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 a physician’s identity.
1. Practice medicine within the scope of generalism with the expertise of an undifferentiated generalist physician.
1.1.1 Demonstrate a commitment to high-quality patient care.
1.1.2 Apply knowledge from the clinical, biomedical and social/behavioral sciences to accurately interpret symptoms and signs of common acute and chronic health challenges across the age spectrum.
1.1.3 Provide all care in the context of each patient’s determinants of health.
1.1.4 Perform safe, sensitive and timely clinical assessments with recommendations presented in an organized manner.
1.1.5 Deliver clinical responsibilities in the face of multiple competing demands.
1.1.6 Recognize and respond appropriately to the complexity, uncertainty, and change inherent in medicine.
1.1.7 Demonstrate an understanding of and involvement in delivering longitudinal care to patients and families in the management of chronic health challenges.
2. Perform a patient and family-centered clinical assessment, formulate a diagnosis, create and implement a management plan.
1.2.1 Identify and prioritize issues to be addressed in each patient encounter.
1.2.2 Elicit a relevant, concise history, perform a complete or focused accurate physical and/or mental health examination as appropriate to the patient context and adapted to the clinical presentation.
1.2.3 Deliver a prioritized relevant differential diagnosis for a patient clinical presentation by applying evidence based problem solving and clinical judgment skills.
1.2.4 Select and interpret appropriate cost-effective interventions for the purpose of management, prevention and health promotion in patient care.
1.2.5 Establish goals of care in collaboration with other health professionals, patients and their families to optimize outcomes.
1.2.6 Develop an effective and appropriate patient-centered management plan.
1.2.7 Participate in patient and family-centered care by valuing each patient’s and family’s unique needs.
3. Plan and perform procedures and therapies for the purpose of patient management.
1.3.1 Determine the most appropriate procedures or therapies for a patient’s care.
1.3.2 Participate in obtaining and documenting informed consent, including the risks, benefits and rationale for a proposed procedure or therapy.
1.3.3 Discuss and participate in how to prioritize a procedure or therapy, taking into account clinical urgency and available resources.
1.3.4 Perform a designated procedure in a skillful and safe manner at the level of an undifferentiated physician, adapting to unanticipated findings or changing clinical circumstances.
1.3.5 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 recognize and seek timely consultation.
1.4.1 Formulate and assist in implementing a comprehensive patient-centered care plan.
1.4.2 Perform timely follow-up on all inquiries, investigations, response to treatment and suggest further 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.
1.5.1 Recognize and respond to patient safety incidents arising from health care delivery.
1.5.2 Understand the principles of and contribute to patient safety and quality improvement while addressing human and system factors.
1.5.3 Participate in a disclosure of medical adverse events to patients, families, caregivers with other professionals.
As Communicators, learners form relationships with patients, families, communities, colleagues and members of interprofessional teams to facilitate gathering and sharing essential knowledge and creating plans for effective health care. Communicator involves all verbal and non-verbal actions in encounters. As Communicators, learners invoke a professional approach to discussions using verbal and non-verbal skills, written text, and illustrations in all facets of conveying information, including social and the electronic media within all relationships.
1. Develop and recognize the essential skills as a communicator.
2.1.1 Engage in a patient-centred approach to care that supports autonomy in decision making and establishes trust while demonstrating empathy, respect and compassion.
2.1.2 Demonstrate effective verbal and non-verbal communication skills in all contexts of care.
2.1.3 Effectively communicate while respecting the diversity and background of patients, families, communities and colleagues.
2.1.4 Ensure an appropriate physical location for all discussions while understanding the context and supporting patient safety, comfort, dignity, privacy and diversity.
2.1.5 Deliver information to the patient and family in a humane manner that is clearly understood, encourages discussion and supports full participation in decision-making.
2.1.6 Demonstrate skills to optimize patient decisions and minimize error.
2.1.7 Demonstrate appropriate 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 in an encounter to develop a shared plan of care.
2.2.1 Develop rapport, trust and ethical relationships with patients, families, communities, colleagues and healthcare team caregivers.
2.2.2 Enable patient-centered communication in exploring the patient’s symptoms and illness experience through active listening.
