1. III. LIFELONG LEARNER
1.1. EPAs
1.1.1. A. Be effective life-long learners.
1.1.2. B. Participate in the creation, dissemination, application and translation of new knowledge.
1.1.3. C. Participate in the systematic improvement of clinical practice.
1.1.4. D. Raise questions and bring fresh perspectives to existing practice.
1.2. 1. Formulate clinical questions, search the literature, and evaluate the results to inform diagnosis, prevention, treatment and supportive care for patients. (A, D)
1.3. 2. Know the appropriate use and limitations of scientific and statistical methods to address questions in basic, clinical, population, health services, and translational research. (B)
1.4. 3. Reflect critically upon and monitor one’s own performance using appropriate sources of data and practice standards. (A, B, C)
1.5. 4. Assess learning needs and develop and implement personal learning plans. (A, C)
1.5.1. Students will understand the importance of continued professional development and be able to develop their own learning plans.
1.6. 5. Identify and weigh opportunities for practice improvement in one’s own clinical practice and in healthcare systems and institutions. (C)
1.6.1. Understand governance and committee structures of healthcare institutions in relation to quality assurance, improvement, and patient safety
1.7. 6. Teach and learn from others. (A, D)
2. IV. SKILLED CLINICIAN
2.1. EPAs
2.1.1. A. Perform an accurate and patient-centred history and physical in diverse populations of patients.
2.1.2. B. Develop and propose a differential diagnosis and appropriate plans for investigation and management.
2.1.3. C. Provide safe, supportive and evidence-based care for patients, within scope of training.
2.1.4. D. Communicate and collaborate effectively and respectfully with patients, families, and colleagues in the team environment and across the continuum of care.
2.1.5. E. Help patients navigate the illness and healing experience.
2.1.5.1. Untitled
2.2. 1. Under supervision, manage and provide care across the lifespan of patients with acute, chronic or undifferentiated illness.
2.2.1. Establish therapeutic relationships in which patients are active partners. (D, E)
2.2.2. Assist patients in evaluating and interpreting sources of knowledge. (D, E)
2.2.3. Demonstrate skilled listening and responding in communicating with diverse patients, their families or other caregivers, and colleagues. (D)
2.2.4. Understand and respect the roles, expertise, and perspectives of health care professionals when learning, consulting, and collaborating. (C, D)
2.2.5. Understand the psychosocial implications of health and illness across the life cycle for patients and families. (E)
2.2.5.1. New node
2.2.6. Take account of patient context in their clinical approach. (D, E)
2.3. 2. Diagnosis:
2.3.1. Perform a comprehensive or focused history and physical for diverse patient populations across the lifespan, as determined by patient presentation. (A)
2.3.2. Select and interpret appropriate laboratory and diagnostic studies. (B)
2.3.2.1. Select investigative techniques according to an understanding of their underlying principles.
2.3.3. Perform selected therapeutic and diagnostic procedures. (B)
2.3.4. Develop well-reasoned diagnostic hypotheses and differential diagnoses. (B)
2.4. 3. Treatment and Management:
2.4.1. Under supervision, formulate and propose treatment plans, weighing pharmaceutical, surgical, behavioral, and supportive options as appropriate, for therapy and for symptom management. (B, C)
2.4.2. Identify and use opportunities for prevention and health promotion in the clinical encounter. (B, C)
2.4.2.1. Deploy the scientific basis of inherited diseases and susceptibilities and principles of infectious disease control for prevention and screening.
2.4.3. Know the risks and benefits of common therapeutic interventions and know when these are indicated. (C)
2.4.3.1. Manage pharmaceutical treatment according to the underlying mechanisms of action of commonly used agents.
2.4.4. Support patients and families in the appropriate use of self-care strategies. (B, C, E)
2.4.5. Counsel and support patients as appropriate in the presence or absence of established diagnosis or treatment. (D, E)
2.4.6. Demonstrate knowledge, skills and attitudes that support end of life care. (E)
2.4.7. Connect patients and families to appropriate community resources for support and care. (E)
2.5. 4. Information management:
2.5.1. Communicate effectively by spoken, written and electronic methods, respecting patient confidentiality. (D)
2.5.1.1. legal responsibilities
2.5.1.2. ethics of control/access/sharing
2.5.2. Maintain accurate, effective, and comprehensive records of patient care. (D)
2.5.2.1. legal responsibilities
2.5.2.2. ethics of control/access/sharing
2.5.3. Make judicious use of informatics tools and information sources to provide evidence-informed patient care, monitor patient outcomes, and maintain medical records. (C)
