The CanMEDS competencies are a set of roles of current and aspiring physicians considered integral to being a capable doctor. While they are typically groan-inducing if mentioned to a group of physicians or med students after they get over that "OMG I'm in Med School" feel (typically takes 2 months), they do serve as a reasonably useful framework.
The reason I find them useful is that deficiencies in any one of them by a physician tends to lead to problems for patients, though not always in obvious, easily identifiable ways. As such, they're qualities every well-rounded physician should be working on improving and maintaining.
Yet every single physician has a weakness in at least one of those roles (full disclosure - for me, I believe it's "Collaborator" and to a lesser extent, "Health Advocate"). That's not a terrible thing - we all have strengths and weaknesses, interests and areas where we struggle. Being less-than-stellar in these areas does lead to sub-optimal care, but doctors are humans and no human is perfect, so a degree of sub-optimal care is unavoidable. More importantly, there's a bit of a diminishing return on improving in many of these roles. Being merely competent at all roles gets a physician most of the way to providing good-quality care.
Where trouble can arise is when physicians are exceptionally strong in one area and almost completely deficient in another. The stereotypical example is the physician who is a strong Medical Expert and Scholar, but a horrible Communicator - I can think of several physicians off the top of my head that fit that description. Being great in one role doesn't compensate for being inadequate in another, because physicians have to jump between these roles frequently.
Another point of trouble is when physicians as a group collectively struggle in any one role. Medicine is ultimately a team sport, so mild deficiencies from an individual perspective can be overcome by strength from a group perspective. The "Scholar" role fits that description well - there are certainly many physicians who are not the strongest Scholars, but because the medical field places such an emphasis on scholarly work, the profession overall does pretty well on that front.
There are certainly some of the CanMEDS roles where physicians, as a group, are lacking. We do well on the "Medical Expert" side of things and, as I said, are pretty good from the "Scholar" perspective. Everything else is a bit of a mixed bag. I'd like to briefly focus on one role that I find often gets neglected: "Manager".
When thinking about management, a lot of physicians immediately think of the administrative tasks that we all hate to do, or the administrators whose primary function sometimes seems to be making practicing medicine more difficult. (As an aside, those administrative tasks and administrators are often quite necessary or helpful, but often in a long-term, big-picture way that's hard to appreciate day-to-day). Yet management, at a fundamental level, really just involves organizing groups of people (including yourself) to accomplish a task efficiently and effectively. Physicians do this all the time, whether it's managing other physicians or members of a larger healthcare team. Knowing how to do this effectively is critical to coordinating care.
The basics of this are not that difficult - for the most part, as long as every member of the team knows what they're supposed to do, by when, and who to check in with when it's completed. Yet, it's amazing how often this basic structure does not get followed and how easily teamwork on a project - or a patient - falls apart without it.
Being a good manager also involves knowing how to be managed. Physicians are no longer the automatic leader of any group, for good reason. Being a good team-member is vital to being a good leader. By following, you learn how certain leadership strategies work and how some of them fail, where they can be adapted or improved upon. Following is a skill that physicians don't work enough on and as a consequence, we could be a lot better at the Manager role.
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