2025 CMPA Annual Meeting (Complete)
Dr. Birinder Singh: Hi everyone again, I'm Dr. Birinder Singh and I'm President of the Canadian Medical Protective Association. Welcome to our 121st Annual Meeting. Our meeting this year is being delivered virtually and in person here from Toronto, Ontario.
We're excited to have... we're not quite sure of the numbers right now, but over a 100 members with us in person and online from across Canada. As you can see, we will be taking a break halfway through the session to give you time to stretch before we discuss and vote on our proposed By-law amendments to modernize CMPA’s governance model. And, if the amendments are passed, we will also have a discussion and vote on a member motion. I hope you will all stay with us for this important discussion and vote on the proposed By-law.
Much of today’s meeting will be delivered in English, but everyone has access to simultaneous interpretation. In-person attendees can use the headsets provided, and those online can select the appropriate language on your screens. Thank you all for taking the time to join us. Let’s get started.
Lisa, over to you.
Dr. Lisa Calder: Thanks Birinder, and thanks everyone for your patience as we're navigating these technical challenges we seem to have resolved our online challenges that we're monitoring closely, so thank you again for bearing with us as we navigate the modern realities of hybrid meetings.
So I'm Dr. Lisa Calder, I'm the CEO of the CMPA. Bienvenue à toutes et à tous, je suis Dre Lisa Calder, directrice générale de l'ACPM.
Interpreter's voice: Welcome everyone, I'm Dr. Lisa Calder, Chief Executive Officer of the CMPA.
Dr. Calder: To begin our meeting, I would like to introduce Kawennanoron Cindy White. Kawennanoron Cindy White is Onondaga Snipe Clan from the Mohawk community of Akwesasne, currently living in Six Nations Grand River Territory. Cindy has been actively engaged in her personal healing and spiritual training since 1996. She attended the State University of New York at Plattsburgh where she studied nursing and received a Bachelor of Science degree.
Kawennanoron is a Ceremonial Leader and a Traditional Healer. She has travelled among First Nations and across the globe to bring the Sacred Fire. And in her role as the Elder-in-Residence at Women’s College Hospital here in Toronto, Cindy provides guidance for program development and implementation of practices specific to Indigenous peoples.
Kawennanoron Cindy White, it is an honour to have you with us today, and I will now turn the floor over to you to open our meeting.
[Applause]
Kawennanoron Cindy White: [Speaking in Indigenous language]
Greetings for my heart to your heart. I welcome you. My name is precious words. [Indigenous language] My lineage is Onondaga. I'm a member of the Haudenosaunee Confederacy, a citizen of the Confederacy, and my clan is the family of the Snipe. I'd like to thank you Lisa for that beautiful welcome and introduction, and I just first would like to acknowledge all the people that work really hard behind the scenes to have everything come together, even with the technical glitches. It's not easy and it always will be a challenge, so... Thank you all of you now for your hard work to pull this together.
I'd like to offer some words of greetings and thanksgiving before we move forward, before you move forward to conduct your business.
The words that come before the others. [Indigenous language] Also known as the thanksgiving address.
[Indigenous language] We give you greetings, Creator, the one who made us. In the great peace. We thank you for this beautiful day that you've laid in front of us. And we send our love and our gratitude to our Mother the Earth. And to all the lifeforms in Creation that sustain us. And we'd like to give our deepest gratitude to those Thunder Beings that visited us last night. Because in this region in particular, and across Turtle Island, we haven't seen too much of them this summer season. And it shows each time you take a walk in the park and feel that grass crunch. We give thanks and send our love to the mineral life. Where the Creator visited the most beautiful places in the universe. To gather the dusts to form our Mother. We acknowledge the waters, the great salt waters, the fresh waters. The rain waters. And the life waters. The birth waters that bring forward the new life. We acknowledge that there are four grandmothers with the responsibility to manage. All those bodies of water that cover our Mother the Earth. We acknowledge the plant life and we keep them in our hearts, because we're in the height of gathering all our vegetables and some of the fruits – it's peach season, it's... all the vegetables are ripe now as we move toward harvest time. Those sustainers, the Three Sisters in this region as it's known, have the responsibility – the corn, beans and squash – to manage those, the plant life that would nurture us. And to the medicines. Those wild strawberries have been selected by the Creator to manage the medicines here on the Earth. The many trees, the flowers, the grasses. We know they're struggling, so keep them close to our heart.
We acknowledge all the animal life, the crawling life, the swimming life. The flyers, the four-leggeds. We send them our love and our deepest gratitude because they provide many things for us. Sustenance. Tools. Nothing goes to waste in some of them. They give unconditionally. Medicines. Sustenance. Clothing. They keep us warm. And more... currently, they give us a lot of company. With the pets that we keep at home. We acknowledge the Four Winds of which we can really appreciate during these summer months. But you have to have the same appreciation that you do now in those cold months. And as we look to the heavens, of course again we acknowledge those Thunder Beings that descend from high in the heavens. And we look to the Sun, that great warrior that rises each day to spread that medicine across Creation. To burn away those things from yesterday that do not serve us. So that we can write a new chapter each day. And to our grandmother the Moon, who manages the life force that moves through all the female life in Creation. She also watches over us during our night. The nighttime hours. To pray for us and to protect us. And as we continue to look to the heavens, we acknowledge that great constellation, the Milky Way, that forms a bridge from this world to the spirit world, the sky world, the Creator's land. On one side of that bridge travel those souls that have just left this place. And on the other side of that bridge is the new life coming to the Earth. And that road is lined with those beautiful wild strawberries. They're part of our creation stories, Haudenosaunee people. Brought to us by that spirit being, Sky Woman. They come from the Creator's land. That's why we're so grateful, and you'll often see strawberries on our regalia. To acknowledge that. And as we continue to look up, we acknowledge the stars. They represent our ancestors. Those stars, those ancestors, actually walk in front of us for as much as we believe that they line up behind us. To the original beings. In your ancestor lineages that the Creator placed on this earthly plane. They walk in front to help us, to inform us of the challenges of life. To help us to navigate those challenges. Sometimes we can simply walk around. Sometimes we must push forward and just walk through those challenges. With all the courage of the great ones.
And so we give thanks to our ancestors, and we acknowledge that there're many faith traditions that hold the ancestors in the highest of esteem. And they're always there to call on. They know what it is to carry the troubles that we have. The heavy heart, the confused mind. And they can inform our movement forward. And clear a path for us. And there's a great Council Fire in the heavens. Where all the spirit helpers that the Creator sit. Awaiting the Creator's instruction up to what their duties are for the next day. They receive those instructions, and then they act. Those great ones. Some would see them as the angels; we can them the grandmothers and the grandfathers. The bear, the buffalo. The eagle. Why is it that we, as a human family, think that we're above divine guidance and direction? That we think that we are the source? There have been many great ones that have walked the Earth. To show us what it is to walk in humility, to know that there's only one supreme power and that power is infinite. To change any condition. And when we align with that supreme being, however you see that in your faith tradition, all things are possible. And I know that you have much business to tend to in these next 48 hours, roughly. And I would ask the Creator's forgiveness. As we acknowledge the Creator in the last stretch here. But I know that I've left many pieces of the words of thanksgiving out, and for that I ask for forgiveness and to do better next time.
And I would ask you Creator to hold time so that all the business can be conducted. In a good way, to come together with one heart and one mind. And I would challenge all of you to go deep within, to try to remember why it is that you're here in the first place. To remember that every human being was sent to the Earth to be kind, to be generous, to be caring, to uphold one another. And most importantly, to love. To love oneself, to love the source of power, and to love the natural world. Because your children, your grandchildren, and for some of you great-grandchildren, but more importantly, those that are waiting to come, are waiting for you. To change a system that doesn't completely serve the way it used to. And so that's the work that lies in front of you, to remember that you have marching orders. A spiritual mandate coming from the highest. To remember your original relationship with the one who made you. And in doing so, to come together with the highest moral and ethical values that should govern how you conduct the care that you give to remember that it's a... a life of service.
And with that, I say thank you very much. [Indigenous language]
Thank you.
[Applause]
Dr. Singh: Thank you, Kawennanoron.
For over 20 years, I have called Toronto my home. Toronto is also known as Tkaronto, a Mohawk word that means: the place in the water where the trees are standing. The land on which we gather today is part of the Treaty Lands and Territory of the Mississaugas of the Credit. For thousands of years, Indigenous peoples inhabited and cared for this land. I acknowledge the territory of the Anishinabek, Huron-Wendat, Haudenosaunee and Ojibway/Chippewa peoples; the land that is home to the Metis; and most recently, the territory of the Mississaugas of the Credit First Nation who are direct descendants of the Mississaugas of the Credit.
I would also like to acknowledge that the CMPA offices, located in Ottawa, are on the unceded, unsurrendered Territory of the Anishinaabe Algonquin Nation, whose presence there reaches back to time immemorial. We honour and pay our respect to these lands, and to all First Nations, Inuit and Métis Peoples throughout Turtle Island.
Dr. Calder: Thank you Birinder, and thank you Kawennanoron for that very meaningful opening.
A couple of housekeeping items. Please note that only active members can vote on motions at this meeting and ask questions, and that's as per the CMPA By-law. Members who are online will vote on their screens, and those of you in person have those green flashing keypads in front of you. Please let us know if you're having technical issues before the voting begins; we continue to monitor for that online, and we're here to support you here in person.
For members here with us today, there are a couple of microphones situated in the room that you can come forward to to ask questions. Please identify yourself, share with us your name and your province and/or territory. And I would ask you to take a moment to review the slide; there's details here on how to vote, how to ask questions, and where you can ask for technical help.
Dr. Singh: We're joined today by a number of colleagues from senior leadership, Council, and General Counsel who will either be presenting or who are available to answer your questions. We are also fortunate to have 5 former Presidents of the CMPA with us: Drs. Debra Boyce, Jean-Hugues Brossard, Michael Cohen, Drs. Jean-Joseph Condé and Peter Fraser who are joining virtually, as well as former CMPA CEOs Drs. Doug Bell and John Gray. Thank you all for joining us.
