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Rebuttal: Will the Triple C curriculum produce better family physicians?: YES

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Canadian Family PhysicianLe Médecin de famille canadien

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Vol 58: oCToBER oCToBRE 2012

Debates | Web exclusive

Rebuttal: Will the Triple C curriculum produce better family physicians?

David Tannenbaum

MD CCFP FCFP

YES

M

y esteemed colleague argues1 that an absence of evidence supporting educational change precludes proceeding with new ways of doing things (including evolving toward a competency-based curriculum). Yet the traditional way of educating residents was never built on evidence. There is no doubt that educational research should be expanded (and this will hope- fully be an important spinoff of the introduction of the Triple C curriculum)—in the meantime we must be will- ing to support innovation and the study of new meth- ods. Success will be hard to “prove,” but the College is embarking on an evaluation of these curricular changes in an effort to identify best practices.

Dr Whitehead suggests that the only signifi- cant new aspect of the Triple C curriculum is that it is competency-based. I would suggest that the family medicine–centred component is equally important.

Family medicine–centred implies ensuring that we focus training on content that is fully relevant to family medi- cine, and that we train residents predominantly in family medicine environments where skilled clinician-teachers, including some in focused practice, provide coaching and role modeling. (This does not preclude using highly effective “specialty” educational experiences that help residents acquire specific competencies.)

Adopting the CanMEDS–Family Medicine roles as a competency framework is viewed by my colleague as an unnecessary move away from the 4 principles of family medicine. Yet many view the CanMEDS–Family Medicine roles as far more intuitive, easier to work with, and better aligned with directions taken by the broader

medical education community—and it incorporates all of the key aspects of the 4 principles.

Dr Whitehead cautions that we not lose the holistic aspects of training and become slaves to checklists and burdensome forms. Those involved in the implementa- tion of Triple C are certainly sensitive to these concerns.

The educational excellence that has evolved over many years in family medicine residency training in Canada will serve as the base from which creative educators build flexible resident-centred programs that incorporate better ways of teaching and assessing learners. Through the move to Triple C we are witnessing the development of a remarkable, cohesive community of practice among educators from the 17 medical schools and their many training sites. This synergistic alliance, supported by the College, will no doubt lead to important educational progress and stronger training programs overall.

Dr Tannenbaum is Chair of the Working Group on Curriculum Review of the College of Family Physicians of Canada, Associate Professor in the Department of Family and Community Medicine at the University of Toronto, Family Physician-in-Chief at Mount Sinai Hospital in Toronto, and President of the Ontario College of Family Physicians.

Competing interests

Dr Tannenbaum is Chair of the Working Group on Curriculum Review of the College of Family Physicians of Canada.

Correspondence

Dr David Tannenbaum, Mount Sinai Hospital, Family Medicine, 60 Murray St, Box 25, 4th Floor, Toronto, ON M5T 3L9; telephone 416 586-4800, extension 3190; fax 416 586-3175; e-mail [email protected]

Reference

1. Whitehead C. Will the Triple C curriculum produce better family physicians?

No [Debate]. Can Fam Physician 2012;58:1071, 1073 (Eng), 1075,1077-8 (Fr).

These rebuttals are responses from the authors of the debates in the October issue (Can Fam Physician 2012;58:1070-3 [Eng], 1074-8 [Fr]).

Cet article se trouve aussi en français à la page e540.

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