2015 Regional Family Physician of the Year Nomination Instructions and Form The Regional Family Physician of the Year Award recognizes the overall outstanding contributions of seven OCFP members who consistently provide exemplary care to their patients and are passionately involved in activities that contribute to ongoing improvements and excellence in family medicine. Nomination is open to any OCFP member, who has been in good standing for at least 10 years, and has made a meaningful contribution in: Providing exceptional care to their patients. Making meaningful contributions to the health and well‐being of their communities. Dedicating themselves to life‐long learning and/or as researchers and educators of future generations of family doctors. Exemplifying the Four Principles of Family Medicine as defined by the College of Family Physicians of Canada: The family physician is a skilled clinician. Family medicine is a community‐based discipline. The family physician is a resource to a defined practice population. The patient‐physician relationship is central to the role of the family physician. The seven winners of Regional Family Physician of the Year Awards are recognized at the OCFP’S Awards Ceremony in November. One of the seven winners is then chosen as Ontario’s Family Physician of the Year and recognized by the College of Family Physicians of Canada at their annual Family Medicine Forum. Please note, if an OCFP member has not been a member for 10 years, but has made an outstanding contribution in the last two years, he or she can be nominated to receive an Award of Excellence. Please see the Award of Excellence Nomination Form for more information. Deadline for Nominations – April 10, 2015 OCFP 2015 Regional Family Physicians of the Year Nomination Form & Instructions 1/3 INSTRUCTIONS Please include the following materials in the Regional Family Physician of the Year Award nomination package: The nomination form (see last page). A nomination letter that describes the nominee and provides examples illustrating how he/she demonstrates excellence in family medicine. The nomination letter must reflect the categories listed below. Please type the nomination letter to ensure it is clear and legible and keep it to four pages maximum. Feel free to use bullets where appropriate. At least three letters of support from colleagues other than the nominator. A maximum of seven letters can be included with the package. The nominee’s CV. Categories for the nomination letter: 1) Skilled Clinician: Describe the nominee as a skilled clinician by providing evidence of: The level of care provided for patients, especially those with complex problems The ability to function as a leader in the early adoption of best practices A positive relationship with other providers and healthcare organizations that has had a major impact on the community’s ability to deliver good care and improve the health of the population The ability to organize services for individual patients and the practice population as a whole The ability to develop trusting relationships with patients and the impact that has on patient care. 2) Teacher and learner: Describe how engaged the nominee is in their academic pursuits, such as: Teaching medical students, family medicine residents and other student learners Providing continuing professional development/CME programs for their peers Functioning as a source of guidance and support to his/her peers Functioning as a mentor, coach and opinion leader in the community Examples of a life‐long commitment to learning Other academic endeavors such as research activities 3) Community leader: Describe how the nominee has contributed to the well‐being of people in their communities, Canadians and/or family physicians through their contributions to the College, other organizations such as hospitals and/or local, provincial and national committees or by functioning as a patient or healthcare advocate. 4) Visionary Leader: Describe how the nominee has performed as a visionary leader who leads by example, continually develops professionally and personally through additional training and education to meet the needs of the practice and the community and encourages others to do the same. OCFP 2015 Regional Family Physicians of the Year Nomination Form & Instructions 2/3 Regional Family Physician of the Year Nomination Form Please print or type NAME OF THE NOMINEE: NAME OF THE NOMINATOR: CFPC MEMBERSHIP # (IF KNOWN): CFPC MEMBERSHIP # (IF A MEMBER): ADDRESS: ADDRESS: TELEPHONE: TELEPHONE: EMAIL: EMAIL: NUMBER OF PAGES ATTACHED: Deadline for Nominations – April 10, 2015 Please send the completed form and nomination package by email, mail or fax. Attention of OCFP Awards: Mail: Ontario College of Family Physicians 400 University Avenue, Suite 2100 Toronto, ON, M5G 1S5 Email: [email protected] Fax: 416‐867‐9990 OCFP 2015 Regional Family Physicians of the Year Nomination Form & Instructions 3/3
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