[Applause]
In advance of the voting today, we've identified 2 scrutineers: Dr. Alex Barron and Dr. Sally Jorgensen. If you wish to raise an objection to the scrutineers, please let us know now by using the Ask a question button online or using one of the mics in the room. We’ll pause briefly to allow any objections to be noted. As there are no objections, Dr. Alex Barron and Dr. Sally Jorgensen are appointed scrutineers of the voting.
I would now like to seek approval of the minutes from the 2024 Annual Meeting, which were posted on the CMPA website. Members attending in person, please raise your hand to move or second the motion. And members online can move or second the motion by clicking the Messaging tab and selecting Move or Second from the drop-down menu. I see Dr. Darcy Johnson and Dr. Jean-Hugues Brossard first moving and seconding the motion. No changes to the minutes as proposed have been received.
I would now ask members to vote to approve the minutes. The motion will come up on the screen for our virtual members, and we'll pause now for voting. Alright, thanks to all who voted. The minutes from the 2024 Annual Meeting are approved. Over to you Lisa.
Dr. Calder: Thanks, Birinder. This past year, we have heard directly from our members and from healthcare leaders who are all deeply concerned about the challenges that are facing the Canadian healthcare system. The CMPA is actively engaged in responding to these challenges and has met with governments, healthcare organizations about various topics, including artificial intelligence, equity, diversity, and inclusion, and the support for international medical graduates who are new to practice in Canada. Our Strategic Plan is aimed at meeting member needs amid these challenges. And the focus is on 3 key priorities: supporting our members and employees; strengthening our foundation through collaboration; and adapting to the changing healthcare environment through modernization.
Dr. Singh: Supporting our members’ medico-legal needs underpins everything we do. As you can see on the screen, in 2024 we supported members like you with compassionate, peer-to-peer guidance over 54,000 times, on the phone and online. We were there to answer members’ medico-legal questions and provide informed guidance, helping our members prevent patient harm and practise medicine safely. And we understand just how stressful medico-legal events can be. We help members cope with this stress and continue to look for new ways to do this. For example, this year we launched the Physician Well-Being Index to our members, bringing it to Canadian physicians for the first time in French and in English. Validated by the Mayo Clinic, the Well-Being Index is an online tool which provides members with an effective way to assess their levels of distress against their peers and links them to local resources.
Dr. Calder: Another way that we support the wellness and medico-legal needs of our members is through the Member Support Program. And this program provides tailored support to members who are experiencing either a high or increasing number of medico-legal issues. This program has had impactful results. As you can see here, a vast majority of the participants who we surveyed took steps to improve their practice. And long-term impacts have included impressive reductions in College and hospital complaints.
I'm now about to speak in French, so those of you who need to may wish to put on their headsets. En plus de notre...
Interpreter's voice: In addition to our efforts to support physician wellness, we continue to modernize the member experience. We consolidated online resources on medical assistance in dying, AI and health biases, and we've made them more accessible. When the law on medical assistance in dying changed in Québec, we provided medico-legal advice to help our members manage the risks. To make peer support more accessible, we reduced our call return time to one working day. Members can also choose a time when that best suits their busy schedule for our return call.
Dr. Singh: As you can see on the screen, earlier this year we held a general membership survey, in which 97% of respondents agreed that CMPA services met the medico-legal needs of the profession, while "trusted" was a top word used to describe the CMPA. We have a mandate to provide (on behalf of our members) timely and appropriate compensation to patients proven to have been harmed by negligent care. In 2024, we paid $322 million dollars in compensation to patients.
And I will be speaking again in French, so please put on your headsets if needed. L'EDI est une valeur...
Interpreter's voice: EDI is an essential value for efficient and safe healthcare. It is at the heart of our mission. Our members have confirmed that EDI issues are closely linked to medico-legal issues. That's why our commitment to EDI is stronger than ever.
As you can see on the screen, we've taken concrete steps to make our services more inclusive and to provide equity scholarships.
Dr. Calder: We also used alternate dispute resolution processes in several cases and we've engaged with stakeholders who have an interest in restorative approaches to healthcare harm. In medico-legal cases where members faced racism and/or discrimination, we implemented a new extent of assistance principle which is intended to better assist and support our members. We're also striving to build a stronger healthcare system by collaborating with stakeholders.
And one key area of support is for international medical graduates new to practice in Canada. We recently published new research called 10 things to know about IMGs, which myth-busts commonly held narratives using CMPA data. For those of you in person, you can check out our IMG poster which is in the back of the room. We engaged with the federal government and with provincial and territorial medical associations and federations to address the barriers IMGs face when integrating into the healthcare system in Canada.
Dr. Singh: We will continue to monitor the healthcare environment and the legal landscape for issues that may impact our members. For example, we are aware of significant reforms being proposed to Ontario’s civil justice system. Rest assured, we will support you throughout these proposed changes. We continue to strive to develop and deliver inclusive, data-driven learning products that are responsive to the needs of our members and advance safety in medical care.
This past year, our learning and advice helped support a group of physicians to keep a medical clinic, on the verge of closing, open in a First Nations community. We published a paper on our Test Results Follow-Up workshop, in which 97% of participants said the improvements they made to their test follow-up system significantly enhanced patient safety within their practice. And participants in the Patient Safety Primer course for residents reported a marked improvement in their communication skills – including cultural and language sensitivity – resulting in an enhanced trust between physicians and patients.
Under Council’s lead, and building on the last 3 years of work including extensive member engagement, we continued to focus on modernizing our governance model. Our aim is to enhance our agility for continued success in an ever-changing environment. Following last year’s membership vote to approve a new governance model, we have made amendments to the By-law and will present those changes after the break. There will be an opportunity for you to ask questions before we ask you to vote on the proposed By-law. So please stay tuned.
Dr. Calder: We continue to maintain the largest collection of physician-based medico-legal data in the world. And we developed tailored risk information by specialty in 8 new Know Your Risk reports, including tools to allow members to self-assess their medico-legal risks against their peers. And we helped shape the future of AI in healthcare by offering guidance to members via webinars, position papers, and stakeholder engagements.
So that completes our high-level overview of our progress against the Strategic Plan, by continuing to support our members, strengthen our foundation through collaboration, and adapt to the changing healthcare environment through modernization.
We're now gonna turn to our financials. And we're gonna start with a message from Dr. Katy Shufelt, First Vice-President and Chair of the Audit Committee, who I will invite to the podium. Welcome Katy.
Dr. Katy Shufelt: Thank you Lisa, and good afternoon, everyone. The CMPA Audit Committee is comprised of 5 members of Council plus 2 external financial experts, all of whom are independent of management. The committee meets quarterly to ensure its duties are discharged in an appropriate manner consistent with good governance and sound operational procedures.
As Chair of the Audit Committee, I am pleased to report on our activities with respect to the 2024 financial statements, which have been prepared by management and audited by the firm KPMG. The Audit Committee has reviewed these statements with management and with the auditors. KPMG has attested that the CMPA's statements properly present the results of operations in 2024 and the financial position of the Association as of December 31st, 2024.
In the next few minutes, we’ll watch a video where our Chief Financial Officer, Cory Garbolinsky, shares the 2024 Financial Report. We’ll then watch a video narrated by our CEO, Lisa Calder, outlining the regional fee requirements for 2026. Let’s start with the first video.
2024 Financial report
Mr. Cory Garbolinsky: CMPA has a responsibility to maintain sufficient funds to support our more than 115,000 physician members and on their behalf, compensate patients proven to have been harmed by negligent care today, tomorrow, and well into the future. Our unique financial model supports CMPA’s long-term financial health. Today, we’ll take a closer look at the financial model before I summarize CMPA’s 2024 financial performance.
4 key principles to keep in mind when considering CMPA finances and our financial performance are:
First: Occurrence-based protection. Physicians are eligible for CMPA assistance any time in the future, even in retirement, as long as they were CMPA members when the care was provided. This means we must hold funds to support members and compensate patients up to 4 decades from the time the care was delivered.
Two: Members pay the expected cost of their protection through yearly membership fees. Each year we collect the membership fees needed for the estimated cost of protection for all potential medico-legal occurrences taking place in that year. Keep in mind, these occurrences may take years, even decades, to become apparent.
Third: CMPA is a not-for-profit, member-based organization. As a not-for-profit, we do not seek to generate a profit. Our financial goal is to hold at least 1 dollar of assets for every dollar of liability to appropriately compensate patients and support physicians.
Four: CMPA’s financial model is self-correcting. While we take great care in our financial estimations, our actual year-end results often differ from our estimates, creating either an excess or a deficit in our net assets. As a not-for-profit, we are not allowed to pay dividends to our members. Instead, we increase or decrease membership fees year to year in an effort to balance our net asset position.
Our financial model has several interconnected components: our net asset position; membership fees; medico-legal costs; assets for future and outstanding claims; and our investment portfolio. Let’s look at how they are connected.
Our net asset position is the difference between the total assets of the Association (primarily the investment portfolio) and the total estimated liabilities (primarily the amount needed for future and outstanding claims). Our net asset position is a key factor in determining membership fees in any given year. Membership fees are used to pay the medico-legal costs of supporting our more than 115,000 members and compensating patients on their behalf. Medico-legal costs and their changing trends, such as the cost per case, case complexity, and new case volume, shape the size of our assets needed for future and outstanding claims. This is the amount of money needed to appropriately compensate patients proven to be harmed by negligent care and to manage future legal and administrative expenses. The membership fees are invested in our investment portfolio, which in turn earns income to ensure we can appropriately compensate patients on behalf of members and pay our members’ future medico-legal expenses.
Now that we’ve seen a high-level view of our financial model, let’s look more closely at our 2024 financial performance.
As of December 31, 2024, our net asset position was $1.1 billion dollars, an increase of $163 million from 2023. This increase was mainly the result of strong investment returns, which we’ll look more closely at a little later.
