The Canadian Society of Hospital Medicine is spearheading an initiative called the Core Competencies in Hospitalist Medicine Document Project, which could be used to clarify what the field is, update certification processes, and define its future growth.
Neither the Royal College of Physicians and Surgeons of Canada nor the College of Family Physicians of Canada is likely to pursue board certification for a subspecialty in hospital medicine, says Peter Jamieson, MD, CCFP, FCFP, a hospitalist at Foothills Medical Center in Calgary, Alberta.
“If you think about hospital medicine as a construct—and take the focus off the person and put it instead onto the patient and onto the work, then you can describe the necessary competencies,” Dr. Jamieson says. “What are the preparation, the evaluation, and all of the associated functions? We want to be clear about what this job really is. We don’t have to be defined by training in a particular specialty.”
Writing and reviewing the competencies has been assigned to large physician working groups, with a well-defined process for validation, Dr. Jamieson says.
“Next steps will include elaborating the evaluation criteria, the learning objectives, and those sorts of things. That’s all going on right now,” he explains. “Our objective is to have all of them in a publishable format within the next year or so. Then we’ll need to get the regulatory folks to agree that this represents a subset of practice and a discrete and obtainable set of skills.
“As time goes by, it will become more and more obvious that hospital medicine is a discrete set of skills—not that any doctor couldn’t obtain those skills, but in order to obtain and maintain them you will need some training through a professional development pathway that creates and maintains the professional competencies.” TH