A new framework for a competency-based approach to medical education
A new competency framework for the MD Program, which represents a collaborative effort to align the existing U of T MD Program objectives with a competency-based approach to medical education, will take effect August 1, 2016.
“Competency-based objectives are linked directly to clinical practice. They ensure our students exit the MD Program with the breadth of abilities they will need as residents, and then as practicing physicians,” notes Dr. Martin Schreiber, Director of UME Curriculum.
The new competency framework consists of ‘key’ and ‘enabling’ competencies that are organized 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.
In 2003 the U of T MD Program adopted the CanMEDS Physician Competency Framework as the basis for our program and course objectives. We were among the first medical schools in Canada to do this. In 2013–14, under the leadership of Dr. Schreiber, we initiated a review of those objectives.
“We had a number of reasons for this review,” explains Dr. Schreiber. “We wanted our objectives to align with the 2015 CanMEDS update, which emphasizes a competency-based approach to medical education. Accreditation was another important factor, as MD programs are now required to define their educational objectives in competency-based terms.”
To facilitate the review, a Steering Committee and working groups for each of the seven CanMEDS roles were established. Guided by a number of review principles, each of the working groups developed draft key and enabling competencies for their respective roles. These draft competencies were then reviewed by the Steering Committee to ensure integration and avoid unnecessary redundancy among the seven roles. In May 2015, the Steering Committee widely circulated a consultation document, along with an invitation for feedback to the draft competencies. Over 60 individuals provided feedback, which informed the development of a formal proposal that was approved by Faculty of Medicine Faculty Council on February 8, 2016.
Next steps include the mapping and alignment of course-level objectives with the program’s new competency framework. “Our goal is to integrate these competencies while making the program objectives clearer and more usable, particularly for the development of course-level learning objectives,” says Dr. Schreiber. To support that integration, development of milestones for each of the enabling competencies is well underway.