For the last several years, we have been in a fortunate position to provide our members with varying levels of fee reductions. Between 2021 and 2024, we reduced fees by a total of $770 million dollars, meaning $770 million fewer dollars out of our members’ pockets. In 2024, fee reductions totaled $108 million dollars, which were more modest than the reductions in the previous two years. To understand why the fee reductions were smaller in 2024, we need to look back to 2022, which saw lower than expected market performance and a steady increase in medico-legal costs in almost all regions.
The combination of higher medico-legal costs and lower investments returns meant our overall financial position decreased. Membership fees help pay medico-legal costs, which include compensation to patients proven harmed as a result of negligent care, legal and expert fees, safe medical care learning programs, and the costs to run the Association. Compensation to patients is the Association’s single largest expense. In 2024, on behalf of our members, we paid nearly $322 million in compensation to patients, an all-time high. While the total compensation amount varies from year to year, the CMPA has paid a total of $2.5 billion dollars in patient compensation over the past 10 years, or an average of $249 million per year. The legal costs over this same 10-year period were $1.9 billion.
The assets for future and outstanding claims are the sum of all the estimated future medico-legal costs resulting from the care provided by members up to and including 2024. For care delivered in 2024, we ensure we have funds available to cover any expense related to care for the next 4 decades. As of December 31, 2024, the estimate for all future and outstanding claims was $4.4 billion, an increase of $217 million from 2023, based on updated cost-trends. Compensation to patients accounts for over two-thirds of this $4.4 billion amount.
To provide impartial oversight of our actuarial calculation, we engaged an external peer reviewer, Ernst & Young, to perform an independent calculation, which strongly aligned with our own. This was then audited by KPMG as part of their external audit of our financial statements. We target our investment portfolio to match or exceed a 6% investment return over the long term. However, over the past 10 years, we have achieved exceptional returns on our investments, earning a 7.3% compound annual return. In 2024, the investment portfolio had a net value of $5.9 billion, an increase of $309 million from 2023. The growth in the net investment portfolio over 2023 levels was due to an overall increase in financial markets, in which we exceeded our target, earning an investment return of 13.6%. Our positive financial position will help us to weather the financial markets and fluctuating medico-legal case volumes and costs. We continue to invest responsibly to maintain an appropriate financial position that ensures timely and appropriate compensation to patients on behalf of our members, protection and support to physicians, and safe medical care learning and research to support patient safety in Canada.
As I conclude my financial update, I’d like to summarize 3 key takeaways:
First: Due to our occurrence-based protection, CMPA operates with a long-term financial horizon of up to four decades into the future, allowing us to protect members and compensate their patients today, tomorrow, and for years to come.
Second: Fee increases or decreases are the primary tool used by CMPA to manage our overall net asset position. And finally, our positive net asset position in 2024 should provide confidence to members and their patients that we are here for them when needed. Thank you.
2026 Regional fee requirements
Dr. Calder: Each year we set membership fees to support the financial sustainability of CMPA, while striving to keep fees as low as possible. Membership fees vary across our four fee regions due to regional differences in medico-legal costs, the number of physicians, frequency of cases, and the risk levels of different specialties. Membership fees are collected to pay the estimated medico-legal costs of any given year - including compensation to patients and the cost to support our members - for up to 4 decades. We’re committed to managing our members’ fees with care and foresight. Our aim is to keep membership fees relatively stable over the long term - even as investment markets and medico-legal costs fluctuate. Depending on our financial position, we use fee debits and credits, and in the last four years alone we’ve returned close to $770 million to our members in fee credits, largely due to the positive performance of our investment portfolio. This means the returns from our investment portfolio have paid a large portion of our members’ cost of protection, rather than our members themselves.
While membership fees are paid entirely by members, all provincial and territorial governments and their medical associations or federations have negotiated reimbursement agreements that are intended to offset some of the cost of liability protection. CMPA is not party to these negotiations.
In 2024, our investments performed better than expected, which is a positive story for both our financial position and 2026 membership fees. Overall, the 2026 average membership fees which I am about to show you are similar to those in 2025, with small changes in some fee regions due to increasing medico-legal costs. As mentioned, CMPA has 4 unique fee regions due to the regional cost differences across the country, allowing for an equitable allocation of costs. The 4 regions are: British Columbia and Alberta, Ontario, Québec, and Saskatchewan, Manitoba, Atlantic provinces, and the Territories. Each region is independent and there is no subsidization between the regions. For example, if one region is in a positive or negative financial position, this does not impact the other regions. The amount to be collected in each region is called the total cost per region. The average fee per member is the total cost per region divided by the number of members in that region. It is an average, used for illustrative purposes, and not an actual membership fee.
When determining membership fees, we first calculate the total cost for the region and use this as the foundation to determine regional fees based on specialty or type of work. I will now share the 2026 average fee requirements starting with British Columbia and Alberta.
The medico-legal costs in this region are trending upwards, meaning the total regional fee requirement is increasing by $12 million to $167 million. Therefore, the average fee requirement per member will increase slightly by 5% in 2026, or about $250 per member on average. Part of this fee increase can be attributed to increases in medico-legal costs over the past 5 years that were slightly higher than we predicted.
The cost of providing medical liability protection in Ontario is greater than in any other region, which is reflected in the membership fee. Due to a strong financial position in Ontario, the total regional fee requirement in 2026 will decrease by $28 million to $308 million. This means the average fee requirement per member decreases by 10% to $6,558.
Turning now to the Québec fee region, which is in a strong financial position. In 2026, members in Québec will see no increase in their fees. The total regional fee requirement remains at $10 million, and the average fee requirement per member remains the same at $448.
The fees in the Saskatchewan, Manitoba, Atlantic & Territories region will increase in 2026 to ensure alignment with projected medico-legal costs. In 2026, the total regional fee requirement will increase by $5 million to $26 million. This means the average fee requirement per member will increase by 20% to $1,704, or an average increase of $284 per member. When compared to the fee requirements in 2021 and 2022, they are still considerably lower.
Here is an overview of recent average fee requirements per member by region. As you can see, even though fees have increased in the Saskatchewan, Manitoba, Atlantic & Territories region and the British Columbia/Alberta region, fees in all regions are still below 2020 average fees. Having shared the average fees per member, here’s an example of actual membership fees for family physicians in type of work code 35. The full listing of 2026 membership fees is now available on our website. You will be notified by email in the fall when the Annual Invoices are available on our website via the secure CMPA member portal.
Our strong financial position should assure members that we will continue to be there for you and compensate patients proven to have been harmed by negligent care on your behalf, today, tomorrow, and well into the future. Thank you.
Dr. Calder: So I'm now pleased to share with you the 2025 Council election results. As you can see, we are pleased to welcome a number of new and returning councillors from across Canada. All who are with us here in person today. Welcome.
[Applause]
I would also like to recognize our 4 departing Council members: Dr. Susan Chafe, Dr. Toye Oyelese, Dr. Tracey Ross and Dr. Sanjeeve Sockanathan. I wanna sincerely thank you for your commitment to the Association and to its members during your tenure as CMPA councillors.
[Applause]
And now I'm gonna take a moment to recognize the end of a chapter in CMPA history. After almost 40 remarkable years of service, Domenic Crolla, right there... our esteemed Lead General Counsel, is retiring from his position. Dom has been a steadfast presence and a guiding force through decades of change in both the legal and the medical professions. His wisdom, his integrity, and unwavering commitment have shaped CMPA in profound ways. Dom, your presence will be deeply missed. On behalf of CMPA, thank you. We wish you all the best in this next chapter.
[Applause]
Dr. Singh: I would now like to open the floor to questions. After the Q&A period we’ll take a 15-minute break and then return for a discussion and vote on our proposed By-law. And, if the proposed By-law is passed, we will also have a discussion and vote on a related member motion, that is advisory. You will have a chance to ask questions about our proposed By-law and the advisory member motion at that time. Please stay with us for that.
If you have a question in person today about what we have discussed so far, please proceed to a microphone in the room and identify yourself by name and province or territory. If you are joining us online, click the Messaging tab and select Ask a question.
I have asked Dr. Todd Watkins and Dr. Pamela Eisener-Parsche to assist me in managing the questions from the floor and online.
Dr. Dominique Tremblay: Dominique Tremblay, Québec. Je suis aussi le président de l'Association...
Interpreter's voice:
Dominique Tremblay from Québec. I am equally President of the Association of obstetricians and gynecologists in Québec. And I understand that there's no plan to increase membership contributions in Québec. However, there's a case, a pending case in the obstetric division to the tune of about $29 million that was a decision from the Superior Court. And this brings about new jurisprudence on payments in the private sector as well as potential losses of income, and this is of concern because if this becomes the new norm, the consequences may be quite significant. So, what are the calculations and the forecast of CMPA on the impact on the contributions, both in Québec– not just in Québec, because this could become a precedent-setting decision for the rest of Canada, and even across America, I don't know– That's my first point, I don't know if you want to address this first?
Interpreter's voice: Thank you for your question. I'll address your question in English to allow all those here present to be able to understand.
Dr. Calder: So it's early for us to draw conclusions on the impact of that case, the implications of that case, and one of the questions was, is it gonna impact fees in Québec? The region of Québec is in a strong financial position. We've offered a lot of fee credits in that region recently, so we believe it's in a strong position. But our actuaries are very carefully looking at the impacts of the provision. And looking at making sure that we have the resources we need. And I'm gonna ask Dom if he has any further comments on the jurisprudence around the case, but again, we're not commenting specifically on it because it is under appeal, so it's early to understand full implications, but Dom, you may have more to add.
Mr. Domenic Crolla: Thanks, Lisa. I would just add that of course we're paying attention to the case, it was an unusual one in Québec, and as Lisa said, it is under appeal. So it's premature to talk about its impact outside of Québec, to say nothing of inside Québec. But it's carefully being monitored and has been, leading up to the decision and since.
Dr. Singh: Thank you. Dr. Watkins, do we have any online?
Dr. Todd Watkins: Thank you, Dr. Singh. Just– we have no questions coming online just yet, but maybe while we're waiting, we can post a question related to civil justice reform in Ontario. Pam may wish to say a few words about some of the significant changes that are being proposed in Ontario, and Dom may wish to add to that.
Dr. Singh: Go ahead, Pam.
