“Intrinsic Roles” rather than “armour”: renaming the “non-medical expert roles” of the CanMEDS framework to match their intent

Abstract

We read with interest the e-publication by Whitehead et al. (2011) that argues that the CanMEDS framework is organized in a defensive fashion with the central Medical Expert Role ‘‘armoured’’ by the other Roles (Communicator, Collaborator, Manager, Health Advocate, Scholar, and Professional). We believe this is a significant misinterpretation of the constructs underlying one of the world’s most widely used competency frameworks, particularly as one of the authors (BH) contributed to its development (Frank et al. 1996). CanMEDS, like many high-utility competency frameworks, was derived not from political machinations, but from a systematic needs assessment that included the perspectives of the public on what they needed from physicians (Frank et al. 1996). While the authors share our concern that simply ‘‘anatomizing’’ physician competence into a series of sub-domains may impair the fidelity of global competence (i.e. the sum is more than the parts), evidence from the learning sciences suggests that dividing competence into its component parts has educational value, thus refuting such concerns (Frank et al. 2010; Swing and International CBME Collaborators 2010). In fact, the educational utility of an explicit model is seen in the influence of the CanMEDS framework in