New warning shot on the training of doctors

A group of education experts affirms in turn that the training of medical specialists in Quebec “lacks rigor”. In a new analysis that The duty obtained, four pedagogues deplore the confusion of roles between Canadian and Quebec authorities in the area of ​​medical education.

This critical point of view on the training of medical specialists is signed by the educational consultant Christian Boyer, by professors Steve Bissonnette and Frédéric Morneau-Guérin, of the Education Department of TELUQ, and by the philosopher and essayist Normand Baillargeon, also a columnist at To have to.

The authors argue that the pedagogical method focused on “skills development” put in place in 2017 for the training of medical residents is not proven and is not supported by any evidence from scientific research.

” [Nous] maintain that the Canadian and Quebec medical world, by adopting [cette formule pédagogique]has moved away from the evidence, the necessary rigor and the conscientious caution that it usually exercises with regard to medical innovations, ”write the authors of this 108-page report dated September 2022.

Experts agree with the Federation of Resident Physicians of Quebec (FMRQ), which has denounced this “improvised” educational reform in recent days. This method obliges future medical specialists to have hundreds of observation and evaluation sheets filled out by their supervisors during their five years of residency. The residency consists of paid internships with real patients in a hospital setting.

Resident doctors claim that this formula leads to overwork and a mad rush to fill out paperwork, in addition to creating anxiety among medical students. This method is also supposed to allow more feedback from internship supervisors to their students — which the residents want — but has the opposite effect, deplores the FMRQ.

“Far from being a success, this method is an example of what not to do,” adds researcher Christian Boyer in an interview with the To have to.

According to him and his colleagues, the Royal College of Physicians and Surgeons of Canada, which oversees the training of physicians across the country, should have implemented its reform gradually, through pilot projects, and adapted it by conducting scientific observations on field. Rather, the Royal College launched its reform in a rush.

Confusion of roles

The FMRQ has been sounding the alarm for five years about the shortcomings of this “pedagogical revolution”, but the medical authorities remain insensitive, deplore Christian Boyer and his colleagues.

After five years of this reform, “has the quality of patient care improved? Have the professional skills of medical residents improved? Is the rate of adverse events [ou d’erreurs médicales] decreased ? We don’t know because these elements have not been measured rigorously,” the researchers write.

“Who is responsible for education and medical training in Quebec? Could it be the Royal College of Physicians and Surgeons of Canada? The College of Physicians of Quebec? […] Medical schools? add the authors of the study.

For its part, the Federation of Resident Physicians of Quebec is calling for a helm “to do what should have already been done several years ago: that those responsible for the medical education system and the health care system in Quebec stop s rely solely on pan-Canadian groups in medical education, such as the Royal College [du Canada]to decide what is best for our medical succession, for our health care system and for the people of Quebec”.

Canadian standards

The College of Physicians of Quebec (CMQ) explains that it has eliminated its own certification exams for medical students in the wake of a national agreement that has paved the way for the practice of the profession throughout Canada.

“Like most candidates in Quebec [faisaient] Royal College (RC) or College of Family Physicians of Canada (CFPC) exams in addition to those specific to Quebec, the CMQ has decided to no longer require license applicants to pass written and oral CMQ exams to be able to obtain their certification from our College. The example often given at the time was why a doctor from Ottawa, if he wanted to practice in Gatineau, had to pass additional exams to obtain CMQ certification, while a doctor from Gatineau could practice in Ottawa, only with the CR or CFPC exams”, underlines the College of Physicians.

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