Dr. Pamela Eisener-Parsche: Thank you Birinder and Todd. This has been a really interesting development that we've been watching very carefully and have been engaging in. And... it is clear that there are significant changes afoot; Dom can reflect on how significant those changes are, but of a magnitude that we've not seen certainly in my time at the Association and prior to that. The impact on members will really be around a upfront loading of the responsibility of members to contribute to the defense of their case. So it is highly likely for instance that there will be a prelitigation protocol before a case goes to court. In other words, the two parties will need to come together and develop some approaches to managing the file, identifying substantive issues, etc.
That's going to mean that individual physicians are going to need to engage in their defense much earlier in the case than they might have otherwise engaged in their defense. And be much more responsive in the early days as we try to put together the foundations of the response to the claim. That's just one example.
Overall, we see some benefits that will enhance the effectiveness and efficiency of the system, but will also allow for some earlier settlements in cases where those settlements should be occurring more quickly. So there will be a combination of issues that members will need to deal with, but overall we are feeling quite optimistic about it.
Dom, did you have anything you wanted to add to that?
Mr. Crolla: Just the timeline... so we don't actually have the final recommendations on reform. We expect them to be announced in September, within a period to follow where they will be operationalized into rules of procedure. But there is no question; what's being considered would represent the most substantial reform to civil justice in Ontario in about 40 years. Just about when I started! And so it's a significant change, we're paying very close attention, in fact, participating in the consultation process.
And I would also comment, perhaps a little bit editorially, that's it's probably necessary. The current civil justice system in Ontario and across the country does not move quickly. And it is in a need of reform. It needs to be modernized along with the rest of the world. And so something needs to happen, and hopefully these reforms will move in that direction.
Dr. Calder: And I'll just add to that. We have been very much, not just following this, but in active conversations with the groups who are preparing these reforms, and so it's been an opportunity for us to bring forward what we think is not just in the interest of improving the judicial system, but what's also going to support our members. I know that HIROC is here, we've also been working with HIROC on this as well, and just making sure that we have informed views of what to expect, what to anticipate, so we can best support our members.
Dr. Singh: Thank you. One more question from the CMPA while we wait. Many provinces are actively recruiting international medical graduates at present. What is the CMPA doing to help IMGs new to Canadian practice? I'll ask Dr. Aalamian to comment on this one.
Dr. Armand Aalamian: Thank you, Birinder.
So as Lisa mentioned in the presentation, international medical graduates have been a focus for us. It is no surprise to anyone in this room and online that we have an HR crisis, human health resources crisis, in Canada. And one of the solutions to this crisis is recruiting and having more international medical graduates within the system, the healthcare system. So, Lisa made a reference, again we can't show that, for those who are online, you can certainly go on our website and see the infographic that Lisa was referencing; for those in the room, there's an infographic at the back. And that infographic highlights the alignment between some of the departments within CMPA where we've come together, really taking this issue seriously and trying to understand what are some of the challenges for international medical graduates who are new to practice in Canada. And some of the biggest challenges are, again this will be no surprise to anyone in this room, is integrating into the healthcare system. The complexities within the healthcare system. Understanding how to navigate the healthcare system and what are these barriers that they need to overcome.
So we have put in several resources through our different support systems, through our different departments, through our Physician Support and Wellness department, through our Learning, through our Research, through our EDI office, looking at these barriers, looking at how to best support members. And incidentally, it is one of our fastest-growing segment of our membership. So, really important. And we'll continue to be putting efforts in this area to support members who are new to practice, coming from international jurisdictions and new to practice in Canada.
Dr. Singh: Thank you, Armand. We do have... before we head to break, we do have one question online.
Dr. Watkins: We do, Birinder. It's just a follow-up from our friend Dr. Atul Kapur; he's back to the Ontario civil justice reform, wondering if these reforms... if we anticipate any changes to our legal expenses as a result of these reforms.
Dr. Singh: I think it's early to say at this point. We don't know actually how the rules will be implemented in practice and we're again heavily involved in monitoring this and making sure that we're going to be acting appropriately for our members and providing the best support we can, but from a costs standpoint, it's very difficult to know whether costs will go up, how much they will go up, or if they'll go down, even. You know, the idea behind many of these changes is to actually lower costs throughout the system for civil legal cases. So we're monitoring and we'll keep you apprised, but at this point we can't really comment much beyond that.
Dr. Cohen! So we'll let Dr. Cohen have the last question at the mic.
Dr. Michael Cohen: Thank you. Mike Cohen. General practice in Newfoundland, past President. First of all, kudos to the Investment Committee. I don't know if anybody said that, but I wanna make sure they know. That they heard it from me.
[Applause]
For what they did. Cory, there's no risk to our not-for-profit statuses, with that nice number we saw earlier?
Mr. Garbolinsky: Hmm... yeah. I think there's always risk as to where we have our financial position, but feel like we're in a solid position. We do feel like... because what we use our excess assets to do, is to lower membership fees in the future. And we will that sets us up well to be able to have a strong argument in support of the position that we have.
Dr. Cohen: Thank you. One last comment here: international medical graduates are very interesting. I work with three, I see the threats they're under and oftentimes, the threats come from patients. To try to force them to do things that they don't want to do. Because they will lodge a complaint with the College. Which threatens their ability to move in provincially or otherwise. And it's going to increase. So again, kudos to CMPA for working, Armand, to try and solve these issues, but it's gonna become a bigger, bigger problem. Thank you.
Dr. Singh: Thanks, Dr. Cohen. So thank you all for your great questions. We'll now take a short break. Please come back at 3:15, Eastern Standard Time, to discuss our...
Dr. Calder: 3:30.
Dr. Singh: Oh, 3:30! I don't have a watch! 3:30 to discuss our proposed By-law and to vote. Thank you everyone.
Hello, thank you! So thank you again for all joining us. [Laughter] Thanks, Darcy!
We'll now discuss our proposed By-law. Just before we start, we are aware that a small number of people are having trouble logging in online. So those who have reached out to us, we will give them an opportunity, if they're still unable to sign in, to vote by email, and we'll tally those. But most of the issues with any online participation have been solved and most people have been able to get into the meeting. So as a side note, our current governing body is known as Council. In By-law 53, the one we're presenting today, it's proposed that Council be renamed the Board, and councillors be called Board directors. In our discussion today, we will also use this new terminology.
As you may know, CMPA was formed by an Act of Parliament. Amending our By-law is therefore a complex and lengthy process, which requires approval from the federal Cabinet. Given this, we only amend our By-laws when changes are truly needed. As you can see, we haven’t made a By-law change in 15 years. Our current By-law has served us very well, but to be a modern organization, we acknowledge that we need to evolve. The proposed By-law we put for you today, which you’ll vote on today, reflects this evolution. Our members are very clear. They want a responsive and agile CMPA with a governing Board that is positioned to respond to changes in the healthcare and medico-legal environment. By-law 53 responds to this need. It has been developed to reflect CMPA’s and the healthcare systems’ complex and ever-evolving environments. It aims to be relevant for at least the next 10 years. It uses modern and flexible language which allows us to more easily adopt modern business practices. And most importantly, it's written such that it allows for adaptability over time.
Before we look at some of the major amendments to the By-law, let’s take a minute to walk through how we got here. In 2022, a motion to review our governance model was approved by the membership. This motion was very timely as Council had already begun to explore modernizing our governance framework. Following that motion, we consulted with members, engaged with experts, and conducted research to build a series of recommendations to enhance our governance model for years to come. At last year’s Annual Meeting, members voted to approve recommendations to enhance our governance model, detailed in the Modernizing CMPA Governance Review Report. Following the vote, we committed to implementing the recommendations and bringing back the proposed By-law to members for a vote at the 2025 Annual Meeting. And we’ve done just that.
I’m excited to share with you today the proposed By-law 53 for member review and vote. We've listened to our members and been thoughtful in the amendments we’re proposing today. We believe these changes will give members more opportunities to shape CMPA governance, including being elected or appointed to the Board or to the Nominating Committee. The amendments will give CMPA more flexibility to support members, by increasing our organizational responsiveness; providing opportunities to strengthen skills and diversity across our Board; and supporting strong decision-making. No matter how our governance and By-laws evolve, please know that CMPA will continue to be there for you with compassionate support, medico-legal assistance, and data-driven learning and research to help you reduce risk in your practice.
In a moment, we’ll watch a video that walks you through some of the key By-law amendments. Following the video, the motion will be presented, the floor will be opened for questions, and then members will be asked to vote on proposed By-law 53. If the proposed By-law is approved, we will then present a member’s advisory motion which relates to By-law 53’s nomination process. Let’s roll the video.
By-law 53 review and approval
Dr. Singh: In 2024, members approved a number of recommendations to modernize CMPA governance and strengthen our ability to be agile and responsive. These approved recommendations were: to progressively decrease the Board size to 15-25 directors; to streamline Board nominations to a single process and maintain geographical representation on the Board; to provide the Board with the ability to appoint up to four Directors when needed, and create 12-year term limits for Board directors; and to maintain an appropriate mix of family physicians, specialists, and other physicians.
And on June 5th and 6th, we shared the proposed By-law 53 with members for review and discussion. This video highlights 6 key By-law amendments which will increase members’ opportunities to participate in governance and make CMPA more agile and responsive. These 6 amendments are: to maintain elected, geographical representation on the Board; to elect national positions to the Board; to appoint up to 4 physician members-at-large to the Board, when needed; to foster renewal with 12-year term limits; to maintain a balance of specialties on the Board; and to streamline Board nominations to a single process.
Before we take a closer look, there are a few areas staying the same that I want to highlight. First, the By-law will maintain members’ ability to participate in elections. Elections will continue in geographical areas and the Board will determine the number of positions. The Board remains a national body which supports CMPA’s work at a national level. CMPA remains committed to maintaining the balance of specialties on the Board. The Board will continue to set the skills and competencies needed for each Board position. The Board will evaluate a slate of candidates recommended by the Nominating Committee using a robust skills and diversity matrix. Most importantly, CMPA will continue to be here for members with compassionate assistance, advice, and guidance.
