O Canada, still beholden to DEI

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O Canada, still beholden to DEI
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Most Canadians may hate him, but at least Donald Trump is fighting against the discriminatory and divisive ideology that endangers people’s health.

In particular, he has successfully pressured the accreditor who oversees the country’s 150-plus medical schools to ditch its DEI mandates, so that medical education focuses more on its mission of training physicians to provide the best care.

. Yet medical education in Canada, where I practice, is moving in the other direction. Would that we had someone, anyone, in our government with the courage to oppose it and put patients first.Despite being one of the U.S.’s worst exports, DEI has been gleefully embraced by Canadian institutions. Two years ago, I to the Royal College of Physicians and Surgeons of Canada, the powerful organization that sets the standards for training medical and surgical residents at the country’s 18 medical schools. It had just announced that it was updating its physician-education framework, known as CanMEDS. While Canada’s medical education system is comparatively small, its global impact is quite large. CanMEDS, as the Royal College notes, is “the most widely accepted and applied physician competency framework in the world.”. The most powerful working group developing CanMEDS had called for “a new model” of learning that “centre values such as anti-oppression, anti-racism, and social justice, rather than medical expertise.” Let that sink in. The group that shapes physicians’ training didn’t want them to learn primarily about medicine. Yet as I can attest, people become doctors to improve — and even save — patients’ lives. With human well-being and life on the line, what could possibly be more important than medical expertise? Two years later, the Royal College still hasn’t issued the new version of CanMEDS, likely because of a groundswell of public opposition to its DEI plans. The good news is that it has backtracked its attempt to completely devalue medical expertise. In a March update, the Royal College declared that the “medical expert role remains foundational” to its forthcoming framework. The bad news is that, despite this change, “health equity is integrated throughout.” It appears that in the new framework, expertise and equity will be on par with one another — the two things that future physicians in Canada, and across the world, are expected to master. But any amount of equity is too much. As I’ve seen in medical practice across the country, and also in my work as a professor at McGill University School of Medicine, equity demands the devaluation of medical expertise. It alternately requires fixating on a patient’s race, to the point of providing preferential care that’s by definition discriminatory; or, to the point of advocating public policies. No doubt, policy matters to healthcare access and quality, but doctors are in the business of providing treatments, not pushing for wealth redistribution or welfare expansion. Every day spent studying or training to influence policy is a day not spent learning about clinical care, the latest science, and even how to develop a good bedside manner. Medical education, this is not.The Royal College is still at least six months away from issuing its new physician-education framework. Yet it’s crystal clear that DEI will be a preeminent component of the final version, shaping the education that the next generation of physicians receives in Canada and worldwide. It’s hard to see the Royal College getting off this ideological bandwagon — not when the government in power in Ottawa is fully aligned with DEI, too. There’s broad public opposition to the diminishment of Canada’s medical profession, though it’s not as widespread as in the United States. Regardless, it takes political leadership and willpower to effect change.

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