WHAT'S IT ALL WORTH
Pursuant to your recent articles "Trying... and trying... to get my CCFP" (Vol 2 No 1) in the January 15 issue, "It's not the testing, it's the test" (Vol 2 No 3) in the February 15 issue, and correspondence regarding practice-eligible CCFP, it's my opinion that there are fundamental problems with the mandate and policies of the College of Family Physicians that date years back.

One tends to question the purpose of belonging to the College. I have had my CCFP and been a member of the College since graduation over 30 years ago. I receive a monthly journal from the College that seems to be dedicated more to advertising than to informing — just count and compare the number of pages devoted to pure medical education. I suspect income from advertising is enormous and I wonder where all the money really goes.

Investigation of the meandering policies of the College over the years reveals that at one time, MainPro C credits (very expensive at origin) were to be mandatory for retention of the CCFP designation. When wholesale resignation loomed, the College made MainPro C non-mandatory then suddenly changed policy and decided to confer a 'fellowship' designation, which did require MainPro C (although not originally).

I was honoured by notification of my 'fellowship' last year. The 'fellowship' was withdrawn one day later when it was found that I had no MainPro C credits. I decided years ago that I wouldn't be forced to pay exorbitant fees for 'approved' MainPro C activities. They have been rendered much easier to obtain now. I've had my day of glory and will 'bow out' of medicine with my lowly CCFP.

Dr Robert C Dickson
Hamilton, ON

US DOCS ENVY EVERYTHING BUT THE CCFP
I have a quick addition to the dialog on CCFP (certificate, College of Family Physicians) exams that's been running over the last few issues of NRM. I'm a US trained physician practising in rural BC. I attended an accredited medical school in northwestern US and completed a three-year residency in an accredited (and acclaimed) university based family practice program also in the US. I'm board certified in the US and retake my exams regularly to maintain that certification. I came to Canada with over 15 years' experience in medicine that includes running my own 10-physician clinic and chairing various hospital departments and sitting on regional medical boards.

I didn't come to Canada for financial reasons but for lifestyle issues and I'm not the only one with this priority. I get calls weekly from US doctors with resumés much more impressive than mine, who heard of my journey and are interested in making that same trip north. They would fill a niche needed in western Canada and not take jobs from newly graduating Canadian residents. However these board certified, US-trained MDs with years of experience aren't willing to make the trip because of the time and expense in having to take the required exams to practise in Canada. It truly seems a shame that Canadian needs cannot be met by US manpower without meaningless hurdles.

Dr Michael R Hudson
Pender Island, BC

KICKING IT TO KICKBACKS
I thank you for having the courage of addressing the subject of kickbacks in your article "Doctor kickbacks: just how illegal are they" (Vol 2 No 4) in your February 28 issue. We must not forget that kickbacks can bring short term advantages to doctors but jeopardizes the credibility of our whole profession. In some situations powerful financial conglomerates take unfair advantage of doctors, which can result in terrible financial consequences for those who refuse to trade their professional independence. Kickbacks also affect the whole profession by competing with financial incentives offered by governments.

Dr Daniel Poulin
Saint Constant, QC