21. Committees

Introduction

As individuals, we have all had the opportunity to participate in committee meetings. In some cases, we have volunteered or been asked to attend and in other cases we have been mandated to attend because of a specific job or role that we held. However, only a small proportion of us have had the opportunity to chair a committee. Those who have played the role of chair quickly realize that there is a definite skill required to effectively lead a group, to keep the participants engaged, to motivate them to help and to encourage them to openly bring their voice and opinions to committee meetings.

As a program director, you will be chairing your program’s residency program committee (RPC). A program cannot exist without this committee, as it is an accreditation requirement of the Royal College of Physicians and Surgeons of Canada. The function of the RPC is to “support the program director in planning, organizing, evaluating, and advancing the residency program” (program accreditation standard 1.2).¹ For more information on RPCs refer to the RPC chapter in this manual. To effectively carry out its functions, the RPC may create a number of subcommittees. These subcommittees will be under your ultimate oversight. One such subcommittee is the competence committee (CC). The CC or equivalent is “responsible for reviewing residents’ readiness for increasing professional responsibility, promotion, and transition to practice” (program accreditation standard 1.2.2.5).¹ In addition, you will be a member of the postgraduate education committee which is chaired by the faculty’s postgraduate dean and its role is to “facilitate the governance and oversight of all residency programs” (institution accreditation standard 1.3).² But your committee involvement won’t stop there. As program director, you will also be a member of your national specialty committee and probably a number of other committees because of your unique leadership role.

Therefore, having a solid understanding of good committee structure and function is critical if you want to be an effective committee member and, more importantly, a good committee chair. There are several elements that are critical to the proper functioning of a committee, including terms of reference, rules of order, ongoing committee review and proper administrative support. Each of these will be described in detail.

Terms of reference

Best governance practices suggest that committees should have clear and transparent terms of reference. These describe the structure and purpose of a committee of people who are working together toward a shared goal. As such, every individual on the committee has a stake in the proper functioning of the committee and has a reason to be engaged. Several critical elements should be included in terms of reference:

• Purpose statement. This outlines the overall reason why the committee exists. It is meant to be fairly high level, akin to a mission statement.
• Functions of the committee. This section outlines the specific roles and responsibilities of the committee. It should be fairly granular and should fully outline all of the areas in which the committee will have jurisdiction.
• Membership. A list of required individuals needs to be specifically outlined.
  • Roles, rather than the names of individuals, should be listed (e.g., site representatives; resident representative from the Competence by Design cohort).
  • In certain cases, some members of the committee may be ex officio members. Ex officio members are members by virtue of their position. For example, the postgraduate dean is an ex officio member of each RPC in the faculty of medicine at their institution. Ex officio members are often non-voting.
  • Consideration needs to be given to whether term limits should be set for any member(s) of the committee. Term limits are not usually required on RPCs or CCs but they may be needed for some other types of committees. If term limits are imposed, the terms of reference should indicate whether terms can be renewed (e.g., individuals are appointed for a term of three years, which is renewable once). If a committee has term positions that can be renewed, it is important to clearly outline the requirements for renewal as well as the process for renewal.
  • In some cases, it may be appropriate to include a statement about whether guests may be invited to attend meetings. If this is the case, it would be prudent to specify the circumstances under which guests may attend.
  • In some circumstances, committees may explicitly note how they intend to seek and ensure diverse representation as part of their membership and composition.
• Decision-making process. If the committee has decision-making capability, it is essential to outline the specific process through which decisions will be made (e.g., through formal voting). With respect to voting, consideration needs to be given to whether voting will be open (e.g., show of hands) or confidential (e.g., electronic platform) and which individuals on the committee have the right to vote. The terms of reference should also indicate whether the chair will vote in all matters or will only be required to vote in the case of a tie. Ex officio members may or may not be given the right to vote — this is up to the committee to decide. Although decision making processes may seem self-explanatory, the way that discussion occurs and the process through which decisions are made are essential to optimal committee functioning. For example, many committees may strive for consensus-based decisions, yet be uncomfortable with dissent. However, program directors are advised to reframe dissent as something constructive and important to a committee’s functioning.
• Quorum. The terms of reference should define the number of individuals who must be present for the meeting to be called to order. If too few committee members are present, the committee will not be able to conduct its business because of a lack of adequate representation. Additionally, certain members of the committee may be required in order to meet quorum (for example, the meeting must have a resident representative in attendance).
• Attendance rule. If the committee is to carry out its duties effectively, it is important not only that meetings do not get cancelled but also that all members attend on a regular basis. Therefore, it is strongly suggested that the terms of reference include a statement indicating that it is expected that each member will attend a prespecified percentage of meetings annually (e.g., 75%) and that members who do not meet this target will be removed from the committee and replaced. A functional committee is a committee in which all members participate. A member who does not show up is not fulfilling their obligation to the rest of the committee and such circumstances should require further investigation and action. It is also important to note that there are equity considerations regarding what time meetings occur that may advantage or disadvantage some participants from being able to attend.
• Frequency, timing and duration of meetings. The terms of reference should clearly state how often meetings are to be held and any specific details about timing (e.g., second Monday of the month). Terms of reference generally do not specify the duration of meetings, as the amount of material to be covered in each meeting may vary.
• Frequency of review of terms of reference. It is considered best practice to specify how often all elements of the terms of reference for the committee, and any subcommittees, are to be reviewed. A good rule of thumb is to review these at least every two years. If a new committee has been set up, it is recommended to review its terms of reference after the first year.
• Statement regarding conflict of interest. There should be an explicit statement that directs any member with a real or perceived conflict of interest to declare this at the beginning of the meeting. It is then generally up to the chair of the committee or the committee as a whole to determine the nature of the conflict of interest, its impact on the committee’s functioning and the mechanism to deal with the conflict and to then clearly document this in the meeting minutes.
• Confidentiality statement. In general, the minutes of RPC meetings are not confidential and should be open to review by any resident in the program or any faculty member who teaches and assesses within the program (in fact, these minutes should be open to everyone). However, portions of the RPC meetings where resident performance are discussed as well as the proceedings of CC meetings must be kept strictly confidential, and members participating in any of these discussions should be reminded at the beginning of the discussion that they must keep all information confidential. These members should also sign a confidentiality agreement, which should be kept on file by the program.

