Table 3. Final competency framework
Role 1. Medical expert
  Key competency 1: Practise medicine within their defined scope of practice and expertise
  Have and apply knowledge about embryology, anatomy, genetics and the physiology of the female genital organs and breasts and understand bio-psychosocial aspects of obstetrical and gynaecological conditions as listed in addendum* (ADDENDUM: OBSTETRICAL AND GYNAECOLOGICAL EXPERTISE)
Perform appropriately timed clinical assessments with adequate responsiveness to situations where the wellbeing of the patient is endangered or compromised, and present recommendations in an organized manner
Carry out professional duties in the face of multiple, competing demands
Recognize and respond to the complexity, uncertainty, and ambiguity inherent in medical practice
Key competency 2: Perform a patient-centred clinical assessment and establish a management plan
  Prioritize issues to be addressed in a patient encounter, based on urgency and further planning
Elicit a patient and family history including social issues, perform a physical exam, select appropriate investigations, and interpret their results for the purpose of (differential) diagnosis and management, disease prevention, and health promotion
Establish goals of care in collaboration with patients and their families, which may include slowing disease progression, treating symptoms, achieving cure, improving function, and palliation
Establish a concrete patient-centred management plan, based on the postulated goals
Key competency 3: Plan and perform procedures and therapies for the purpose of assessment and/or management
  Order the appropriate investigations for gynaecologic and obstetric assessment; interpret their results for the purpose of formulating an appropriate (differential) diagnosis; determine the most appropriate therapies or preventive interventions including the safe prescription of common drugs; all in an evidence-based manner
  Obtain and document informed consent, explaining the risks and benefits of, and the rationale for, a proposed procedure or therapy
  Prioritize a procedure or therapy, taking into account clinical urgency and available resources
  Perform the gynaecologic and obstetric skills as listed in addendum, in a skilful and safe manner, adapting to unanticipated findings or changing clinical circumstances (ADDENDUM: PRACTICAL SKILLS)
Key competency 4: Establish plans for ongoing care and, when appropriate, timely consultation
  Implement a patient-centred care plan that supports ongoing care, follow-up on investigations, response to treatment, and further consultation
Key competency 5: Actively contribute, as an individual and as a member of a team providing care, to the continuous improvement of health care quality and patient safety
  Recognize and respond to harm from health care delivery, including patient safety incidents
Identify the limits of one's own competency and act within them by asking for help when needed
Deliver the highest evidence-based quality of care, including the adoption of strategies that contribute to the promotion of patient safety, and address human and system factors
Role 2. Communicator
  Key competency 1: Establish professional therapeutic relationships with patients and their families
  Communicate using active listening and a patient-centred approach that encourages patient trust and autonomy and is characterized by empathy, respect, and compassion
Optimize the physical environment for patient comfort, dignity, privacy, engagement, and safety
Recognize when the values, biases, or perspectives of patients, physicians, or other health care professionals may have an impact on the quality of care, and modify the approach to the patient accordingly
Respond to a patient’s non-verbal behaviours to enhance communication
Manage disagreements and emotionally charged conversations
Adapt to the unique needs and preferences of each patient and to his or her clinical condition and circumstances
Key competency 2: Elicit and synthesize accurate and relevant information, incorporating the perspectives of patients and their families
  Use patient-centred interviewing skills to effectively gather relevant biomedical and psychosocial information
Provide a clear structure for and manage the flow of an entire patient encounter
Seek and synthesize relevant information from other sources, including the patient’s family, with the patient’s consent
Key competency 3: Share health care information and plans with patients and their families
  Share information and explanations that are clear, accurate, and timely, while checking for patient and family understanding
Disclose harmful patient safety incidents to patients and their families accurately and appropriately
Key competency 4: Engage patients and their families in developing plans that reflect the patient’s health care needs and goals
  Facilitate discussions with patients and their families in a way that is respectful, non-judgmental, and culturally safe
Assist patients and their families to identify, access, and make use of information and communication technologies to support their care and manage their health, ensuring patient empowerment
Use communication skills and strategies that help patients and their families make informed decisions regarding their health, facilitating the balance between evidence-based recommendations and patient's preferences
Key competency 5: Document and share written and electronic information about the medical encounter to optimize clinical decision-making, patient safety, confidentiality, and privacy
  Document clinical encounters in an accurate, complete, timely, and accessible manner, in compliance with regulatory and legal requirements
Communicate effectively using a written health record, electronic medical record, or other digital technology
Share information with patients and others in a manner that respects patient privacy and  confidentiality and enhances understanding
Role 3. Collaborator
  Key competency 1: Work effectively with physicians and other colleagues in the health care professions
  Establish and maintain positive relationships with physicians and other colleagues in the health care professions, by focussing on team performance and developing effective communication, to support relationship-centred collaborative care and contribute to a constructive working environment
Negotiate overlapping and shared responsibilities with physicians and other colleagues in the health care professions in episodic and ongoing care
Engage in respectful shared decision-making with physicians and other colleagues in the health care professions, recognizing and relying on the expertise of others
Key competency 2: Work with physicians and other colleagues in the health care professions to promote understanding, manage differences, and resolve conflicts
  Show respect toward collaborators
Implement strategies to promote understanding, manage differences, and resolve conflicts in a manner that supports a collaborative culture
Key competency 3: Hand over the care of a patient to another health care professional to facilitate continuity of safe patient care
  Determine when care should be transferred to another physician or health care professional