Now, let’s walk through the amendments. The first amendment looks at how we will maintain geographical representation on a smaller board while supporting members’ access to the Board. So, what’s new? The Board size will be reduced to 15-25 directors. The current By-law provides a minimum threshold of “no fewer than 1” elected position from each geographical area and dictates the number of geographical areas for election. With a smaller Board, the By-law will state that each geographical area must have “1 or more” elected Board positions. Also, the Board will determine the number of geographical areas to meet the needs of the Association. The Board can and will specify when more than 1 position is needed for an area.
The second amendment looks at creating elected positions at a national level, to provide opportunities to strengthen diversity and skills across our Board, and to increase opportunities to vote, as members will be able to vote for candidates in their region and for national candidates.
Moving forward, the Board will include positions elected at a national level (as well as by geographical area). With a smaller Board, CMPA needs more flexibility to adjust the Board to reflect the makeup of the membership. National positions provide this. National positions will also allow us to include elements that are missing in the Board composition, including specialties, skills, practice settings, career stages, diverse lived experiences and viewpoints, geography, and more.
Within the Governance Manual, the Board will determine the criteria needed for national positions as well as the number of positions needed each year. Currently, there is one national Board position allocated to a resident. This position will be sunset, and residents will be able to seek nomination for any open position.
The third amendment looks at appointing up to 4 physician members-at-large to the Board, when needed. With a smaller Board, CMPA needs more flexibility to adjust composition to better reflect the makeup of the membership or address skill and diversity gaps, things that may not always be captured during the electoral process. The amendment will also increase members’ opportunities to sit on the Board. The appointed positions will be used to enhance the Board’s skills and diversity, and ensure the Board reflects various viewpoints and lived experiences. The positions will also provide an opportunity to address geographical diversity. Definition for the member-at-large positions will be established by the Board and articulated in the Governance Manual and may include attributes such as medical specialty, skills, practice setting, geographic area, career stage, and diverse lived experiences and viewpoints. Candidates for the member-at-large positions will be reviewed and recommended by the Nominating Committee and approved by the Board. Any member will have the opportunity to be considered for an appointment as a member-at-large, as long as they contribute to the skills and experience needed by the Board.
The fourth amendment looks at how we will introduce term limits to foster greater Board renewal, and support stability and maintaining knowledge within our senior governors. Currently, Board members do not have term limits. With the proposed By-law all directors will have 12-year term limits, promoting Board renewal. To maintain stability, support expert leadership, and sustain knowledge, the President’s and Vice-President’s time in office as senior governors will not count towards their term limits.
The fifth amendment focuses on how we will address the balance of family medicine, specialists, and other physicians on the Board while giving us the flexibility to reflect diversity of medical practice. We’ve heard loud and clear that maintaining a balance of specialties is crucial to our members. And we are committed to doing so. What’s new is how we will maintain the balance. The current By-law divides the Board into two Divisions. Division A: family medicine and 1 resident position; Division B: other specialties. The definitions of these divisions use language which no longer captures the diversity of medical practice. Specific definitions and categories will be removed from the By-law. The Board will define roles and maintain an appropriate balance using the Governance Manual, giving CMPA more leeway to respond to emerging issues and changing needs.
The sixth amendment looks at how we will streamline nominations to a single process to standardize evaluation and enhance members’ access to the Nominating Committee. The current By-law dictates a two-stream nomination process (through the Nominating Committee and through the membership with 10 signatures). Members have told us this is confusing. Within this current process, the Nominating Committee can only recommend one candidate to the Board per geographical area, making the candidate pool quite small. With the proposed By-law, there will be one nomination stream. All candidates for open positions (e.g. national positions or geographical area positions) will be reviewed by the Nominating Committee and recommended to the Board, ensuring equal evaluation for all candidates using a skills and diversity matrix. When selecting candidates, the committee may recommend more than one candidate for each position, increasing the slate. Any interested members can seek nomination and election as long as they contribute to the skills and experiences sought by the Board.
Additionally, at least two of the Nominating Committee positions will be filled by CMPA members who do not sit on the Board. The selection process for these will be determined, if By-law 53 is approved. This will support an increase in diverse viewpoints on the Nominating Committee and help to mitigate bias when considering candidates who may have differing viewpoints from those of the current Board directors. The skills and experiences needed for open positions will be determined by the Board and will be clearly communicated to all members seeking nomination, supporting transparency.
In addition to the 2 CMPA members, the Nominating Committee will be composed of 6-10 members, including the President. At least half of the Committee must be Board directors. All 6 of the major amendments we’ve just covered incorporate members’ approved governance model recommendations from 2024. The proposed By-law 53 will give members more opportunities to shape governance and help make CMPA more agile and responsive.
Dr. Singh: Projected is the motion to approve the By-law. In the interest of time, I would ask that all speakers, including the mover, restrict their comments to 2 minutes – this should allow us to hear from as many members as possible.
The process of the By-law 53 motion will be as follows. The motion will be displayed on the screen. Dr. Paul Healey will move the motion. I will then call for the motion to be seconded. Once the motion has been seconded, Dr. Healey will speak to it briefly. Then I will open the floor to questions and monitor the discussion and address any issues accordingly. Dr. Watkins and Dr. Eisener-Parsche will assist me in managing the questions. Paul, if you could please come to the mic to move the motion.
Dr. Paul Healey: I would like to move the motion that is displayed on the screen and has been present on the CMPA website.
Dr. Singh: Do I have a seconder for this motion? I'll take Dr. Clover Hemans in the room, thank you.
With the motion formally moved and seconded, I invite Paul to speak to the motion for 2 minutes.
Dr. Healey: Thank you, Birinder.
So my name's Dr. Paul Healey, I'm an emergency physician from Oakville, Ontario, and I'm a CMPA Board member. I would like to speak in favour of the motion. And I think a lot of times, physicians with the organizations that represent them sometimes they can seem like a blackbox, where decisions are made and we don't always understand how that process works. And we wonder how decisions made on our behalf are in our best interest. And I just want to share my experience as a CMPA Board member for the last 4 years. That the point we're at right now, it's been reached with a lot of discussion, with debate, and then compromise by people who disagree over all of these issues that we're facing today. Anytime you have a document like this, there will always be things that make you unhappy. And I think that's the mark of a good document. Because something that everyone agrees with, there's probably a problem with that.
So this represents a lot of debate and a really detailed process to get here. Sometimes with our organizations too, we always wonder about what's going on behind the scenes with these blackboxes. And I wanna reassure you that in the last 4 years, I have only seen professionalism from the management, from the Board, from our senior governors. And that there is a will to make sure that members are taken care of and that how we set up our governance and the By-laws are how we're going to do that. And so I've seen a real commitment to members and I think that this is something that will be good for the organization and that we'll move it forward.
So I would put it back to you Birinder, and I hope that everyone will take advantage of asking questions about any areas they have concern about. Because you have an incredible amount of expertise here, who have probably already looked at those questions you are worried about and debated them extensively.
Dr. Singh: Thank you, Paul.
I will now open the floor to questions and discussion. I would ask that your questions focus on the specifics of the proposed By-law. If this motion passes, we will then have a discussion on the member motion, at which time you will have an opportunity to ask questions specific to it. Please ask your questions online by clicking the Messaging tab and select Ask a question, or by using a microphone in the room. I'll start with Dr. Rinaldi.
Dr. fred Rinaldi: fred Rinaldi, family physician, Alberta. I would like to speak against this motion.
I'd first like to thank CMPA councillors, staff and advisors for the enormous amount of work that went into this. I am currently not a councillor; if and when I become a councillor, I will 100% respect the vote of the membership today. My concern is regarding the single stream nomination process to becoming a councillor. I believe that the By-laws are, loosely put, a contract that affords members an understanding of their rights and obligations. And that changing the By-laws and putting things into less firm documents decries that. I believe that the removal of member nomination from the principle undermines democracy and transparency. There will no longer be any access to Council except through the Nominating Committee. This will not provide extra opportunities for members to join Council nor to participate in Council selection, nor to be involved in governance in any kind of a meaningful way.
Do the By-laws need to be changed? One hundred percent: yes, they do. My thought is that it is better to wait one year, until the next AGM, while CMPA clarifies the nomination process and gets membership input than to wait another 15 years when we again bring the By-laws forward.
Thank you for your time.
Dr. Singh: Thanks, Freddy.
You know, this is a... probably the most discussed and debated topic that we faced through this process, and you know, it's a very valid concern, and I think it's something that's difficult to see change in such a drastic way to the way we've done things. But again, we've viewed this holistically that as we moved down from... right now, we have a system entirely based in geographic positions and we have a large Board. But when you start to look at coming to a much smaller Board and starting to have, you know, gaps in skills that we need, we felt that having a Nominating Committee that's empowered to find us these skills and get them on our Board was very important.
The thing I can say to hopefully reassure is that, you know, the plan going in is that the geographic positions, the Nominating Committee is going to have a very light touch. The idea is not to tailor and eliminate people's opportunities to participate; those positions are for geographic regions, and if people are eligible, they should be able to run. It's where, you know... it's where we have national positions, appointed positions; that's where the Nominating Committee will likely have a stronger hand in kind of tailoring who we're bringing forward.
As the Board gets smaller and smaller, we don't know what will happen and so this is why we've created some flexibility there. But we are gonna come forward with Governance Manual changes that will outline what the rules will be and how we will implement all these changes. The basic premise behind all this, though, is exactly what you said. We have found it difficult, when we have to make By-law changes, when we strictly put rules in our By-law, that then has to be approved by government, the federal government, the Cabinet. It's very difficult to make By-law changes, whereas some organizations can make By-law changes every few years, and so if we start hardcoding certain things that we don't know the outcomes of, and we don't know how it's gonna affect our functioning as a Board, we're worried that that will affect our ability to serve members in the best way possible. So we've created that flexibility, we are going to, assuming the By-law passes today, we will create a robust Governance Manual with provisions that members will be able to look at, and opine on, and again, I think this empowers members more than anything. Because the way the By-law is when people bring forward motions, we can't actually act on many of those things because we can't easily go and change our By-law. If we have rules that are set forth in our Governance Manual, as most of our rules have been for decades, members can actually look at that and members can make motions that will cause us to look and make changes.