3. I. PROFESSIONAL
3.1. EPAs
3.1.1. A. Demonstrate appropriate professional attitudes and ethical commitments.
3.1.2. B. Demonsrate commitment to the well-being of the patient.
3.1.3. C. Promote health and provide healthcare equitably.
3.2. 1. In all professional duties, demonstrate personal integrity, honesty, reliability, respect, compassion and commitment towards others. (A)
3.2.1. Demonstrate honesty and reliability in educational activities
3.2.1.1. Know and adhere to standards of academic Integrity
3.2.2. Demonstrate honesty and reliability in clinical duties
3.2.3. Moderate appropriately emotional responses to distressing and stressful clinical and professional activities
3.3. 2. Practice medicine in a manner consistent with the fundamental rights of patients to self-determination, and responsibilities of physicians and healthcare institutions in Canada. (A, C)
3.3.1. Relate professional responsibilities to legal framework of negligence and malpractice
3.3.2. Understand profession-led regulation: role, function and procedures of provincial colleges, and role of student/physician in regulatory colleges
3.3.3. Understand governance of hospitals and healthcare institutions ...
3.3.4. Apply Charter of Rights and Freedoms and International Declaration of Human Rights to healthcare and medical practice
3.3.5. Understand central professional responsibilities, integrating health law and ethics
3.3.5.1. Confidentiality
3.3.5.2. Informed consent
3.3.5.3. Fiduciary responsibilities
3.4. 3. Recognize ethical dilemmas and dimensions of professional practice, and critically analyze situations in order to propose well-reasoned courses of action. (A)
3.4.1. Know the common dilemmas and public and professional consensus or controversies about their appropriate resolution
3.4.1.1. Know how to access and interpret codes and policies, at the institutional, provincial, national, and international levels
3.4.1.1.1. Practical understanding of the legal status of codes and policies
3.4.1.2. Understand the application of legal concepts and limits ...
3.4.1.3. Able to communicate/explain in discussion with patients, colleagues, the public, professional practices in
3.4.1.4. E.g.: treatment refusal, compliance, conflict of interest,
3.4.2. Develop/adopt an approach to managing unresolved dilemmas in clinical practice
3.4.2.1. Be able to search and evaluate the medical and health professions ethics, law, and policy literature
3.4.2.2. Balance and integrate perspectives/advice of ethics and law
3.4.2.3. Be able to consult with medical and interprofessional colleagues and fellow learners around ethical dilemmas and dimensions of practice
3.4.2.4. Be able to communicate/share appropriately with patients in the resolution of ethical challenges in practice
3.4.2.5. Be able to identify structural constraints and opportunities in action
3.4.2.6. Be able to strategize appropriately...
3.4.3. Be able to identify the impact of common practices (the daily, what is taken for granted) on diverse groups, being aware of/sensitive to their perspectives and aware of own situation/biases
3.4.3.1. Professional privileges
3.4.3.2. Patient vulnerability and resilience
3.4.3.3. Have a broad understanding of diverse attitudes in relation to core values of medical practice (e.g. autonomy, health)
3.4.3.4. Be able to consider practice guidelines from the perspectives of various stakeholders
3.5. 4. Take into account the uniqueness of each person and the diversity in populations in communicating respectfully with the public and in providing supportive and culturally appropriate care. (C)
3.6. 5. Take responsibility for situations that place patients at risk. (B)
3.6.1. Patient safety
3.6.2. Infection control
3.6.3. As medical students
3.6.4. For future professional life
3.7. 6. Offer and accept constructive feedback. (A, B)
3.8. 7. Manage personal well-being in order to meet professional responsibilities, appropriately recognizing limitations and seeking help or consultation. (A, B)
3.8.1. Students will begin to identify what constitutes meaningful work for them, and align their efforts toward achieving their main priorities.
4. II. COMMUNITY CONTRIBUTOR
4.1. EPAs
4.1.1. A. Contribute to the improvement of healthcare institutions and systems.
4.1.2. B. Use their professional role to promote the public good.
4.1.3. C. Pay particular attention to identifying inequities and the needs of the most vulnerable.
4.2. 1. Identify the determinants of health and community needs, including barriers to access to care and the particular situation of marginalized and vulnerable populations. (B, C)
4.2.1. SES
4.2.1.1. 1. To understand the importance of socioeconomic status and poverty as determinants of health.
4.2.1.2. 2. To understand pathways through which socioeconomic status and poverty affect health, and vice-versa.
4.2.1.3. Evaluate the extent to which the Canadian health care system is successful at addressing socioeconomic disparities in health.
4.2.1.4. 4. To be able to discuss social and health policy alternatives for reducing socioeconomic disparities in health.
4.2.1.5. 5. To understand the extent of homelessness in Canada, its determinants, and its consequences for health. And models for/physician role in addressing the healthcare needs of the homeless!
4.2.2. Aboriginal Health
4.2.2.1. Describe the health issues facing aboriginal populations in Canada, and their burden.
4.2.2.2. Apply determinants of health analysis to aboriginal populations (income & social status; education and literacy; social environments; physical environments; health services; cultural impact)
4.2.2.2.1. Health implications of watershed management and strategies
4.2.2.2.2. Poor quality housing
4.2.2.3. Understand history context and role of federal govt in service delivery
4.2.2.3.1. Institutional trust and communities
4.2.2.4. Develop a cultural competency/safety approach to aboriginal health
4.2.2.5. Appreciate political and social environment of life on a First Nation reserve
4.2.2.6. Gain insight into culture issues for healthcare providers working in First Nation health delivery
4.2.3. Addictions
4.2.3.1. 1. To define and discuss the terms: addiction, alcoholism, heavy episodic drinking, and alcohol and drug abuse, dependence and tolerance.
