For those of you who are not in the medical education game, CANMEDS is a very big project based around “outcomes based medical education” that sets a framework for undergraduate and postgraduate physician training. As such, it is compulsory.

Unfortunately, they have captured the Australians (there is a peculiar self righteousness in the Canadian Liberal the Australians find pleasant and the Kiwis irritating) and I have to know it. This is from the CANMEDS framwork.

A physician’s professional identity is central to this Role. The Professional Role reflects contemporary society’s expectations of physicians, which include clinical competence, a commitment to ongoing professional development, promotion of the public good, adherence to ethical standards, and values such as integrity, honesty, altruism, humility, respect for diversity, and transparency with respect to potential conflicts of interest.
It is also recognized that, to provide optimal patient care, physicians must take responsibility for their own health and well-being and that of their colleagues. Professionalism is the basis of the implicit contract between society and the medical profession, granting the privilege of physician-led regulation with the understanding that physicians are accountable to those served, to society, to their profession, and to themselves

Please not that respect for diversity is now added to the values of professionalism. The framework is now weaponized, and the colleges can be appealed to. I don’t think this includes tolerating Calvinists or Tories.

The consequences of this framework is conversations among senior clinicians about how to subvert it, how we “Halo” fill in forms, and how the trainees think that if they meet the criteria in the curriculum and framework they are good doctors, as if the framework is the profession.

And if the long. painful, apprenticeship to clinical expertise can be shortened by the pen of a committee.

I have seen the products of CANMEDS, and they frighten me. They lack doubt. They think that their education was correct. They have not seen enough, failed enough, and reflected enough. And they are boring in their correctness.

This is making the colleges and their guidance, particularly in Canada (the rot has not got to the heartwood in Australasia yet) without utility. And this project will fail any test: unsurprisingly, there are no clinical trials or outcome data.