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Family physician
competencies in
different organization
Dr.Basma Mohamed Abd El Aziz
2017
objectives
 Can MEDS-Family Medicine(Can MEDS-
FM) Competencies
Can MEDS-Family Medicine(Can
MEDS-FM) Competencies
 2009  2005
Components ofthe Family
Medicine Expert Role
 Integrate all the CanMEDS-FM roles in order to function
effectively as generalists
 Establish and maintain clinical knowledge, skills and attitudes
required to meet the needs of the practice and patient
populationserved
 Demonstrate proficient assessment and management of
patients using the patient-centred clinical method
 Provide comprehensive and continuing care throughout the life
cycle incorporating appropriate preventive, diagnostic and
Therapeutic interventions
 Demonstrate proficient and evidence-based use of procedural
skills
 Provide coordination of patient care including collaboration and
consultation with other health professionals and caregivers
Communicator
 Develop rapport, trust and ethical therapeutic relationships with
patients and families
 Accurately elicit and synthesize information from, and
perspectives of, patients and families, colleaguesand other
professionals
 Accurately express needed information and explanations to
patients and families, colleagues and other professionals
 Develop a common understanding on issues , problems and
plans with Patients and families, colleagues and other
professionals to develop, provide and follow-up on a shared
plan of care
 transmit effective oral and written information
Collaborator
 Participate in a collaborative team-based model
and with consulting health professionals in the
care of patients
 Maintain a positive working environment with
consulting health professionals, health care team
members, and community agencies
 Engage patients or specific groups of patients and
their families as active participants in their care
Manager
 Participate in activities that contribute to the
effectiveness of their own practice ,healthcare
organizations and systems
 Manage their practice and career effectively
 Allocate finite healthcare resources Appropriately
 Serve in administration and leadership roles, as
appropriate
Health Advocate
 Respond to individual patient health needs and
issues as part of patient care
 Respond to the health needs of the communities
that they serve
 Identify the determinants of health within their
communities Promote the health of individual
patients, communities and populations
Scholar
 Maintain and enhance professional activities through Ongoing
self-directed learning based on reflective practice
 Critically evaluate medical information, its sources, and its
relevance to their practice, and apply this information to
practice decisions
 Facilitate the education of patients, families, trainees ,other
health professional colleagues, and the public ,as appropriate
 Contributeto the creation, dissemination, application, and
translation of new knowledge and practices
Professional
 Demonstrate a commitment to their patients,
profession, and society through ethical practice
 Demonstrate a commitment to their patients,
profession, and society through participation in
profession-led regulation
 Demonstrate a commitment to physician health and
Sustainable practice
 Demonstrate a commitment to reflective practice
The Accreditation Council for
Graduate Medical Education
ACGME Family Medicine
Competencies 2015
 Established in 1972. Responsible for
accrediting the majority of
graduate medical training programs (i.e.,
internships, residencies, and fellowships,
a.k.a. subspecialty residencies) for
physicians in the United.
 Patient care
 Medical Knowledge (MK)
 Systems-Based Practice (SBP)
 Practice-Based Learning and Improvement
(PBLI)
 Professionalism (PROF)
 Interpersonal and Communication Skills (C)
Patient Care
 Cares for Acutely Ill or Injured Patients in Urgent and Emergent
Situations and in All Settings
 Cares for Patients With Chronic Conditions
 Partners with the Patient, Family, and Community to Improve
Health through Disease Prevention and Health Promotion
 Partners with the Patient to Address Issues of Ongoing Signs,
Symptoms, or Health Concerns That Remain Over Time Without
Clear Diagnosis Despite Evaluation and Treatment, in a Patient-
Centered, Cost-Effective Manner.
