The Royal College of Physicians and Surgeons of Canada (French: Collège royal des médecins et chirurgiens du Canada) is a regulatory college which acts as a national, nonprofit organization established in 1929 by a special Act of Parliament to oversee the medical education of specialists in Canada.The Royal College is an association of physicians concerned with setting national standards for medical education and continuing professional development in Canada for 80 medical specialties. As such, the Royal College is neither a licensing nor a disciplinary body. Instead, it is a regulatory authority that helps ensure that the training and evaluation of medical and surgical specialists and two special programs maintain certain standards of quality.All specialists in Canada, with the exception of family physicians, must be certified by the Royal College before they obtain a provincial or territorial licence to practise. The only exception is in the province of Quebec, where the Royal College shares the responsibility for certifying physicians with the Collège des médecins du Québec.To become certified, a physician must pass Royal College examinations. Access to these examinations is usually gained by completing a Royal College-accredited residency program at a Canadian university. Access is also available for medical residents who complete a Royal College-recognized residency program in the United States. Certain international training programs approved by the Royal College provide limited access to Royal College examinations.Since its founding, the Royal College has been granted the patronage of the Canadian monarch, currently Elizabeth II.
Background:Artificial intelligence (AI) is changing continuing professional development (CPD) in health care and its interactions with the broader health care system. However, current scholarship lacks an integrated theoretical model that explains how AI impacts CPD as a complex sociotechnical system. Existing frameworks usually focus on isolated phenomena, such as ethics, literacy, or learning theory, leaving unaddressed the dynamics of how those phenomena interact in the complex sociotechnical AI-enhanced CPD system, as well as the new roles that AI-empowered patients and society play. Objective:The objective of this study is to propose a comprehensive, theory-driven framework that provides insight into how AI transforms CPD systems. The goal was to integrate established AI constructs with Complexity Theory (CT) and Actor-Network Theory (ANT) to develop a model that guides practice, research, and policy. Methods:We conducted a multimethod theory construction. The process started with identifying the AI-enhanced CPD as an established yet evolving phenomenon. Through a structured literature review, the main building blocks of AI-enhanced CPD were identified, as well as the ontological base (CT and ANT). The model was developed through iterative human-led and AI-assisted abductive analysis. The final model was abductively validated on a case study of a national organization pioneering AI use, demonstrating the theoretical model makes sense in practice. All conceptual decisions were reviewed collaboratively by the author group. Results:The ALEERRT-CA framework is made of 6 pillars: AI literacy, explainability, ethics, readiness, reliability, and learning theories, and 2 theoretical lenses: CT and ANT. CT elucidates macro-level system behaviors in the AI-enhanced CPD system. Those behaviors include emergence, feedback loops, adaptation, and reality made of nested complex systems. ANT explains how localized interactions among human and nonhuman actors shape AI-enhanced CPD. Together, these lenses illustrate how AI redistributes agency, amplifies tensions, and generates emergent learning dynamics within CPD and the broader health care system. Conclusions:This study presents a novel conceptual model of AI-enhanced CPD as a sociotechnical system. The integration of CT and ANT with AI constructs improves explanatory power of the ALEERRT-CA framework. Educators, program leaders, and policymakers can use the framework as a structured toolset to evaluate AI readiness, design responsible AI-enhanced CPD practices, and plan future empirical research. The framework provides a theoretical lens for observing the rapidly evolving field of AI-enhanced CPD and health care practice.
One of the most important challenges in environmental remediation, especially for the treatment of wastewater contaminated with dyes, is the development of highly effective and readily recoverable photocatalysts. In order to overcome this, novel magnetically separable Cu0.5Ni0.5MnxFe2-xO4 (where x = 0.0-1.0) nano ferrites were successfully synthesized using a sol-gel auto-combustion technique and annealed at 800 degrees C. X-ray diffraction (XRD) analysis confirmed the formation of a single-phase spinel structure, while Raman spectroscopy revealed slight structural distortions induced by Mn doping. FESEM and TEM characterizations exhibited an aggregated morphology of partially developed nanoparticles, with elemental composition and oxidation states validated by EDX and XPS, respectively. Crucially for practical catalyst recovery, VSM analysis demonstrated robust magnetic properties; although the saturation magnetization (Ms) decreased from 64.176 emu/g to 30.995 emu/g with increasing Mn substitution, the ferrites retained sufficient magnetization for rapid and facile separation from the reaction medium using an external magnet. The optical band gap, estimated via UV-DRS, indicated favourable solar light absorption. The photocatalytic efficacy of these nano ferrites was evaluated through the degradation of Reactive Orange (RO) dye under natural solar irradiation. Remarkably, the x = 1.0 composition exhibited the highest photocatalytic degradation efficiency, benefiting from optimized band structure and enhanced charge carrier separation. Furthermore, the catalyst demonstrated excellent stability and reusability over multiple cycles. These findings establish the Cu0.5Ni0.5MnxFe2-xO4 system as a highly promising, magnetically recoverable platform for practical and sustainable wastewater treatment.
