The Saad Truth with Dr. Saad


Canadian Physicians - Medical Expertise is No Longer the Key Competency (The Saad Truth with Dr. Saad_628)


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In this episode, Dr. Ghat Saad talks about a new report from the Royal College of Physicians and Surgeons of Canada (RCPSC) on the need for new competencies for Canadian medical doctors.

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00:00:00.200 Hi, everybody. This is Ghat Saad. A few days ago, I received an email from a young physician
00:00:08.320 who wanted to share with me a report that he had come across, which I didn't have a chance
00:00:16.940 to go over until today. And so, I thought that I would share some of the issues in that
00:00:25.420 report. So, this is coming from CANMEDS, C-A-N for Canada, meds for, I guess, medicine, medical
00:00:33.280 doctors. So, CANMEDS is a framework for improving patient care by enhancing physician training
00:00:38.760 developed by the Royal College in the 1990s. Its main purpose is to define the necessary
00:00:44.140 competencies for all areas of medical practice and provide a comprehensive foundation for medical
00:00:51.940 education and practice in Canada. And I got this from the royalcollege.ca. So, www.royalcollege.ca.
00:01:05.080 And then you could look up for what CANMEDS is. And so, the report in question is a 2023 report
00:01:12.940 that basically argues, you know, what are some new competencies, some new things that Canadian
00:01:20.480 physicians should develop. And so, I wanted to read for you here some of these. So, bear
00:01:29.100 with me as I read because it truly is incredible. I won't read you. I think the whole report is
00:01:33.620 15 pages. I will start on page 11 titled Equity, Diversity, Inclusion, and Accessibility Interim
00:01:42.500 Report. Right. So, again, remember, this is from the Royal College of, I guess, Physicians and
00:01:47.100 Surgeons, where they have this program, CANMEDS, that always thinks about what are the core competencies
00:01:53.780 and expertise areas that a practicing Canadian physician should possess. So, here we go.
00:02:03.060 CANMEDS 2025 affords us the opportunity to think critically and propose a vision for the practice of
00:02:09.420 medicine, which is rooted in social justice, anti-racism, anti-oppression, and cultural safety,
00:02:17.040 promoting a broader cultural shift, which is necessary for the profession. So, you see here,
00:02:23.240 the practice of medicine is no longer about healing an individual who comes to you with a particular
00:02:31.040 medical ailment. It's much bigger than that. It's about fighting anti-colonialism, anti-racism,
00:02:39.060 and anti-rape of Mother Earth. As a profession and a health system, we participate daily in the
00:02:46.560 perpetuation of structural violence upon those most marginalized amongst us, particularly those who
00:02:54.020 are racialized and live at the intersections of marginalization because of our race, ethnicity,
00:02:59.660 religion, sex, gender, identity, social class, ability, immigration status, and more. A new model
00:03:07.720 of CANMEDS would seek to center values such as anti-oppression, anti-racism, and social justice
00:03:17.160 rather than medical expertise. I'm going to read that sentence one more time for you. This is the framework
00:03:25.940 that is put forth in deciding what are the core competencies that medical doctors in Canada
00:03:35.480 should possess. So, you're ready? I'm going to read it very slowly. A new model of CANMEDS would seek
00:03:42.440 to center values such as anti-oppression, anti-racism, and social justice rather than medical expertise.
00:03:52.140 It would prioritize bi-directional relationships with patients, providers, communities, the land,
00:03:59.020 the health system, and society at large rather than the individual physician as a gatekeeper of
00:04:05.440 professionalized knowledge. With this new model, we can reflect a stance of humility over hubris and
00:04:13.100 demonstrate how we as physicians must be constantly seeking to learn, explore, critically reflect,
00:04:19.280 and grow. Existing competencies can be reorganized and modified under a new model which would also
00:04:26.680 feature the teaching of critical reflection and self-reflexivity as well as understanding of
00:04:37.380 equity and advocacy so as to allow physicians to more effectively engage in community-led social
00:04:43.600 change, right? So, physicians are not there to heal individuals who come to them with medical
00:04:51.880 ailments. They are activists who must serve as protagonists in social change. All right, let's keep
00:05:01.880 going. Such a model of CANMEDS would allow medical schools to appropriately embed and infuse lenses of
00:05:11.300 social justice, anti-oppression, advocacy, and equity throughout their teaching and thereby teach
00:05:18.120 future physicians how to incorporate such thinking into all of their clinical teaching and research work.
00:05:24.500 The Anti-Racism Expert Working Group has formed a consensus definition of anti-racism to guide the work
00:05:31.960 of CANMEDS Renewal 2025. So, now I'm going to read you the quote of what that framework is.
