Canadians often chafe at American cultural imperialism, but Canada’s health-care leaders appear set to import American-style wokeness to the country’s medical schools.
Next year, the Royal College of Physicians and Surgeons of Canada, which oversees the training and licensure of the country’s doctors, will roll out the newest version of CanMEDS, a physician-education framework that effectively dictates the curriculum at Canada’s 17 accredited medical schools, including McGill University School of Medicine, which I attended and where I now serve on the faculty. The Royal College, established by an Act of Parliament in the 1929, proudly notes that CanMEDS is “the most widely accepted and applied physician competency framework in the world,” surpassing the equivalent system in the U.S.
But the new CanMEDS framework is on track to be disastrous. The final version won’t be released until later this year, but in November, the Royal College’s “anti-racism expert working group” released its interim report, demonstrating how the framework is taking shape. While the working group doesn’t officially control CanMEDS and is ostensibly merely seeking feedback, it is widely seen as setting the tone for the future of Canadian medical education.
The working group’s report, written by physicians, contains several stunning statements. The group recommends adopting “a new model” of education that “centre[s] values such as anti-oppression, anti-racism, and social justice, rather than medical expertise.” Elsewhere, it explicitly calls for “de-centering medical expertise,” and encourages educators to cultivate “an explicit stance of anti-racism, which requires constant learning and unlearning” and to “decoloniz[e] our minds and our institutions.”
The group’s proposal would go further than similar standards implemented by the U.S.-based Association of American Medical Colleges. Though the AAMC laces its own physician training with progressive ideology, unlike CanMEDS’s anti-racism working group, it hasn’t said that fighting oppression is more important than treating patients.
Canadian doctors and health-care workers deluged the Royal College with nearly 7,500 responses to the group’s proposal. I organized a letter from more than 300 medical professionals, calling on the Royal College to “reject any proposal to replace or water down medical training with political ideology.” As someone who clinically trains medical students in a large and diverse teaching hospital, I have yet to speak with a single colleague who supports the working group’s proposal. Even those who strongly believe in what Canadians often call EDI—equity, diversity, and inclusion—tell me that medical education should be centered on, well, medical education.
Will the Royal College listen to the country’s practicing physicians, to say nothing of the patients who want to see qualified doctors, not quasi-activists? It seems unlikely. While the Royal College’s CEO in December issued a plaintive note about the working group merely trying to “solicit input,” since then, the college has laid the groundwork for moving ahead with an ideologically motivated framework.
In January, CanMEDS’s leadership decried the supposed “misrepresentation” of the working group. Regarding those 7,000-plus responses, the CanMEDS Steering Committee claimed it is “working towards obtaining an independent qualitative analysis” of the feedback. It seems the Royal College may be looking for an excuse to ignore Canadian physicians and plow ahead with the ideological framework.
We Canadians pride ourselves on our medical system. My fellow physicians routinely tout our training as more intense and difficult than that of our American peers. Some Americans come to Canada for medical care, seeking lower prices and, we hope, superior outcomes. If the Royal College doesn’t change course, these medical tourists—and a far greater number of Canadian citizens—will soon see physicians poorly trained in medicine yet perfectly trained in politics. At least the American visitors will feel at home, since they’ve grown accustomed to woke medicine.
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