 – SPC COI Declarations: All members of the SPC must submit to the physician organization/SPC chair, a written description of all relationships with for-profit and not-for-profit organizations over the previous 2 years. These relationships must also be disclosed to the audience. Please explain the process for this (e.g. COI collection and review, 3-step COI disclosure slides).

NOTE: All SPC COI forms must be submitted along with the accreditation application.

Q31 – Managing SPC COIs: The physician organization/SPC Chair must review all disclosed financial relationships in advance of the program/event, to determine whether action is required to manage potential, perceived, or real COIs. There must also be procedures in place to be followed if a COI comes to its attention prior to or during the event. Please explain the process for this.

NOTE: For more information on managing COIs, please see the CFPC’s Quick Tips Identification and Manage of Conflicts of Interest and Transparency to Learners.

Speakers/Presenters, Facilitators, Moderators, etc.

Q32 – Inclusion of Speakers/Presenters, Facilitators, Moderators, etc.: Indicate whether or not the program includes speakers/presenters, facilitators, moderators, etc. outside of the SPC members. If there aren’t any, skip the rest of the questions in this section and proceed directly to Part 3.

Q33 – Selection Process for Speakers, Facilitators, etc.: The selection process for speakers, facilitators, moderators, etc. must be under the exclusive control of the SPC. Briefly describe the process of how they were chosen and (if applicable) trained.

Q34 – Speaker, Facilitator, Moderator, etc. COI Declarations: All speakers, facilitators, moderators, authors, etc. must submit to the SPC a written description of all relationships with for-profit and not-for-profit organizations over the previous 2 years. These relationships must also be disclosed to the audience. Please explain the process for this (e.g. COI collection and review, 3-step COI disclosure slides).

NOTE: All speaker, facilitator, moderator, author, etc. COI forms must be submitted prior to the event.

Q35 – Managing Speaker, Facilitator, Moderator, etc. COIs: The SPC must review all disclosed financial relationships in advance of the CPD activity, to determine whether action is required to manage potential, perceived, or real COIs. There must also be procedures in place to be followed if a COI comes to its attention prior to or during the CPD activity. Please explain the process for this.

Part 3: Educational Information

Needs Assessment

Q36-38 – Needs Assessment Process: Accredited programs must be based on the needs of the target audience. Therefore, a needs assessment of the target audience must be completed to identify areas of knowledge, skills, performance and/or health outcomes that the program intends to address or improve. Describe the process of the assessment and select the strategies that were used and list the needs that were identified.

NOTE: Documentation around the needs assessment must be submitted with the application.

Q39 – Impact of Previous Programs: If applicable, explain how the previous occurrences of the program have impacted the planning for the program (whether it was previously accredited or not). For example, has anything changed because of participant feedback? Were there any identified issues in previous programs that are getting resolved/addressed?

Learning Objectives

Q40 – Learning Objectives and Identified Needs: The needs assessment must be used to inform the development of the learning objectives. Please explain this process for both the overall program and session-specific learning objectives. Examples are provided on the form.

Q41-42 – Learning Objectives: List the learning objectives developed for the overall program as a whole and for the specific sessions/activities/modules, and the most applicable CanMEDS competencies addressed by the learning objectives. (There should be at least one learning objective for activity.) If the learning objectives are listed in another document (e.g. the brochure or other written program materials), that may be referenced instead.

NOTE: The learning objectives must be developed according to the Colleges’ standards (written from the learner's perspective, be measurable, and using action verbs to state what the learner will know and/or be able to do after attending the activity). They must be printed on the brochure and/or other written materials, so the participants have them in advance.

Program Content

Q43 – Content Development: State the organization(s) that developed the content for the program. (Specific interests of any sponsor must not have any direct or indirect influence on the content and/or materials of an accredited program.)

Q44 – Content Information Sources: Indicate the sources of information for the program content. (Content must be evidence-based, up to date with current practice trends, and consider Canadian context.)

