Triple C

Triple C Curriculum

Over the last few years, working groups within the College of Family Physicians undertook a thorough review of post-graduate Family Medicine Residency Programs in Canada. The College of Family Physicians of Canada (CFPC) is advancing post-graduate family medicine education in Canada through the Triple C Competency-based Curriculum (Triple C).

The goal of Triple C is to ensure that every family physician training program in Canada develops graduates who are:
  • competent to provide comprehensive care;
  • prepared for the evolving needs of society; and
  • taught the best available evidence on patient care and medical education

Competency-based Curriculum

The move toward Competency-based Education is in keeping with the need for medical education to meet societal expectations of accountability. It depends upon well-defined program outcomes, resident assessment methodologies, and an integrated curriculum design. This outcomes-oriented approach will take the place of the traditional time-based educational. It requires residents to be active learners, shifting the role of a resident supervisor toward that of a resident's "coach."

The competency material developed by the CFPC (CanMEDS-FM, priority topics and key features, six skill dimensions, and Scope of Training) guides programs in the provision of appropriate educational opportunities for their residents and in working with individual residents to track and document the achievement of these competencies.

Three components of Triple C

Comprehensive Education and Patient Care

Comprehensive programs are essential to family medicine training. Family medicine residents need to learn and demonstrate skills across a spectrum of clinical domains, such as psychiatric care and care of the elderly, and in health promotion and disease prevention. The goal of residency education is to allow residents to provide a prescribed level of comprehensive care upon graduation, while understanding that learning will continue throughout their career.


Continuity of Education and Patient Care

Continuity is essential in the development of physicians whose practice is truly comprehensive. Continuity of patient care solidifies strong relationships between physicians and patients, which is fundamental to our discipline. Teaching and assessment facilitated by assigning a small core of primary preceptors contributes to authentic assessment of learners over time. This helps to nurture the trust and honesty necessary to develop learning experiences shaped through ongoing feedback and assessment. A shift to programs being centred in family medicine will increase the continuity of learning environment.


Centred in Family Medicine

Family medicine should be at the core of family medicine programs. The context of learning should be:
  • primarily within family medicine settings;
  • relevant to the needs of future family physicians; and
  • controlled and managed by family medicine program coordinators.
Augmentation with teachers and contexts outside Family Medicine may well be necessary for residents to achieve the full range of competencies. However, the learning content must be relevant, such that in every educational experience residents must develop their identity as family physicians.

Oandasan, I. Advancing Canada's family medicine curriculum: Triple C. Can Fam Physician June 2011 57: 739-740
Triple C Competency-based curriculum. Report of the Working Group on Postgraduate Curriculum Review - Part 1. March 2011