Table 3.

The definitive competence inventory as confirmed by the experts in the last Delphi round

CanMEDS role	Key competence
Medical Expert	* has insight in required medical knowledge with regard to a clinical problem, i.e.:
the student	∘ applies the acquired knowledge
	∘ applies medical decision making
	* efficiently applies acquired medical skills with regard to a clinical problem
	* accomplishes a health care plan:
	∘ performs a relevant and adequate intake and anamnesis
	∘ performs an efficient physical or other examination
	∘ generates a differential diagnosis
	∘ efficiently gathers, analysis, and interprets data (from anamnesis, physical examination, and technical investigations)
	∘ generates an accurate diagnosis
	∘ presents efficient treatment plans
	* generates an accurate, multidisciplinary health care plan with specific attention for patient’s self care and follow up care
	* defines symptoms of the most common and critical diseases and recognises alarm symptoms (also for differential diagnosis)
	* integrates the different CanMEDS roles
Communicator	* clearly and understandable reports a relevant, complete, systematic and accurate intake and anamnesis
the student	* writes reports concerning patients encounters in the medical record and in referral letters to other health care providers
	* can manage a patient record, and clearly and structurally provides (all) the information to other health care providers.
	* verbally reports on patients encounters to other doctors and health care providers
	* communicates scientific research in a clear, complete and structural way
	* communicates during a patient’s encounter according to the rules of good practice
	* establishes (and maintains) an empathic, trustful and ethical doctor-patient relationship and doctor-family relationship
	* reflects on own communication skills and their progression
Collaborator	* knows and involves the profile and competences of other health care providers
	* actively takes part in team work
the student	* effectively contributes to the interdisciplinary teamwork concerning patient care, education and research
	* integrates following aspects with regard to team work:
	∘ taking and giving responsibility
	∘ delegating and organising
	∘ giving and taking suggestions to/of other health care providers
	∘ supporting the “chain-of-care” (increasing effective team work)
	∘ coping with conflicts between professionals
	* reflects on teamwork and on respecting the opinions of other team members
Manager	* reflects on self-care and the balance between work and personal development (work/private time management)
the student	* ranks information in order of importance and urgency; responsibly prioritises, and motivates priorities (professional time management)
	* correctly and punctually deals with administrative and organisational tasks
	* registers, classifies, and transfers patient related data in an effective (and trustful) way
	* uses information technology to:
	∘ optimise patient care and practice organisation – (patient related databases)
	∘ stimulate “life long learning” – (medical databases)
	* can work within the health care system and other care systems (welfare, justice) in Belgium
	* has insights in costs of medical care and their implication for society, patients and medical doctors
	* has insights in procedures for solicitations and contractual negotiations
Health advocate	* reflects on: psychological, social, economical, biological, ethical, cultural, and religious aspects influencing patients’ health
the student	* attends to the individual patient and the population regarding health-related aspects (primary prevention)
	* deals with prevention and health promotion for the individual patient and the population (secondary prevention)
	* has attention for patient safety
	* efficiently accompanies patients through the health care system and reasons in support of a decision making
	* prioritises the patient’s benefits
	* involves and facilitates the accessibility of health care during daily practice, especially for vulnerable groups of patients
	* reflects on critical incidents in doctor’s practice
Scholar	* poses relevant, practical and scientific questions with regard to patient care
the student	* performs searches in medical scientific databases/sources in an efficient, purposeful and rapid way
	* questions the quality of consulted medical scientific databases/sources
	* adequately applies scientific information in decision making in doctor’s practice
	* development and follow up of a personal learning plan
	∘ can critically reflect on daily performance in the doctor’s practice
	∘ describes and analyses own personal learning needs
	∘ applies an adequate learning method
	∘ self evaluates or evaluates with peers his learning results and remediates
	* assists in creating, spreading, and applying new medical knowledge and practice
	* stimulates training of patients, family, students, trainees, other health care workers, population
	* adapts his functioning to societal evolutions in health care
	* is open-minded towards “life long learning”
Professional	* utilises the highest quality of care for his patient in an integral, upright and ethical way
the student	* understands the meaning of and applies:
	∘ professional codes
	∘ ethical codes and dilemmas (= uses an ethical frame)
	∘ legal codes
	* reflects on
	∘ own behaviour
	∘ own professional attitude: shows willingness to offer medical care in an optimal, ethical, and patient centred way
	∘ attitude and behaviour of others and evaluates this for himself
	∘ legal implications of patient care (patient rights, professional secrecy or professional confidentiality, DNR-codes, end-of-life coaching)
	∘ professional, ethical and legal codes
	* has an appropriate professional attitude and behaviour, demonstrating
	∘ honesty
	∘ integrity
	∘ engagement
	∘ respect
	∘ understanding, empathy
	∘ altruism
	and remediates (himself) when needed
	* recognises his own limits, weaknesses or lacunas and can cope with these