Cesium gold halides are prominent lead-free distorted double perovskites with potential as photovoltaic, photocatalytic, and photosensitive materials. They exhibit Cs2Au2X6 (X= Cl, Br, I) stoichiometry and crystallize in a tetragonal structure at room pressure due to the presence of mixed-valence gold states (AuI and AuIII). At moderate pressures, they tend to undergo a phase transition to the cubic perovskite with CsAuX3 stoichiometry, characterized by single-valence AuII. Here, we theoretically investigate the paradigmatic case of Cs2Au2Cl6 under compression and its transformation into CsAuCl3. Our results demonstrate that the tetragonal-to-cubic phase transition in this perovskite family is governed by a fundamental change in the chemical bonding. In Cs2Au2X6, bonding is dominated by 1D and 2D X‒Au‒X electron-rich multicenter bonds (ERMBs). In CsAuX3, bonding is characterized by 3D electrondeficient multicenter bonds (EDMBs) occurring as infinite linear ‒X‒Au‒X‒Au‒X‒ chains in the three directions. This transformation reflects the gradual pressure-induced polymerization of the [AuICl2]‒ and [AuIIICl4]‒ anions into a three dimensional network. The bonding change follows the stages recently proposed by the unified theory of multicenter bonding, which explains the origin of ERMBs and EDMBs in compounds involving electron-rich elements with valence s- and p-type electrons, such as halides. This study thus reveals that low-symmetry perovskites can feature ERMBs and that cubic perovskites, even those including elements with valence d-type electrons, such as gold, can exhibit EDMBs. These findings provide a bonding-based framework for understanding the unconventional properties of both distorted and ideal perovskites, which cannot be adequately described within the traditional classification of ionic, covalent, and metallic bonding.
BACKGROUND:Health inequities arising from systemic factors and contextual conditions result in avoidable and unjust differences in health outcomes, with profound social and economic implications. Health inequities can frequently go unreported in observational studies. Observational studies can uniquely inform how we understand and address persisting health inequities through collecting, reporting and analyzing health equity factors using 'inclusive' methodological considerations. While the STROBE (STrengthening the Reporting of OBservational studies in Epidemiology) reporting guideline aims to improve observational study reporting quality, existing extensions lacked a specific focus on health equity. Engaging those who will use or be impacted by research ("knowledge users"), including participant-research collaborators, is central to bridging the gap between knowledge production and real-world application. Therefore, the purpose of this study was to gather a range of perspectives from these knowledge users as part of, and to inform, the development of the STROBE-Equity guideline extension, which aims to improve the reporting of equity-relevant considerations in observational studies. METHODS:This study used a qualitative description approach, employing semi-structured key informant interviews and framework analysis to collect and analyze the views of researchers, policymakers, decision-makers, funders, journal editors, ethicists, and participant-research collaborators. Participants were purposefully sampled to reflect diverse perspectives from knowledge users with relevant experience on health equity reporting. RESULTS:Eleven key informants participated in the interviews. Information from interviews was categorized into seven themes: "Clarifying equity", "Equity is dynamic", "The challenges of making equity claims", "Making reporting on equity feasible", "Using reporting guidelines to manage tension", "Potential for better outcomes", and "Nobody's perspective is neutral". Participants emphasized the need for standardized equity-relevant reporting practices and offered insight into challenges, opportunities, and strategies for integrating equity-relevant considerations into observational study reporting. CONCLUSIONS:Findings show that participants viewed equity as a complex concept and stressed the need for practical guidance to support equity reporting in observational studies. They highlighted barriers such as limited time, resources, and publication word limits, and perceived the STROBE-Equity extension as a valuable tool for structuring reporting, raising awareness, and encouraging reflection, with the potential to improve the quality and impact of equity-relevant research.
Competence by Design (CBD) is a Canadian competency-based medical education (CBME) initiative aiming to enhance residency training through clearly defined outcome competencies, sequenced progression, tailored learning experiences, competency-focused instruction, and robust programmatic assessment. Internal medicine (IM) residency programs nationwide transitioned to CBD in 2019, prompting early evaluation of implementation fidelity. We aimed to examine CBD implementation in four IM programs approximately 18 months post-launch to identify key successes and challenges. A rapid evaluation study was conducted with four IM residency programs in Canada. Data were collected via interest holder interviews and focus groups with residents and faculty at each site. Qualitative thematic analysis was guided by the CBME Core Components Framework to explore intended versus actual implementation, and identify program-level adaptations. Key successes included more frequent feedback and direct observation of trainees, enhanced coaching relationships, and proactive curricular review to align training with outcome competencies. However, challenges were also prominent, including unclear expectations of trainees and faculty regarding required performance at different training stages, reflecting gaps in shared understanding of sequenced progression. Technological limitations of electronic assessment systems hindered efficient use of data for tracking progress, and the increased assessment burden contributed to assessor fatigue. Early evaluation of CBD implementation in IM programs in Canada has yielded notable improvements in feedback culture, direct observation, and curriculum alignment. Significant cultural and logistical challenges persisted, including confusion about expectations and high assessment workload suggesting areas for improvement. Ongoing program refinements, faculty development, and technological support are needed to realize CBD’s full potential in IM training.
