Medical Expert

Definition

As Medical Experts, physicians integrate all of the CanMEDS Roles, applying medical knowledge, clinical skills, and professional values in their provision of high-quality and safe patient-centred care. Medical Expert is the central physician Role in the CanMEDS Framework and defines the physician’s clinical scope of practice.

Description

As Medical Experts who provide high-quality, safe, patient-centred care, physicians draw upon an evolving body of knowledge, their clinical skills, and their professional values. They collect and interpret information, make clinical decisions, and carry out diagnostic and therapeutic interventions. They do so within their scope of practice and with an understanding of the limits of their expertise. Their decision-making is informed by best practices and research evidence, and takes into account the patient’s circumstances and preferences as well as the availability of resources. Their clinical practice is up-to-date, ethical, and resource efficient, and is conducted in collaboration with patients and their families,* other health care professionals, and the community. The Medical Expert Role is central to the function of physicians and draws on the competencies included in the Intrinsic Roles (Communicator, Collaborator, Leader, Health Advocate, Scholar, and Professional).

KEY CONCEPTS

Agreed-upon goals of care: 2.1, 2.3, 2.4, 3.2, 4.1
Application of core clinical and biomedical sciences: 1.3
Clinical decision-making: 1.4, 1.6, 2.2
Clinical reasoning: 1.3, 1.4, 2.1, 3.1
Compassion: 1.1
Complexity, uncertainty, and ambiguity in clinical decision-making: 1.6, 2.2, 2.4, 3.2, 3.3, 3.4
Consent: 3.2
Continuity of care: 2.4, 4.1
Duty of care: 1.1, 1.5, 2.4
Integration of CanMEDS Intrinsic Roles: 1.2
Interpreting diagnostic tests: 2.2
Medical expertise: all enabling competencies
Patient-centred clinical assessment and management: 1.4, 2.2, 2.4, 3.1, 3.3, 3.4, 4.1, 5.2
Patient safety: 1.5, 3.4, 5.1, 5.2
Prioritization of professional responsibilities: 1.4, 1.5, 2.1, 3.3, 5.1
Procedural skill proficiency: 3.1, 3.3, 3.4
Quality improvement: 5.1, 5.2
Self-awareness of limits of expertise: 1.4, 3.4
Timely follow-up: 1.4, 2.2, 4.1
Working within the health care team: 1.3, 1.4, 2.1, 2.4, 3.3, 4.1, 5.1

Key competencies	Enabling competencies
Physicians are able to:
1. Practise medicine within their defined scope of practice and expertise	1.1 Demonstrate a commitment to high-quality care of their patients 1.2 Integrate the CanMEDS Intrinsic Roles into their practice of medicine 1.3 Apply knowledge of the clinical and biomedical sciences relevant to their discipline 1.4 Perform appropriately timed clinical assessments with recommendations that are presented in an organized manner 1.5 Carry out professional duties in the face of multiple, competing demands 1.6 Recognize and respond to the complexity, uncertainty, and ambiguity inherent in medical practice
2. Perform a patient-centred clinical assessment and establish a management plan	2.1 Prioritize issues to be addressed in a patient encounter 2.2 Elicit a history, perform a physical exam, select appropriate investigations, and interpret their results for the purpose of diagnosis and management, disease prevention, and health promotion 2.3 Establish goals of care in collaboration with patients and their families, which may include slowing disease progression, treating symptoms, achieving cure, improving function, and palliation 2.4 Establish a patient-centred management plan
3. Plan and perform procedures and therapies for the purpose of assessment and/or management	3.1 Determine the most appropriate procedures or therapies 3.2 Obtain and document informed consent, explaining the risks and benefits of, and the rationale for, a proposed procedure or therapy 3.3 Prioritize a procedure or therapy, taking into account clinical urgency and available resources 3.4 Perform a procedure in a skilful and safe manner, adapting to unanticipated findings or changing clinical circumstances
4. Establish plans for ongoing care and, when appropriate, timely consultation	4.1 Implement a patient-centred care plan that supports ongoing care, follow-up on investigations, response to treatment, and further consultation
5. Actively contribute, as an individual and as a member of a team providing care, to the continuous improvement of health care quality and patient safety	5.1 Recognize and respond to harm from health care delivery, including patient safety incidents 5.2 Adopt strategies that promote patient safety and address human and system factors

* Throughout the CanMEDS 2015 Framework and Milestones Guide, references to the patient’s family are intended to include all those who are personally significant to the patient and are concerned with his or her care, including, according to the patient’s circumstances, family members, partners, caregivers, legal guardians, and substitute decision-makers.