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University Students

Preparing to Apply to Medicine….


Dr. Kayla Berst, NOSM Assistant Professor and Alumna, speaks about her NOSM journey.

The Royal College of Physicians and Surgeons of Canada has created a framework that identifies and describes the abilities required by doctors to effectively meet the health-care needs of the people they serve.

This framework of abilities is called the CanMEDS Roles, and the NOSM University Admissions process is set up to look for the potential of an individual to develop these skills in those who apply to medicine. So, as you consider what to focus on and what skills you need to develop while you are in university, and/or while you are working or volunteering, consider the CanMEDS Roles.

CanMEDS DiagramCopyright © 2015 The Royal College of Physicians and Surgeons of Canada. Reproduced with permission.

Medical Expert (the integrating role)

As Medical Experts who provide high-quality, safe, patient-centred care, physicians draw upon an evolving body of knowledge, their clinical skills, and their professional values. They collect and interpret information, make clinical decisions, and carry out diagnostic and therapeutic interventions. They do so within their scope of practice and with an understanding of the limits of their expertise. Their decision-making is informed by best practices and research evidence, and takes into account the patient’s circumstances and preferences as well as the availability of resources. Their clinical practice if up-to-date, ethical, and resource-efficient, and is conducted in collaboration with patients and their families*, other healthcare professionals, and the community. The Medical Expert Role is central to the function of physicians and draws on the competencies included in the Intrinsic Roles (Communicator, Collaborator, Leader, Health Advocate, Scholar, and Professional).¹

¹Banji F, Lawrence K, Goldszmidt M, Walton M, Harris K, Creery D, Sherbino J, St-Marie L-G, Stang A. Medical Expert. In: Frank JR, Snell L, Sherbino J, editors. CanMEDS 2015 Physician Competency Framework. Ottawa: Royal College of Physicians and Surgeons of Canada; 2015.


Physicians enable patient-centred therapeutic communication by exploring the patient’s symptoms, which may be suggestive of disease, and by actively listening to the patient’s experience of his or her illness. Physicians explore the patient’s perspective, including his or her fears, ideas about the illness, feelings about the impact of the illness, and expectations of health care and health care professionals. The physicians integrates this knowledge with an understanding of the patient’s context, including socio-economic status, medical history, family history, stage of life, living situation, work or school setting, and other relevant psychological and social issues. Central to a peitent0centred approach is shared decision-making: finding common ground with the patient in developing a plan to address his or her medical problems and health goals in a manner that reflects the patient’s needs, values, and preferences. This plan should be informed by evidence and guidelines.

Because illness affects not only patients but also their families, physicians must be able to communicate effectively with everyone involved in the patient’s care.¹

¹Neville A, Weston W, Martin D, Samson L, Feldman P, Wallace G, Jamoulle O, François J, Lussier M-T, Dojeiji S. Communicator. In: Frank JR, Snell L, Sherbino J, editors. CanMEDS 2015 Physician Competency Framework. Ottawa: Royal College of Physicians and Surgeons of Canada; 2015.


Collaboration is essential for safe, high-quality patient-centred care, and involves patients and their families*, physicians and other colleague in the health care professions, community partnets, and health system stakeholders.

Collaboration requires relationships based in trust, respect, and shared decision-marking among a variety of individuals with complementary skills in multiple settings across the continuum of care. It involves sharing knowledge, perspectives, and responsibilities, and a willingness to learn together. This requires understanding the roles of others, pursuing common goals and outcomes, and managing differences.

Collaboration skills are broadly applicable to activities beyond clinical care, such as administration, education, advocacy, and scholarship.¹

¹Richardson D, Calder L, Dean H, Glover Takahashi S, Lebel P, Maniate J, Martin D, Nasmith L, Newton C, Steinert Y. Collaborator. In: Frank JR, Snell L, Sherbino J, editors. CanMEDS 2015 Physician Competency Framework. Ottawa: Royal College of Physicians and Surgeons of Canada; 2015.


The CanMEDS Leader Role describes the engagement of all physicians in shared-decision making for the operation and ongoing evolution of the health care system. As a societal expectation, physicians demonstrate collaborative leadership and management within the health care system. At a systems level, physicians contribute to the development and delivery of continuously improving health care and engaged with others in working toward this goal. Physicians integrate their personal lives with their clinical, administrative, scholarly, and teaching responsibilities. They function as individual care providers, as members of teams, and as participants and leaders in the health care system locally, regionally, nationally, and globally.¹

¹Dath D, Chan M-K, Anderson G, Burke A, Razack S, Lieff S, Moineau G, Chiu A, Ellison P. Leader. In: Frank JR, Snell L, Sherbino J, editors. CanMEDS 2015 Physician Competency Framework. Ottawa: Royal College of Physicians and Surgeons of Canada; 2015.

Health Advocate

Physicians are accountable to society and recognize their duty to contribute to efforts to improve the health and well-being of their patients, their communities, and the broader populations they serve.† Physicians possess medical knowledge and abilities that provide unique perspectives on health. Physicians also have privileged access to patients’ accounts of their experience with illsness and the health care system.

