Royal College clarifies CanMEDS framework renewal plans after backlash on equity-oriented proposals

As renewal efforts for the CanMEDS physician competency framework continue, the Royal College of Physicians and Surgeons has released a statement affirming medical expertise to be “an essential, fundamental defining competency for physicians.”The joint statement was released on Wednesday alongside the Association of Faculties of Medicine of Canada, Collège des médecins du Québec and the College of Family Physicians of Canada—the other organizations that are involved in the CanMEDS revision. The statement said the four organizations “encourage respectful and thought-provoking dialogue to support innovation and progress in the development of the physician competency framework.”Speaking on the sidelines of the International Conference on Residency Education in Ottawa, Dr. Glen Bandiera, executive director of standards and assessment at the Royal College, said the statement sought to “establish some clarity” on these issues.“It was important for us to start to reflect on the feedback that we've been hearing and the information we've been getting about the CanMEDS revision, and to establish some clarity around what we consider to be some emerging positions, or where the direction seems to be headed at the early stages, so that we can set aside unnecessary debate about those areas,” he told the Medical Post Thursday.CanMEDS is the framework that outlines the competencies that physicians are required to meet. Since 2021, work has been underway to update this framework to also include components of anti-racism, EDI (equity, diversity and inclusion), social justice and planetary health, among other concepts. But last year, an October 2023 report for the CanMEDS project drew significant backlash among doctors and media commentators. In particular, the report suggested “de-centering medical expertise,” and said values such as anti-racism, anti-oppression, social justice or decolonization could be at the centre of the new model.Read: Dr. Gary Bloch: Resisting the backlash against equity in medicine will improve health outcomes for allThe statement released on Wednesday also emphasized medical expertise would have a “continuing foundational role” in the CanMEDS framework, and that medical expertise “must include the recognition of health disparities and their causes.”“Interventions to address social determinants of health, including the pursuit of evidence to further eliminate health disparities, are critical features of contemporary medical expertise,” the statement also says.Dr. Bandiera noted further that the October 2023 report that discussed “de-centering medical expertise” in favour of social justice arose from a working group “that was tasked to comment on that very specific issue.”“We we've incorporated the thought leadership of that group as well as the feedback that we've gotten in response to that . . . and feel a need to reestablish that the bulk of the information we're getting is very much supportive of keeping medical expert as the foundation upon which physicians then build a competency skill set to serve society,” he said.Dr. Bandiera says the expert working groups are expected to finish their work by the end of December, with a first draft ready by “early-to-late spring.” The Royal College is aiming to have a finalized draft of the framework by early 2026 and launch the full framework later that year.

Royal College clarifies CanMEDS framework renewal plans after backlash on equity-oriented proposals

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