Graduation Competencies/ Program Learning Outcomes

The Doctor of Medicine (MD) Program renewed curriculum is a competency based model aligned with national standards and evolving processes of medical student learning.

The MD Program will support each student as an independent learner, achieving graduation stage for each of our new Program competencies.

The competency framework document was developed with a process of students, faculty and staff, drawing form the 2015 CanMEDS framework used in all Canadian medical education and approved by the Program Curriculum Committee.

1.0 Medical Expert

Medical Expert, the central physician competency integrating with all other competencies, represents the cornerstone of physician identity, defines scope of practice and encompasses the knowledge, skills, values and attitudes for a clinical decision maker providing high quality and safe patient-centered care. Medical Expert involves integration of the foundational sciences and other knowledge into patient and family centered care.

1. Practice medicine within the scope of generalism as an undifferentiated generalist physician.

1.1 Demonstrate commitment to quality patient care.
1.2 Apply knowledge from the clinical, biomedical and social/behavioral sciences in acute and chronic health challenges across the age spectrum.
1.3 Provide all care in the context of each patient’s determinants of health.
1.4 Perform safe, sensitive and timely clinical assessments with recommendations presented in an organized manner.
1.5 Deliver clinical responsibilities in the face of competing demands.
1.6 Recognize and respond appropriately to the complexity, uncertainty, and change in medicine.
1.7 Demonstrate an understanding of longitudinal care to patients and families in the management of their health challenges.

2. Perform a patient and family-centered clinical assessment, formulate a diagnosis, create and implement a management plan.

2.1 Identify and prioritize issues to be addressed in each encounter.
2.2 Elicit a relevant, concise history and perform a complete or focused accurate physical and/or mental health examination as appropriate to the patient context and clinical presentation.
2.3 Deliver a prioritized relevant differential diagnosis for each patient clinical presentation.
2.4 Select and interpret appropriate cost-effective interventions for the management, prevention and health promotion in patient care.
2.5 Establish goals of care in collaboration with other health professionals, patients and their families to optimize outcomes.
2.6 Develop an effective and appropriate patient-centered management plan.
2.7 Participate effectively in patient and family-centered care, valuing each patient’s and family’s unique needs.

3. Plan and perform procedures and therapies for the purpose of patient management.

3.1 Determine appropriate procedures or therapies for a patient’s care.
3.2 Participate in obtaining and documenting informed consent (including risks, benefits and rationale) for a proposed procedure or therapy.
3.3 Discuss and participate in prioritizing a procedure or therapy, considering clinical urgency and available resources.
3.4 Perform a designated procedure in a skillful and safe manner at the level of an undifferentiated physician, adapting to findings and changing clinical circumstances.
3.5 Demonstrate effective documentation of a procedure or therapy recommended or delivered to a patient.

4. Formulate and implement plans for ongoing patient care and when appropriate seek timely consultation.

4.1 Formulate and assist in implementing a comprehensive patient-centered care plan.
4.2 Perform timely follow-up on all inquiries, investigations, outcomes and suggest consultation or intervention where appropriate.

5. Actively contribute as a member of a team providing care, to the continuous improvement of health care quality and patient safety.

5.1 Recognize and respond to patient safety incidents arising in health care.
5.2 Understand the principles of and contribute to patient safety and quality improvement through human and system factors.
5.3 Participate in a disclosure of adverse events to patients, families, caregivers with other health professionals.


2.0 Communicator

Communicators form relationships with patients, families, communities, colleagues and members of interprofessional teams to facilitate gathering and sharing essential knowledge and create plans for effective care. Communicator involves all verbal and non-verbal actions in encounters. As Communicators, learners invoke a professional approach to all discussions using verbal and non-verbal skills, written text, and illustrations to convey information, including social and electronic media.

1. Develop and recognize the essential skills of a communicator.

1.1 Engage in patient-centred care that supports autonomy in decision-making and establishes trust while demonstrating empathy, respect and compassion.
1.2 Demonstrate effective verbal and non-verbal communication in all contexts of care.
1.3 Demonstrate effective communication to optimize care outcomes and minimize errors.
1.4 Effectively communicate respecting the diversity and background of patients, families, communities and colleagues.
1.5 Ensure an appropriate physical location for all discussions while understanding the context and supporting patient safety, comfort, dignity, privacy and diversity.
1.6 Deliver information to the patient and family in a humane manner that is clearly understood, encourages discussion and supports full participation in decision-making.
1.7 Demonstrate skills and methods in the disclosure of adverse outcomes in a timely and complete manner.

2. Develop a common understanding on issues, problems and plans with patients, families, colleagues and other professionals to develop a shared plan of care.

