The CanMEDS Competency Framework in laboratory medicine: a phenomenographic study exploring how professional roles are applied outside the clinical environment


  • Chloe Bogaty Centre hospitalier affilié universitaire Hôtel-Dieu de Lévis
  • Janneke Frambach Maastricht University



Background: The CanMEDS Competency Framework is an internationally recognized model used to outline the proficiencies of a physician. It has predominantly been studied in clinical environments but not all medical specialties take part in direct patient contact. In laboratory medicine, the role of the physician is to promote and enhance patient diagnostics by managing and overseeing the functions of a diagnostic laboratory.

Methods: This phenomenographic study explores the lived experiences of biochemistry, microbiology, and pathology residency program directors to better understand how they utilize the CanMEDS competencies. Eight laboratory medicine program directors from across Canada were individually interviewed using a semi-structured interview, and the data was analysed using inductive thematic analysis.

Results: The findings show that the current framework is disconnected from the unique context of laboratory medicine with some competencies appearing unrelatable using the current standardized definitions and expectations. Nevertheless, participants considered the framework to be an appropriate blueprint of the competencies necessary for their professional environment, but to make it accessible more autonomy is required to adapt the framework to their needs.

Conclusion: Newer renditions of the CanMEDS Competency Framework should better consider the realities of non-clinical disciplines.


Metrics Loading ...


ACGME International. ACGME International Home. Chicago USA; 2000 (updated 2022). Available from: [Accessed on Dec 8, 2022].

Frank JR, Snell L, Sherbino J, editors. CanMEDS 2015 Physician Competency Framework. Ottawa (Canada): Royal College of Physicians and Surgeons of Canada; 2015.

Tromp F, Vernooij-Dassen M, Grol R, Kramer A, Bottema B. Assessment of CanMEDS roles in postgraduate training: the validation of the Compass. Patient Educ Couns. 2012(89):199-204. DOI:

Norman G, Sherbino J, Dore K, et al. The etiology of diagnostic errors: a controlled trial of system 1 versus system 2 reasoning. Acad Med. 2014;89(2):277-284. DOI:

Kogan JR, Holmboe S. Preparing residents for practice in new systems of care by preparing their teachers. Acad Med. 2014;89(11):1436-1437. DOI:

Jippes E, van Luijk S, Pols J, Achterkamp M, Brand P, van Engelen J. Facilitators and barriers to a nationwide implementation of competency-based postgraduate medical curricula: a qualitative study. Med Teach. 2012;34(8):e589-602. DOI:

Ellaway R. CanMEDS is a theory. Adv Health Sci Educ Theory Pract. 2016;21(5):915-917. DOI:

Kwon H, Lee Y, Chang H, Kim A. Needs assessment of a core curriculum for residency training. Korean J Med Educ. 2015;27(3):201-212. DOI:

LaDonna K, Kahlke R, Scott I, van der Goes T, Hubinette M. Grappling with key questions about assessment of the Health Advocate role. Can Med Educ J. 2023;14(1):80-9. DOI:

Do V, Maniate J, Sonnenberg L. To lead or to influence? Can Med Educ J. 2021;12(5):59–60. DOI:

Verkerk M, de Bree M, Mourits M. Reflective professionalism: interpreting CanMEDS' “professionalism”. J Med Ethics. 2007;33(11):663–6. DOI:

Roberts G, Beiko D, Touma N, Siemens D. Are we getting through? A national survey on the CanMEDS communicator role in urology residency. Can Urol Assoc J. 2013;7(11-12):437-41. DOI:

Berger E, Chan M, Kuper A, et al. The CanMEDS role of Collaborator: How is it taught and assessed according to faculty and residents? Paediatr Child Health. 2012;17(10):557-60. DOI:

Chou S, Cole G, McLaughlin K, Lockyer J. CanMEDS evaluation in Canadian postgraduate training programmes: tools used and programme director satisfaction. Med Educ. 2008;42(9):879-886. DOI:

van der Vleuten CP, Schuwirth LW, Scheele F, Driessen EW, Hodges B. The assessment of professional competence: building blocks for theory development. Best Pract Res Clin Obstet Gynaecol. 2010;24(6):703-719. DOI:

Ringsted C, Hansen TL, Davis D, Scherbier A. Are some of the challenging aspects of the CanMEDS roles valid outside Canada? Med Educ. 2006(40):807-815. DOI:

Yusuf E, Ong DSY, Martin-Quiros A, et al. A large survey among European trainees in clinical microbiology and infectious disease on training systems and training adequacy: identifying the gaps and suggesting improvements. Eur J Clin Microbiol Infect Dis. 2017(36):233-42. DOI:

Royal College of Physicians and Surgeons of Canada. Objectives of Training in the specialty of Medical Microbiology. Ottawa, Canada: Royal College of Physicians and Surgeons of Canada; 2018.

Royal College of Physicians and Surgeons of Canada. Objectives of Training in the specialty of Anatomical Pathology. Ottawa, Canada: Royal College of Physicians and Surgeons of Canada; 2013.

Lopez KA, Willis DG. Descriptive Versus Interpretive Phenomenology: Their Contributions to Nursing Knowledge. Qual Health Res. 2004;14(5):726-35. DOI:

Savin-Baden M, Major C. Chapter 14: Phenomenology. Qualitative research: the essential guide to theory and practice. London (England): Routledge; 2013.

Akerlind GS. Variation and commonality in phenomenographic research methods. High Educ Res Dev. 2005;42(4):321-34. DOI:

Royal College of Physicians and Surgeons of Canada. Competence By Design: Canada’s model for competency-based medical education. Ottawa (Canada); updated 2023. Available from: [Accessed on Dec 8, 2022].

Creswell JW, Creswell JD. Research design: qualitative, quantitative, and mixed methods approaches (5th Ed) California (USA): SAGE Publications Inc; 2018.

Renting N, Raat ANJ, Dornan T, et al. Integrated and implicit: how residents learn CanMEDS roles by participating in practice. Med Educ. 2017(51):942-52. DOI:

Haller BL. Resident training in microbiology. Clin Lab Med. 2007(2):369-80. DOI:

ten Cate O, Scheele F. Competency-based postgraduate training: can we bridge the gap between theory and clinical practice? Acad Med. 2007;82(6):542-7. DOI:

LoGiudice A, Sibbald M, Monteiro S, et al. Intrinsic or Invisible? An Audit of CanMEDS Roles in Entrustable Professional Activities. Acad Med. 2022;97(8):1213-8. DOI:

van der Lee N, Fokkema J, Westerman M, et al. The CanMEDS framework: relevant but not quite the whole story. Med Teach. 2013;35(11):949-55. DOI:

van der Lee N, Westerman M, Fokkema J, van Der Vleuten C, Scherpbier A, Scheele F. The curriculum for the doctor of the future: messages from the clinician’s perspective. Med Teach. 2011;33(7):555–61. DOI:

Jippes E, van Engelen J, Brand P, Oudkerk M. Competency-based (CanMEDS) residency training programme in radiology: systematic design procedure, curriculum and success factors. Eur Radiol. 2010;20(4):967–77. DOI:




How to Cite

Bogaty C, Frambach J. The CanMEDS Competency Framework in laboratory medicine: a phenomenographic study exploring how professional roles are applied outside the clinical environment . Can. Med. Ed. J [Internet]. 2023 Dec. 11 [cited 2024 Apr. 21];15(1):26-3. Available from:



Original Research