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Background Challenges associated with the use of the CanMEDS physician competency framework (CanMEDS) have been the subject of several studies. Most of these have focused on the adoption of specific roles in an Anglophone context. This study aims to investigate how Francophone postgraduate medical education (PGME) program directors have integrated the CanMEDS framework into their programs. Methods We invited Francophone PGME program directors to participate in group interviews aimed at exploring their experiences using the CanMEDS framework. We used an open-ended interview guide and realized a thematic analysis of the transcripts. Results We held five group interviews between February and December 2014 with 17 Francophone program directors representing 13 out of a maximum of 62 different specialties/subspecialties. Although program directors endorsed the framework, its integration was seen as challenging, particularly the assessment of non-medical expert roles. To overcome these challenges, they relied on common strategies including a longitudinal approach to the framework, improving inter-program collaboration, and subcontracting the teaching of certain roles. Conclusion While integrating the CanMEDS framework into their programs, Francophone program directors struggled with teaching and assessing non-medical expert roles and ensuring their longitudinal integration over time. Directors relied on various strategies, some of which (e.g., subcontracting) may ultimately limit the adoption of the framework as a whole. ___

Strategies identified by program directors to improve adoption of the CanMEDS framework