Q45 – Evidence: Describe how evidence was identified and selected. Content must be evidence-based, up to date with current practice trends, and (if applicable) within the scope of family medicine. Emerging evidence from peer-reviewed sources that challenge currently approved practice may be included for discussion. The best available evidence should be used for all assertions or recommendations within a program. Content must consider the Canadian context and diverse communities across Canada when making recommendations or speaks to implementation of evidence.

Q46-47 – Off-Label or Unapproved Treatments: If the program includes discussion of off-label or unapproved treatments, explain the relevance.

Q48 – Program Keywords: List at least one keyword for your program (consider the area of interest, specific illness/condition, medical specialty involved, etc.). A full list of the available keywords is included with the accreditation package.

Q49-50 – CanMEDS Roles: Accredited activities must addresses gaps in physician competency through CanMEDS competencies. You must indicate which CanMEDS roles are applicable to the program (at least one must be selected) and describe how they were considered in the needs assessment process.

Program Format

Q51-52 – Learning Methods: Consider how the activity design and format will lead to the achievement of the learning objectives and state what these methods will be. (The participants’ current level of knowledge and skills, available resources and time, online vs in-person learning, EDIA principles, etc. should be taken into consideration when considering learning methods.)

Q53 – Interactivity: At least 25% of the total education time must be allocated for interactive learning. Describe the methods that are being used for this program. (Consider both learner-to-learner and learner-to-facilitator interactivity. Live, group learning activities must include interactivity with other learners and the speakers/facilitators. Asynchronous, self-learning activities must include a means for participants to ask questions and receive answers about the material being taught.)

NOTE: The interactivity time must be indicated in the agenda.

Q54 – Barriers to Change: Indicate whether discussion of barriers to change is included in the program.

Evaluation and Outcome Assessment

Q55 – Evaluation Feedback Review: Program developers must have a plan in place to review and respond to evaluation feedback for quality improvement purposes. 

Participants must be provided with an opportunity to evaluate the overall event and each individual session in a meaningful and confidential manner. Some specific questions must be included. A copy of the evaluation tool(s) must be included with the accreditation application.

Part 4: Ethical and Financial Information

Ethical Standards

Q56 – Compliance with the National Standard and CMA Guidelines: Indicate if the program complies with the standards. (All accredited programs must comply with these standards.)

Q57 – Ensuring Validity, Objectivity, and Balance of Program Content: There isn’t necessarily a right or wrong answer to this, and it will vary depending on the type of program. For example, these principles may be addressed in the speakers letter (asking that they adhere to a scholarly approach for their presentation), and presentation objectives and/or slides may be reviewed in advance.

Q58 – Handling Non-Compliance with the National Standard: Explain the processes that will be used to ensure compliance with the National Standard. For example, (if found ahead of time) the speaker may be asked to alter the content of the presentation, or (if found after the fact) participants may be notified of the situation and the speaker may be sanctioned.

NOTE: The COI form includes a declaration section (with the questions around therapeutic recommendations and generic names) to help ensure that speakers are complying with the National Standard. The planning committee should follow up with speakers (as necessary) to ensure there won’t be any issues with bias and taking steps to mitigate it, if necessary.

Q59-60 – SPC Control over Program Elements: Indicate if the SPC has control over the listed elements and provide an explanation if not. (The SPC may consider data or advice from all sources, but they must retain exclusive control over the final decisions.)

Q61-62 – Communication with Speakers/Facilitators/Moderators/etc.: Speakers, facilitators, moderators, etc. should be notified about the various requirements and expectations for their presentations/sessions (even if they’ve presented for accredited programs before). The provided list is a guideline on different topics that ought to be communicated to them. (Not every topic will necessarily be applicable for every program.)

NOTE: A sample copy of the communication with speakers is required to be submitted with the application.

