Governance review

Modernizing CMPA’s governance model

Good governance is people, process, and structures designed to improve decision making, drive success, and reduce the likelihood of poor outcomes.

We have heard from our members that they want a responsive and agile CMPA. We are in a strong position to look proactively at improvements to our governance to set us up for future success. To this end, 2 years ago we embarked on a thorough examination of our governance model to lay the foundation for our governance for the next decade and beyond.

Consultation and engagement activities
No matter how our governance model evolves, we will continue to be there for members with compassionate support, medico-legal protection, and relevant learning and research to help reduce your risk.

Join us at the 2024 Annual Meeting and have your say

Informed by our consultations, research and feedback and focusing on agility, Council has now developed final recommendations for enhancements to our governance model.

The recommendations will be posted to our website in the coming weeks, as well as sent to all members and presented at our Annual Meeting. In the meantime, you can learn about the changes being considered below.


Governance review: changes being considered

Current state:

  • CMPA bylaw mandates 25 to 35 positions available on Council. Currently 30 Council members.
  • The composition of Council is determined by geography and specialty.
    • All 13 provinces/territories are divided into 10 Council Areas.
    • Each province/territory has designated representative(s) on Council, e.g. Area 1: BC and Yukon has 4 positions.
    • Councillors do not represent the provincial/territorial or regional interests of members. They have a fiduciary duty to the CMPA and support CMPA’s work at a national level.
    • There are over 65 physician advisors who work for the CMPA and provide peer support to members. These physicians have an essential role at the CMPA – to directly support members. The role of the physician advisor is different from the role of physicians on Council.

Key considerations:

  • Council size should enhance agility, facilitate responsive decision-making and reduce duplication and complexity of current governance processes.
  • Decreasing size could do this, maintaining size could help maintain representation and diversity.

Change being considered:

  • Exploring changing the size of Council.

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Current state:

  • There are currently 2 ways to be nominated for Council:
  1. Via the Nominating Committee: members submit their name for consideration to the Nominating Committee. The Committee considers the incumbent (if any) based on a set of criteria determined by Council. They also consider interested candidates, and they then submit a single candidate for the election area.
  2. Via the Membership: members get 10 signatures from member colleagues in the same geographical areas as the nominee and submit their name and form to become a candidate.
  • All 13 provinces/territories are divided into 10 Council Areas.
  • Each province/territory has a designated representative(s) on Council, e.g. Area 1: BC and Yukon has 4 positions.
  • Councillors do not represent the provincial/territorial or regional interests of members. They have a fiduciary duty to the CMPA and support CMPA’s work at a national level.

Key considerations:

  • Current nomination process can be confusing.
  • Crucial that the members’ right to elect physicians to Council be preserved, and that members have a robust slate of candidates.
  • Changing the nomination process could increase the likelihood that individuals with the sought-after skills, experience, and diversity needs are being elected to Council.
  • Regional model could mean amalgamating some of the current 10 geographical areas listed in the bylaw. For example, our funding model currently amalgamates Saskatchewan, Manitoba, Atlantic provinces, and the Territories into one region. This could be an election region.

Changes being considered:

  • Exploring a one stream nomination process.
  • Considering moving to a regional model for elections.

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Current state:

  • We have identified a desire to optimize skills and diversity on Council. Differing viewpoints and a variety of lived experiences are essential to helping us understand and support our members.
  • All Councillors are elected, physician members.
  • There are no term limits. Councillors are elected for 3-year terms and can seek re-election without limit.
  • Council strives to reflect diversity across characteristics such as gender, age, sexual orientation and gender identity, ethnicity and race, persons with disabilities, as well as within medical professionals and representation from the entire country. The current election process means these goals are not always achieved.
  • The Nominating Committee uses a robust skills and diversity matrix to identify candidates for election – helping to round out the diversity and skills on Council.

Key considerations:

  • Significant correlations between diverse leadership teams and better business outcomes.
  • Introducing a small number of appointed physician positions, in addition to the majority elected positions, could round out the skills and diversity needs on Council which may not have been satisfied through the election process.
  • Currently non-physician experts sit on some committees such as investment, pension, and audit but not on Council. Appointed, non-medical, external experts would not be eligible to sit on committees which involve member case decisions, extent of assistance decisions, or other committees focused on members.
  • Term limits could ensure regular Council renewal, bringing on new skills.
  • It takes time for new Councillors to build an understanding of CMPA’s complexities and nuances. Term limits could impede this process.

Changes being considered:

  • Examining appointing a small number of Council positions (positions for physicians).
  • Exploring appointing non-physician experts to Council.
  • Considering term limits.

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Current state:

  • Bylaw requires that all Council members to be either Family Medicine (Division A) or Royal College of Physicians and Surgeons of Canada (Royal College)/ Collège des médecins du Québec (CMQ) specialists (Division B)
    • In an area which has 2 positions, there is one Division A position and one Division B position available.

Key considerations:

  • The needs of different specialties vary.
  • Family medicine has changed since the Division A/B system was created and is now recognized as a specialty.

Change for consideration:

  • Exploring if a split between Family Medicine and Royal College/CMQ specialities on Council is still relevant.

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Additional reading