So... it's probably not a satisfactory answer to everything and I respect the dissent on the position here, but hopefully that does help to allay some of the concerns.
Mic 2?
Dr. Santanna Hernandez: Thank you. Santanna Hernandez, I'm a rural family med resident in Southern Alberta.
So mine's not for or against yet, depending on the answer. So as an Indigenous woman, I often am brought on Boards for my unique skill set in governance. However, I see many Indigenous physicians end up being exploited for their skills, to ultimately not advance into senior leadership tracks due to the lack of experience. Yet policies like this can potentially block them from getting those experiences if they're making it to the door and getting a seat at the table from being appointed as opposed to being elected. Or they're there for tokenistic reasons.
So I recognize the really good intention behind some of the changes that are being made, but what is the CMPA planning to do to not perpetuate further harm of those with lived experiences?
Dr. Singh: You know, I think the simple fact of our recent approach in delving into EDI has been something that has been a strong push of Council, and our Board, and will continue to be so. And I think we're a learning organization, we're gonna make missteps, we're continuing to learn and grow. And I think we need... we all need to acknowledge that. We're a very different Council than when I joined 10 years ago and we'll continue to be different as we go forward.
But I really view these opportunities to get people in the door and utilize their skills, utilize their lived experience. We put... you know, again, we put this in our materials because we truly believe in this. We think having people there isn't for tokenistic reasons. Because we truly see the value in bringing in people with diverse lived experience and how that impacts our members, how it impacts our day-to-day practice, but also how it impacts how we view governance and how we implement governance changes. So it's a difficult thing to say, because we've seen so many examples, as you pointed out, where people are brought in the door and then aren't given opportunities to move forward. Every individual has a different background, a different skill set, and so I think we have to utilize who we have, and I think as we get to a smaller Board, our hope is that we'll be able to ensure we have those skills and have people with lived experience that are gonna be able to propel our Board even more positively going forward.
Mic 3?
Dr. Calder: Birinder?
Dr. Singh: Oh, we have online?
Dr. Watkins: Yes. So just in follow-up to one of the other questions: Dr. Kapur wants reassurance that the Board will provide the final approval of the Nominating Committee's recommendations?
Dr. Singh: Yeah, we have always said that we're... once we.... Oh sorry, can you just clarify that again?
Dr. Watkins: Dr. Kapur is wondering if the Board will make final approval on the Nominating Committee's recommendations.
Dr. Singh: Yes. The Board will approve the Nominating Committee's slate, but the Nominating Committee is meant to be at arm's length and doing this work separate from the Board, but the Board will make final approval and bring it forward to the members.
Go to mic 3, Dr. Brossard.
Dr. Jean-Hugues Brossard: Jean-Hugues Brossard, from Montréal.
Last year, I was standing on the podium where Birinder is and presenting the governance review. So that governance review was supported by the membership and in fact, that governance review dictates what has to be done. It says that you will decrease the size of the Board. And it says that we will have a single route for nomination. All that is in that governance review that was supported and adopted by the assembly here. So in fact, the By-law that you're looking at are just the actualization, operational actualization of what was in that governance review. And in fact, there's something that can be done one way or the other way, but not much.
When it says we will implement a single nomination route, it says we will implement–and it's what is written in the By-law as it is. When it says we'll decrease the size to 15 to 25, you will need to follow what was there. It's the membership last year that said: We're supporting that.
So what you're looking at today, it's the operational actualization of that governance review. And even the Council as it is this year, we debated a lot. I was just an observer, but I observed those debates. And they were... they were there! But at the same time we need to follow what the membership said that we need to do. And we know our plan, our order were given last year by the AGM. Thanks.
Dr. Singh: Thank you, Dr. Brossard.
Mic 1, Dr. Rosen?
Dr. Wayne Rosen: Thank you, Birinder. Wayne Rosen from Calgary, Alberta, I'm a general surgeon. I do sit on Council and I wanna speak in favour of the motion. I have seen, over the last couple of years, a great deal of thought and work go into the creation of this By-law. There's no such thing as a perfect By-law. Otherwise we would invariably have landed on it a while back. It's a series of compromises, and we try to achieve a degree of consensus on many of the changes.
This By-law may not be in my own best personal interest, if I wanna continue on as a councillor, or Board member on the CMPA– but speaking as a fiduciary, I have very, very little doubt that this is a By-law that's in the best interest of our membership and Canadian physicians as a whole. The final goal of the CMPA is to defend the integrity of physicians. And I try never to forget that; that's what we're really aiming for. And having a nimble, agile, responsive Board that can change as things modify with healthcare over the next few years, is a really great thing.
And so, I would speak strongly in favour of this motion. I think it's a... it's not a perfect By-law, because there is no such thing, but I think it is definitely in the best interest of our members and in the best interest of the CMPA. Thank you.
Dr. Singh: Thanks Dr. Rosen. We'll go online for questions... Dr. Watkins?
Dr. Watkins: Indeed, thanks Birinder. So, Dr. Elizabeth Wiley asks to seek clarification about the fact that repeatedly, we mentioned the new By-law will allow us to be more responsive and agile. And she is looking for some examples in the current model where we haven't been as responsive or agile as we might have otherwise been.
Dr. Singh: So I think the most prominent example that we can give is the size of our Council and our ability to get together and make decisions in a quick manner. So when you have anywhere from, you know, 29 to 31 councillors, our meetings have to be quarterly and we're in a sophisticated business and there's a lot of decisions that need to be made. And rightfully so, all the Council members wanna be involved in these decisions. They're fiduciaries, they have to be comfortable with the decisions that are being made on their behalf.
Ultimately, we have an Executive Committee that needs to make a lot of decisions in between meetings, which is only a portion of the entire Council. So by providing us with an ability to create a smaller Board, we can have hopefully the opportunity to eliminate an Executive Committee, or at least eliminate an Executive Committee that takes on such a heavy role and such heavy lifting. And will allow the Council, all the members of the Board, Council board, to be fully involved in all discussions and be able to make more decisions together.
And we think ultimately this is what's driving us down to a smaller Board. You know, as you saw from our presentation earlier, we have a highly successful organization, a highly respected organization, a valued organization. There's not a major issue here we're trying to solve. We're trying to stay ahead of the curve, we're trying to modernize and we're trying to do what's best for our members. This isn't for us. This is to make sure that we have an organization that has a governance structure that doesn't impede the work, important work that management is doing. We help our management team and we're able to question them meaningfully, in a timely manner.
And so I think the size issue really is something that's really important in terms of being able to be more nimble and being able to work in a modern business environment.
One more online?
Dr. Watkins: There's a question from Dr. Abohweyere. She was asking, will the general membership still be able to vote on the slate of nominated candidates?
Dr. Singh: Yes, the general membership... That's exactly the idea. The slate of candidates that's brought forward, whether it's for geographic positions, whether it's for national positions, or... not for appointed, but for any elected positions, the general membership will be able to vote. You'll be able to vote for those in your geographic region, and all members will be able to vote for anyone who's put forward for a national position. The national positions, again, will be looking to find skills we're missing: if we're missing a high-risk obstetrician, if we're missing a rural family physician from Québec. Like these are important characteristics we need on our Board.
And so we would... we could open up positions and try to get them through there, and then if we're still missing them, we can do it through appointed positions. So there's a lot of different opportunities, and that flexibility will allow us to hopefully create the most effective Board that will help serve members in the best way possible.
Microphone number 2?
Dr. Tariq Saeed: I'm Tariq Saeed, I'm a family physician from Mississauga.
So I'm not really involved so much in the Board, unlike other people talking that were actually Board members already. But for me, it makes sense to have a smaller Board to be more effective. But on the other hand, limiting who can be eligible by only from one committee, is kinda, you know... you're saying you're gonna have more diversity and things like that, but it really has a potential to cut down diversity if you have one Nominating Committee and a smaller number of people on the Board. That's why I'm against it.
Dr. Singh: And again, we acknowledge that that's the risk, but I think we have to be aware of the risks, and that's why we're being upfront with the idea that we're hoping to mitigate any risk of these things happening, because inherently, when you get to a smaller Board, if we just had elected positions, we're very... you know, it's very possible that you could lose a lot of that diversity and skills that you're looking for. As we go smaller, we've created opportunities through these other avenues to have people come in and still have that diversity, have the skills, have... You know, again, we have significant actuarial... a significant actuarial department, investment department, pensions... we need skills.
And the one thing we heard loud and clear from members is this Board should be physicians. We should not have non-physicians on the Board. This was a decision that was made, and so if our Board is going to be physicians, entirely physicians, we need to be able to get the skills to properly oversee the organization and act as a proper governance Board.
So, you know again, this is the first step. I think the By-law getting passed doesn't mean you won't have opportunities to look at our nominating process. To look at how we do things. That's going to be in the Governance Manual and a lot of work will go into creating those rules in detail, that you'll have the opportunity to look at, and come back to us at an AGM and say I don't like the way you're doing things, I want you to change this.
Microphone number 1.
Dr. Laurence Batmazian: OK, Laurence, I'm a family doctor here in Ontario, sometimes in Nova Scotia. Look, the CMPA is a beloved organization. I sometimes think of it like public health, I don't know what you guys do behind the scenes, but whatever you do helps me sleep better at night. And I'm OK with that. And I think a lot of that comes from the fact that the governance for the CMPA thus far has been good. I've had the opportunity to meet with some of the leadership here and I've nothing but the utmost confidence and respect in them.
My worry isn't now, it's 20 years from now, when you get a malevolent Board. And the issue is that right now, we can vote them out. Right? I can run, I wouldn't want to, but let's say I wanted to run, I could run and find 10 colleagues and we could replace a malevolent Board. But under this, I'm a little bit more worried. Because the Board is the majority on the Nominating Committee. And I may have read the By-law wrong, this isn't my area of expertise, so correct me, but I don't see anything that says that the Nominating Committee is barred from just nominating one person for a slot. Which would mean that there is no election for that spot. Or for nominating only people who share the viewpoints that the Board in place at that time has. And that worries me, because the way to mitigate that is to allow the electorate to choose. But it's not a real choice if there's a committee that decides who's eligible to be chosen from. So that's my worry. And again, it's not now that I'm worried about. It's 20 years from now. Where we don't have as excellent governance and what to do to oust them. Thank you.
