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1
CanMEDS for South
African Pathology Training
J Bezuidenhout NHLS/Stellenbosch University, V
Burch university of Cape Town, S Nayler College
of Pathologists, W Grayson NHLS/ Wits
University, E Janse van Rensburg NHLS/University
of Pretoria, R Erasmus HLS/Stellenbosch
University, J Mahlangu NHLS/WitsUniversity, J
Vellema College of Forensic Pathologists, M
Altini NHLS/ Wits University, E Wasserman
NHLS/Stellenbosch University, Drs Meyer,
Moodley, Senekal, and Prof Loftus National
Pathology Group
C
ontext and Setting
What?
The Royal College of Physicians and Surgeons of
Canadas competency framework (CANMeds), where
the general competencies of specialists are
clustered into seven major roles, was selected
as the basis for establishing an initial
framework on which to base a national training
programme for South Africa. This model was used
to conduct a survey of all pathologists and
pathologists-in-training in the country. The
purpose of the survey was to establish a
consensus opinion of the most important
components of the CANMeds model considered
important and/or essential in local post-graduate
training programmes. A 6-point Likert scale
(essential, very important, somewhat important,
less important, unimportant, unnecessary) was
used to score survey responses.
Why?
The parallel certification systems led to real
and perceived inconsistencies in the training
programmes offered by universities. In
particular, programme outcomes and educational
alignment between programme content and
assessment practices have been a cause for
ongoing concern. Furthermore, alignment
between university programmes and the COP of
South Africa assessment process has never been
standardised. The need to establish a
national framework of programme outcomes,
suitable for teaching and assessment, is
apparent.

Background
In South Africa a parallel system of
post-graduate specialist certification exists.
Universities are tasked with training all
enrolled candidates. Certification examinations
are conducted by both universities and a national
College of Pathologists (COP) of South Africa.
Successful completion of either examination
permits trainees to register as pathologists with
the Health Professions Council South Africa and
allows for training and supervision of
Registrars.
R
esults
A response rate of 48 of 400 electronically
distributed surveys was achieved. All seven
major roles identified by CANMeds were regarded
as somewhat important, very important or
essential, by the majority of respondents
medical expert 99, communicator 88,
collaborator 99, manager 96, health
advocate 93, scholar 93, professional
98. The results were presented at the annual
national Federation of South African Societies of
Pathology conference and the development of a
national framework based on the CANMeds model was
unanimously accepted by the Federation and the
COP of South Africa Council.

C
Communicator
Medical Expert
onclusions
99 74 94 77 65 9999 99
Demonstrate diagnostic and therapeutic skills
for ethical and effective patient care.
Demonstrate specialist knowledge of disease
processes. Access and apply relevant
pathological information to clinical practice.
Demonstrate effective consultation services with
respect to patient care, education. Demonstrate
knowledge of of biomedical and pathological
sciences which underpinning pathology. Have
experience and knowledge in choice of
investigation, interpreting data, providing
advice on further patient management. Be
familiar with sample collection methods. Make
informed decisions about diagnostic and
therapeutic interventions. Develop new tests
where appropriate. Evaluate and incorporate new
laboratory techniques appropriately.
99 100 100 96 99 9699 95 90 98
Demonstrate effective, clear and unambiguous
communication skills in the settings of patient
care, medical education. Establish effective
relationships with patients their families,
demonstrate appropriate attitudes and
behaviour. Listen effectively. Obtain and
synthesise relevant history from patients,
families and communities. Discuss appropriate
information with patients and families. Communicat
e with clinicians concerning patient histories
and test results. Competently interpret pathology
to clinicians. Identify potentially
life-threatening results and communicate them in
a timely and effective manner to the treating
clinician.
Health Advocate
This critical first step paves the way to
develop a standardised, uniformly
accepted model of training
and assessment of pathologists.
The 7 roles identified in the
CanMEDS
framework are all
important and should be
included in any framework that is
developed in South Africa.

Identify the important determinants of health
affecting patients. Contribute effectively to
improved health of patients and
communities. Recognize and respond to those
issues where advocacy is appropriate. Promote
understanding of health and disease to patients
clinicians and the media. As members of an
interdisciplinary team of professionals endeavour
to ensure that laboratory practices and test
selection are regularly evaluated to determine
that they meet these community needs. Reinforce
to the public and to the profession the essential
contribution of laboratory medicine to health.
Promote the just allocation of resources to the
provision of pathology services.
94 90 89 92 97 9796
Manager
Scholar
Balance patient care, learning needs and outside
activities Use health care resources wisely,
working effectively and efficiently in a health
care organisation Demonstrate competence in basic
computer skills, utilize information technology
to optimise patient care, life-long learning and
other activities. Be able to handle urgent and
out-of-hours work Demonstrate knowledge of how
pathology services are organised and
function Demonstrate knowledge of the principles
of laboratory management and administration
office procedures record keeping data storage and
confidentiality issues Demonstrate knowledge of
the methods of quality control and health and
safety in the laboratory Demonstrate knowledge
of standards and accreditation requirements Demons
trate knowledge of human resources management
including conflict resolution skills Demonstrate
understanding of the interaction of all of the
above with patient management
96 96 98 99 98 9798 98 94 91
Develop implement and monitor a personal
continuing education strategy. Facilitate the
education and learning of patients, their
families and the wider community. Facilitate the
appropriate education training learning of
students, other health professionals. Critically
appraise sources of medical information and apply
them appropriately. Construct rigorous case
reports. Demonstrate ability to justify
decisions. Demonstrate teaching skills. Train
laboratory staff. Plan and formally present
results of scientific investigations to other
health professionals eg. lectures, journals,
conferences. Contribute to the development of new
knowledge by undertaking ethically-conducted
research.
97 81 97 97 89 98 92 92 94 92

Furthermore, it demonstrates
the potential use of the CANMeds
model for standardising postgraduate
training programmes in other
specialty disciplines in the country.
Professional
Deliver highest quality care with respect,
integrity, honesty and compassion. Exhibit
appropriate personal and interpersonal
professional behaviour. Act as an appropriate
role model for students and others. Have an
appreciation of the crucial role of the
pathologist in providing quality patient
care. Acknowledge individual professional
limitations, necessity of seeking appropriate
second opinions. Respect the knowledge/skills of
their own colleagues, other medical colleagues,
health professionals. Seek to develop
constructive and cooperative working
relationships with other professional staff. Take
appropriate action in regard to unprofessional
conduct by or ill health in a colleague. Practice
medicine ethically, respect for human beings and
appreciation of the diversity of human and
cultural values. Have a desire to ease pain and
suffering. Recognise that the health interests of
the patient and the community are
paramount. Demonstrate knowledge of the
principles of informed consent. Know when to
consult other professionals for advice and
assistance. Refuse to participate in situations
where pathology knowledge is ab/misused including
business practices. Demonstrate respect
compassion and integrity accountability to
patients, society and the profession and a
commitment to excellence and on-going
professional development.
100 97 99 99 98 99 98 97 9896 97 97
98 99 98