2.2.3 Understand the patient and family’s beliefs, values, gender, religion, culture, emotions, knowledge, preferences and perspective on their expectations for care.
2.2.4 Integrate socio-economic, medical, family, life stage, demographic, work/school, and other relevant personal and social history factors in the clinical encounter.
2.2.5 Participate in shared decision-making through finding common ground for diverse patient and community values when developing plans to address patient health goals.
2.2.6 Participate in obtaining informed consent.
2.2.7 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.
2.3.1 Document clear, accurate and appropriate written and electronic records.
2.3.2 Effectively present verbal reporting of clinical encounters and treatment plans to patients, families, colleagues and other health professionals.
2.3.3 Demonstrate effective reporting of encounters and treatment during transitions of care.
2.3.4 Demonstrate and maintain professionalism in all communication.
2.3.5 Discuss privacy, data security and confidentiality in written, social media, verbal and all electronic communication.
Collaborators work cohesively with health-care professionals, community partners, system leaders and stakeholders, physicians, patients and families to develop, provide, promote, evaluate and improve 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 lead and participate in effective shared decisions of medical care education, administration, and scholarship. Collaboration is integral to the success of all competencies and 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.
3.1.1 Demonstrate an understanding of the integrated responsibilities and skillsets of all health care team members.
3.1.2 Demonstrate the ability to identify, develop, research and communicate new knowledge in patient care with members of the health care team.
3.1.3 Work effectively and respectfully with patients, families and health professional partners to assess, plan and provide patient and family-centered care.
3.1.4 Participate in shared decision-making with patients, families, and other health care professionals.
3.1.5 Demonstrate the verbal and written skills necessary to safely handover care to all health care team members in all clinical contexts.
2. Contribute to a positive professional work and care environment.
3.2.1 Demonstrate respect for patients, families and all collaborative partners.
3.2.2 Demonstrate how to navigate interpersonal differences, misunderstandings, and limitations of dialogue to foster a positive collaborative professional culture.
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 their actions through collaboration, communication, engagement, empowerment and continual improvement while balancing their 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.
4.1.1 Discuss the science of quality improvement as applied to improving systems of care.
4.1.2 Contribute to the promotion of patient safety through quality improvement.
4.1.3 Demonstrate the ability to analyze and address patient safety incidents to enhance care.
4.1.4 Utilize health informatics to improve the quality of care and optimize patient safety.
4.1.5 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.
4.2.1 Understand how optimal patient care is impacted by healthcare resources.
4.2.2 Apply evidence-based processes to deliver cost-appropriate care across all patient care contexts.
4.2.3 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.
4.3.1 Apply the principles of change management to enhance healthcare outcomes.
4.3.2 Set priorities and manage time to integrate professional responsibilities and your personal life.
4.3.3 Implement processes to ensure personal and professional continuous improvement.
4.3.4 Participate effectively in respectful and effective decision making as a member of interprofessional healthcare teams.
4.3.5 Demonstrate an approach to managing professional and personal finances.
Health advocacy is integral to physicians advancing the health and well-being of patients and their families, communities and the populations they serve. As advocates, students deliver on our social accountability mandate for improving local, national and global health care. Students learn to focus attention on and speak out on behalf of, or with: patients and families, health care partners and system leaders and stakeholders. As advocates, students work to support effective change to advance patient care and system performance using all forms of communication.
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.
5.1.1 Utilize a determinants of health approach including environmental, social, behavioral and health system perspectives when working to improve access to care.
5.1.2 Work with patients and their families to adopt healthy behaviours.
5.1.3 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 by advocating for system-level change that promotes healthy behavior and disease prevention.
5.2.1 Actively engage with communities or populations to identify and address determinants of health including environmental, social, behavioral and system policies that impact their health.
5.2.2 Advance patient care by health promotion, disease prevention and health surveillance in the needs of communities they serve.
5.2.3 Apply health knowledge to a quality improvement process that positively improves the health of our communities and populations.