Equity, Diversity, Inclusivity, and Accessibility (EDIA)

Q63-65 – Considering EDIA: The principles of EDIA can (and should) be considered in all aspects of program planning. (A list of examples can be found in the Accreditation/Certification Policy.) Explain how this has been done for this program, how participants will be notified about these considerations, and (if applicable) what and how barriers need to be overcome.

Financial Details

Q66 – Expense Payments: As per the National Standard, the physician organization/SPC can either assume or delegate to a third party the payment of travel, lodging, legitimate out of pocket expenses and any honoraria. The physician organization/SPC must approve what payments are delegated and retain overall accountability. Please explain how these payments will be made. If not applicable, say so.

Q67 – Incentives: As per the National Standard, the physician organization/SPC must approve any incentive provided to participants. (For example, an “exhibitor passport” where the completed passport is entered into a draw for a prize. In this example, the incentive is the ability to win a prize by participants visiting exhibit booths.) If applicable, explain the process for review and approval for these incentives.

Q68 – Participant Number: State how many participants you anticipate for the program.

NOTE: The Colleges generally define “small groups” as approximately 10 learners per facilitator.

Q69 – Sources of Funding: Indicate where all the funds for the program are coming from. (These may or may not be from financial sponsors.)

Q70 – Receiving Sponsorship: Indicate whether or not the program will receive support (financial or in-kind) from an external organization. If not, skip the “Sponsorship Details” section below and continue to Part 5.

Sponsorship Details

Q71 – Receiving Financial/In-Kind Support: Confirm that, as per the National Standard, the physician organization/SPC is responsible for receiving any financial and in-kind support.

Q72 – Sponsor List: List and provide the details for all financial and in-kind sponsors. Tis includes:

• the name of the sponsor/organization providing support
• the sponsor type (for-profit or not-for-profit)
• the support type (financial or in-kind)
• the support details (the amount, or a description of the in-kind support and the approximate monetary value of this support)

If you are providing this list in a separate document, please ensure all the details are included and indicate where to find that list in the application (i.e. the name of the document).

NOTE: If the support has not been finalized at the time of the application, list all the potential support (with the details) and indicate that the support has not been finalized in the Description column. A final list of the sponsors will be required before the program begins.

Q73 - Interactions with Sponsors: State the methods being used to ensure interactions with sponsors meet professional and legal standards. Consider your policies and procedures for:

• Protecting the privacy and confidentiality of individuals and groups who participate in your programs
• Governing how the organization respects copyright and other contractual law regulations

Q74 – Sponsor Acknowledgement: Confirm that the standard acknowledgement statement is being used on the sponsor recognition/acknowledgement page (whether that’s in the brochure, on a website, or other written materials). We will require a copy of the document (or a link to the website) for verification.

Q75-76 – Product-Specific Advertising, Promo Materials, and Branding Strategies: Confirm that, as per the National Standard, product-specific advertising, promotional materials, and branding strategies are separate and distinct from educational content and activities.

Part 5: Application Checklist

Please use this checklist to ensure that your application is complete. If any documents are missing, the application is considered incomplete; we will send you a request for the missing documents. 

Part 6: Declarations

The Chair of the SPC must read and agree to the declaration statements, and add their name and the date of completion.

Processing the Application

When we receive an application, the Accreditation Program Coordinator will first review the application and follow up as needed on any outstanding documents or items that require clarification. Then, the full application will be forwarded to the Program Reviewer(s) for approval. (If necessary, we will provide feedback/revision requests to ensure your program meets the accreditation/certification standards.) 

Once we approve the program, we will issue the accreditation letter and invoice to the SPC Chair and our main contact(s). The accreditation letter will indicate that the program is approved, provide the required accreditation statements for the final brochure, and provide instructions on the next steps.

If applicable, we will list your program/event on our Conference webpage, in the Colleges’ event calendars, and in the DoctorsNS magazine in the month prior to the date of the event/program.

We are happy to answer any questions that you may have concerning the accreditation process. (Please contact CPDME.Accreditation@dal.ca.)