00:05:41.560 Quote, Anti-racism is an explicit stance, a process, and a systematic method of analysis requiring a proactive
00:05:51.400 course of action for individuals, institutions, and societies to undertake. Anti-racism sheds light on the
00:05:59.880 structures of racism rooted in the justification of colonization, slavery, and white supremacy with
00:06:08.060 manifestations at the individual, interpersonal, and systemic levels. Anti-racism actively seeks to
00:06:15.560 identify, remove, prevent, and mitigate racially inequitable outcomes and power imbalances and change
00:06:25.560 the structures that sustain inequities. Anti-racism is deeply rooted in anti-oppression, which analyzes the
00:06:34.500 world through the lens of power, including the historical and ongoing structures of racism, white supremacy,
00:06:43.660 settler colonialism, heteropatriarchy, capitalism, ableism, classism, sexism, homophobia,
00:06:54.380 transphobia, and more. Anti-racism and anti-oppression call for action on the manifestations of oppression
00:07:03.200 based on race, ethnicity, religion, sex, gender identity, sexual orientation, socioeconomic status,
00:07:11.920 immigration status, and more. Anti-racism in medicine and healthcare requires us to examine,
00:07:19.420 acknowledge, acknowledge, and work to mitigate and dismantle the deep roots and manifestations of racism
00:07:27.860 and other intersecting oppressive structures in our day-to-day work. So that was, I just read page 11
00:07:34.640 and the start of page 12. I could go on and read you the rest of it, but it's just simply unbelievable.
00:07:41.540 Okay? It's more than mass psychosis. It really is. I mean, I'm not trying to engage here in a, you know,
00:07:52.360 self-patting on my own back, but that's why I use the neuroparasithological framework in my book,
00:07:59.740 In the Parasitic Mind, because nothing could explain such zombified behavior where everyone, including people
00:08:09.720 that have objective knowledge, such as in the practice of medicine, where they can come out with
00:08:17.880 such insane orgiastic nonsense. So we no longer judge the core competencies of physicians via their
00:08:28.040 medical expertise, but rather through a lens of anti-racism, anti-colonialism, and whatever the
00:08:36.040 rest of the stuff is heteropatriarchy, right? So by the way, that concept basically argues that,
00:08:42.100 you know, there's this notion of heteronormativity, that, you know, people, you know, the natural thing
00:08:48.200 is for us to be heterosexual, and that's wrong, right? So under that lens, heterosexuality is a
00:08:56.080 learned sexual orientation, because we live in a heteropatriarchal, heteronormative
00:09:01.800 society, but homosexuality is innate. So we are a sexually reproducing species that relies on the 1.00
00:09:12.540 mechanisms of heterosexuality to then create morons like those who generate these reports. But that's 1.00
00:09:22.460 because of heteronormativity. So a physician now should fight against heteronormativity, heterosexuality,
00:09:30.640 capitalism. So you go to see your physician, and you say, hey, my family comes with a history of
00:09:39.000 colon cancer, and I have a blockage. I'm worried that maybe my cysts in my colon have turned
00:09:46.740 cancerous. Can we maybe do a colonoscopy? And your physician looks at you and says,
00:09:53.620 have you thought about perhaps beginning with a land acknowledgement? Have you realized that we must
00:10:01.320 indigenize our medical curriculum? Can you tell me what your preferred pronouns are? Can you tell me
00:10:09.980 how you're going to be an ally to fight against anti-racism? Imagine that we are at this point
00:10:19.540 in our history. 21st century, the governing bodies that determine what constitutes the core competency
00:10:31.180 of a physician are now proposing that it shouldn't be medical expertise. We must be dismantling capitalism
00:10:40.840 and ableism. And we must fight against transphobia. I'm surprised that they didn't put Islamophobia in
00:10:47.800 there. Many, many years ago, I warned you about all this stuff. And everyone kept writing to me and
00:10:57.800 saying, yes, we get it. But surely that's just a problem in some esoteric department in the humanities
00:11:04.000 and some silly department in the social sciences. Surely those ideas are never going to take a
00:11:11.780 foothold, you know, in the natural sciences, in medicine and so on. And I said, no, they will.
00:11:17.640 Because human minds have always had the capacity to be parasitized. What is unique about the current
00:11:23.720 moment is that there is a set of idea pathogens that have been uniquely unleashed so that the melange,
00:11:31.400 the cocktail of these idea pathogens, has sent us into a descent towards the abyss of infinite lunacy
00:11:39.040 in a manner that is difficult to imagine in other historical period where that has happened. Yes,
00:11:45.680 there have been many instances of mass psychoses, of departures from reason. But there is something
00:11:52.000 very, very unique about the specific set of idea pathogens that are affecting us in the here and now
00:11:58.740 in the 21st century. Have a good day, everybody.