Preparing our Future Family Physicians

1. Canada’s family physicians are competent, well trained within university-based residency programs, and meet the high educational standards established by the CFPC.
2. The CFPC has undertaken a critical review of family medicine training and made recommendations through Preparing our Future Family Physicians: An educational prescription for strengthening health care in changing times, so Canada’s family doctors can continue to meet the evolving health needs of patients and communities.
3. It is essential to better link education with practice and to support graduates to practice in a way that we know to be most effective and professionally fulfilling. Training enhancements that expose learners to the Patient’s Medical Home practice vision that will allow them to learn from other health professionals and build competence as part of an interprofessional team.
4. Recommended changes to training, including adding a third year, are geared toward improving patient access by enhancing the ability of family physicians to:
   • Care for patients and communities with changing and complex health care needs in a range of settings
   • Incorporate new technologies to improve access and continuity of care
   • Practice in rural and remote areas
   • Provide care that is culturally safe
5. The CFPC will work closely with universities and other key partners to support the change process. Changes based on the recommendations will be reflected in the CFPC’s educational standards starting in 2027 with more details forthcoming.
6. Recommended educational changes are necessary but insufficient on their own to improve access for patients. Education and health system reform as per the Patient’s Medical Home must be combined to realize the full potential of family medicine in a transformed health care system.

Curricular changes will have a renewed emphasis on training for full scope (comprehensive) training now clearly defined by the CFPC’s Residency Training Profile based on the Family Medicine Professional Profile and made possible with longer training.
Specifically:

• More training in areas of societal need such as home and long-term care, mental health and addiction, Indigenous health, cultural safety and trauma-informed care, anti-racism, virtual care, and health informatics.
• Greater emphasis on the development of adaptive expertise as essential to the preparation for generalist practice, to the ability to respond to changing community needs, and to manage the high level of complexity and medical uncertainty inherent to family practice.
• Enhancements to support family physicians’ increasing involvement in health system leadership, population and public health, and practice improvement particularly for underserved communities.
• More opportunities to train and then practice in evidence-based, interdependent, team care visions like the Patient’s Medical Home (PMH).
• Clarified expectations for enhanced skills training programs leading to a Certificate of Added Competence (CAC) with a greater emphasis on development of health system leadership and support for comprehensive primary care integrated within PMH-type care visions.
• A longer training period (increase from two to three years) is required to support the necessary curricular enhancements.

Family physicians are being called on to manage increasingly complex health care and social needs as well as an aging population with multiple health issues. The training of family physicians must keep pace with these changes. The COVID-19 pandemic highlights current inequities and fragmentation in the health system. It is essential that the health system be reorganized to support fully integrated team-based practice models as described in the Patient’s Medical Home vision to ensure coordination of care and support for primary care practitioners. Training must be better aligned with and supportive of reformed care models. The federal government has pledged that every Canadian will have access to a family physician/primary care team. Education reform must be linked with health system reform to achieve this goal. A greater investment in training family physicians is an important part of the effort to ensure equitable and timely access to comprehensive care for people in Canada. Evidence tells us that our graduates have a strong preference for group/team-based practices like the PMH, yet are frustrated in not having access to these on graduation. It is critical and timely to bring about health system reform linked with education reform to recruit and retain family physicians and achieve health workforce goals.
 

We will work closely with our university partners on implementing these recommendations and strike an Education Reform Taskforce to help us guide this change. The CFPC will introduce changes to its residency accreditation standards in five years (2027) to allow for a responsible change engagement approach including the resources needed to support the change. We will work closely with our provincial Chapters and university partners to advocate with federal and provincial governments to support the recommendations to enhance the delivery of family medicine for all the people of Canada.