Demonstrate safe handover, referral and discharge planning of care; using both verbal and written communication during a patient transition to a different health care professional, setting or stage of care
Role 4. Leader
  Key competency 1: Contribute to the improvement of health care delivery in teams, organizations, and systems
  Contribute to the improvement of systems of patient care, by applying the science of quality improvement
Contribute to the organisation of health care within their own facility
Contribute to a culture that promotes patient safety
Analyze patient safety incidents to enhance systems of care
Use health informatics to improve the quality of patient care, optimize patient safety and maintenance of own expertise
Contribute to the progress of health care by facilitating the implementation of innovation
Key competency 2: Engage in the stewardship of health care resources
  Allocate health care resources, such as equipment, human and financial resources, for optimal patient care
Apply evidence and management processes to achieve cost-appropriate care
Key competency 3: Demonstrate leadership in professional practice
  Manage health care in a socially responsible way and demonstrate leadership skills to enhance health care
Manage and lead stressful situations with effective responses to challenge, complexity and stress in gynaecology and obstetrics
Facilitate change in health care to enhance services and outcomes
Key competency 4: Manage career planning, finances, and health human resources in a practice
  Set priorities and manage time, by working efficiently and organised, to integrate practice and personal life
Manage a career and a practice
Implement processes to ensure personal practice improvement
Role 5. Health advocate
  Key competency 1: Respond to an individual patient’s health needs by advocating with the patient within and beyond the clinical environment
  Work with patients to address determinants of health that affect them and their access to needed health services or resources
Work with patients and their families to increase opportunities to adopt healthy behaviours
Incorporate disease prevention, health promotion, and health surveillance into interactions with individual patients
Key competency 2: Respond to the needs of the communities or populations they serve by advocating with them for system-level change in a socially accountable manner
  Work with a community or population to identify the determinants of health that affect them (If applicable)
Improve clinical practice by applying a process of continuous quality improvement to disease prevention, health promotion, and health surveillance activities
Contribute to a process to improve health in the community or population they serve
Role 6. Scholar
  Key competency 1: Engage in the continuous enhancement of their professional activities through ongoing learning
  Develop, implement, monitor, and revise a personal learning plan to enhance professional practice
Identify opportunities for learning and improvement by regularly seeking and accepting feedback and by reflecting on and assessing their performance using various internal and external data sources
Engage in collaborative learning to continuously improve personal practice and contribute to collective improvements in practice
Key competency 2: Teach students, residents, the public, and other health care professionals
  Be a good role-model and recognize the influence of role-modelling and the impact of the formal, informal, and hidden curriculum on learners
Promote a safe learning environment
Ensure patient safety is maintained when learners are involved
Plan and deliver a learning activity to students, colleagues and other healthcare professionals
Provide adequate feedback to enhance learning and performance
Assess and evaluate learners, teachers, and programs in an educationally appropriate manner
Key competency 3: Integrate best available evidence into practice
  Recognize practice uncertainty and knowledge gaps in clinical and other professional encounters and generate focused questions that address them
Identify, select, and navigate pre-appraised resources
Critically evaluate the integrity, reliability, and applicability of health-related research and literature
Integrate evidence into decision-making in their practice
Key competency 4: Contribute to the creation and dissemination of knowledge and practices applicable to health
  Demonstrate an understanding of the scientific principles of research and scholarly inquiry and the role of research evidence in health care
Identify ethical principles for research and incorporate them into obtaining informed consent, considering potential harms and benefits, and considering vulnerable populations
Contribute to the progress of health care via the work of a research program (critical literature review, data collection and analysis, reporting research results)
Pose questions amenable to scholarly inquiry and select appropriate methods to address them
Summarize and communicate to professional and lay audiences, including patients and their families, the findings of relevant research and scholarly inquiry
Role 7. Professional
  Key competency 1: Demonstrate a commitment to patients by applying best practices and adhering to high ethical standards
    Exhibit appropriate professional behaviours and relationships in all aspects of practice, demonstrating honesty, integrity, humility, commitment, compassion, respect, altruism, respect for diversity, and maintenance of confidentiality; see the patient in a holistic perspective and give individualized care
Work with respect for the universal human rights of women
Demonstrate a commitment to excellence in all aspects of practice
Work according to ethical standards and recognize and respond to ethical issues encountered in practice
Recognize and manage conflicts of interest
Exhibit professional behaviours in the use of technology-enabled communication
Key competency 2: Demonstrate a commitment to society by recognizing and responding to societal expectations in health care
  Demonstrate accountability to patients, society, and the profession by responding to societal expectations of physicians
Key competency 3: Demonstrate a commitment to the profession by adhering to standards and participating in physician-led regulation
  Fulfill and adhere to the professional and ethical codes, standards of practice, guidelines and laws governing practice
Recognize and respond to unprofessional and unethical behaviours in physicians and other colleagues in the health care professions, according to the principles of effective feedback
Participate in peer assessment and standard setting
Key competency 4: Demonstrate a commitment to physician health and well-being to foster optimal patient care
  Exhibit self-awareness and manage influences on personal well-being and professional performance
Manage personal and professional demands, by maintaining a healthy work-life balance, for a sustainable practice throughout the physician life cycle
Promote a culture that recognizes, supports, and responds effectively to colleagues in need by facilitating the process to help
Int J Med Educ. 2025; 16:21-35; doi: 10.5116/ijme.679e.0509