Health Advocate Role
Transcript Health Advocate Role
Preparing Future Physicians for the
CanMEDS Health Advocate Role: A
work in progress
Medical Education Rounds
April 7, 2010
S. Dharamsi & I. Scott (RCPSC Funded Research)
S. Dharamsi & F. Shroff (FDIG)
L. Mu (Community Med Resident)
Department of Family Practice
Requests for community- & social responsiveness
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Committee on Accreditation of Canadian Medical Schools
Liaison Committee on Medical Education (LCME)
“healthcare disparities and the development of solutions to
the importance of meeting the healthcare needs of
medically underserved populations ... and
[about] core professional attributes, such as altruism and
Health Advocate Role
Frank JR, Langer B. Collaboration, communication, management, and
advocacy: teaching surgeons new skills through the CanMEDS
Project. World J Surg. 2003;27(8):972-8.
“vulnerable or marginalized”
“the ethical and professional issues inherent in health advocacy,
including altruism, social justice, autonomy, integrity and
Health Advocate Role
As Health Advocates, physicians responsibly use their expertise and influence to
advance the health and well-being of individual patients, communities, and
Identify opportunities for advocacy, health promotion and disease prevention
in the communities that they serve, and respond appropriately
Identify the determinants of health of the populations, including barriers to
access to care and resources; and implement a change
Identify vulnerable or marginalized populations within those served and respond
Leveridge M, Beiko D, Wilson JW, Siemens DR. Health advocacy
training in urology: a Canadian survey on attitudes and experience
in residency. Can Urol Assoc J. 2007 Nov;1(4):363-9.
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the voices of physician health advocates. Acad Med
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teaching and evaluating the role of health advocate: a study at one
Canadian university. Acad Med 2005;80:103-8.
Oandasan IF, Barker KK. Educating for advocacy: exploring the source
and substance of community-responsive physicians. Acad Med
Herbert CP. The fifth principle. Family physicians as advocates. Can
Fam Physician 2001;47:2441-3, 2448-51.
Dharamsi & Scott Study
Interviews and focus groups
To explore Program Directors’ perspectives on the
CanMEDS role of the physician as Health Advocate;
How the competencies related to health advocacy
can best be addressed in residency training.
Your Department has recently had a Royal College review and received
accolades for strengths in the Medical Expert Role. However, the
Department as been cited for deficiency in the Health Advocate Role
The Residency Program Committee has been gathered to discuss the
matter. The Committee has brought in an expert for advice. The expert
suggests that efforts to integrate HA into the training program is likely
to be more effective if it is undertaken using a participatory approach
(i.e., actively involving learners).
The Committee is convinced and decides to involve the Urology residents
in reviewing the identified weaknesses in the existing curriculum, and
to develop a plan to correct them with a focus on the Health Advocate
A session with the residents is organized. The expert gives an
interactive presentation on the HA role and invites questions at the
After an awkward silence, one resident says:
“Health advocacy is important but we really need to develop
proficiency in clinical and surgical skills…the other ‘stuff’ we can
figure out later, once we get going in our careers.”
Several residents nod in agreement.
Faculty Development Initiatives Grant
To create an educational primer on Health Advocacy
(HA) for post-graduate medical educators
Co-Investigator: Dr. Farah Shroff
Adjunct Professor in the Department of Family Practice at UBC.
Health Advocate Role: Key
Physicians are able to…
Respond to individual patient health needs and
issues as part of patient care;
Respond to the health needs of the communities
that they serve;
Identify the determinants of health of the
populations that they serve;
Promote the health of individual patients,
communities and populations.
2. Respond to the health needs of the
communities that they serve;
2.1. Describe the practice communities that they serve
2.2. Identify opportunities for advocacy, health promotion and
disease prevention in the communities that they serve, and
2.3. Appreciate the possibility of competing interests between
the communities served and other populations
3. Identify the determinants of health
for the populations that they serve
3.1. Identify the determinants of health of the populations,
including barriers to access to care and resources
3.2. Identify vulnerable or marginalized populations within
those served and respond appropriately
4. Promote the health of individual
patients, communities, and
4.1. Describe an approach to implementing a change in
determinant of health of the populations they serve
4.2. Describe how public policy impacts on the health of the
4.3. Identify points of influence in the healthcare system and
4.4. Describe the ethical and professional issues inherent in
health advocacy, including altruism, social justice,
autonomy, integrity and idealism