CanMEDS Professional Role
Definition:
Physicians are committed to the health and wellbeing of individuals and society through:
- Ethical practice
- Profession-led regulation
- High personal standards of behaviour.
*Note: the Professional Role encompasses more than what we usually think of as “professionalism”.
Physicians are able to demonstrate a commitment to:
- Their patients, profession and society through ethical practice
- Their patients, profession and society through participation in profession-led regulation
- Physician health and sustainable practice
*Note: the emphasis is not just on individual patients but also to society and the profession.
Enabling Competencies:
Physicians are able to...
1. Demonstrate a commitment to their patients, profession, and society through ethical practice
1.1. Exhibit appropriate professional behaviors in practice, including honesty, integrity, commitment,
compassion, respect and altruism
1.2. Demonstrate a commitment to delivering the highest quality care and maintenance of competence
1.3. Recognize and appropriately respond to ethical issues encountered in practice
1.4. Appropriately manage conflicts of interest
1.5. Recognize the principles and limits of patient confidentiality as defined by professional practice
standards and the law
1.6. Maintain appropriate relations with patients.
2. Demonstrate a commitment to their patients, profession and society through participation in profession-led regulation
2.1. Appreciate the professional, legal and ethical codes of practice
2.2. Fulfill the regulatory and legal obligations required of current practice
2.3. Demonstrate accountability to professional regulatory bodies
2.4. Recognize and respond to others’ unprofessional behaviours in practice
2.5. Participate in peer review
3. Demonstrate a commitment to physician health and sustainable practice
3.1. Balance personal and professional priorities to ensure personal health and a sustainable practice
3.2. Strive to heighten personal and professional awareness and insight
3.3. Recognize other professionals in need and respond appropriately
Residents should also be aware of the Physician’s Charter on Medical Professionalism, first published by the ABIM Foundation and now published in 22 national and international medical journals and translated into 7 languages. The Charter has been endorsed by over 100 national and international medical
Physician Charter - Fundamental Principles
- Principle of primacy of patients’ welfare
- Principle of patients’ autonomy
- Principle of social justice
Physician Charter – Ten Commitments
- To professional competence
- To honesty with patients
- To patients’ confidentiality
- To maintaining appropriate relationships
- To improving quality of care
- To improving access to care
- To a just distribution of finite resources
- To scientific knowledge
- To maintaining trust by managing COI’s (can you clarify what is COI)
- To professional responsibilities
*Note: the emphasis again is not just on individual patients, but also includes responsibilities to society. |
| Ideas For Teaching Professional Role |
*This is a BRIEF summary only. For more complete resources including references, please review the following presentations “Professional Role: Teaching Resources” and “Collegial Conversations”.
As attendings we are comfortable with the formal curriculum, but students/residents learn much more about professionalism from the hidden or informal curriculum, which can have profound (often negative) effects on their professional development. Teaching professionalism by silent ‘role modeling’ is inadequate. We must make explicit what we are doing and why.
Monica Branigan (MD, MHSc) has kindly provided a list of teaching resources and strategies as can be seen in the above document. She has also developed a framework for teaching professionalism which she calls “Collegial Conversations”. Using a conversational approach can merge teaching and feedback, which can be very useful to both sides. In this approach one would:
- Identify a learning issue
- Create a safe environment
- Explore context and motivation
- Consider professional relationships
- Clarify learning issues
- Take action where possible and appropriate
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Evaluation of Professional Role
**This is a BRIEF summary only. For more information and complete references PLEASE review the presentation “Professional Role: Evaluation Strategies".
Evaluation of the professional role has largely focused on the first competency, “ethical practice” (what we usually think of as professionalism). We often treat this differently than other knowledge and skills, and have trouble as attendings giving appropriate feedback and evaluation. Some points to keep in mind:
- Focus on observable behaviours, rather than presumed personality traits or character
- Consider the context in which the behaviour took place
- Consider the presence of any conflicting values (e.g., honesty vs. confidentiality, improving quality of care vs. access to care/efficiency) as perceived by the resident
- Explore how the resident resolved the dilemma and decided how to act
- Consider the type and purpose of evaluation (formative vs. summative)
As attendings we must also get over our reluctance to evaluate this competency, as residents do not learn without appropriate feedback. In fact, students/residents’ sense of professionalism, ethics and morals often decline during training.
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Faculty Champion
Shiphra Ginsburg, MD, MEd, FRCPC
Associate Professor, University of Toronto
Respirology and Internal Medicine
Mount Sinai Hospital
600 University Ave, Ste. 433
Toronto, Ontario M5G 1X5
Tel: (416) 586-8671
Fax: (416) 586-8864
Email : shiphra.ginsburg@utoronto.ca
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Biography
Shiphra Ginsburg received her MDCM degree from McGill University in 1990 before completing postgraduate training at the University Toronto (Internal Medicine, 1994) and McMaster University (Respirology and Critical Care Medicine, 1995-96). She completed a Master’s degree in Higher Education (specialization in the Health Professions) at OISE/UT in 1999. Dr. Ginsburg is currently an Associate Professor (Medicine) at the University of Toronto and is on staff at Mount Sinai Hospital. She is cross-appointed as a Scientist at the Wilson Centre for Research in Education. Her primary research program focuses on issues of understanding and evaluating professionalism in medical education. Other research interests include the evaluation of clinical competence, professional development, education scholarship, and qualitative methodology. Dr. Ginsburg has won several awards for her research, including the 2011 G. Malcolm Brown Lectureship (CIHR) and participates in professionalism initiatives at the local, national and international levels. Since 2009 she has served as Deputy Editor at the journal Medical Education, and is the current Kimball Scholar at the American Board of Internal Medicine.
Web Resources
CMA Code of Ethnics
www.cma.ca/index.cfm/ci_id/2419/la_id/1.htm
Student Code of Conduct at U of T
www.sa.utoronto.ca/details.php?wcid=130
ABIM Foundation Project on Professionalism
www.abimfoundation.org/professionalism/index.shtm
NBME Monograph on the Behaviours of Professionalism
http://ci.nbme.org/professionalism/default.asp
MedEdPortal at AAMC.org (Search Professionalism)
http://services.aamc.org/jsp/mededportal/goLinkPage.do?link=home
Post Graduate Education in Medical Bioethics at U of T
http://www.utoronto.ca/pgme
CPSO Policies (Also Excellent Legal References)
http://www.cpso.on.ca/Policies/policy.htm
CMPA Resources (Consent: A Guide for Canadian Physicians, A Medico-legal Handbook for Canadian Physicians)
http://www.cmpa-acpm.ca/
Royal College Best Practices
http://rcpsc.medical.org/canmeds/bestpractices/BP-abstracts_e.php#role
Other Resources (Acrobat PDF files)
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