Rules of order

If you have participated in more formal meetings, you may be familiar with Robert’s rules of order.³ Although these rules were originally devised to guide parliamentary procedure, they provide a very useful framework and etiquette for running any committee meeting. The rules ensure that everyone is heard and allow for decisions to be made without confusion. They provide guidance on how to set an agenda, including such items as a call to order, a roll call of members present, reading of the minutes of the last meeting, discussions of unfinished business and new business, and adjournment. Although some of the material included in Robert’s rules of order is not directly relevant to RPC and CC meetings, the rules do provide a framework for these meetings.

The rules also describe how committee members should express themselves in the form of moving motions. Members can bring forward a motion, second a motion, debate a motion and vote on a motion. Voting can be done by voice (those in favour and those against), by roll call (each individual member is called upon to answer yes or no), by general consent (when a motion is not likely to be opposed), by division (a variation of a voice vote where members either stand or raise their hands) or by ballot (if individual votes are to be kept confidential). Although the rules go into many more details, many relating more specifically to large meetings and to parliamentary procedure, they are worth reading, particularly if you expect to chair meetings where contentious issues will be brought up and discussed.

Ongoing committee review

A weakness of many committees is the lack of a regular review of the terms of reference and of the overall functioning of the committee. The committee chair should lead a detailed review of the terms of reference at least every two years. If a committee has been newly constituted, it is prudent to review the terms of reference after the first year.

The chair should also take responsibility for conducting regular check-ins with the committee members. Informally, the chair can periodically ask the committee members what aspects of the meetings they feel are going well and what aspects could be improved. A potential drawback of this approach is that committee members may be reluctant to be completely truthful. A useful alternative approach is to send committee members a survey asking for feedback on various aspects of how the committee processes are running. As with any form of assessment, narrative feedback is ideal, so any survey should allow for, and encourage, written narrative feedback on specific aspects of the committee.

Administrative support and communication

Proper administrative support is critical if committees are to function effectively. For most residency programs, this support comes from a program administrator who is well versed in residency training and residency accreditation.

The program administrator can schedule committee meetings, ensure that meetings have quorum by asking committee members to RSVP in advance of the meeting, draft the agenda, take attendance, ensure each meeting truly has quorum, take minutes, track action items, record motions and tally the results of votes. In addition, the administrator can support the chair in ensuring that the agenda is followed, that an appropriate (not excessive) amount of time is spent on each item and that the meeting starts and ends on time. The administrator can also provide advice on rules of order.

In cases in which a trained administrator is not available to attend a meeting, you will need to either assume some of the administrator’s roles or delegate them to other committee members, at the beginning of the meeting. In particular, it can be quite important to delegate a member to keep track of time to ensure that all items on the agenda get discussed and that the meeting finishes on time and to delegate someone to take minutes. Since it is critical that the chair remain engaged in running the meeting and in leading the discussion, it is important to have other members of the committee support the chair in watching the time and recording what is being discussed.

Common pitfalls and how to manage them

Even when committee members have the best of intentions, meetings can run into problems. Some of the more common issues are discussed below, with some advice on how to address them.

Members do not show up

There are few things more frustrating than showing up to chair a meeting and realizing that you don’t have quorum, which means that no firm decisions can be made. This situation ends up being somewhat disrespectful of members’ time, and doesn’t further the mission of the committee and program.  For this reason, it is critical to create an RSVP list several days before the meeting to ensure that the meeting will have the number of attendees required to make the meeting useful and productive. Although it is possible that last-minute unforeseen circumstances may prevent some members from attending, asking people to RSVP will minimize the risk of insufficient attendance at the meeting.

