Following Professor Leigh Revers’ recent sharp critique of the CanMEDS 2025 project, it is crucial for us to take a deeper dive into the troubling implications of this proposed ideological overhaul of Canadian medical practice. As a Toronto-based physician and faculty member at Queen’s University, I have witnessed firsthand the creeping influence of what I would describe as far-left ideologies within our medical institutions, culminating in the CanMEDS 2025 framework.
The CanMEDS 2025 initiative, driven by the Royal College of Physicians and Surgeons of Canada and three other academic bodies, reflects a troubling shift away from evidence-based medicine towards a framework heavily infused with social justice rhetoric. The proposed revisions reveal an unsettling fixation on concepts like ‘white supremacy’ and ‘critical race theory,’ the kind of trendy idioms that are, in fact, the long shadows cast by a thoroughly Postmodern, neo-Marxist mind palace. These changes threaten to undermine the core principles of medical expertise and meritocracy that have long been the foundation of our healthcare system.
In my new book, Lost and Found: How Meaningless Living is Destroying Us—and Three Keys to Fix It, I explore how the abandonment of traditional values and the rise of replacement ideologies, such as radical social justice activism, have contributed to our current cultural and social malaise. The CanMEDS 2025 project exemplifies this phenomenon, prioritizing as it does ideological conformity over medical competence.
The emphasis on ‘other ways of knowing’ and wholly subjective ‘lived experiences’ as equivalents to empirical medical expertise is particularly concerning. While patient perspectives are important, they cannot replace the rigorous scientific training that physicians undergo. This de-emphasis of evidence-based medicine in the tradition of the Enlightenment is reminiscent of Frantz Fanon’s anti-Western, pro-Marxist teachings, which advocate for the dismantling of all perceived ‘colonial structures’ without ever considering the consequences.
Today, in 21st Century Canada, the activist physicians assert that our medical institutions are ‘colonial.’ By this, I suspect they mean they are fundamentally flawed and in need of radical transformation; or perhaps it just means whatever they dislike, especially if it might have originated from someone who is White. However, this perspective ignores the incredible advancements and improvements in patient care that have been achieved through evidence-based medicine. Dismantling these systems in favour of a nebulous and ideologically driven framework is not progress — it is a step backward, a retrogressive move towards a new Dark Age of medicine.
The CanMEDS project’s claim of fostering a ‘diversity of voices’ rings hollow, even after the most superficial inspection. The lack of small-C conservative viewpoints and the exclusion of dissenting opinions suggest that these expert working groups are selective, catering only to those who align with the prevailing ideology. Is anyone surprised? Of course, this exclusionary approach is evidently antithetical to true diversity and open dialogue, which are the essential touchstones for any meaningful progress.
Moreover, the strident insistence for doctors to view every aspect of medical practice through the lens of power dynamics, as espoused by critical race theory, is reductive and divisive. It ignores the complexities of healthcare and reduces patient care to a rudimentary, over-simplistic narrative of oppressors and oppressed. This approach not only undermines the doctor-patient relationship but also erodes trust in the medical profession as a whole.
The practical implications of these proposed changes are alarming. Imagine a healthcare system where medical decisions are influenced more by ideological purity than by scientific evidence, where physicians are expected to prioritize social justice activism over their medical training. This is not a hypothetical scenario — it is the railroad we are all riding if the CanMEDS 2025 framework is implemented in its current form as the identitarians intend.
In the U.S., similar ideas have already taken root. The University of California School of Medicine is already piloting programs where some classes are racially segregated. This is a dangerous path that threatens to balkanize the medical profession and undermine the principles of unity and collaboration that are essential for effective healthcare delivery.
In a positive development, and possibly due to recent public awareness of this topic, the Royal College released a brief update earlier this month in which it affirmed that “medical expertise is an essential, fundamental defining competency for physicians”. Further, it encouraged dialogue.
The implementation date has also been delayed until 2027. With this delay, public and physician pressure should continue to encourage them to rinse the politics and ideology out of the framework’s rollout, especially in how it defines medical expertise.
The final CanMEDS should certainly not be used to smuggle in wording of a progressive agenda, which one could plausibly see even in a clause from the recent update: “interventions to address social determinants of health, including the pursuit of evidence to further eliminate health disparities, are critical features of contemporary medical expertise.” Unmentioned in the update are topics such as anatomy, biology, physiology, and pathology, which many of us feel are the most critical to medical expertise. Moreover, doctors are hopeful the authors will explicitly distance themselves from the woke jargon previously mentioned in this and other critiquing pieces, which the CanMEDS supporting documents are full of. In the meantime, all healthcare professionals are invited to sign the organization Do No Harm’s petition calling for this.
Ultimately, the original CanMEDS 2025 project represents a radical departure from the principles of evidence-based medicine and meritocracy. It prioritizes ideological conformity over conventional and well-established systems of medical knowledge and threatens to erode the trust and competence that are the hallmarks of the Canadian healthcare system. CanMEDS 2025 (or now 2027) must be free of such ideology and politics. As I argue in Lost and Found, we must resist the institutional capture by the spirit of wokeness and reaffirm our commitment to free speech, traditional values, and personal responsibility. Only then can we hope to restore meaning and excellence among Canadian doctors.
Mark D’Souza is a Toronto-based physician and author of Lost and Found: How Meaningless Living is Destroying Us—and Three Keys to Fix It
National Post