 Performs Specialty-Appropriate Procedures to Meet the Health
Care Needs of Individual Patients, Families, and Communities,
and Is Knowledgeable About Procedures Performed by Other
Specialists to Guide Their Patients' Care
Medical Knowledge (MK)
 Demonstrates MK of Sufficient Breadth and
Depth to Practice Family Medicine
 Applies Critical Thinking Skills in Patient Care
Systems-Based Practice (SBP)
 Provides Cost-Conscious Medical Care
 Emphasizes Patient Safety
 Is an Advocate for Individual and Community
Health
 Coordinates Team-Based Care
Practice-Based Learning and
Improvement (PBLI)
 Locates, Appraises, Evidence From Scientific
Studies Related to the Patients' Health
Problems
 Demonstrates Self-Directed Learning
 Improves Systems in Which the Physician
Provides Care
Professionalism (PROF)
 Completes the Process of Professionalism
 Demonstrates Professional Conduct and
Accountability
 Demonstrates Humanism and Cultural
Proficiency
 Maintains Emotional, Physical, and Mental
Health, and Pursues Continual Personal and
Professional Growth
Interpersonal and
Communication Skills (C)
 Develops Meaningful, Therapeutic
Relationships With Patients and Families
 Communicates Effectively With Patients,
Families, and the Public
 Develops Relationships and Effectively
Communicates With Physicians, Other Health
Professionals, and Health Care Teams
 Uses Technology to Optimize
Communication
Saudi Arabia competence
 A national competence framework has been
developed by medical schools in the Kingdom of
Saudi Arabia. The framework has seven domains .
The framework will guide curriculum development
and assessment in the Kingdom and ensure that
medical education adapts to changing needs. The
creation of a national framework promises the
delivery of equivalent standards between medical
schools while at the same time guaranteeing the
schools' autonomy
 approach to daily Practice,
 Dr and patient,
 Dr and community,
 communication skills,
 professionalism,
 Dr and information technology,
 Dr and research.
 We recently adopted a competency based
curriculum based on the CanMEDs model.
We propose that our framework can be a
model for other universities in Saudi Arabia to
consider when shifting to a competency
based curriculum
WONCA
 is a the first five initials of the
World Organization of National
Colleges, Academies and
Academic Associations of
General Practitioners/Family
Physicians. WONCA's short
name is (World Organization
of Family Doctors.)
 WONCA was founded in 1972
and now has over 130 Member
Organisations representing
some 600,000 family doctors
in some 150 countries
 2002
 These new definitions and the statement of core competencies
are published in order to inform and to contribute to the debate
on the essential role of family medicine within health systems, at
both national and pan –European level
 2005
 has maintained all the elements of the previous definition.,
Nevertheless, there was a feeling that more work should be done
in order to improve its clarity, so that it would be more easily
understandable. This is the reason why the definition was revised
and a new version created
2011
 At the meeting of 2010 minor revision of the European Definition
of General Practice has been done in order to include two new
concepts:
 Patient Empowerment and Continuous Quality Improvement.
Promotes patient empowerment” has been included .
 Concerning Continuous quality improvement there isn’t a new
bullet in the first definition, because it is not a core characteristic
of general practice but of all the disciplines..
Primary Care Management
 to manage primary contact with patients, dealing
with unselected problems;
 to cover the full range of health conditions;
 to co-ordinate care with other professionals in
primary care and with other specialists;
 to master effective and appropriate care provision
and health service utilisation;
 to make available to the patient the appropriate
services within the health care system;
 to act as advocate for the patient
 to continuously monitor, asses and improve quality
and safety of care.
Person-centred Care
 to adopt a person-centred approach in dealing with
patients and problems in the context of patient’s
circumstances;
 to develop and apply the general practice
consultation to bring about an effective doctor-
patient relationship, with respect for the patient’s
autonomy;
 to communicate, set priorities and act in partnership;
 to promote the goals of patient empowerment;
 to provide longitudinal continuity of care as
determined by the needs of the patient, referring to
continuing and co-ordinated care management.
Specific Problem Solving Skills
 to relate specific decision making processes to the prevalence
and incidence of illness in the community;
 to selectively gather and interpret information from history-taking,
physical examination,
 and investigations and apply it to an appropriate management
plan in collaboration with the patient;
 to adopt appropriate working principles. e.g. incremental
investigation, using time as a tool and to tolerate uncertainty;
 to intervene urgently when necessary;
 to manage conditions which may present early and in an
undifferentiated way;
 to make effective and efficient use of diagnostic and therapeutic
interventions.
