Medical Council of Canada

Competency descriptors

Competency descriptors

National Assessment Collaboration (NAC)

The following are descriptors of acceptable performance levels per competency for the NAC Exam.

Competency Expectations
History taking Acquires from the patient, family or another source a chronologic, medically logical description of pertinent events. Gathers information in sufficient breadth and depth to permit a clear definition of the patient’s problem(s).
Physical examination Elicits physical findings in an efficient logical sequence that documents the presence or absence of abnormalities and supports a definition of the patient’s problem(s). Sensitive to the patient’s comfort and modesty; explains actions to the patient.
Organization Approaches interaction in a coherent, succinct and systematic manner. Manages time effectively (including oral questions).
Communication skills Uses a patient-centered approach: establishes trust and respect, and shows sensitivity. Provides clear information and confirms patient’s understanding throughout clinical encounter: encourages questions, and uses repetition and summarizing to confirm and/or reinforce understanding. Respects confidentiality. Avoids use of jargon /slang. If applicable, negotiates a mutually acceptable plan of management and treatment. Demonstrates appropriate non-verbal communication (e.g., eye contact, gesture, posture, and use of silence).
Language fluency Speaks clearly (volume and rate) with clear pronunciation; accent does not hinder interaction. Uses coherent flow of words, phrases, sentences and verb tenses to convey intended meaning. Uses appropriate choice of words and expressions for the context (e.g., vocabulary).
Diagnosis Discriminates important from unimportant information and reaches a reasonable differential diagnosis and/or diagnosis.
Data interpretation Interprets investigative data appropriately in the context of the patient’s problem(s).
Investigations Selects suitable laboratory or diagnostic studies to elucidate or confirm the diagnosis; takes into consideration associated risks and benefits.
Therapeutics and management Discusses therapeutic management, including but not limited to pharmacotherapy*, adverse effects and patient safety, disease prevention and health promotion, when appropriate. Selects appropriate treatments (including monitoring, counseling, follow-up); considers risks and benefits of therapy and instructs the patient accordingly.

* Drug classes are more likely to be required than specific drugs (except when required in urgent circumstances), and dosages are typically not expected.