Table 2:

Summary of the core competencies of geriatric psychiatrists, geriatricians and family physicians with certification in Care of the Elderly, by CanMEDS Roles

CanMEDS role	Competency	Geriatric psychiatrist	Geriatrician	Family medicine, Care of the Elderly
Medical expert/family medicine expert	Differentiates normal and abnormal aging	X	X	X
	Considers a patient’s comorbidities, frailty and functional status to prognosis	X	X	X
	Prevents, diagnoses and manages delirium	X	X	X
	Examines, diagnoses and manages neurocognitive disorders (i.e., dementia) and associated behavioural changes or disturbances	X	X	X
	Appropriately prescribes pharmaceuticals	X	X	X
	Elicits patient histories	X	X	X
	Tailors interventions for health promotion and disease prevention	X	X	X
	Assesses issues related to capacity and competency (i.e., personal decision-making, driving)	X	X	X
	Enquire about caregiver stress and capacity	X	X	X
	Knowledgeable about end-of-life care	X	X	X
	Applies best practices for falls prevention and screening		X	X
	Diagnoses and manages osteoporosis and fracture risk		X	X
	Develops rehabilitative approaches		X	X
	Performs detailed medication reviews		X	X
	Assesses for urinary incontinence		X	X
	Diagnoses and manages pain		X	X
	Manages palliative and end-of-life care issues		X	X
	Knowledgeable about psychotherapeutic constructs, psychopharmacology and therapeutic approaches	X
	Exhibits extensive knowledge about mental illnesses and psychiatric disorders	X
	Performs a comprehensive geriatrics assessment		X
	Diagnoses and manages bowel dysfunction		X
Communicator	Elicits and synthesizes information from patients, families and care providers	X	X	X
	Recognizes and mitigates communication barriers	X	X	X
	Considers the merits of a second opinion	X	X	X
	Ensures communication during transfers or handover	X	X	X
	Prioritizes issues for patient encounters with a recognition that the role is that of a specialist (not a primary care provider)	X	X
	Proficient in the use of telepsychiatry	X
Collaborator	Performs timely consults	X	X	X
	Exhibits respect for team members	X	X	X
	Collaborates on assessments and care management	X	X	X
	Respects the scopes of practice, differences and overlapping or shared responsibilities of providers	X	X	X
	Engages in shared decision-making with families and caregivers	X	X	X
	Identifies opportunities for learning and improvement	X	X	X
	Plans and delivers learning activities	X	X	X
	Describes the roles and responsibilities of geriatric mental health care teams and show leadership in teams	X
	Acts as an expert resource on issues such as mental health legislation	X
Leader	Knowledgeable about community resources	X	X	X
	Mediates and resolves conflicts within interprofessional teams	X	X	X
	Applies quality improvement principles to evaluate and improve health care systems and cost-appropriate care	X	X	X
	Understands the health care system relevant to caring for older patients	X	X
	Competent in the use of health informatics to improve care quality and optimize safety		X
	Engages in stewardship of health care resources	X	X	X
Health advocate	Adapts to meet patient needs and preferences	X	X	X
	Recognizes and manages abuse, neglect and mistreatment of older adults	X	X	X
	Advocates for essential hospital and community resources and services	X	X	X
	Identifies and responds to policies affecting health	X	X	X
	Identifies vulnerable and marginalized populations and responds to cultural issues	X	X
	Identifies patient vulnerabilities		X
	Advocates for evidence-based health promotion		X
	Determines the need for immediate intervention, such as home visits			X
Scholar	Recognizes knowledge limitations or gaps in literature specific to the medical care of geriatric populations	X	X	X
	Critically appraises evidence, research and literature	X	X
	Poses scholarly questions, selects and applies methods to address questions, and communicates and disseminates findings	X	X
	Participates in research, program development, medical education and other activities that improve the delivery of services	X	X	X
	Recognizes the influence of role modelling and the effect of the formal, informal and hidden curricula on learners		X
Professional	Identifies the capacity for decision-making	X	X	X
	Obtains and documents informed consent	X	X	X
	Respects confidentiality, privacy and ethical codes	X	X	X
	Adheres to substitute decision-making policies	X	X	X
	Exhibits appropriate professional boundaries	X	X
	Shows a commitment to high-quality care and excellence	X	X
	Prioritizes personal and professional duties	X	X