The CanMEDS 2015 project: Methodology

Since its beginning in the 1990s, CanMEDS has been the product of an evidence-informed, collaborative process involving hundreds of Royal College Fellows, family physicians, educators, learners and other expert volunteers. Its development has involved countless hours of literature reviews, stakeholder surveys, focus groups, interviews, consultations, consensus-building exercises, debate, and work on educational design. Many people in Canada and around the world feel that the strength of the CanMEDS Framework lies in the fact that it was derived explicitly from societal needs. Click here for a list of the 1996, 2005 and 2015 contributors.

In 2012, a three-year plan was developed to update the CanMEDS 2005 Physician Competency Framework to ensure that it reflects the modern realities of medical specialists. This most recent update — the third one in the 20 years since the framework was first released — occurred in a very special context. It was part of the Royal College’s Competence by Design initiative, a multi-year project to implement an enhanced model for competency-based medical education in residency training and specialty practice in Canada.

As part of the CanMEDS 2015 project, the Royal College engaged as many experts and partners as possible to ensure that the updated version of the framework would be a valid and practical foundation for excellence in patient care, now and in the future. In early 2013, the Royal College convened a series of committees and 13 expert working groups (EWGs) to revise aspects of CanMEDS. Committee members were recruited for a range of reasons, including subject matter expertise, perspective on a particular stage of physician development, understanding of the health care and medical education systems, and geography.

Each EWG was tasked with reviewing the recent literature and reports relevant to a specific CanMEDS Role and providing their recommendations for new standards. As was done for the original 1996 framework, we conducted focus groups and surveys with health professionals and the public to get a variety of perspectives on what abilities are needed of physicians. A national and an international advisory committee each gave feedback as reports came in. An overarching Integration Committee edited the vast amounts of data into successive versions of a coherent new framework. Finally, a dedicated group of bilingual physicians chaired by Dr. Andrée Boucher wrote a version of the framework and milestones en français.

Over a two-year period, the Royal College ran a series of consultations to give stakeholders meaningful opportunities to help shape the design and content of the framework. In 2014, we released three drafts of the framework (Series I-III) and two drafts of the milestones guide so stakeholders could review and provide feedback on the competencies as they were developed. With each release, the Royal College consulted with key partners and stakeholders to ensure we were on the right track to develop a framework that reflects modern practice.

Throughout 2014, more than 1,000 people participated in our consultations through a variety of means, including online surveys, webinars, focus groups, social media, and town hall sessions at the International Conference on Residency Education (ICRE). Together, they generated more than 2,500 comments. The feedback received was carefully analyzed, shared with the EWGs and the Integration Committee, and incorporated into each subsequent release of the framework.

The penultimate draft of the CanMEDS 2015 Framework (Series IV) was released in early 2015. This version was approved for adoption by the Royal College’s Education Committee, Executive Committee and Council.

The final version of the framework, and its accompanying faculty development and support tools, were released at ICRE 2015 in Vancouver, Canada.

The CanMEDS 2015 Framework was developed in collaboration with 12 medical education organizations as part of their work on the CanMEDS 2015 National Advisory Committee. Each of the Association of Faculties of Medicine of Canada, the Canadian Federation of Medical Students, the Canadian Medical Association, the Canadian Medical Protective Association, the Canadian Patient Safety Institute, the Collège des médecins du Québec, the College of Family Physicians of Canada, the Fédération des médecins résidents du Québec, the Fédération médicale étudiante du Québec, the Federation of Medical Regulatory Authorities of Canada, the Medical Council of Canada and Resident Doctors of Canada has endorsed the use of the CanMEDS 2015 Physician Competency Framework to inform their organization’s work, adapting it for their own specific context.