The Saad Truth with Dr. Saad - December 07, 2023


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


Episode Stats


Length

12 minutes

Words per minute

118.77077

Word count

1,430

Sentence count

72

Harmful content

Toxicity

1

sentences flagged

Hate speech

1

sentences flagged


Summary

Summaries generated with gmurro/bart-large-finetuned-filtered-spotify-podcast-summ .

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.

Transcript

Transcript generated with Whisper (turbo).
Toxicity classifications generated with s-nlp/roberta_toxicity_classifier .
Hate speech classifications generated with facebook/roberta-hate-speech-dynabench-r4-target .
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.