Improving health is not limited to mitigating illness or trauma, but also involved disease prevention, health promotion, and health protection. Improving health also includes promoting health equity, whereby individuals and populations reach their full health potential without being disadvantaged by, for examples, race, ethnicity, religion, gender, sexual orientation, age, social class, economic status, or level of education.

Physicians leverage their position to support patients in navigating the health care system and to advocate with them to access appropriate resources in a timely manner. Physicians seek to improve the quality of both their clinical practice and associated organizations by addressing the health needs of the patients, communities, or populations they serve. Physicians promote healthy communities and populations by influencing the system (or by supporting others who influence the system), both within and outside of their work environments.

Advocacy requires action. Physicians contribute their knowledge of the determinants of health to positively influence the health of the patients, communities, or populations they serve. Physicians gather information and perceptions about issues, working with patients and their families* to develop an understanding of needs and potential mechanisms to address these needs. Physicians support patients, communities, or populations to call for change, and they speak on behalf of others when needed. Physicians increase awareness about important health issues at the patient, community, or population level. They support or lead the mobilization of resources (e.g. financial, material, or human resources) on small or large scales.

Physician advocacy occurs within complex system and thus requires the development of partnerships with patients, their families and support networks, or community agencies and organizations to influence health determinants. Advocacy often requires engaging other health care professionals, community agencies, administrators, and policy makers.¹

In the CanMEDS 2015 Framework, a “community” is a group of people and/or patients connected to one’s practice, and a “population” is a group of people and/or patients with a shared issue or characteristic.

¹Sherbino J, Bonnycastle D, Côté B, Flynn L, Hunter A, Ince-Cushman D, Konkin J, Oandasan I, Regehr G, Richardson D, Zigby J. Health Advocate. In: Frank JR, Snell L, Sherbino J, editors. CanMEDS 2015 Physician Competency Framework. Ottawa: Royal College of Physicians and Surgeons of Canada; 2015.


Physicians acquire scholarly abilities to enhance practice and advance health care. Physicians pursue excellence by continually evaluating the processes and outcomes of their daily work, sharing and comparing their work with that of others, and actively seeking feedback in the interest of quality and patients safety. Using multiple ways of learning, they strive to meet the needs or individuals patients and their families* and of the health care system.

Physicians strive to master their domains of expertise and to share their knowledge. As lifelong learners, they implement a planned approach to learning in order to improve in each CanMEDS Role. They recognize the need to continually learn and to model the practice of lifelong learning for others. As teachers they facilitate, individually and through teams, the education of students and physicians in training, colleagues, co-workers, the public, and others.

Physicians are able to identify pertinent evidence, evaluate it using specific criteria, and apply it in their practice and scholarly activities. Through their engagement in evidence-informed and shared decision-making, they recognize uncertainty in practice and formulate questions to address knowledge gaps. Using skills in navigating information resources, they identify evidence syntheses that are relevant to these questions and arrive at clinical decisions that are informed by evidence while taking patient values and preferences into account.

Finally, physicians’ scholarly abilities allow them to contribute to the application, dissemination, translation, and creation of knowledge and practices applicable to health care.¹

¹Richardson D, Oswald A, Chan M-K, Lang ES, Harvey BJ, editors. Scholar. In: Frank JR, Snell L, Sherbino J, editors. CanMEDS 2015 Physician Competency Framework. Ottawa: Royal College of Physicians and Surgeons of Canada; 2015.


Physicians serve an essential societal role as professionals dedicated to the health and care of others. Their work requires master of the art, science, and practice of medicine. A physician’s professional identity is central to this Role. The Professional Role reflects contemporary society;s expectations of physicians, which include clinical competence, a commitment to ongoing professional development, promotion of the public good, adherence to ethical standards, and values such as integrity, honesty, altruism, humility, respect for diversity, and transparency with respect to potential conflicts of interest. It is also recognized that , tor provide optimal patient care, physicians must take responsibility for their own health and well-being and that of their colleagues. Professionalism is the basis of the implicit contract between society and the medical profession, granting the privilege of physician-led regulation with the understanding that physicians are accountable to those served, to society,m to their profession, and to themselves.¹

¹Snell L, Flynn L, Pauls M, Kearney R, Warren A, Sternszus R, Cruess R, Cruess S, Hatala R, Dupré M, Bukowskyj M, Edwards S, Cohen J, Chakravarti A, Nickelle L, WRight J. Professional. In: Frank JR, Snell L, Sherbino J, editors. CanMEDS 2015 Physician Competency Framework. Ottawa: Royal College of Physicians and Surgeons of Canada; 2015.

*Throughout the CanMEDS 2015 Framework and Milestone Guide, references to the patients family are intended to include all those who are personally significant to the patients and are concerned with his or her care, including, according to the patient’s circumstances, family members, partners, caregivers, legal guardians, and substitute decision-makers.

For more information about the CanMEDS Framework visit the Royal College of Physicians and Surgeons of Canada CanMEDS webpage.

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