As Scholars, learners demonstrate a lifelong commitment to excellence in practice through lifelong learning, teaching and modelling others, evaluating evidence in decision making, and contributing to 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 while comparing their work with that of others, and actively seek feedback in the interest of quality improvement and patient safety. Recognizing uncertainty in patient care, and formulating questions to address knowledge gaps, scholars arrive at clinical decisions informed by evidence. Scholars identify pertinent evidence, evaluate it using specific criteria, and apply it in practice and scholarly activities while including patient values and preferences.
1. Engage in life-long learning.
6.1.1 Identify personal learning needs and create a plan of action.
6.1.2 Identify opportunities for learning and improvement by regularly assessing their performance using various internal and external data sources.
6.1.3 Engage in collaborative learning with colleagues and other health professionals.
6.1.4 Review outcomes using quality improvement processes to identify items for review or further analysis.
2. Participate actively in the education of self and others.
6.2.1 Recognize and address the power of role modelling and impact of the formal, informal and hidden curriculum.
6.2.2 Promote a safe learning environment for all.
6.2.3 Plan and deliver personal and other professionals or community lifelong learning activities.
6.2.4 Provide meaningful feedback for improvement to peers, mentors and programs.
6.2.5 Assess and evaluate peers, teachers, and education programs using relevant tools and practices.
3. Integrate best available evidence into learning and decision-making.
6.3.1 Recognize personal and system uncertainty and knowledge gaps in patient care.
6.3.2 Generate focused questions that address gaps.
6.3.3 Critically evaluate the integrity, reliability and applicability of health-related research and literature.
6.3.4 Integrate evidence into clinical decision-making.
6.3.5 Formulate well-structured questions and consult scholarly resources in confronting a patient care problem.
6.3.6 Discuss methods of action to select the most appropriate action in the absence of evidence.
6.3.7 Interpret qualitative and quantitative knowledge using standardizes practices that address bias, validity, barriers, and relevance to care.
6.3.8 Apply new knowledge and evaluate the impact on patient care.
4. Contribute to creation and dissemination of knowledge applicable to health care.
6.4.1 Demonstrate an understanding of the scientific principles of research and the role of evidence and research in health care.
6.4.2 Identify ethical principles for research and incorporate them into obtaining informed consent, considering potential harms and benefits and considering vulnerable populations.
6.4.3 Pose questions for scholarly inquiry, select methods to address them and share results.
6.4.4 Communicate findings of relevant research and scholarly research to peers, other health professionals, communities, patients and families.
6.4.5 Generate original and shared scholarly work for dissemination to broad or specific communities.
As health professionals, students work throughout their studies to develop a professional identity shaped by traditional and evolving forces, acknowledging they have a responsibility of commitment to the health and well-being of patients, families, society, themselves and their colleagues. While embracing ethical involvement in patient care, high personal standards of behavior, accountability to the profession and society, adherence to the professional and ethical standards of the educational program and maintenance of personal health, students evolve as professionals. As Professionals, students 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.
7.1.1 Demonstrate appropriate professional behaviours and relationships in all aspects of patient care while respecting diversity, and maintaining confidentiality.
7.1.2 Demonstrate a commitment to excellence in all aspects of patient and family centred care.
7.1.3 Recognize and develop an approach to ethical dilemmas as they present.
7.1.4 Recognize and manage all conflicts of interest.
7.1.5 Demonstrate professional behaviours in the use of technology-enabled communication.
7.1.6 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.
7.2.1 Demonstrate accountability to patients and families, society, the community you serve and our profession in responding to expectations of physicians.
7.2.2 Demonstrate a regular 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.
7.3.1 Understand and adhere to the professional and ethical codes, expectations and requirements of our school, program and profession.
7.3.2 Recognize and respond to address any and all unprofessional and unethical behaviours in colleagues, teachers, mentors, patients and families, communities and other health care professionals.
7.3.3 Contribute regularly to meaningful peer assessment.
4. Demonstrate a commitment to personal health and well-being.
7.4.1 Exhibit self-awareness and address all influences on personal well-being and professional performance.
7.4.2 Promote a culture that recognizes, supports, and responds effectively to colleagues in need.
7.4.3 Develop and maintain sustainable personal heath, work and learning habits.
7.4.4 Demonstrate skill in reflective practice and individual improvement to seek excellence in personal performance.