You may find that certain members of your committee attend infrequently. There can be a variety of reasons for their absences. Until you find out what these reasons are and address them, absenteeism will continue to be a problem. Your first course of action in such cases should be to meet with these committee members individually and ask them about their specific circumstances around meeting attendance. Once you know their specific circumstances, you may be in a position to help to address them. During this meeting, you could explore with them whether they feel they are able to fulfill a specific role and that emphasize that their attendance is important and valued to ensure proper functioning of the committee. If they feel that they cannot commit, you may need to discuss replacing them on the committee. To ensure that expectations around attendance are clear to all committee members, you may want to consider including an attendance rule in the committee’s terms of reference, as discussed above. You should also consider what time meetings are held and ensure that timing is decided upon in an inclusive way.

Members show up late

As chair, you need to set the example here: plan to arrive at each meeting a few minutes early. Stress to all members the importance of arriving promptly so that the meeting can not only start on time but also end on time. While it is acceptable to allow a few minutes for all members to arrive, you should begin the meeting no more than five minutes after the scheduled start time. If a member repeatedly arrives late, it would be important to discuss with them the expectations, and discuss their specific circumstances and see if there might be a workable solution.

Members are not prepared for meetings

Members need to be given adequate time to review materials before a meeting so that they come prepared. A good rule of thumb is to send meeting materials to committee members five to seven days in advance of the meeting.

Meetings consistently run overtime

Most committees are made up of volunteers who are dedicating their personal time to the service of the committee. It is therefore essential to respect their time by ensuring that meetings end on time. It is your role as chair to ensure that the rules of order are followed during the meeting and to allocate a specific amount of time to each topic to ensure that all topics get covered in adequate detail. If during a meeting it becomes clear that more time is required for a particular topic, you will want to decide if other agenda items can be deferred to a subsequent meeting, if the current topic needs to continue to be discussed at a subsequent meeting or if a special meeting needs to be convened to discuss the issue. Regardless of the decision that is made, every effort should be made to ensure that the meeting finishes at the predefined time.

People talk over one another, not waiting for their turn

It is not uncommon for individuals in a meeting to either talk over one another or to interject their comments before other members have had a chance to speak up. As chair it is your responsibility to role model and clearly set out the rules that are to be followed during the meeting and to ensure that these rules are adhered to. Members of the committee should be encouraged to raise their hands should they wish to speak. You or a delegate could recognize people who have raised their hands and give them the opportunity to speak on the basis of the order in which they raised their hands. In a respectful way, you should ensure that everyone who wants to speak gets the opportunity to do so.

There is no clear follow-up of tasks

Most committee meetings are conducted with the goal of getting things done. The task list may be extensive, and tasks are often assigned to either individuals or subcommittees. It is critical that the minutes be completed in a timely fashion and that they clearly indicate what tasks need to be completed and by whom. The tasks should appear on future committee meeting agendas to ensure that the necessary follow-up is done.

The meetings are boring and nothing gets accomplished

As chair, you have the opportunity to set the tone for the meeting. This is a chance to role model your enthusiasm as this will be reflected in the conduct of the meetings, and it is very likely that the committee members with feed off this positivity. The most effective committees are the ones where things get discussed and things happen. When a meeting’s sole purpose is to only deliver or share information, members become disengaged. Information can easily be shared through other forms of communication (e.g., newsletter, email), so unless information is of critical importance it is best to share it outside of committee meetings. Ideally, meetings should be goal oriented: people should leave feeling that something was accomplished and decisions were made. This is the most effective way to keep members engaged.

The chair does all of the work

A committee is made up of people who are working towards a common goal, and the opinions of all members are extremely valuable. Every member is a stakeholder in the committee’s outcomes and has a role to play in ensuring that committee work get done. As such, you should seek volunteers who are motivated and can carry out critical tasks. In a situation where a volunteer doesn’t come forward, you may consider delegating tasks to specific individuals on the committee.

Conclusion

If chairing and participating on committees is a newer responsibility for you, you can expect to find your first year of meetings to be full of learning opportunities. Your colleagues will be understanding and supportive, especially when you show that you’re willing to learn and grow in your role. The good news is that there are members of your committee(s), including your program administrators, who are experienced and willing to share their knowledge. Observe colleagues who set up, run and participate effectively in committee meetings and model their behaviours. Be aware of the typical pitfalls and watch how others avoid or mitigate the impacts. Confidence in your role as a member or chair of a committee comes with experience — being realistic about the learning curve will help you and others enjoy the experience.

References

1. General standards of accreditation for residency programs. Version 2.0. Ottawa: CanRAC; 2020.
2. General standards of accreditation for institutions with residency programs. Version 2.0. Ottawa: CanRAC; 2020.
3. Robert HM, Honemann DH, Balch TJ, Seabold DE, Gerber S. Robert’s rules of order. 12^th New York (NY): Hachette; 2020.