Training for Transformation
TPC Insights | By Ivy Oandasan and Ivy Bourgeault
We hear it weekly in the news: Canada’s health care system is in crisis, with many unable to access care reliably. Innovative solutions are needed and we’re going to need brave leaders to implement changes, particularly in the face of criticism. The complexity of care facing all primary care providers needs new practice and training approaches with a commitment by government to strengthen primary care.
Our collective mission as Team Primary Care partners is to transform primary care training and education, equipping Canada’s primary care workforce to work more effectively together. Education is not the only solution to the primary care crisis, but it plays an important part. In our envisioned future, Team Primary Care was funded to support the development of new and enhanced training required of all primary care providers. Each complements the other to enable everyone in Canada to have access to cradle-to-grave care, from health promotion and chronic disease management to urgent, palliative, and mental health care to office-based surgical procedures.
Recently, one of more than 100 Team Primary Care (TPC) health professional partners has been challenged in the media for its recommendations to enhance clinician preparedness to provide comprehensive primary care. Specifically, the College of Family Physicians of Canada (CFPC) has proposed that family medicine residency programs design and implement training that reflects the Residency Training Profile, which describes the competencies and core professional activities that graduates must be prepared to do. The CFPC’s Outcomes of Training Project aims to prepare future family medicine graduates to practice in team-based models that better support the realities of the increasingly complex care that is being faced in primary care.
This call for educational reform comes with the recommendation to extend time of training to ensure appropriate exposure is provided with adequate preparation and an intentional transition into practice design. The extension to three years of training would bring Canada in line with all other family medicine training programs in the world which are three to five years in length. Criticism in the media has only focused on the change to the length of training, failing to explain why the recommendation was made.
These changes are aligned with the vision of Team Primary Care: An integrated health system in which every individual receives equitable, high-quality, comprehensive care from a well-trained, well-supported and optimally utilized primary care team and with the training being developed by TPC’s 100-plus primary care partners.
In this vision of primary care, health professionals work at the top of their scope, complementarily. Substitution of care providers is not the goal. Team-based practice models support the right complement of primary care providers to meet the distinct needs of a practice population guaranteeing comprehensive continuity of care. This aspirational vision requires family physicians to work with primary care trained health professionals interprofessionally, integrating care plans to keep patients healthy and out of the emergency departments, with fewer hospital admissions and readmissions.
As members of the Team Primary Care community, we are all working collectively to enhance primary care training. Collectively TPC is preparing the workforce for the kind of comprehensive primary care Canadians deserve. We recognize that defining primary care competencies and aligning training with similar principles and common approaches will positively influence the outcomes of our shared patients and increase the satisfaction of our primary care providers, in turn supporting recruitment and retention.
Each of our TPC partners will undoubtedly face its own criticism while advocating for their educational changes. The CFPC happens to be the first accrediting and certification body to tackle the proposed need for educational reform. By understanding the CFPC’s reasons for educational reform, we have an opportunity to stand in solidarity. Let us walk the talk and have each other’s backs modelling the type of teamwork we are manifesting for the future. Team Primary Care was designed like no other project before – let us ensure that we demonstrate that training can catalyze transformation.