Comprehensive Approach
 to manage simultaneously multiple
complaints and pathologies, both acute and
chronic health problems in the individual;
 to promote health and well being by applying
health promotion and disease prevention
strategies appropriately;
 to manage and co-ordinate health promotion,
prevention, cure, care and palliation and
rehabilitation.
Community Orientation
 to reconcile the health needs of individual
patients and the health needs of the
community in which they live in balance with
available resources
Holistic Approach
 to use a bio-psycho-social model taking into
account cultural and existential dimensions
Contextual Aspects
 (Understanding the context of doctors themselves and the
environment in which they work, including their working
conditions, community, culture, financial and regulatory
frameworks)
 Having an understanding of the impact of the local community,
including socio-economic factors, geography and culture, on the
workplace and patient care.
 Being aware of the impact of overall workload on the care given
to the individual patient, and the facilities (eg staff, equipment)
available to deliver that care.
 Having an understanding of the financial and legal frameworks in
which health care is given at practice level
 Having an understanding of the impact of the doctor’s personal
housing and working environment on the care that s/he provides
Attitudinal Aspects
 (Based on the doctor's professional capabilities, values, feelings
and ethics)
 Being aware of one's own capabilities and values - identifying
ethical aspects of clinical practice (prevention/diagnostics/
therapy/factors influencing lifestyles);
 Having an awareness of self: an understanding that one’s own
attitudes, and feelings are important determinants of how one
practises
 Justifying and clarifying personal ethics;
 Being aware of the mutual interaction of work andprivate life and
striving for a good balance between them.
Scientific Aspects
 (Adopting a critical and research based approach topractice and
maintaining this through continuing learning and quality
improvement)
 Being familiar with the general principles, methods, concepts of
scientific research, and the fundamentals of statistics (incidence,
prevalence, predicted value etc.);
 Having a thorough knowledge of the scientific backgrounds of
pathology, symptoms and diagnosis, therapy and prognosis,
epidemiology, decision theory, theories of the forming of
hypotheses and problem-solving, preventive health care;
 Being able to access, read and assess medical literature
critically;
 Developing and maintaining continuing learning and quality
improvement.

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Family physician competencies in different organization

  • 1. Family physician competencies in different organization Dr.Basma Mohamed Abd El Aziz 2017
  • 2. objectives  Can MEDS-Family Medicine(Can MEDS- FM) Competencies
  • 3. Can MEDS-Family Medicine(Can MEDS-FM) Competencies  2009  2005
  • 4.
  • 5.
  • 6. Components ofthe Family Medicine Expert Role  Integrate all the CanMEDS-FM roles in order to function effectively as generalists  Establish and maintain clinical knowledge, skills and attitudes required to meet the needs of the practice and patient populationserved  Demonstrate proficient assessment and management of patients using the patient-centred clinical method  Provide comprehensive and continuing care throughout the life cycle incorporating appropriate preventive, diagnostic and Therapeutic interventions  Demonstrate proficient and evidence-based use of procedural skills  Provide coordination of patient care including collaboration and consultation with other health professionals and caregivers
  • 7. Communicator  Develop rapport, trust and ethical therapeutic relationships with patients and families  Accurately elicit and synthesize information from, and perspectives of, patients and families, colleaguesand other professionals  Accurately express needed information and explanations to patients and families, colleagues and other professionals  Develop a common understanding on issues , problems and plans with Patients and families, colleagues and other professionals to develop, provide and follow-up on a shared plan of care  transmit effective oral and written information
  • 8. Collaborator  Participate in a collaborative team-based model and with consulting health professionals in the care of patients  Maintain a positive working environment with consulting health professionals, health care team members, and community agencies  Engage patients or specific groups of patients and their families as active participants in their care
  • 9. Manager  Participate in activities that contribute to the effectiveness of their own practice ,healthcare organizations and systems  Manage their practice and career effectively  Allocate finite healthcare resources Appropriately  Serve in administration and leadership roles, as appropriate
  • 10. Health Advocate  Respond to individual patient health needs and issues as part of patient care  Respond to the health needs of the communities that they serve  Identify the determinants of health within their communities Promote the health of individual patients, communities and populations
  • 11. Scholar  Maintain and enhance professional activities through Ongoing self-directed learning based on reflective practice  Critically evaluate medical information, its sources, and its relevance to their practice, and apply this information to practice decisions  Facilitate the education of patients, families, trainees ,other health professional colleagues, and the public ,as appropriate  Contributeto the creation, dissemination, application, and translation of new knowledge and practices
  • 12. Professional  Demonstrate a commitment to their patients, profession, and society through ethical practice  Demonstrate a commitment to their patients, profession, and society through participation in profession-led regulation  Demonstrate a commitment to physician health and Sustainable practice  Demonstrate a commitment to reflective practice
  • 13. The Accreditation Council for Graduate Medical Education ACGME Family Medicine Competencies 2015
  • 14.  Established in 1972. Responsible for accrediting the majority of graduate medical training programs (i.e., internships, residencies, and fellowships, a.k.a. subspecialty residencies) for physicians in the United.