I look forward to being corrected in my understanding of the By-law, but I'll leave it there.
Dr. Singh: You know, as someone who ran through the membership route, I was not through the Nominating Committee. I ran with 10 signatures. You know, I fully support these changes. I think there's a risk there, absolutely, that what you're saying could come to fruition. But what we're... what we're looking at, is in terms of creating robust rules and protections within the Governance Manual, which is exactly what's been done up to now.
When people say they're worried about lack of representation as we move down, the current By-law only indicates one position per province or geographic area. It's the Governance Manual! We lay out the rules. It says, no, we're gonna have 10 from Ontario, we're gonna have 7 from Québec... Like, this is how... the Governance Manual is really how we do things. You're gonna have full access to be able to impugn anything that we're doing in the Governance Manual that you think is not appropriate. Those safeguards you're talking about can absolutely be put forward through the Governance Manual. We're simply going based on experience from the last 15 years of being hamstrung in many ways by specific rules within our By-law. They made it difficult for us to implement modern governance changes. And be responsive to members, in fact. So when we have a motion to look at term limits, we couldn't even really entertain that. And that's the members speaking out about something they want. Because it was prohibited in our By-law.
So this isn't an attempt to do anything that will limit members. My view is that this is empowering to members, because the rules are gonna be set forth in the Governance Manual that we'll bring forward to you, and that you will be able to provide feedback, create motions and forums like this, and say we want you to change things to make sure members are protected.
Dr. Leung, mic 3.
Dr. Fay Leung: Thank you. My name's Fay Leung, I'm an orthopedic surgeon in Vancouver, British Columbia. I'm also a Council member and I'd like to speak in favour of the motion. And specifically address the last speaker's questions and Dr. Rinaldi's comments.
The By-law change about eliminating this double stream was actually specifically to improve accessibility to the general members. The current system of one nominated position, one nominated individual and member-driven stream was confusing to people. The nominated person would have a star beside their name, whereas the member-voted person would not. And that created some confusion and a lack of transparency. And the proposed By-law, what it really means, is that anybody can self-nominate. That self-nominated person will be vetted by the Nomination Committee. We actually talked about what exclusionary criteria will be required to eliminate the person from being eligible. And those exclusionary criteria were actually very minimal.
So in the current... the By-law that's proposed, there would be someone that's nominated by the Nomination Committee, but any of you, if you wanted to be... if you wanted to put your name forward, could do so. And would be vetted and would be on that ballot. So the intent was really to increase your ability, increase the transparency, and your accessibility to Council.
There's also two different streams, of the regional as well as the national. So for instance, if you put yourself forward geographically and you were not successful, you still actually now have an opportunity to put yourself forward on a national level.
So that actually creates more opportunities for members to be involved. I hope that helps.
Dr. Singh: Thank you. Online?
Dr. Watkins: Thanks, Birinder. Dr. Pat Bergin, past CMPA councillor from PEI, is seeking clarification about the geographic allocation of Board members and how that differs from the present process.
Dr. Singh: The geographic positions, the ones that will be allocated, we will again determine through the Governance Manual how many positions will be allocated per geographic area, as we do today. So in practice, there won't be a significant change in that department. There may just be less positions per geographic area in order to allow for national positions also, and as we come down to a smaller Board, inherently, some of those numbers are gonna have to change. But the rules will be similar to how it works currently with our geographic positions.
Microphone 1! Or... microphone 2 was first? OK. Go ahead. Dr. Bernard.
Dr. Carrie Bernard: Yeah, thank you. Carrie Bernard, I'm a practising physician in Ontario and President of the CFPC. First, I wanna thank Council and everybody involved in really thinking hard and being so transparent and so thoughtful and slow with this.
I see a direct line from what happened last year to what's happening this year, so that makes me feel heard, it makes me feel like what's... membership has a voice, I fully appreciate how difficult it is to get all of the boxes right, but what I see in these changes is a reflection of what we see in best practices in governance right now. I don't know how you manage with a 32-person Board to get stuff done, and really, becoming more nimble and limiting terms is really what I would expect to see in a modern organization. I felt that the materials were so well laid out and so well explained that I feel that I have a voice and as some of the members have discussed, this requires trust... it requires trust in what's happening right now– and I'm happy to hear that through the Governance Manual, there will still be more opportunities for voice.
So the things that I'm hearing and the reassurance about the Governance Manual make me feel very reassured that the membership was listened to, that it wasn't just a decision of Council. That in some ways, this takes people who are right now on Council in a direction where they may not be able to be anymore. It's not in their best interest. And so I feel really proud to be a member of the organization; I wanna thank you for the work.
Dr. Singh: Thank you, Dr. Bernard. Dr. LaFontaine?
Dr. Alika LaFontaine: Alika LaFontaine, I'm an anesthesiologist from Grande Prairie, Alberta. Once again, this is an enormous undertaking; I think some of the concerns have remained in small sections of the undertaking, and I always wonder what these omnibus, like it says on the sign, omnibus motions, like why not take the small part that most people don't agree with and just kinda move that as a separate thing? That way you don't have to bundle everything together and have people feel uncomfortable, but the point I want to ask about, just for clarification, was just: with the Governance Manual, members will be informed of what's in there, but they won't actually have any power outside of soft influence to change it or to get on to Council to change it. So that's one concern that I have and I don't know why in these governance changes there wouldn't be some sort of mechanism to have membership actually be an active part of kind of co-creating that in some sort of cadence.
The second is, the problem with skills and diversity matrices is that they're skills plus diversity. And they're not always weighted the same. I can tell you that I'm probably the most experienced Board server, like, among Indigenous physicians in the country. I don't have actuarial experience. I'm not a CPA. I don't have my law degree. I doubt there's any colleagues I could find again across the entire country that are First Nations, Inuit or Metis that have those backgrounds. And so although diversity is desired, if there's a strong need for actuary experience, which none of the applicants would have, How do we decide what's weighed? And none of those discussions will ever be public, for good reasons. How do we know why things were weighed outside of one-line statements? That this was the consideration?
And in the current mechanism, I see no way to actually interrogate those reasons. And so I personally think By-laws are written, that way you deal with the worst situation an organization can put themselves into; I don't think we're there. But I do worry that there's kind of a self... self-sustaining aspect to all of this; Nomination Committee makes a decision, most of the people are from the Board, the Board approves their own decisions. And that just cycles over and over. So hopefully those questions are clear. Thank you.
Dr. Singh: Thank you. You know, it's... it's a difficult thing to... like you said, you know, there's trust here and how we move forward with some of these things is difficult. The reason we've set it up as a skills and diversity matrix is exactly for the reason you're saying: they're not the same, they're very different.
You know, as someone who was a strong proponent of moving into looking at EDI issues and how we do our nominating process and how we bring on people to our Board, to our Council, you know, that's something I always want to be front of mind, and something that we're always being transparent about. And I think, like you said, those are skills we need, and there are diversity and lived experience components that we acknowledge make a Board better.
You know again, we do surveys through who is currently on the Board, we're going to have structures where, once elections occur, we'll look at what skills and what diversity elements we have on the Board, and then we're able to appoint people. If we still don't need that, we can adjust who we have the next year in terms of national positions and what we're looking for in those national positions.
You know, those sort of protections, again, I really do think can come through the Governance Manual. And to your point, motions can be brought at the AGM every year. If you're not seeing strong enough movement, you know, as you've seen at CMA and other places, people can bring motions today and say: Look, we're not happy with the level of detail, with the transparency, with what's going on. And you can say to us, I'm bringing a motion that says, I would like this part of the Governance Manual changed, you know, a specific provision. And that's empowering to our members. I think that's much more empowering than having to go through a process every 15 years where we can make some changes to really meet the needs of all of our members. So, you know, do we want you to trust us? A little bit! But we're gonna come back to you, in a year or two, with Governance Manual provisions around nominating, around these other things that people are worried about. And say look, this is where we've landed, these are what the details are, let us know what we're missing. What do we need to change? Who are we excluding here? And that's really how we're looking at this.
Microphone 2?
Dr. Diane Francoeur: Diane Francoeur, obstétricienne-gynécologue à Montréal et aussi directrice générale...
Interpreter's voice: Diane Francoeur, working in Montréal and also director of the Society of Obstetricians and Gynaecologists of Canada. I rise in favour of the motion and I'll explain why.
The SOGC has made the governance changes that you're proposing. These are similar to what we had 3 years ago and we're happy to mention that we have a Nominating, Awards and Talent Acquisition Committee that is very, very active, that's working right and doesn't stop anyone from taking part and that allows us, in our association, to seek out the hidden talent across our country that can make the difference.
We brought about other changes that will be considered for eventual discussions, and I think that if we want to draw younger people, 6-year terms are too long and this scares young people. They don't want to commit for that long. And at SOGC we very much appreciate the contribution of external members, who bring another perspective to the decisions that are taken. These external members are generally members with experience, like lawyers, accountants or actuaries, who've been part of other Boards of directors and who have added value that they bring to the table.
We rise in favour of this motion and we encourage all physicians to trust the Council.
Dr. Singh: Thank you very much. We appreciate the experience and the support of the SOGC, and the work you've done already in the same area. Again we've looked to all of our fellow organizations for help in terms of what's important, in terms of what we brought forward.
Unfortunately, I have to cut off questions now. We have to call the vote due to restrictions with our people online. I really do apologize to those who were standing and those online who have not had time to have their questions answered.
So I will now open the voting. Please use the keypad or the online interface to vote. Once you've cast your vote, it will take a few minutes to tally the results. Adoption of this motion requires a two-thirds vote of the members present and casting a vote. So please vote now and we'll come back to you once we have some results.
Voting is now closed. Thank you to all who voted. Please stand by. We will get some results, but we also wanna make sure we're getting results from those online, we're having trouble, so it may take a few minutes. Thank you.
