CanMEDS 2015

The CanMEDS 2015 Framework

CanMEDS is an educational framework that describes the abilities physicians require to effectively meet the health care needs of the people they serve. It is the basis for the educational and practice standards of the Royal College.

*For the AODA-compliant of the CanMEDS Framework, please see the Royal College CanMEDS website.

Implementing CanMEDS

Full implementation of CanMEDS 2015 will happen gradually as disciplines transition through the CBD process. In the meantime though, the Royal College has introduced a CanMEDS 2015 Special Addendum to the Objectives of Training Requirements (OTR) to any discipline that will transition to CBD after July 1, 2018. The purpose of the Special Addendum is to ensure that the highlights of CanMEDS 2015 are incorporated efficiently into training programs in a timely manner, without over-burdening stakeholders who are also undergoing significant changes associated with CBD.

*For the AODA-compliant version of the CanMEDS OTR Addendum, please see the Royal College CanMEDS website.

Key content changes by CanMEDS Role

General changes:

  • Arguably the biggest change from 2005 to 2015 is the introduction of new CanMEDS Milestones.
  • Areas of overlap between Roles are minimized, resulting in a 3.5% decrease in the number of key competencies and a 29.4% decrease in the number of enabling competencies.
  • Role descriptions and definitions are expressed in simpler, more direct language.
  • Competencies and milestones describe the abilities to be demonstrated in practice, as distinct from the information or content related to aspects of a Role.
  • Competencies in safeguarding and enhancing patient safety have been integrated throughout the framework, as recommended by the Patient Safety and Quality Improvement Expert Working Group (EWG) and validated in early consultations.
  • The concepts of complexity, uncertainty and ambiguity are now more explicit.
  • The Role reflects some of the complexity in decision-making and clinical reasoning that occurs before, during and after the completion of procedures.
  • The definition, description and first key competency of the Medical Expert Role highlight the importance of integrating the six other Roles (the Intrinsic Roles).
  • The reference to providing expert legal testimony or advising governments has been presented as an enhanced expertise milestone that may be relevant to some, but not all, specialties.
  • A key competency has been added to address the evolving recognition of patient safety and continuous quality improvement as important components of medical expertise.
  • The scope of the Communicator Role now focuses exclusively on the interaction between physicians and their patients, including patients’ families.
  • Communication with other colleagues in the health care professions is now covered explicitly in the Collaborator Role.
  • Patient-centred and therapeutic communications are emphasized.
  • The concept of cultural safety is now explicit.
  • A new key competency addresses handovers and care transitions.
  • Collaboration is reflected more broadly, to extend beyond the context of a formalized health care team.
  • The concept of intraprofessional collaboration has been given more emphasis.
  • A relationship-centred model of care is presumed.
  • Value is placed on including the patient’s perspective in the shared decision-making process.
  • New emphasis on leadership competencies
  • Resource allocation is conceived as a function of good stewardship.
  • A name change for the Role from “Manager” to “Leader” to reflect an emphasis on the leadership skills needed by physicians to contribute to the shaping of health care.
  • Patient safety and quality improvement processes have been given increased emphasis.
  • Competence in health care informatics is viewed as crucial for medical leaders and managers and vital to the delivery of health care.
  • Competence in ensuring patient safety and quality improvement, including through the incorporation of patient safety standards such as adverse event reporting was added.
  • Now includes an expanded and refined definition and description
  • Includes the notion of partnership in advocacy
  • A new key competency on evidence-informed practice is included.
  • There is a new emphasis on skills in structured critical appraisal.
  • The life-long learner component of the Scholar Role has been reorganized into three enabling competencies that reflect (1) both planned and opportunistic learning as well as the need to integrate learning into daily work, (2) the use of data from a variety of sources to guide learning and (3) continuous learning as an active part of a community of practice.
  • The concepts of patient safety and a safe learning environment have been explicitly added to the teacher component of the Role.
  • The concept of research has been broadened, and the contribution and dissemination of skills as a consumer of research are emphasized over those of participant in research.
  • There is now an increased emphasis on physician health and well-being.
  • The emerging concept of professional identity formation is woven throughout the Professional Role.
  • Key competencies have been reorganized to reflect the commitment of the physician to the patient, to society and to the profession.
  • The notion of commitment to actions or tasks is emphasized as germane to the Professional Role, as distinct from the specific actions or tasks themselves.