  • 15.  Patient care  Medical Knowledge (MK)  Systems-Based Practice (SBP)  Practice-Based Learning and Improvement (PBLI)  Professionalism (PROF)  Interpersonal and Communication Skills (C)
  • 16. Patient Care  Cares for Acutely Ill or Injured Patients in Urgent and Emergent Situations and in All Settings  Cares for Patients With Chronic Conditions  Partners with the Patient, Family, and Community to Improve Health through Disease Prevention and Health Promotion  Partners with the Patient to Address Issues of Ongoing Signs, Symptoms, or Health Concerns That Remain Over Time Without Clear Diagnosis Despite Evaluation and Treatment, in a Patient- Centered, Cost-Effective Manner.  Performs Specialty-Appropriate Procedures to Meet the Health Care Needs of Individual Patients, Families, and Communities, and Is Knowledgeable About Procedures Performed by Other Specialists to Guide Their Patients' Care
  • 17. Medical Knowledge (MK)  Demonstrates MK of Sufficient Breadth and Depth to Practice Family Medicine  Applies Critical Thinking Skills in Patient Care
  • 18. Systems-Based Practice (SBP)  Provides Cost-Conscious Medical Care  Emphasizes Patient Safety  Is an Advocate for Individual and Community Health  Coordinates Team-Based Care
  • 19. Practice-Based Learning and Improvement (PBLI)  Locates, Appraises, Evidence From Scientific Studies Related to the Patients' Health Problems  Demonstrates Self-Directed Learning  Improves Systems in Which the Physician Provides Care
  • 20. Professionalism (PROF)  Completes the Process of Professionalism  Demonstrates Professional Conduct and Accountability  Demonstrates Humanism and Cultural Proficiency  Maintains Emotional, Physical, and Mental Health, and Pursues Continual Personal and Professional Growth
  • 21. Interpersonal and Communication Skills (C)  Develops Meaningful, Therapeutic Relationships With Patients and Families  Communicates Effectively With Patients, Families, and the Public  Develops Relationships and Effectively Communicates With Physicians, Other Health Professionals, and Health Care Teams  Uses Technology to Optimize Communication
  • 23.  A national competence framework has been developed by medical schools in the Kingdom of Saudi Arabia. The framework has seven domains . The framework will guide curriculum development and assessment in the Kingdom and ensure that medical education adapts to changing needs. The creation of a national framework promises the delivery of equivalent standards between medical schools while at the same time guaranteeing the schools' autonomy
  • 24.
  • 25.  approach to daily Practice,  Dr and patient,  Dr and community,  communication skills,  professionalism,  Dr and information technology,  Dr and research.
  • 26.  We recently adopted a competency based curriculum based on the CanMEDs model. We propose that our framework can be a model for other universities in Saudi Arabia to consider when shifting to a competency based curriculum
  • 27.
