Today we heard what patients expect, some concepts about the future role of the physician and about the move to more competency-based education. Patients expect to and will be expected to participate in their care and will come to the MD with access to similar knowledge as the physician. Access will take a variety of forms including virtual. Physicians will be expected to interpret and guide the patient through increasing and sometimes conflicting information. The physician will be navigator, supporter, confidant and employ computer AI, work in teams, and provide true leadership in the medical team, in the health care arena and in the broader community. Medical education will be more competency-based and balance assessments for learning with assessments of learning. Physicians will be expected to demonstrate competency throughout their practice lifetime through a variety of assessments including: Detailed practice analysis Guided self reflection of knowledge and skills Assessment of patient, peer and health professional interactions
While the ARTF report framed recommendations, the establishment of an implementation committee ensured they became our strategic directions. While the report identified some differences of opinion about timing, the was overwhelming reaffirmation for a national standard of assessment of knowledge, clinical decision making and clinical skill ability. The message was to make sure the examinations were assessing critical core knowledge and clinical ability necessary for all physicians in current practice. The blueprint exercise required an extensive practice analysis which not only examined the collected health data across the country but analyzed national survey data from patients, physicians, nurses and pharmacists as well as data documenting presentaitons to community-based clinics. It also include a commissioned paper on the future of assessment and tapped into the work done by Claire Touchie for her Master’s thesis on Entrustable professional activities. This dramatically changed our blueprint which will be introduced next year.
The focus on physician activities and the dimensions of care align with the directions outlined in the national FMEC UG and PG reports, readily map to CanMeds competencies and truly focus on the core competencies required of any physician in practice.
The frequency of examinations and moving the MCCQE I to be available internationally has been achieved – internationally in 2019 allowing us to use this assessment to replace the MCCEE To do this has required an increase in the support material especially for international medical graduates. (Also available for CMGs) The PRA has required collaboration with the CFPC and the RC with the involvement of their specialty committees to establish the basic competencies that would ensure the successful physicians with a provisional licence can be expected to provide safe, if limited and less complete than certified specialist patient care in these three areas , The development of new tools or the consideration of new tool development to assist the practicing physician to demonstrate their competence across their professional life-time.
Recalibrated for the 21st Century? Moving beyond the Assessment Review Task Force