Defining Content for a Competency-based (CanMEDS) Postgraduate Curriculum in Ambulatory Care: A Delphi Study

  • René Wong University of Toronto


Background: Ambulatory training in internal medicine has been noted to be dysfunctional and inadequate. In this study, we developed a set of competency-based outcomes specific to ambulatory care to guide the design, implementation and evaluation of instructional events to ensure that societal needs are addressed.

Methods: In 2007 a Delphi technique was used to reach consensus and define the priorities for competency-based training in ambulatory care for internal medicine residents. Four groups of stakeholders in Canada participated: program directors, members of the Canadian Society of Internal Medicine, recent graduates, and residents.

Results: Two rounds of the Delphi process were required to reach consensus on a set of sixty competency-based educational objectives in ambulatory care that were classified under the CanMEDS roles. The inclusion of recent graduates in this study resulted in the addition of non-clinical topics that would have otherwise been missed, falling under roles historically viewed as being challenging to teach and evaluate (Manager, Health Advocate).

Conclusion: This study is the first time a Delphi-process has been used to define the priorities for ambulatory care training in internal medicine under a competency-based framework. The resulting compendium of competency-based objectives provides a foundation from which educators can design, evaluate and modify existing training experiences.

Author Biography

René Wong, University of Toronto


Assistant Professor

Department of Medicine, University of Toronto


How to Cite
Wong, R. (2012). Defining Content for a Competency-based (CanMEDS) Postgraduate Curriculum in Ambulatory Care: A Delphi Study. Canadian Medical Education Journal, 3(1), e21-e32.
Major Contributions