Psychiatrists and neurologists who are certified in Canada will soon be able to take the examination needed to gain U.S. certification. Their U.S. counterparts who have been certified by the American Board of Psychiatry and Neurology (ABPN) will in turn gain the opportunity to become certified in Canada.

This new cross-border certification option is the result of a recently announced reciprocity agreement between the ABPN and the Royal College of Physicians and Surgeons of Canada (RCPSC), which is Canada’s primary physician-certification organization.

Canadian physicians who want to apply to take the ABPN certification examination need to have graduated from an RCPSC-approved psychiatry or neurology residency program, already have RCPSC certification, and have an unlimited license to practice in one of the Canadian provinces.

The requirements for ABPN-certified physicians who want to take the Canadian certification test are possession of an unlimited license to practice in a U.S. state, territory, or possession and completion of either an additional year of residency training, that is, a fellowship, or one year of practice. Psychiatrists and neurologists in Canada must complete five years of residency—one more than most of their U.S.-trained counterparts—before they become eligible to take the RCPSC certification examination.

The ABPN now allows certification candidates to meet its residency requirements by successfully completing a training program approved by the RCPSC. That will change, however, on July 1, 2001, when the ABPN will begin requiring applicants for certification to have graduated from a residency program approved by the Accreditation Council on Graduate Medical Education.

That change in the residency requirement led to protests from APA and the American Neurological Association and a call for the ABPN to reconsider the policy, since it would have prevented most Canadian-trained psychiatrists and neurologists from qualifying for ABPN certification. The reciprocity agreement is the outcome of a year of talks between the U.S. and Canadian certifying bodies.

While the requirement that ABPN applicants must have graduated from an ACGME-approved residency will still take effect next July, the reciprocity agreement opens the door for Canadians who are already certified in their country to gain ABPN certification.

Canadian Psychiatric Association President Michael Myers, M.D., described the reciprocity agreement as "very good news." It should, he noted, "relieve the anxiety of both Canadian- and American-trained psychiatrists who wish to obtain certification by both the Royal College and the ABPN."

Myers pointed out as well that the agreement is a "tangible result" of another reciprocal agreement—this one between APA and the CPA called the Complementarity of Vision Statement. Signed by the then presidents of the two organizations, APA’s Rodrigo Muñoz, M.D., and CPA’s Nady el Gubaly, M.D., the statement described several areas in which the psychiatric associations would work together, and one of these was psychiatric education and training issues.

ABPN’s senior vice president, Thomas Kramer, M.D., pointed out that the agreement is particularly significant because it is the first such agreement between the U.S. certifying body and a counterpart in another country. "Americans and Canadians have always had a special relationship, including training in each other’s countries," he told Psychiatric News. The agreement "eliminates some of the awkwardness" if a U.S.-trained Canadian physician wants to return to his or her native country to practice or a Canadian-trained U.S. citizen decides to practice back in the U.S.