  • 28. WONCA  is a the first five initials of the World Organization of National Colleges, Academies and Academic Associations of General Practitioners/Family Physicians. WONCA's short name is (World Organization of Family Doctors.)  WONCA was founded in 1972 and now has over 130 Member Organisations representing some 600,000 family doctors in some 150 countries
  • 29.  2002  These new definitions and the statement of core competencies are published in order to inform and to contribute to the debate on the essential role of family medicine within health systems, at both national and pan –European level  2005  has maintained all the elements of the previous definition., Nevertheless, there was a feeling that more work should be done in order to improve its clarity, so that it would be more easily understandable. This is the reason why the definition was revised and a new version created
  • 30. 2011  At the meeting of 2010 minor revision of the European Definition of General Practice has been done in order to include two new concepts:  Patient Empowerment and Continuous Quality Improvement. Promotes patient empowerment” has been included .  Concerning Continuous quality improvement there isn’t a new bullet in the first definition, because it is not a core characteristic of general practice but of all the disciplines..
  • 31.
  • 32. Primary Care Management  to manage primary contact with patients, dealing with unselected problems;  to cover the full range of health conditions;  to co-ordinate care with other professionals in primary care and with other specialists;  to master effective and appropriate care provision and health service utilisation;  to make available to the patient the appropriate services within the health care system;  to act as advocate for the patient  to continuously monitor, asses and improve quality and safety of care.
  • 33. Person-centred Care  to adopt a person-centred approach in dealing with patients and problems in the context of patient’s circumstances;  to develop and apply the general practice consultation to bring about an effective doctor- patient relationship, with respect for the patient’s autonomy;  to communicate, set priorities and act in partnership;  to promote the goals of patient empowerment;  to provide longitudinal continuity of care as determined by the needs of the patient, referring to continuing and co-ordinated care management.
  • 34. Specific Problem Solving Skills  to relate specific decision making processes to the prevalence and incidence of illness in the community;  to selectively gather and interpret information from history-taking, physical examination,  and investigations and apply it to an appropriate management plan in collaboration with the patient;  to adopt appropriate working principles. e.g. incremental investigation, using time as a tool and to tolerate uncertainty;  to intervene urgently when necessary;  to manage conditions which may present early and in an undifferentiated way;  to make effective and efficient use of diagnostic and therapeutic interventions.
  • 35. Comprehensive Approach  to manage simultaneously multiple complaints and pathologies, both acute and chronic health problems in the individual;  to promote health and well being by applying health promotion and disease prevention strategies appropriately;  to manage and co-ordinate health promotion, prevention, cure, care and palliation and rehabilitation.
  • 36. Community Orientation  to reconcile the health needs of individual patients and the health needs of the community in which they live in balance with available resources
  • 37. Holistic Approach  to use a bio-psycho-social model taking into account cultural and existential dimensions
  • 38. Contextual Aspects  (Understanding the context of doctors themselves and the environment in which they work, including their working conditions, community, culture, financial and regulatory frameworks)  Having an understanding of the impact of the local community, including socio-economic factors, geography and culture, on the workplace and patient care.  Being aware of the impact of overall workload on the care given to the individual patient, and the facilities (eg staff, equipment) available to deliver that care.  Having an understanding of the financial and legal frameworks in which health care is given at practice level  Having an understanding of the impact of the doctor’s personal housing and working environment on the care that s/he provides
  • 39. Attitudinal Aspects  (Based on the doctor's professional capabilities, values, feelings and ethics)  Being aware of one's own capabilities and values - identifying ethical aspects of clinical practice (prevention/diagnostics/ therapy/factors influencing lifestyles);  Having an awareness of self: an understanding that one’s own attitudes, and feelings are important determinants of how one practises  Justifying and clarifying personal ethics;  Being aware of the mutual interaction of work andprivate life and striving for a good balance between them.
  • 40. Scientific Aspects  (Adopting a critical and research based approach topractice and maintaining this through continuing learning and quality improvement)  Being familiar with the general principles, methods, concepts of scientific research, and the fundamentals of statistics (incidence, prevalence, predicted value etc.);  Having a thorough knowledge of the scientific backgrounds of pathology, symptoms and diagnosis, therapy and prognosis, epidemiology, decision theory, theories of the forming of hypotheses and problem-solving, preventive health care;  Being able to access, read and assess medical literature critically;  Developing and maintaining continuing learning and quality improvement.