Un programme national d’études en anesthésie: justification, élaboration, mise en œuvre et implications

Abstract

In 2010, the Specialty Committee of the Royal College of Physicians and Surgeons of Canada (RCPSC) approved the use of the National Postgraduate Medical Education Curriculum in Anesthesia as a companion to the description of the Role of Medical Expert in the Objectives of Training Requirements (OTRs). The National Curriculum in Anesthesia represents the first of its kind in postgraduate medicine in Canada and will be a model for other national curricula moving forward. A collective consensus was reached amongst the Association of Canadian University Departments of Anesthesia (ACUDA) program directors and the RCPSC Specialty and Examination Boards that the time had come for a national curriculum. Ironically, the concept of developing a national curriculum in anesthesia was not new. The first efforts at developing a national curriculum in anesthesia began in 1971. A committee was established through the University Departments of Anesthesia (now known as ACUDA) to build a curriculum that would align curriculum objectives to specialist national exam criteria. In their commentary in 1974, Green et al. articulated the same rationale as is the impetus for the current project. Several sound reasons exist to create the standardized national curriculum. Over time, residents have found it more difficult to prepare for national examinations given the increasing overlap with other specialty disciplines in medicine and general surgery. Furthermore, the Examination Board did not have a well-defined curriculum around which to define the examination. With 17 different curricula driving one national exam, there was no assurance that anesthesia residents in all centres were being exposed to the specific elements of the medical expert competencies. With the growing demands of social accountability, there is increased pressure for programs to adapt to meet the challenges of aging populations, continuing change in health care systems, and complex work environments. While all postgraduate residency anesthesia programs were based on OTRs set out by the RCPSC and were all well developed prior to the National Curriculum in Anesthesia, there remained a gap in standardized curricular content to prepare residents for a standardized national exam in anesthesia. The introduction of competencies and the development of training models outside of the traditional apprenticeship approach to medical education were creating gaps for postgraduate medical educators in terms of matching objectives to assessment and learning strategies. The development of the recent National Curriculum in Anesthesia is a milestone in narrowing this gap.