2.1 Develop rapport, trust and ethical relationships with patients, families, communities, colleagues and healthcare providers.
2.2 Enable patient-centered active communication in exploring patient symptoms and experience.
2.3 Understand the patient and family’s beliefs, values, gender, culture, knowledge, preferences and perspective on care.
2.4 Integrate social, economic, medical, family, life stage, demographic, work/school, and other relevant history factors in the clinical encounter.
2.5 Participate in shared decision-making through common ground for diverse patient and community values including, but not limited to gender, religion and cultural beliefs to address patient health goals.
2.6 Participate in obtaining informed patient consent.
2.7 Demonstrate an approach to managing physical, verbal and emotionally challenging scenarios.

3. Develop practices for documenting and sharing written and electronic information on the encounter to optimize clinical decision-making, patient safety, confidentiality and privacy.

3.1 Document clear, accurate and appropriate written and/or electronic records.
3.2 Effectively report clinical encounters and treatment plans to patients, families, and health professionals.
3.3 Demonstrate effective reporting of encounters and treatment during transitions of care.
3.4 Demonstrate professionalism in all communication.
3.5 Demonstrate privacy, data security and confidentiality in written, verbal, social media and electronic communication.


3.0 Collaborator

Collaborators work cohesively with health-care professionals, community partners, system leaders and stakeholders, colleagues, patients and families to develop, provide, promote, evaluate and improve on quality and efficient patient care. Collaborator is grounded in the team skills of mutual trust, respect, and sharing knowledge in decision-making while respecting diversity across the continuum of care. Through collaboration, physicians participate in effective shared decisions of medical care, education, administration, and scholarship. Collaboration extends as a life skill into the professional’s professional, personal and community life.

1. Work effectively and appropriately within an interprofessional health care team.

1.1 Demonstrate an understanding of the integrated responsibilities and skillsets of health care team members.
1.2 Demonstrate the ability to identify, develop, research and communicate new knowledge in care with the health care team.
1.3 Work effectively and respectfully with patients, families and health professionals to provide patient and family-centered care.
1.4 Participate in shared decision-making with patients, families, and other health professionals.
1.5 Demonstrate the verbal and written skills necessary to safely handover care to health care team members in all clinical contexts.

2. Contribute to a positive professional work and care environment.

2.1 Demonstrate respect for patients, families and all health professionals.
2.2 Demonstrate how to navigate interpersonal differences, misunderstandings, and limitations of dialogue to foster a positive collaborative professional culture.


4.0 Leader

As leaders, physicians engage with members of the health care team and other system partners in the creation, delivery, review and continuous improvement of patient care and system function. Leaders demonstrate actions through collaboration, communication, engagement, empowerment and continual improvement while balancing personal, clinical, scholarly and educational roles. Leaders frame all decisions in local, national and global contexts.

1. Contribute to the improvement of health care delivery in teams, organizations and systems.

1.1 Apply the science of quality improvement to improving patient safety and systems of care.
1.2 Analyze and address patient safety incidents to enhance care.
1.3 Utilize health informatics to improve the quality of care and optimize patient safety.
1.4 Demonstrate an understanding of the governance and financial operations of the Canadian healthcare system.

2. Demonstrate the ability to utilize resources for cost-effective health care.

2.1 Understand how care is impacted by healthcare resources.
2.2 Apply evidence-based processes to deliver cost-appropriate care across all patient care contexts.
2.3 Describe how public health and health policy shape the delivery of our healthcare system.

3. Demonstrate key elements of leadership in your role as an individual, professional, team contributor and a member of the community.

3.1 Apply the principles of change management to enhance healthcare outcomes.
3.2 Set priorities and manage time in professional responsibilities and personal life.
3.3 Implement processes to ensure personal and professional continuous improvement.
3.4 Participate in teams with other health professionals in respectful and effective decisionmaking.
3.5 Demonstrate an approach to managing professional and personal finances.


5.0 Health Advocate

Health advocacy is integral to advancing the health and well-being of patients and families, communities and populations. Advocates deliver on their social accountability mandate for improving local, national and global health care. Advocates focus attention on and communicate for and support effective change on behalf of, or with: patients and families, health care partners and system leaders and stakeholders.

1. Identify and respond in a socially accountable manner to the health care needs of patients and families by advocating for and with them in promoting healthy behavior and disease prevention.

1.1 Utilize determinants of health including environmental, social, behavioral and health system perspectives when improving access to care.
1.2 Work with patients and families to adopt healthy behaviours.
1.3 Demonstrate skills that advance health promotion and surveillance to positively influence the health of patients and their families.

2. Identify and respond in a socially accountable way to the health care needs of communities or populations served by advocating for system-level change that promotes healthy outcomes and disease prevention.

2.1 Engage with communities and/or populations to identify and address determinants of health including environmental, social, behavioral and system policies that impact their health.
2.2 Advance patient care by health promotion, disease prevention and health surveillance in the communities served.
2.3 Apply health knowledge to a quality improvement process that positively improves the health of the communities and populations served.