4.2.3.2. 2. To describe the epidemiology of alcohol, tobacco, illicit drug abuse and prescription drug abuse, and the burden of illness associated with abuse, in Canada and internationally.
4.2.3.3. 3. To discuss various outcomes of interventions addressing addictive behaviours, focusing on abstinence and harm reduction, and to be able to explain harm reduction as pertains to adults versus adolescents, and as pertains to alcohol versus other drugs. To list and briefly explain various approaches to alcohol and drug control operating at the population level.
4.2.3.3.1. Assess the ethical justification of harm reduction approaches
4.2.3.4. 4. Regarding alcohol abuse and dependence, to discuss the role of screening and brief intervention as a part of the family physician’s practice.
4.2.3.5. 5. Regarding prescription opiate abuse specifically, to discuss the evidence of efficacy and/or effectiveness of opiate agonist pharmacotherapy and of psychosocial therapy.
4.2.3.6. 6. To compare and contrast abuse/dependence of heroin versus prescription opiates in terms of management/control at the individual and population level, including the role of triplicate prescription monitoring programs.
4.2.3.7. 7. To identify and discuss practical aspects of a team approach towards the management of individual cases of substance abuse.
4.2.3.8. Consider the responsibilities of the profession as a whole for care of patients with addictions and the implications for personal practice choices.
4.2.4. Immigrant/globally migrant health
4.3. 2. Participate in public health initiatives, such as screening, vaccination, and surveillance, fulfilling professional and legal reporting responsibilities. (B)
4.3.1. Weigh risks to patients, communities, caregivers, families, the pt-dr relationship, and legal risks to physicians in fulfilling reporting requirements
4.3.2. Screening
4.3.3. Vaccination
4.3.4. Health promotion
4.4. 3. Identify, weigh and contribute to opportunities for improved health in the communities to which they belong, locally and globally. (B)
4.4.1. Healthcare system
4.4.1.1. Evolution of medicare
4.4.1.1.1. Path dependency
4.4.1.1.2. Values of Canadian Healthcare
4.4.1.1.3. what's outside: pharmcare, longterm care, workers comp, mvi, military, prison, & aboriginal health
4.4.1.2. Structure of health care system
4.4.1.2.1. Public-private split
4.4.1.2.2. Federal provincial territorial roles
4.4.1.2.3. Healthcare spending
4.4.1.2.4. Physician payment mechanisms
4.4.1.2.5. Hospital payment mechanisms
4.4.1.3. Understand the implications of the Canada Health Act for medical practice and systems
4.4.1.3.1. Know and interpret the five principles
4.4.1.4. Practice design & manegement
4.4.1.4.1. Understand status of user fees, boutique medicine
4.4.1.4.2. Students will have a basic knowledge of what is required in order to establish, develop, and maintain a career in medicine, including adjusting goals and practice patterns over time.
4.4.1.5. Identify key issues in the sustainability of healthcare in Canada
4.4.1.5.1. Human resources
4.4.1.5.2. Primary care models
4.4.1.5.3. Regionalization
4.4.1.5.4. Home care
4.4.1.5.5. Spending trends
4.4.1.5.6. Demographics and population health trends
4.4.1.5.7. Clinical information systems
4.4.1.5.8. Access (see 1)
4.4.2. Global health
4.4.3. Communities
4.4.3.1. Understand role of patient groups
4.4.3.1.1. Advocacy
4.4.3.1.2. Self-management
4.4.3.2. Extent and ethics of charity model
4.4.3.3. Community resilience concepts
4.5. 4. Work effectively and collaboratively in a range of practice contexts to provide patient care and improve healthcare systems. (A)
4.6. 5. Responsibly steward healthcare resources. (A, B)
4.6.1. Have a practical understanding of health technology assessment and formulary decision-making and its impact on practice
4.6.1.1. Understand processes and values involved in weighing harm/benefit in HTA and application/controversies around common measures (QALYs etc)
4.6.2. Identify implicit and explicit methods of resource allocation in canada
4.6.2.1. Employ ethical concepts (fairness, harm/benefit, procedural justice) in resource allocation decisions and in the evaluation of processes of resource allocation
5. Colour code
5.1. Professionalism
5.2. Ethics
5.3. Law
5.4. Population Health
5.5. Policy & Systems
5.5.1. Business of Medicine
5.5.2. Patient Safety
5.6. Self-care
5.7. Career planning
5.8. EBP
5.9. Informatics
5.10. Heavily integrative objective!
5.11. Overarching Educational Outcomes, approved by Curriculum Committee
5.11.1. Outcomes removed in final draft because they belonged one level down