Education goals and competency framework
The MD Program aspires to prepare graduates who are:
• clinically competent and prepared for life-long learning through the phases of their career
• ethical decision-makers dedicated to acting in accordance with the highest standards of professionalism
• adaptive in response to the needs of patients and communities from diverse and varied populations
• engaged in integrated, team-based care in which patient needs are addressed in an equitable, individualized and holistic manner
• reflective and able to act in the face of novelty, ambiguity and complexity
• resilient and mindful of their well-being and that of their colleagues
• capable of and committed to evidence informed practices and scholarship, and a culture of continuous performance improvement
The MD Program's competency framework consists of the key and enabling competencies that are classified according to the seven CanMEDS roles of Medical Expert, Communicator, Collaborator, Leader, Health Advocate, Scholar, and Professional. Learning within each of these CanMEDS roles is facilitated by pursuing the relevant key competencies, and each of the key competencies is in turn supported by achievement of several enabling competencies. The language used to describe the competencies is of necessity fairly general, and for the most part does not specify precisely the desired level of achievement within any given domain.
Work is ongoing to ensure that the MD Program competency framework aligns with the development of AFMC Entrustable Professional Activities (EPAs) for the Transition from Medical School to Residency. The AFMC EPAs are pan-Canadian core clinical activities that all medical students should be able to perform with an indirect level of supervision (supervisor is not in the room but is available to provide assistance) on day one of residency. Each AFMC EPA maps to multiple CanMEDS roles. The MD Program has developed Foundations EPAs, which operationalize the attainment of the MD Program competencies at the point of entry to clerkship and anticipate the achievement of the AFMC EPAs by the end of clerkship. Both the competency framework and EPAs inform how the MD Program assesses that U of T medical students have demonstrated level- and context-appropriate achievement of the knowledge, skills, attitudes and activities required to progress through and graduate from the MD Program.
Further elaboration of several of the competencies (those marked with asterisks) is provided in *Appendix 1.
For Medical Expert 1.2, the approach to clinical presentations is informed by the Medical Council of Canada (MCC) list of clinical presentations and corresponding causal conditions. For Medical Expert 3.5, the approach to technical procedures is informed by encounters required for each clerkship rotation.
The current iteration of the MD Program’s competency framework was approved by Faculty of Medicine Faculty Council on February 8, 2016, effective August 1, 2016. Editorial revisions to selected enabling competencies were approved by the MD Curriculum Committee on June 11, 2019.
Key & enabling competencies