Doctors should have to regularly prove their skills by passing requalifying exams, the head of one of Canada's largest medical schools says.

In an editorial in Tuesday's Canadian Medical Association Journal, Dr. Wendy Levinson, chair of the University of Toronto's department of medicine, called for provincial colleges to require revalidation for all doctors.

"I just basically trust my doctor and hope she knows what she's talking about," said Maureen Ocampo, who lives in Halifax.

Currently, Saskatchewan, Ontario and Quebec require doctors to self report their participation in continuing medical courses.

Alberta and Nova Scotia go one step further, requiring doctors to participate in performance reviews from patients and peers, but even these also lack an external standard for passing, Levinson said.

"There's nothing external checking to see, well did the doctor actually learn something?" Levinson said, adding no one knows whether doctors take what they learn and incorporate it into their practice.

Levinson pointed to the cases of pathology errors in New Brunswick and Newfoundland and Labrador as evidence that the current scrutiny of doctors is insufficient.

In the editorial, Levinson said doctors should be required to take a rigorous written exam every decade, as doctors have to do in the U.S. The United Kingdom also has a more demanding revalidation than most Canadian provinces, the editorial said.

Exams require effort, says one doctor

"Both the practice improvement and the preparation for the [U.S.] examination required significantly more sweat equity than the Royal College's process," in Canada, Levinson said in comparing the process she went through on both sides of the border for internal medicine.

"I studied for four months and was worried that I would fail. I would never have made the effort if not faced with an examination."

But making busy doctors write exams isn't practical and wouldn't reflect true skills, said Dr. Howard Conter, a family doctor in Halifax.

"What we do every day is not really a book learning thing," said Conter, noting regulatory bodies are in place. "To say, in fact, that because you pass an exam makes you a good physician every 10 years is absolutely wrong."

Levinson said that errors such as those in Newfoundland and Labrador and New Brunswick occur and if doctors have not self-regulated enough then governments will step in to create regulations.

The Federation of Medical Regulatory Authorities of Canada, a national group representing medical regulators, is recommending a new validation process for doctors, but it's not clear what the process will look like or when it will be in place.