Training & Practice Management / Formation et gestion d’une pratique
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Using the CanMEDS Roles in Your Practice Professional
of commitment to excellence in clinical practice and mastery of the discipline. This allows us to deliver on those patient needs as medical experts in our field. What we often overlook however, is our own well-being. Physicians spend countless hours training in medical school, residency and fellowship, then enter a busy career dominated by long work hours, which often The CanMEDS framework is a tool used for teaching and for our stretches late into life. It is easy continuing medical education. It is well established, benefits our to understand why burnout profession and has been integrated into the Royal College’s programs is not uncommon. Physicians including Maintenance of Certification. The seven roles of the are more likely to burnout CanMEDS are: than other professionals4.5. Physician burnout, in turn, is an independent predictor of • Medical Expert (the integrating role) higher incidence of medical • Communicator errors and major malpractice • Collaborator suits6.7. It seems selfish, but it is • Leader necessary for us to be in good • Health Advocate physical and mental health to • Scholar deliver the best care for our • Professional patients. Determining exactly where the balance lies is difOver the next few editions of the COA Bulletin, I will be asking ficult for us all, but for the sake various members of the COA to define each of the roles and how of our patients and our own they can be used in day to day practice and education. This series well-being, we must all take will provide guidelines on how to use the CanMEDS roles to their full time to reflect on this.
Ted Tufescu, M.D., FRCSC Program Director, University of Manitoba Winnipeg, MB
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hat defines a professional, and who falls just short of that mark? We would all agree that an amateur is definitely not a professional, so perhaps this is a good place to begin. The word amateur refers to someone who has a love for an activity. Amateurs engage in a pursuit on an unpaid basis, while professionals derive their income from it. But it is not enough to be remunerated for a service to be considered professional? A professional’s performance needs to meet a higher standard, regardless of remuneration, when compared to an amateur. - “A professional is someone who can do his best work when he doesn’t feel like it.” - Alistair Cooke, American journalist (19082004)
advantage in your orthopaedic practice. Dr. Ted Tufescu has kindly agreed to examine the role of Professional in this edition’s feature. Enjoy! – Ed.
Setting high standards is an important pillar of professionalism. For the medical professional, this can be deconstructed into a commitment to patients, to society, to one-self, and to the profession1. Commitment to individual patients comes naturally to us. Simply put, it means doing the best we can, each time, and for each individual patient, with their particular circumstances. However, putting individual patient care first, at all times, can lead to physician burnout. Striking the right balance between patient care and self-care, is an important consideration for a successful professional. Similarly, commitment to our society and to our profession are linked, and best discussed together. Our professional relationship with society is a social contract. On our end, we regulate our profession to best serve society, and in return, we expect society to put trust in us and to deliver the necessary resources we require to function. Commitment to Patients and to One-Self Commitment to the patient is best defined by the ethic of care2,3. The Royal College of Physicians and Surgeons of Canada (RCPSC) asks that we be attentive to the concepts of altruism, compassion and caring, moral and ethical behavior, integrity and honesty, and respect for diversity1. In other words, we need to put the patient first, be considerate of his or her circumstances, and manage our conflicts of interest. The RCPSC also speaks COA Bulletin ACO - Spring / Printemps 2018
Commitment to Society and the Profession Commitment to our patients and to our own well-being, is about balance. Similarly, making a strong commitment to society and to our profession is a two-way street. Government, taxpayers, stakeholder organizations, the media and others, all have expectations that influence our profession. In return, our profession provides services that impact not only individual patients, but also promote public health8. Health promotion is the process of enabling people to increase control over determinants of health, and thereby to improve their health9. Our professional association, the COA, has focused orthopaedic surgeons on countless important societal missions. A current example is the EDUCATE program, which empowers surgeons and allied health-care workers to deal with interpersonal violence, a problem that affects one in six women in our fracture clinics10. As we work toward licensure, we commit to professional standards. There are multiple exams throughout our training that test our ability, and along our career we are expected to continue to develop as medical experts and keep up to date by accessing regular educational opportunities. For example, the RCPSC has a Maintenance of Certification (MOC) program which all Fellows must both adhere to and comply with, in accordance with Article 6 of Royal College Bylaw No. 19. Fellows follow a five-year MOC cycle. To adhere to the MOC program, fellows must accumulate forty credits in each year of the cycle. To comply with the MOC program, fellows must accumulate