6.0 Scholar

Scholars demonstrate a lifelong commitment to excellence through lifelong learning, teaching and modelling, evaluating evidence in decision making, and contributing to expanding the science of medicine. In acting as a Scholar, students commit to the application, dissemination, translation, and creation of knowledge and practices applicable to advancing health care.

Learners acquire scholarly abilities by continually evaluating the processes and outcomes of their daily work and actively seeking feedback in the interest of quality improvement and patient safety. Scholars formulate questions to address knowledge gaps and arrive at decisions informed by evidence. Scholars identify pertinent evidence, evaluate it using criteria, and apply it in practice and scholarly activities while including patient values and preferences.

1. Engage in life-long learning.

1.1 Identify personal learning needs and create a plan of action.
1.2 Identify opportunities for learning and improvement by regularly assessing performance using internal and external data.
1.3 Engage in collaborative learning with colleagues and other health professionals.
1.4 Review outcomes using quality improvement processes to identify items for analysis.

2. Participate actively in the education of self and others.

2.1 Recognize and address role modelling and impact of the informal or hidden curriculum.
2.2 Promote a safe learning environment for all.
2.3 Plan and deliver personal, other professional and community lifelong learning activities.
2.4 Provide meaningful feedback for improvement to peers, mentors and programs.
2.5 Evaluate peers, teachers, and education programs using relevant tools and practices.

3. Integrate best available evidence into learning and decision-making.

3.1 Recognize personal and system knowledge gaps in patient care.
3.2 Generate focused questions that address gaps.
3.3 Critically evaluate the integrity, reliability and applicability of research literature.
3.4 Integrate evidence into clinical decision-making.
3.5 Formulate well-structured questions and consult scholarly resources in confronting a patient care problem.
3.6 Discuss selecting the most appropriate action in the absence of evidence.
3.7 Interpret qualitative and quantitative knowledge using standardized practices that address bias, validity, barriers, and relevance to care.
3.8 Apply new knowledge and evaluate the impact on patient care.

4. Contribute to the creation and dissemination of knowledge applicable to health care.

4.1 Demonstrate an understanding of the scientific principles of research and the role of evidence and research in health care.
4.2 Identify ethical principles for research and incorporate them into obtaining informed consent, while considering potential harms, benefits and needs of vulnerable populations.
4.3 Pose questions for inquiry, select methods to address them and share results.
4.4 Communicate findings of relevant research and scholarly research to peers, other health professionals, communities, patients and families.
4.5 Generate original scholarly work for dissemination to broad or specific communities.


7.0 Professional

As health professionals, students work to develop a professional identity acknowledging a commitment to the health and well-being of patients, families, society and their colleagues. Embracing ethical patient care, high personal standards, accountability to the profession, society and the educational program while maintaining personal health, students evolve as professionals. Professionals commit to competence through ongoing professional development, promotion of the public good, meeting the values of integrity, honesty, altruism, and humility, respecting diversity, and full transparency in any or all potential conflicts of interest.

1. Demonstrate a commitment to the needs of patients and families by applying integrity, honesty, altruism, respect, and best practices while adhering to high ethical standards.

1.1 Demonstrate appropriate professional behaviours and relationships in all patient care while respecting diversity, and maintaining confidentiality.
1.2 Demonstrate a commitment to excellence in all aspects of patient and family centred care
1.3 Recognize and develop an approach to ethical dilemmas as they present.
1.4 Recognize and manage all conflicts of interest.
1.5 Demonstrate professional behaviours in the use of technology-enabled communication.
1.6 Respect autonomy of individual patients regardless of age, sex, gender, ethnic origin or religious beliefs consistent with the Canadian Charter of Rights and Freedoms.

2. Demonstrate a commitment to society by applying integrity, honesty, altruism, and respect in recognizing and responding to community expectations in health care.

2.1 Demonstrate accountability to patients and families, society, the community you serve and our profession in responding to expectations.
2.2 Demonstrate commitment to patient safety and quality improvement.

3. Demonstrate a commitment to the profession by applying integrity, honesty, altruism, and respect in adhering to accepted standards.

3.1 Understand and adhere to the professional and ethical codes, expectations and requirements of our school, program and profession.
3.2 Recognize and respond to address any and all unprofessional and unethical behaviours in colleagues, teachers, mentors, patients and families, communities and other professionals.
3.3 Contribute regularly to meaningful peer assessment.

4. Demonstrate a commitment to personal health and well-being.

4.1 Exhibit self-awareness and address all influences on personal well-being and professional performance.
4.2 Promote a culture that recognizes, supports, and responds effectively to colleagues in need.
4.3 Develop and maintain sustainable personal heath, work and learning habits.
4.4 Demonstrate skill in reflective practice and individual improvement to seek excellence in performance.