Essential Skills and Abilities Required for Postgraduate Training

Approved by PGME Committee: 2 November 2017
Approved by Faculty Council: 2 January 2018

Essential Skills & Abilities Required for Postgraduate Medical Education [PDF-180kB]

The Dalhousie University, Faculty of Medicine, Postgraduate Medical Education Program is responsible for oversight of programs of study that graduate Residents with the knowledge, skills, professional behaviours and attitudes necessary to practice their area of specialty medicine in Canada.

Physicians possess a defined body of knowledge, clinical skills, procedural skills and professional attitudes, which are directed to effective patient-centered care. They apply these competencies to collect and interpret information, make appropriate clinical decisions, and carry out diagnostic and therapeutic interventions. They do so within the boundaries of their discipline, personal expertise, the healthcare setting and the patient’s preferences and context. Their care is characterized by up- to-date, ethical, and resource efficient clinical practice as well as with effective communication in partnership with patients, other health care providers and the community.

The Royal College of Physicians and Surgeons / College of Family Physicians CanMEDS / CanMEDS FM Physician Competency Framework describes the knowledge, skills and abilities that specialist physicians require for the safe and competent practice of medicine. The framework is based on the seven roles that all physicians occupy: Medical Expert, Communicator, Collaborator, Leader, Health Advocate, Scholar, and Professional.  As such, physicians must be able to:

1.     Function effectively as consultants, integrating all of the CanMEDS Roles to provide optimal, ethical and patient-centered medical care;

2.     Establish and maintain up to date clinical knowledge, skills and attitudes appropriate to their practice;

3.     Perform a complete and appropriate assessment of a patient;

4.     Use preventive and therapeutic interventions effectively;

5.     Demonstrate proficient and appropriate use of procedural skills, both diagnostic and therapeutic;

6.     Seek appropriate consultation from other health professionals, recognizing the limits of their expertise.

7.     Engage in reflective practice, using self-assessment and reflection to continually update and improve existing knowledge and skills

POLICY STATEMENTS - Essential Skills & Abilities

1. All candidates for admission, promotion or graduation in the Postgraduate Medical Education Program must have the required Skills and Abilities (Technical Standards) to successfully achieve the required competencies. The skills and abilities are grouped in five broad areas:

1.1 Observation/Perception - A resident must be able to participate in learning situations and acquire information through Observation and Perception by the use of senses and mental abilities. In particular, a resident must participate progressively in patient encounters and acquire information through visual, auditory and somatic sensation.

1.2 Communication - A resident must be able to communicate and to observe individuals or groups of individuals in order to effectively and efficiently elicit and clarify information. In the course of study, the resident must be able to progressively create rapport and develop therapeutic relationships with patients and their families, and establish effective communication with all members of the healthcare team. A resident must also be able to coherently summarize and effectively communicate a patient’s condition and management plan verbally, and in written and electronic form.

1.3 Motor/Tactile Function - A resident must possess sufficient Motor function skills required to safely perform a physical examination on a patient, including palpation, auscultation, percussion, and other diagnostic maneuvers. The examination must be done independently and competently in a timely fashion. A resident must possess sufficient motor function and sensory function in order to be able to use common diagnostic aids or instruments (e.g.,ophthalmoscope, otoscope, sphygmomanometer, stethoscope), either directly or in an adaptive form. A resident must be able to execute the motor movements reasonably required to attain the skills necessary to perform diagnostic procedures, and provide general and emergency medical care to patients in outpatient, inpatient and surgical venues.

1.4 Cognition - A resident must demonstrate higher-level cognitive abilities necessary to measure, calculate, and reason in order to conceptualize, analyze, integrate and synthesize information. In addition, the resident must be able to comprehend dimensional and visual-spatial relationships. All of these problem-solving activities must be achieved progressively in a timely fashion. These skills must contribute to sound judgment based upon clinical and ethical reasoning.

1.5 Professionalism - A resident must consistently display integrity, honesty, empathy, compassion, fairness, respect for others, and dedication.  Residents must take responsibility for themselves and their behaviours. The resident must promptly complete all assignments and responsibilities attendant not only to the study of medicine, but also to

the diagnosis and care of patients. It is essential that a resident progressively develop mature, sensitive and effective relationships with patients and their families, and all

members of healthcare teams. The resident must be able to tolerate the physical, emotional, and mental demands of the program and must develop an ability to function effectively under stress. It is necessary to adapt to changing environments, and function in the face of uncertainties that are inherent in the care of patients.

2. Postgraduate Residency Programs must define any discipline-specific essential skills and abilities in addition to those outlined in 1.1 to 1.5, and these must be posted on the respective CaRMS websites.

3. Some skills may be achieved with reasonable accommodation granted pursuant to and in accordance with the Dalhousie policy entitled Postgraduate Medical Trainee Academic Accommodation Policy which precedes this document.

4. All applicants to the Postgraduate Program of the Faculty of Medicine must review this Essential Skills document to assess their ability to meet these standards. All applicants offered admission will be required to acknowledge via sign off in their letter of offer such review and assessment.

5. Any candidate for residency who cannot attain the required skills and abilities through their course of study may be required to withdraw from the program or dismissed from the program.

6. Residents who anticipate requiring accommodation must follow the appropriate procedures in the Dalhousie Postgraduate Medical Trainee Academic Accommodation Policy.

7. Residents needing an accommodation may request an extension of time within which to complete their Residency Program but must complete their training within the required time as per the guidelines from the Royal College of Physicians and Surgeons of Canada and the College of Family Physicians of Canada. Such requests are considered on a case-by-case basis.

8. Regulations are issued from time to time by the Royal College of Physicians and Surgeons of Canada regarding the accommodation of candidates undertaking examinations as a component of eligibility for licensure: such regulations are supplemental to general information available to all candidates. Accordingly residents are encouraged to contact the Royal College regarding examination accommodations.