Alright, welcome back! So, I'm happy to announce that members have approved proposed By-law number 53. With close to 80% voting in favour of the motion. Congratulations everyone for the hard work on this!
[Applause]
Hearing, you know, 20% voting against, you know again, we're very happy to hear dissenting opinions and we've heard loud and clear the voices in the room, and the voices we hear in Council as well. That there's opportunity to further enhance trust with members and make sure that we have procedures as we go forward. That makes sure that we're all doing what's best for members and creating an organization and a governance structure that will ultimately lead to best outcomes for our members.
As the motion has passed, we will now take the necessary steps to officially amend our By-law. As we were formed by an Act of Parliament, the next step will be to seek Cabinet approval. If approval is granted, we will then work to phase in the changes gradually and responsibly. Now we will move to the advisory motion that has been brought forward by Dr. Laurence Batmazian. Just give us a second.
Member advisory motion review and approval
So we now have an advisory motion to address, as I mentioned. On July 18, all members received an email from the CMPA advising that we had received a member motion related to the proposed By-law number 53. The motion focused on a single path on nominations that would come into effect should By-law 53 be approved, which has just happened.
So the process will be: Dr. Batmazian will move the motion. I will then call for the motion to be seconded. Once the motion has been seconded, Dr. Batmazian will have the opportunity to speak to the motion, and we will then open the floor to questions.
As before, please restrict your comments to 2 minutes so we can hear from as many members as possible. And I will monitor the discussion in the room, and once again, Dr. Watkins and Dr. Eisener-Parsche will monitor any questions and discussion online.
Dr. Batmazian, please come forward to the mic to move the motion.
Dr. Batmazian: I will move the motion.
Dr. Singh: Thank you.
Dr. Batmazian: Is that it?
Dr. Singh: That's good! Move the motion on the screen. Thank you very much. Do we have a seconder for the motion?
Dr. Paul Healey is seconding the motion. Thank you very much. I will now ask Dr. Batmazian to speak to the motion for two minutes.
Dr. Batmazian: One of the things I've learned in life is that lots of policies come out from small anecdotes. So I'm gonna share one of mine. And hopefully it will help with explaining why I proposed this.
So one day I woke up. And I said, I'm tired of hearing people complain about the College, and I should do something about it. So I went online and I called them and I said: Hey, are you looking for people to be on committees? And they said no. And I said: Oh, OK, that's great. And then, the next month later, I got an email saying: Oh, we're looking for people to self-nominate to be on Council. And I said well, I'm an early-career physician, I don't really have much to offer, I've never been chief of an hospital or I'm not a professor at UofT – I respect any of you that are, I just am not. You know, I just go to work, I see my patients, I go home. But I said I'll do it. OK, I'll put my name forward. Let's see. Nothing bad is gonna happen. Right? So I went online, I did the course – they make you do like a 2-hour course or whatever. You have to sign a pledge, pledging allegiance; OK, no problem, signed it. Sent it and didn't hear anything. A month later, I got an email saying: You haven't been selected. OK, no problem. If you wish to appeal, you have 72 hours. And so I did something somewhat provocative, which I try not to do. And I said, I'm just curious: why wasn't I selected? I think that's a reasonable question to ask. So the response I got 2 days later – sorry, you know, clock's ticking, I only have 16 hours to respond – said: we felt that you didn't meet our diversity attributes. You and your patients didn't meet our diversity attributes.
I guess I was sort of taken aback by that. Because I said, I'm not sure how one does do that. How would I demonstrate that I meet the diversity attributes you're looking for?
And that's where I left it, and that's OK. I went home and I slept that night, and I moved on with my life as I always do.
So this motion came from that. Because I really like the CMPA. Again, I don't know what they do behind the scenes, but whatever it does is helpful to me. And I would hate for a future version of someone like me, who is interested in getting involved in some way but does not know how and does not have any special qualifications to do so, I want them to not be stuck in the same situation I was.
So that's where this came from. So I'll just touch on it briefly, it speaks for itself. I'm grateful somebody translated it into French. That's great. So, a couple of things. So one is that I think that the Board's Nominating Committee should nominate as many people as they're qualified. I think that's not outlandish. That's one way to address implicit bias, is by putting people on the ballot, so that the electorate can choose. I think it's really important that if you apply and you didn't get selected, you should get some feedback. Maybe that's not totally unreasonable. And then maybe the Nominating Committee should consider putting people with differing opinions on the committee. Ah, not on the committee, on ballot. And the reason there is because often, it's our dissenting views that move our conversations forward. And it's really easy in these sorts of situations to kind of tune those out. And that's where I'm at.
The last thing I put in the last sentence is just about qualifications. We should not make the qualifications so specific that only one person in the country meets them. We should make them general enough so that lots of people who might be interested – maybe even early-career physicians, such as myself, could be interested in contributing to the profession in some broader way. Because I don't really know how to, otherwise. Like I said, I... I don't research or do anything, I just go to work and see patients. And, anyway. Well, thank you for hearing me out, and I look forward to, I'm sure, some comments. Thank you.
Dr. Singh: Thank you, Dr. Batmazian. We'll now open the floor to questions. I would just comment that, you know, your points... you have many supporters among our councillors and we are very much thinking about all these issues you've raised and wanna make sure we have robust feedback and meet much of the questions you've raised.
Excuse me. Mic 3.
Dr. Victoria Januszkiewicz: Good afternoon. My name is Victoria Januszkiewicz, I'm actually the resident councillor on Council right now and I'm an MFM fellow in Ottawa.
I wanna speak in favour of this motion and mostly because what you've captured in your motion is really what we spent the last 2 years talking about a lot of it, wanting to make sure that we... we do foster that, you know; bringing everybody to the table that we can have, and I said this as someone who was brought in as the first and only resident position– You know, I didn't know when I came to CMPA: would I be a token position? Was it just because they wanted to have that seat at the table? Would I be listened to? And I had no idea what to expect. And I have found, like, mentorship and sponsorship; I was made Chair of a committee; my second year on the Board, I've consistently been put on different committees to try to round out my own experience to make me a better applicant for future Board positions. And I really do believe the intention and the spirit of the Board that is making these changes is to continue to try to get that. They know that the residents' or early-career's voice is important and we wanna see that moving forward.
When we talk about the nomination process and what we maybe vision... because we're still early days thinking about that, but... that it would be: everybody would come on the ballot, short of people with like very direct conflict of interests or major criminal records – like, we haven't set the things, but it's more to be, like, risk management to the organization, while also giving so many more people an option to get on a ballot without it looking biased with a star beside one person's name, you know. And then they're early-career physicians running from the floor that maybe doesn't look as similar of an applicant. So I really do think that exactly what your motion has captured is what we, as a Board, have tried to capture in our discussions.
And I really have faith in this Board, as sort of maybe a not traditional Board member, I didn't have a lot of those hard skills. But I had a point of view and a perspective as a young female, a young mom, young OB-GYN resident. And I feel it's been really valued. So I hope that all of you can hear my comments and have that trust that is the intention of this Board moving forward.
[Applause]
Dr. Singh: Thank you, Dr. Januszkiewicz. Dr. Craigen.
Dr. Gerry Craigen: Gerry is fine. So, first of all, I entirely applaud your motion and I speak strongly in favour of it, as one of those at the other end of the career, with university appointments and all of the things that you mentioned, and formerly on the CPSO.
I think that the opportunity here is that we want diversity. We want the ability for people, if they meet... we set minimum requirements and then everyone who applies, who meets those minimum requirements should be able to run. And I like the advisory, and it sends the message to the upcoming Nominating Committee of the direction we want to take. So you have my vote, and I hope others will vote for it too. Thank you.
Dr. Singh: Thank you very much, Gerry. We have no further questions, and so I'll conclude discussion there and we'll open up the voting. Please use the keypad or online interface to vote, and once you've cast your vote it will again take a few minutes to tally the results. The approval of this motion only needs a simple majority of those present and voting. So please vote now.
Alright, happy to announce that the member motion has been approved by over 90% of members.
[Applause]
We will definitely work towards making sure we have the protection you're asking for and also meeting, you know, the... the real gist of what you're talking about in your motion is really making sure that we have processes to make sure the members really truly have the ability to get involved and help... help really work with the governance of this great organization.
So as the motion has passed, we will ensure the path to nominating through the Nominating Committee is fair, transparent, and one that respects diversity of opinion. Lisa will now share some thoughts on how CMPA is looking ahead and preparing for the future.
Dr. Calder: Thanks, Birinder. And I really appreciate everyone's patience. I know we are overtime, that's not generally our style. But really appreciate people's patience as we work through our technical difficulties.
I'm gonna speak in French a little bit, so those of you who need a headset, now is the time.
Interpreter's voice: Thank you for your comments and support for By-law 53. If Cabinet approves it, we'll take care of the final formalities and then start gradually amend our By-law.
Dr. Calder: [inaudible] Governance Manual in 2026, assuming that Cabinet approval occurs, and gradually decreasing the Board size starting in 2027.
I'm gonna give you just a very brief, 2-second snapshot of what's coming in the coming months. So building on the feedback we've gotten in the membership survey, we're gonna continue to make an even better member experience. We're gonna make our services more accessible, meaningful, easy to use. We're gonna enhance our learning resources, we're gonna continue to strengthen our use of research to drive safe medical care, and we're continuing to look to apply EDI principles in all of our services.
I'm also pleased to share that we're starting our next Strategic Plan, that's gonna be launched in 2027. And we really appreciate the insights that members are giving us and stakeholders, through surveys and engagements. Thank you. Your perspectives are critical to this next plan. And as always, we'll continue to be there for you.
[Applause]
Dr. Singh: Thanks Lisa, and thanks everyone who joined us today, both in person and online. We look forward to seeing you next year at the 2026 Annual Meeting in Calgary on August 19th.
Just for everyone in the room, please leave your voting cards and devices on your table and they will be picked up from there.
If there is no other business, this concludes the Annual Meeting. I declare this meeting adjourned. Thank you everyone.
[Applause]
