Teaching CanMEDS to Ophthalmology Residents in a Post-Modern Era
2009, Volume 2, Number 1 15 Introduction In the early 1990s the Royal College of Physicians and Surgeons of Canada (RCPSC) set a task force to [ensure] that surgical practice meets the needs of the modern society [1]. The result of this task force was the creation of Canadian Medical Education Direc-tions for Specialists (CanMEDS) (2000), which iden-tifies seven ethical principles that a physician needs to follow: medical expert, professional, communicator, scholar, health advocate, collaborator, and manager. These measurable objectives were introduced at an important time. One of the major criticisms of the medical profession in the late twentieth century has been its inability to adjust itself with the changing milieu of the society. While the general perception of the society has changed starting in the late nineteenth century towards post-modernism, medicine has stayed modern. To further expand on this point, post-modern era as opposed to the modern era, which focused on the indefinite ability of medicine and research to cure all, realizes the limitations of science and technology. It could be loosely defined as a change in social atti-tudes towards being suspicious of the value of scien-tific advances, realization of the importance of the socio-political framework within which scientific questions (as in evidence-based medicine) are being asked and answered, and the importance of personal experience of physicians and their wide exposure to medical problems for better diagnosis and cure [2]. The concept of `truth' has also changed, from an an-swer that is `out there' waiting to be discovered, as was the ideology during the modern era, to one that is constructed by the society and is subject to the test of time [3]. In addition, post-modernity emphasizes that Teaching CanMEDS to Ophthalmology Residents in a Post-Modern Era Mahta Rasouli, MD 1 , Louis Giavedoni, MD 2 , and Waiching Lam, MD 3* 1 Department of Ophthalmology, University of Alberta, Edmonton, Alberta, Canada 2 Department of Ophthalmology, University of Toronto and St Michael's Hospital, Toronto, Ontario, Canada 3 Department of Ophthalmology, University of Toronto and Toronto Western Hospital/University Health Network, Toronto, Ontario, Canada * Corresponding Author & e-mail: waiching.lam@utoronto.ca Abstract Teaching Canadian Medical Education Directives for the Specialists (CanMEDS) to the Residents is now a man-datory part of every ophthalmology curriculum in Canada. This paper reviews the role of CanMEDS in a post-modern era. We also assess whether the educational tools used in a two-year period in an ophthalmology residency program have been effective. We report a qualitative analysis of the proficiency of Residents in one ophthalmology program. The first exami-nation included post-graduate year 2 and 3 (PGY-2 and PGY-3) residents, where they were asked to incorporate ethics questions and name six CanMEDS criteria. The second examination which took place a year later, included all the Resi-dents in the program, where they were asked to evaluate case scenarios, keeping the CanMEDS goals in mind. The PGY-2 (n=5) Residents achieved a score of 36% on the ethics questions, and 30% on the naming of the six CanMEDS criteria. The PGY-3 (n=5) Residents achieved 33% on the ethics questions, and 23% on naming the criteria. The Residents' performance on the subsequent examination improved dramatically. The following is the breakdown of the results: PGY-2 (n=4; scored 98%), PGY-3 (n=5; scored 84%), PGY-4 (n=5; scored 84%), and PGY-5 (n=4; scored 88%). From these preliminary results there seems to be a need for alternate approaches to teaching this topic that goes beyond the traditional classroom environment. We also need to find methods of motivating the trainees to actively think about and implement the CanMEDS principles in their daily approach to treating their patients. Accepted for publication March 25, 2009 Revision received April 19, 2009 2009; 2: 15-18. Available via open-access on the web at http://www.academic-ophthalmology.com The author(s) have no personal financial interest in any of the products or technologies cited herein. Â 2009